ArticleJournal of acquired immune deficiency syndromes (1999)2018
Lack of Virological Suppression Among Young HIV-Positive Adults in Botswana.
Article in Journal of acquired immune deficiency syndromes (1999), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01965470 (Botswana Combination Prevention Project), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Botswana Combination Prevention Project: -Evaluation Protocol (Protocol #1): Research Design and Impact Evaluation -Closed Clinical Cohort Protocol (Protocol #3) Implementation, Monitoring and Evaluation of Combination HIV Prevention Interventions in Rural and Peri-Urban Communities in Botswana
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis.Journal of the International AIDS Society · 2022Pooled it
- Cross-sectional estimates revealed high HIV incidence in Botswana rural communities in the era of successful ART scale-up in 2013-2015.PloS one · 2018Trial
- Article
- Evaluation of Viral Suppression in Paediatric Populations: Implications for the Transition to Dolutegravir-Based Regimens in Cameroon: The CIPHER-ADOLA Study.Biomedicines · 2024Article
- Article
- Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey.The lancet. HIV · 2024Article
- Determinants of Immunovirological Response among Children and Adolescents Living with HIV-1 in the Central Region of Cameroon.Tropical medicine and infectious disease · 2024Article
- HIV viral suppression in the era of dolutegravir use: Findings from a national survey in Tanzania.PloS one · 2024Article
- Brief Report: Time to Repeat Viral Load Testing Among Unsuppressed Adolescents and Young Adults Living With HIV in Kenya.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Barriers and facilitators to linkage to care and ART initiation in the setting of high ART coverage in Botswana.AIDS care · 2020Article
- Viral suppression in adults, adolescents and children receiving antiretroviral therapy in Cameroon: adolescents at high risk of virological failure in the era of "test and treat".AIDS research and therapy · 2019Article
- Botswana should consider expansion of free antiretroviral therapy to immigrants.Journal of the International AIDS Society · 2019Article
Corrections and comments
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Authors and funding
25 authors.
Funding
Abstract
backgroundHIV-1 RNA load is the best biological predictor of HIV transmission and treatment response. The rate of virologic suppression among key subpopulations can guide HIV prevention programs.
methodsThe Botswana Combination Prevention Project performed a population-based household survey among adults in 30 communities in Botswana. Data collected included knowledge of HIV-positive status, antiretroviral therapy (ART) coverage, and virologic suppression (HIV-1 RNA ≤400 copies per milliliter). Individuals aged 16-29 years were considered young adults.
resultsAmong 552 young people living with HIV enrolled with RNA load data and ART status available, 51% (n = 279) had undetectable HIV-1 RNA, including 54% of young women and 32% of young men [sex prevalence ratio (PR): 0.53; 95% confidence interval (CI): 0.43 to 0.80; P < 0.001]. Compared with older adults (30-64 years old), young HIV-infected adults were significantly less likely to have undetectable HIV-1 RNA (PR: 0.65; 95% CI: 0.59 to 0.70; P < 0.0001), including both men (PR: 0.43; 95% CI: 0.34 to 0.56; P < 0.0001) and women (PR: 0.67; 95% CI: 0.62 to 0.74; P < 0.0001). Among a subset of people living with HIV receiving ART, young adults also were less likely to have undetectable HIV-1 RNA load than older adults (PR: 0.93; 95% CI: 0.90 to 0.95; P = <0.0001). Analysis of the care continuum revealed that inferior HIV diagnosis and suboptimal linkage to care are the primary reasons for low virologic suppression among young adults.
conclusionsYoung adults in Botswana are significantly less likely to have undetectable HIV-1 RNA load compared with older adults. In the era of broad scale-up of ART, interventions able to diagnose young adults living with HIV and link them to effective therapy are urgently needed.
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