ArticleAIDS (London, England)2013
HIV-infected adolescents in southern Africa can achieve good treatment outcomes: results from a retrospective cohort study.
Article in AIDS (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Pooled it
- 'If I am playing football, I forget that I have this virus': the challenges and coping strategies of adolescents with perinatally acquired HIV in KwaZulu-Natal, South Africa.BMC infectious diseases · 2022Article
- Article
- Article
- Characteristics and outcomes of adolescents living with perinatally acquired HIV within Southern Africa.AIDS (London, England) · 2020Article
- Incidence of Loss to Follow-Up and Its Predictors Among Children with HIV on Antiretroviral Therapy at the University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Data Analysis.HIV/AIDS (Auckland, N.Z.) · 2020Article
- Children and adolescents on anti-retroviral therapy in Bulawayo, Zimbabwe: How many are virally suppressed by month six?F1000Research · 2020Article
- Perceived Stigma and Fear of Unintended Disclosure are Barriers in Medication Adherence in Adolescents with Perinatal HIV in Botswana: A Qualitative Study.BioMed research international · 2019Article
- Characteristics of adolescents living with HIV receiving care and treatment services in antiretroviral therapy clinics in Cambodia: descriptive findings from a cross-sectional study.BMC health services research · 2018Article
- Trends Over Time for Adolescents Enrolling in HIV Care in Kenya, Tanzania, and Uganda From 2001-2014.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Adolescent pregnancy at antiretroviral therapy (ART) initiation: a critical barrier to retention on ART.Journal of the International AIDS Society · 2018Article
- Loss to follow-up and mortality among HIV-infected adolescents receiving antiretroviral therapy in Pune, India.HIV medicine · 2018Article
- Experiences along the HIV care continuum: perspectives of Kenyan adolescents and caregivers.African journal of AIDS research : AJAR · 2017Article
- Loss to follow-up among children and adolescents growing up with HIV infection: age really matters.Journal of the International AIDS Society · 2017Article
- HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries.Journal of the International AIDS Society · 2017Article
- Relationship Between Time to Initiation of Antiretroviral Therapy and Treatment Outcomes: A Cohort Analysis of ART Eligible Adolescents in Zimbabwe.Journal of acquired immune deficiency syndromes (1999) · 2017Article
- Antiretroviral Treatment Adherence: Knowledge and Experiences among Adolescents and Young Adults in Soweto, South Africa.AIDS research and treatment · 2017Article
- Chronic Morbidity Among Older Children and Adolescents at Diagnosis of HIV Infection.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Universal Antiretroviral Treatment Eligibility for Children and Adolescents Living With HIV: A New Era.The Pediatric infectious disease journal · 2016Article
- Community-Based HIV and Health Testing for High-Risk Adolescents and Youth.AIDS patient care and STDs · 2016Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIn this study we examine whether adolescents treated for HIV/AIDS in southern Africa can achieve similar treatment outcomes to adults.
designWe have used a retrospective cohort study design to compare outcomes for adolescents and adults commencing antiretroviral therapy (ART) between 2004 and 2010 in a public sector hospital clinic in Bulawayo, Zimbabwe.
methodsCox proportional hazards modelling was used to investigate risk factors for death and loss to follow-up (LTFU) (defined as missing a scheduled appointment by ≥3months).
resultsOne thousand, seven hundred and seventy-six adolescents commenced ART, 94% having had no previous history of ART. The median age at ART initiation was 13.3 years. HIV diagnosis in 97% of adolescents occurred after presentation with clinical disease and a higher proportion had advanced HIV disease at presentation compared with adults [WHO Stage 3/4 disease (79.3 versus 65.2%, P < 0.001)]. Despite this, adolescents had no worse mortality than adults, assuming 50% mortality among those LTFU (6.4 versus 7.3 per 100 person-years, P = 0.75) with rates of loss to follow-up significantly lower than in adults (4.8 versus 9.2 per 100 person-years, P < 0.001). Among those who were followed for 5 years or more, 5.8% of adolescents switched to a second-line regimen as a result of treatment failure, compared with 2.1% of adults (P < 0.001).
conclusionWith adolescent-focused services, it is feasible to achieve good outcomes for adolescents in large-scale ART programs in sub-Saharan Africa. However, adolescents are at high risk of treatment failure, which compromises future drug options. Interventions to address poor adherence in adolescence should be prioritized.
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