Moomba Kaala, Crowley Talitha, van Wyk Brian
School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.
School of Nursing, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.
South Afr J HIV Med. 2025 Apr 24;26(1):1665. doi: 10.4102/sajhivmed.v26i1.1665. eCollection 2025.
In 2023, an estimated 39.9 million people globally were living with HIV, of which 1.55 million were adolescents aged 10-19 years. The 2021 Zambia HIV Impact Assessment revealed lower viral suppression rates in adolescents (15-24 years old) compared to adults on antiretroviral therapy (ART). Lusaka District, Zambia, has the highest number of adolescents on ART, with a 15.1% HIV prevalence in 2018.
To determine the prevalence and factors associated with viral suppression among adolescents living with HIV (10-19 years) on ART in Lusaka District, Zambia.
A retrospective cohort analysis was done of 3409 adolescents on ART at public health facilities in Lusaka from January 2023 to December 2023, and who had viral loads recorded. Socio-demographic, clinical, treatment and behavioural data were extracted from electronic health records and analysed using SPSS version 29.
The adolescent cohort in Lusaka achieved 91.8% viral suppression rate (< 1000 copies/mL), with 79% fully suppressed (< 50 copies/mL). In multivariate analysis, older adolescents (15-19 years) had lower odds of suppression compared to younger adolescents (10-14 years) (adjusted odds ratio [AOR] = 1.79; confidence interval [CI] : 1.32-2.43). Higher odds of viral suppression were linked to first-line dolutegravir regimen (AOR = 5.12; CI: 3.23-8.11) and optimal adherence (AOR = 1.89; CI: 1.03-3.47), while regimen switches reduced the odds of viral suppression (AOR = 0.60; CI: 0.45-0.80).
Zambia reached the previous UNAIDS 90-90-90 targets with a viral suppression rate of 91.8%. However, to reach the revised 95% target by 2030, tailored interventions should be implemented to improve adherence and retention in care, particularly for older adolescents.
2023年，全球估计有3990万人感染艾滋病毒，其中155万是10至19岁的青少年。2021年赞比亚艾滋病毒影响评估显示，与接受抗逆转录病毒疗法（ART）的成年人相比，青少年（15 - 24岁）的病毒抑制率较低。赞比亚卢萨卡区接受抗逆转录病毒治疗的青少年人数最多，2018年艾滋病毒感染率为15.1%。
确定赞比亚卢萨卡区接受抗逆转录病毒治疗（ART）的艾滋病毒感染青少年（10 - 19岁）的病毒抑制率及其相关因素。
对2023年1月至2023年12月期间在卢萨卡公共卫生机构接受抗逆转录病毒治疗且有病毒载量记录的3409名青少年进行回顾性队列分析。从电子健康记录中提取社会人口统计学、临床、治疗和行为数据，并使用SPSS 29版进行分析。
卢萨卡的青少年队列实现了91.8%的病毒抑制率（<1000拷贝/毫升），其中79%完全抑制（<50拷贝/毫升）。在多变量分析中，年龄较大的青少年（15 - 19岁）与年龄较小的青少年（10 - 14岁）相比，病毒抑制的几率较低（调整后的优势比[AOR]=1.79；置信区间[CI]：1.32 - 2.43）。较高的病毒抑制几率与一线多替拉韦方案（AOR = 5.12；CI：3.23 - 8.11）和最佳依从性（AOR = 1.89；CI：1.03 - 3.47）相关，而方案转换则降低了病毒抑制的几率（AOR = 0.60；CI：0.45 - 0.80）。
赞比亚实现了联合国艾滋病规划署之前的90 - 90 - 90目标，病毒抑制率为91.8%。然而，为了在2030年达到修订后的95%目标，应实施针对性干预措施，以提高依从性和治疗留存率，特别是对于年龄较大的青少年。
