ArticleAIDS care2016
Achieving equity in HIV-treatment outcomes: can social protection improve adolescent ART-adherence in South Africa?
Article in AIDS care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 6 of them syntheses that pooled it.
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Who cites it
53 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Interventions addressing the adolescent HIV continuum of care in South Africa: a systematic review and modified Delphi analysis.BMJ open · 2022Pooled it
- Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low- and middle-income countries.The Cochrane database of systematic reviews · 2022Pooled it
- Counseling for improving adherence to antiretroviral treatment: a systematic review.AIDS care · 2019Pooled it
- Risky behaviours and their correlates among adolescents living with HIV in sub-Saharan Africa: a systematic review.Reproductive health · 2018Pooled it
- Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low- and middle-income countries.The Cochrane database of systematic reviews · 2017Pooled it
- Pooled it
- The long-term impact of family economic empowerment on viral suppression and mental health outcomes among adolescents living with HIV in low-income settings: A cluster-randomized controlled trial in Southern Uganda.Social science & medicine (1982) · 2025Trial
- Point-of-care viral load testing among adolescents and young adults living with HIV in Haiti: a randomized control trial.AIDS care · 2022Trial
- Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda.AIDS and behavior · 2018Trial
- Predictors of Retention in HIV Care Among Youth (15-24) in a Universal Test-and-Treat Setting in Rural Kenya.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- Determinants of retention into HIV care among adolescents living with HIV in two selected districts in Copperbelt Province of Zambia.Journal of public health research · 2026Article
- Baseline Data on Viral Suppression, Treatment Adherence and Mental Health in Peripartum Girls and Young Women With HIV in Zimbabwe.Journal of the International AIDS Society · 2026Observational
- Challenges and Enablers of Antiretroviral Therapy Adherence Among Ethiopian Adolescents: A Qualitative Study.International journal of sexual health : official journal of the World Association for Sexual Health · 2026Article
- ART adherence care strategies among adolescents living with HIV in Ghana's Ashanti Region: a qualitative study.Frontiers in public health · 2026Article
- Article
- Experiences and perceptions on antiretroviral therapy adherence and non-adherence: a scoping review of young people living with HIV in sub-Saharan Africa.BMC public health · 2025Article
- Are social protection and food security accelerators for adolescents to achieve the Global AIDS targets?Journal of the International AIDS Society · 2024Article
- Exploring Self-reported Adherence Measures to Screen for Elevated HIV Viral Load in Adolescents: A South African Cohort Study.AIDS and behavior · 2023Article
- Patient Portal Privacy: Perspectives of Adolescents and Emerging Adults Living with HIV and the Parental/Guardian Role in Supporting Their Care.Applied clinical informatics · 2023Article
- Antiretroviral therapy non-adherence and its relationship with cognitive impairment, alcohol use disorder, and depression in adolescents living with HIV.BMC psychiatry · 2023Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Low ART-adherence amongst adolescents is associated with morbidity, mortality and onward HIV transmission. Reviews find no effective adolescent adherence-promoting interventions. Social protection has demonstrated benefits for adolescents, and could potentially improve ART-adherence. This study examines associations of 10 social protection provisions with adherence in a large community-based sample of HIV-positive adolescents. All 10-19-year-olds ever ART-initiated in 53 government healthcare facilities in a health district of South Africa's Eastern Cape were traced and interviewed in 2014-2015 (n = 1175 eligible). About 90% of the eligible sample was included (n = 1059). Social protection provisions were "cash/cash in kind": government cash transfers, food security, school fees/materials, school feeding, clothing; and "care": HIV support group, sports groups, choir/art groups, positive parenting and parental supervision/monitoring. Analyses used multivariate regression, interaction and marginal effects models in SPSS and STATA, controlling for socio-demographic, HIV and healthcare-related covariates. Findings showed 36% self-reported past-week ART non-adherence (<95%). Non-adherence was associated with increased opportunistic infections (p = .005, B .269, SD .09), and increased likelihood of detectable viral load at last test (>75 copies/ml) (aOR 1.98, CI 1.1-3.45). Independent of covariates, three social protection provisions were associated with reduced non-adherence: food provision (aOR .57, CI .42-.76, p < .001); HIV support group attendance (aOR .60, CI .40-.91, p < .02), and high parental/caregiver supervision (aOR .56, CI .43-.73, p < .001). Combination social protection showed additive benefits. With no social protection, non-adherence was 54%, with any one protection 39-41%, with any two social protections, 27-28% and with all three social protections, 18%. These results demonstrate that social protection provisions, particularly combinations of "cash plus care", may improve adolescent adherence. Through this they have potential to improve survival and wellbeing, to prevent HIV transmission, and to advance treatment equity for HIV-positive adolescents.
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