ArticleBMC health services research2026
Youths' satisfaction with youth-friendly services and its relationship with retention in HIV care and viral load suppression at a tertiary hospital in Enugu State: a retrospective cross-sectional study with retrospective record review.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHIV/AIDS has claimed over 40.1 million lives, including youths aged 15-24 years, since the start of the epidemic in 1981. Sadly, there are still reports of poor retention in care and poor viral load suppression among the youths. Youth-friendly HIV services are intended to improve engagement in care among adolescents and young people living with HIV, but evidence on how perceived satisfaction with these services relates to retention and viral suppression in routine tertiary care remains limited. This study assessed the youths' satisfaction with youth-friendly services (YFS) and their relationship with retention in HIV care and viral load suppression at the HIV clinic, UNTH, Enugu.
methodsThis cross-sectional survey was linked to retrospective abstraction of routine clinical data from electronic medical records. The study included all 178 active youths aged 15-24 years who received HIV care at the ART clinic between July 2022 and June 2023 and met the inclusion criteria. Satisfaction with youth-friendly services was assessed using a structured questionnaire, while clinic visit records and the most recent viral load results were abstracted from medical records. Good retention was defined as three or more documented clinic visits within the 12 months. Viral suppression was defined as viral load < 1000 copies/mL. Associations were assessed using Chi-square or Fisher's exact tests, as appropriate.
resultsAmong 178 youths, 169 (94.9%) were very satisfied with youth-friendly services, 159 (89.3%) had good retention in care, and 164 (92.1%) achieved viral suppression. Satisfaction with youth-friendly services was not significantly associated with retention in care (Fisher's exact p = 1.000). In unadjusted analysis, retention in HIV care was significantly associated with viral load suppression (χ²=34.616, p < 0.001).
conclusionYFS were well rated among active youths in care, but satisfaction was not associated with retention. The findings suggest that maintaining clinic engagement may be more directly linked to viral suppression than satisfaction ratings alone. Because inactive or disengaged youths were not included, the results should be interpreted cautiously and are not generalisable to all youths enrolled in HIV care. CLINICAL TRIAL NUMBER: Not applicable.
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