Evidence map›Paper›PMID 34503473›Full record

ArticleBMC public health2021

The secret life of young adolescents living with HIV in northern Mozambique - a mixed methods study.

Joana Falcão, Allison Zerbe, Claude Ann Mellins, Joanne Mantell, Kirsty Brittain, Bill Kapogiannis, Eduarda Pimentel de Gusmao, Teresa Beatriz Simione, Elaine J Abrams

Open access · goldAbstract read
In one paragraph

Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Correlates of Viral Suppression in Adolescents With HIV Taking Antiretroviral Therapy in Mozambique: Results of a Multicenter Cross-Sectional Survey.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 3 countries.

Joana FalcãoICAP at Columbia University, Mailman School of Public Health, New York, USA. jrf2191@cumc.columbia.edu.
Allison ZerbeICAP at Columbia University, Mailman School of Public Health, New York, USA.
Claude Ann MellinsHIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
Joanne MantellHIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
Kirsty BrittainDivision of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
Bill KapogiannisEunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
Eduarda Pimentel de GusmaoICAP at Columbia University, Mailman School of Public Health, New York, USA.
Teresa Beatriz SimioneNational STI, HIV/AIDS Control Program, Maputo, Mozambique.
Elaine J AbramsICAP at Columbia University, Mailman School of Public Health, New York, USA.
ICAP Global HealthNew York Psychoanalytic Society and Institute · USColumbia University · USEunice Kennedy Shriver National Institute of Child Health and Human Development · USNational Directorate of Geology · MZUniversity of Cape Town · ZA

Funding

CombinADO: a combination intervention strategy to improve health outcomes for adolescents living with HIVUG3HD096926 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ABRAMS, ELAINE JANINE · 2018 to 2019
$2.2M
NICHD NIH HHS UG3 HD096926
6 · The paper itself

Abstract

backgroundIn Mozambique, HIV infection remains a leading cause of adolescent mortality. With advances in antiretroviral treatment (ART), the population of adolescents living with vertically-acquired HIV is growing. Most studies of adolescents living with HIV (ALHIV) focus on older youth with horizontal infection. As part of a larger study, we examined the characteristics and health care needs of younger ALHIV, including those with vertically-acquired infection to inform preventive interventions.

methodsWe used a convergent mixed-methods design and recruited ALHIV aged 12-14 years who were enrolled in HIV care in three health clinics in Nampula, Mozambique. From 11/2019-3/2020, we conducted 61 quantitative surveys and 14 in-depth interviews with a purposively selected subset of ALHIV who were aware of their HIV status. Descriptive statistical analysis was conducted for quantitative data. Qualitative data were transcribed and analyzed using thematic analysis.

resultsThe median age of ALHIV was 13 years, 50% were female, 67% lived with ≥1 parent, 70% had lost a parent, 100% were in school; 10% were in a relationship, and 3% had initiated sexual activity. Among 31 ALHIV aware of their serostatus, the median age of antiretroviral treatment (ART) initiation was 8 years (IQR: 6-11); 55% received caregiver support for ART management; 35% reported missing ≥1 ART dose in the last 30 days; 6% had disclosed their HIV-status to friends and 48% reported no one to talk to about HIV-specific issues. Four main themes emerged from the qualitative interviews with ALHIV: a) learning one's HIV-positive status as the beginning of a secret life; b) importance of caregivers' support for ART management; c) high value of ALHIV peer support to overcome isolation, increase HIV literacy, and support adherence; and d) unmet needs for sexual and reproductive health education.

conclusionHIV-related secrecy prevails among ALHIV, a situation exacerbated by caregivers and healthcare providers. Caregivers play a major role in supporting adherence among young ALHIV, yet ALHIV could also benefit from adolescent-friendly services, including peer support, sexual and reproductive health services and preparation for independent health management. Integrating such programs into ART services in Mozambique may be critical to promoting ALHIV health.

Indexed as

HIV InfectionsReproductive Health ServicesAdolescentAnti-Retroviral AgentsChildFemaleHumansMozambiqueSexual BehaviorAnti-Retroviral Agents

Identifiers

PMID34503473
PMCPMC8431874
OpenAlexW3197829004

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.