ArticleJournal of the International AIDS Society2018
STACKing the odds for adolescent survival: health service factors associated with full retention in care and adherence amongst adolescents living with HIV in South Africa.
Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 4 of them syntheses that pooled it.
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Who cites it
68 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Factors influencing antiretroviral therapy adherence among youth living with HIV: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Impact of HIV-Related Stigma on Antiretroviral Therapy Adherence, Engagement and Retention in HIV Care, and Transition to Adult HIV Care in Pediatric and Young Adult Populations Living With HIV: A Literature Review.AIDS and behavior · 2025Pooled it
- Pooled it
- Systematic review: Development of a person-centered care framework within the context of HIV treatment settings in sub-Saharan Africa.Tropical medicine & international health : TM & IH · 2022Pooled it
- Financial incentives to improve re-engagement in HIV care: results from a randomized pilot study.AIDS care · 2023Trial
- Trial
- Fee for home delivery and monitoring of antiretroviral therapy for HIV infection compared with standard clinic-based services in South Africa: a randomised controlled trial.The lancet. HIV · 2022Trial
- Trial
- Community-based antiretroviral therapy versus standard clinic-based services for HIV in South Africa and Uganda (DO ART): a randomised trial.The Lancet. Global health · 2020Trial
- Needs Assessment to Inform a Life Course-Based Support Programme for Adolescents with Perinatally Acquired HIV in Rural Limpopo, South Africa.International journal of environmental research and public health · 2026Article
- Comparison of treatment outcomes of adolescents on HIV treatment before and during the coronavirus disease 2019 pandemic in Cape Town, South Africa: A retrospective cohort study.Health SA = SA Gesondheid · 2026Article
- Potential enablers for the implementation of multiple family group therapy intervention in the lower Manya Krobo District, Ghana: Perspectives of multiple stakeholders.PLOS global 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
- Determinants of viral load suppression among adolescents on antiretroviral therapy in Eswatini: a cross-sectional study.BMC infectious diseases · 2025Article
- "Swallowing these drugs every day, you get tired": a mixed-methods study to identify barriers and facilitators to retention and HIV viral load suppression among the adolescents living with HIV in TASO Mbale and TASO Soroti centers of excellence.AIDS research and therapy · 2025Article
- Disclosure and Experiences of HIV-Related Stigma among Adolescents and Young Adults Living with HIV in South Africa.AIDS and behavior · 2024Article
- Are social protection and food security accelerators for adolescents to achieve the Global AIDS targets?Journal of the International AIDS Society · 2024Article
- Healthcare provisions associated with multiple HIV-related outcomes among adolescent girls and young women living with HIV in South Africa: a cross-sectional study.Journal of the International AIDS Society · 2024Article
- Long-term retention on antiretroviral treatment after enrolment in prevention of vertical HIV transmission services: a prospective cohort study in Dar es Salaam, Tanzania.Journal of the International AIDS Society · 2024Article
8 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
Abstract
introductionThere are two million HIV-positive adolescents in southern Africa, and this group has low retention in care and high mortality. There is almost no evidence to identify which healthcare factors can improve adolescent self-reported retention. This study examines factors associated with retention amongst antiretroviral therapy (ART)-initiated adolescents in South Africa.
methodsWe collected clinical records and detailed standardized interviews (n = 1059) with all 10- to 19 year-olds ever initiated on ART in all 53 government clinics of a health subdistrict, and community traced to include lost-to-follow-up (90.1% of eligible adolescents interviewed). Associations between full self-reported retention in care (no past-year missed appointments and 85% past-week adherence) and health service factors were tested simultaneously in sequential multivariate regression and marginal effects modelling, controlling for covariates of age, gender, urban/rural location, formal/informal housing, maternal and paternal orphanhood, vertical/horizontal HIV infection, overall health, length of time on ART and type of healthcare facility.
resultsAbout 56% of adolescents had self-reported retention in care, validated against lower detectable viral load (AOR: 0.63, CI: 0.45 to 0.87, p = 0.005). Independent of covariates, five factors (STACK) were associated with improved retention: clinics Stocked with medication (OR: 3.0, CI: 1.6 to 5.5); staff with Time for adolescents (OR: 2.7, CI: 1.8 to 4.1); adolescents Accompanied to the clinic (OR: 2.3, CI: 1.5 to 3.6); enough Cash to get to clinic safely (OR: 1.4, CI: 1.1 to 1.9); and staff who are Kind (OR: 2.6, CI: 1.8 to 3.6). With none of these factors, 3.3% of adolescents reported retention. With all five factors, 69.5% reported retention.
conclusionsThis study identifies key intervention points for adolescent retention in HIV care. A basic package of clinic and community services has the potential to STACK the odds for health and survival for HIV-positive adolescents.
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