Antiretroviral Therapy outcomes among adolescents and youth in rural Zimbabwe

Hdl Handle:
http://hdl.handle.net/10144/278994
Title:
Antiretroviral Therapy outcomes among adolescents and youth in rural Zimbabwe
Authors:
Bygrave, Helen; Mtangirwa, Judith; Ncube, Kwenzakwenkosi; Ford, Nathan; Kranzer, Katharina; Munyaradzi, Dhodho
Journal:
PloS One
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.
Affiliation:
Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa. Helen.bygrave@joburg.msf.org
Issue Date:
20-Dec-2012
URI:
http://hdl.handle.net/10144/278994
DOI:
10.1371/journal.pone.0052856
PubMed ID:
23285204
Language:
en
ISSN:
1932-6203
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorBygrave, Helenen_GB
dc.contributor.authorMtangirwa, Judithen_GB
dc.contributor.authorNcube, Kwenzakwenkosien_GB
dc.contributor.authorFord, Nathanen_GB
dc.contributor.authorKranzer, Katharinaen_GB
dc.contributor.authorMunyaradzi, Dhodhoen_GB
dc.date.accessioned2013-04-04T20:39:05Z-
dc.date.available2013-04-04T20:39:05Z-
dc.date.issued2012-12-20-
dc.identifier.citationAntiretroviral Therapy outcomes among adolescents and youth in rural Zimbabwe. 2012, 7 (12):e52856 PLoS ONEen_GB
dc.identifier.issn1932-6203-
dc.identifier.pmid23285204-
dc.identifier.doi10.1371/journal.pone.0052856-
dc.identifier.urihttp://hdl.handle.net/10144/278994-
dc.description.abstractAround 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.en_GB
dc.language.isoenen
dc.rightsPublished by Public Library of Science, [url]http://www.plosone.org/[/url] Archived on this site by Open Access permissionen_GB
dc.titleAntiretroviral Therapy outcomes among adolescents and youth in rural Zimbabween
dc.contributor.departmentSouthern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa. Helen.bygrave@joburg.msf.orgen_GB
dc.identifier.journalPloS Oneen_GB

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