ArticleBMC infectious diseases2026
Prevalence and determinants of being out-of-care among HIV-positive young people aged 15-24 years in Mozambique: findings from the 2021 population-based HIV impact assessment survey.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundGlobally, young people are falling behind in the push to end the HIV epidemic. Understanding the characteristics of HIV-positive young people who are out-of-care (not on antiretroviral treatment) in Mozambique is important to effectively reach and ensure access to services for this priority population.
methodsUsing data from the 2021 Mozambique Population-based HIV Impact Assessment, we conducted a sub-analysis of HIV-positive young people aged 15–24 years whose blood specimens were tested for the presence of antiretrovirals. Participants testing negative for the presence of antiretrovirals were classified as out-of-care. Weighted prevalence estimates of HIV-care status and select covariates are reported. We used multivariable logistic regression to assess factors associated with out-of-care status. Analyses were weighted and adjusted for the complex survey design.
resultsAmong the 245 HIV-positive young people included, 58.0% (n = 141, 95% Confidence Interval [CI] 49.9–65.7%) were out-of-care. Out-of-care young people were mostly female (75.0%) and living in a rural area (68.3%). In the multivariate model, young people who discussed HIV with a parent or guardian (20.0% of participants) (adjusted Odds Ratio [aOR]: 0.33, 95% CI: 0.17–0.66) or previously heard of pre-exposure prophylaxis (PrEP) (6.1% of participants) (aOR: 0.25, 95% CI: 0.09–0.65) were less likely to be out-of-care than those who had not. Odds of being out-of-care were greater for those from the northern compared to the central provinces (aOR: 2.37, 95% CI: 1.09–5.15) and those who had participated in prevention programs (aOR: 3.19, 95% CI: 1.37–7.41).
conclusionsOver half of young people with HIV in Mozambique met our definition for out-of-care in 2021. Our results reveal important geographic and sex gaps in HIV care. Strengthening existing programs to include components centered on creating a lasting link to health services could improve the identification of new HIV-positive young people. The important role of parents and guardians in young people’s health behaviors and decision-making presents an opportunity to engage families with interventions to strengthen needed services to this priority population in Mozambique. CLINICAL TRIAL NUMBER: Not applicable.
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