Thurman Tonya R, Luckett Brian, Zani Babalwa, Nice Johanna, Taylor Tory M
Tulane International, Cape Town 7806, South Africa.
Highly Vulnerable Children Research Center, Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
Trop Med Infect Dis. 2024 Jul 19;9(7):162. doi: 10.3390/tropicalmed9070162.
Adolescents and young adults living with HIV (AYLHIV) in sub-Saharan Africa experience poorer HIV outcomes than adults, including lower ART adherence and virologic suppression. They also have high rates of unprotected sex, increasing the risk of adverse sexual health outcomes and onward transmission. This one-arm, pre-post study investigates a structured 14-session support group aiming to boost treatment adherence and sexual protective behavior for AYLHIV in South Africa. Logistic and Poisson regression analyses were performed on self-reported pre- and post-intervention survey data collected approximately 7.5 months apart from a cohort of 548 AYLHIV. Participants were significantly more likely to report at least 95% adherence at follow-up and rate their health as "good;" they also demonstrated greater treatment knowledge and had fewer absences from school overall and due to illness. Among sexually active AYLHIV, contraception use at last sex increased significantly, while condom use did not. Effects were small, and greater programmatic emphasis on adherence and multifaceted service packages is likely necessary to promote viral suppression. Nonetheless, the intervention addresses an important gap in service provision for AYLHIV in South Africa. Findings denote the potential for incorporating care and treatment components into sexual and reproductive health interventions tailored for AYLHIV.
撒哈拉以南非洲地区的青少年和青年艾滋病毒感染者（AYLHIV）的艾滋病毒治疗结果比成年人更差，包括抗逆转录病毒治疗（ART）依从性较低和病毒学抑制率较低。他们的无保护性行为发生率也很高，增加了不良性健康后果和病毒传播的风险。这项单臂前后对照研究调查了一个为期14节的结构化支持小组，旨在提高南非AYLHIV的治疗依从性和性保护行为。对从548名AYLHIV队列中收集的、间隔约7.5个月的自我报告的干预前后调查数据进行了逻辑回归和泊松回归分析。参与者在随访时更有可能报告至少95%的依从性，并将他们的健康状况评为“良好”；他们还表现出更多的治疗知识，总体上学缺勤和因病缺勤的情况更少。在有性行为的AYLHIV中，上次性行为时使用避孕措施的情况显著增加，而使用避孕套的情况没有变化。效果较小，可能需要在项目上更加强调依从性和多方面的服务包，以促进病毒抑制。尽管如此，该干预措施弥补了南非AYLHIV服务提供方面的一个重要缺口。研究结果表明，有可能将护理和治疗内容纳入为AYLHIV量身定制的性健康和生殖健康干预措施中。
