Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe


Bygrave, H; Mtangirwa, J; Ncube, K; Ford, N; Kranzer, K; Munyaradzi, D; (2012) Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe. PLoS One, 7 (12). ISSN 1932-6203 DOI: https://doi.org/10.1371/journal.pone.0052856

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Abstract

Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10-30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10-15 (young adolescents) 15.1-19 years (adolescents), 19.1-24 years (young adults) and 24.1-29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95% CI 1.17-4.35). Young adults and adolescents had a 2-3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95% CI 1.62-4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults. Citation: Bygrave H, Mtangirwa J, Ncube K, Ford N, Kranzer K, et al. (2012) Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe. PLoS ONE 7(12): e52856. doi:10.1371/journal.pone.0052856

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 23285204
Web of Science ID: 312794500251
URI: http://researchonline.lshtm.ac.uk/id/eprint/612333

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