Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2021 Apr;68(4):719-727.
doi: 10.1016/j.jadohealth.2020.07.029. Epub 2020 Oct 12.

HIV Care Cascade Among Adolescents in a "Test and Treat" Community-Based Intervention: HPTN 071 (PopART) for Youth Study

Kwame Shanaube  1 , David Macleod  2 , Mwate Joseph Chaila  3 , Constance Mackworth-Young  4 , Graeme Hoddinott  5 , Ab Schaap  6 , Sian Floyd  2 , Peter Bock  5 , Richard Hayes  2 , Sarah Fidler  7 , Helen Ayles  8
Affiliations
Randomized Controlled Trial

HIV Care Cascade Among Adolescents in a "Test and Treat" Community-Based Intervention: HPTN 071 (PopART) for Youth Study

Kwame Shanaube et al. J Adolesc Health. 2021 Apr.

Abstract

Purpose: The PopART for Youth (P-ART-Y) study was nested within the HPTN 071 (PopART) trial, a three-arm community randomized trial in 21 communities in Zambia and South Africa. The P-ART-Y study evaluated the acceptability and uptake of a combination HIV prevention package among young people. We report on the HIV care cascade for adolescents aged 10-19 years from 14 communities receiving the full HIV prevention package in Zambia and South Africa.

Methods: Adolescents were offered participation in the PopART intervention, which included universal home-based HIV testing, linkage to care, antiretroviral therapy (ART) adherence, and other services. Data were collected from September 2016 to December 2017, covering the third round (R3) of the intervention.

Results: We enumerated (listed) 128,241 adolescents (Zambia: 95,295 and South Africa: 32,946). Of the adolescents offered HIV testing, 81.9% accepted in Zambia and 70.3% in South Africa. Knowledge of HIV status was higher among older adolescents and increased from 31.4% before R3 to 88.3% at the end of R3 in Zambia and from 28.3% to 79.5% in South Africa. Overall, there were 1,710 (1.9%) adolescents identified as living with HIV by the end of R3 (515 new diagnoses and 1,195 self-reported). Of the new diagnoses, 335 (65.0%) were girls aged 15-19 years. The median time to initiate ART was 5 months. ART coverage before and after R3 increased from 61.3% to 78.7% in Zambia and from 65.6% to 87.8% in South Africa, with boys having higher uptake than girls in both countries.

Conclusions: The PopART intervention substantially increased coverage toward the first and second UNAIDS 90-90-90 targets in adolescents.

Keywords: 90-90-90 targets; Adolescents; Combination HIV prevention; HIV care cascade; Sub-Saharan Africa.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study intervention participation and HIV testing eligibility and testing uptake among adolescents in Zambia and South Africa.
Figure 2
Figure 2
Proportion of adolescents, among participants, who know their HIV status before and at the end of R3 (top two charts) and proportion of known HIV-positive adolescent participants on ART (bottom two charts) stratified by sex and age. ∗Denominator for lower two plots are those known HIV + after the R3 annual visit (so includes newly diagnosed individuals).
Figure 3
Figure 3
HIV care cascade before Round 3 visit.
Figure 4
Figure 4
90-90: Estimated knowledge among adolescents of HIV-positive status and ART coverage before and after the R3 intervention with extrapolation to the population, by age group. ∗Denominator for the second 90 are those known HIV + after the R3 annual visit (so includes newly diagnosed individuals).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. UNICEF HIV/AIDS continues to stalk children and adolescents -UNICEF 2016. https://www.unicef.org/media/media_91908.html Available at:
    1. Bobat R., Archary M., Lawler M. An update on the HIV treatment cascade in children and adolescents. Curr Opin HIV AIDS. 2015;10:411–419. - PubMed
    1. Gueler A., Vanobberghen F., Rice B. The HIV care cascade from HIV diagnosis to viral suppression in Sub-Saharan Africa: A systematic review and meta-regression analysis protocol. Syst Rev. 2017;6:172. - PMC - PubMed
    1. Mugglin C., Estill J., Wandeler G. Loss to programme between HIV diagnosis and initiation of antiretroviral therapy in Sub-Saharan Africa: Systematic review and meta-analysis. Trop Med Int. 2012;17:1509–1520. - PMC - PubMed
    1. Auld A.F., Agolory S.G., Shiraishi R.W. Antiretroviral therapy enrollment characteristics and outcomes among HIV-infected adolescents and young adults compared with older adults in seven African countries, 2004-2013. MMWR Morb Mortal Wkly Rep. 2014;63:1097–1103. - PMC - PubMed

Publication types