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. 2012;7(12):e52856.
doi: 10.1371/journal.pone.0052856. Epub 2012 Dec 20.

Antiretroviral therapy outcomes among adolescents and youth in rural Zimbabwe

Helen Bygrave  1 , Judith Mtangirwa, Kwenzakwenkosi Ncube, Nathan Ford, Katharina Kranzer, Dhodho Munyaradzi
Affiliations

Antiretroviral therapy outcomes among adolescents and youth in rural Zimbabwe

Helen Bygrave et al. PLoS One. 2012.

Abstract

Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10-30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10-15 (young adolescents) 15.1-19 years (adolescents), 19.1-24 years (young adults) and 24.1-29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17-4.35). Young adults and adolescents had a 2-3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62-4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Kaplan-Meier plots of deaths and loss to follow-up stratified by age category.
Figure 2
Figure 2. Kaplan-Meier plots of loss to follow-up stratified by age category.
See this image and copyright information in PMC

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