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

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.

A screening tool enhances home-based identification of adolescents (aged 10-14) living with HIV in Zambia and South Africa: HPTN 071 (PopART) Study

“…The PopART for Youth (P-ART-Y) study aimed to determine the acceptability and uptake of HIV testing among adolescents and young adults aged 10-24 years (young people) and was implemented from October 2015 to December 2017, the main findings from the study have been published elsewhere (13,18,19). The P-ART-Y study was nested within the HPTN071 (PopART) trial, a three-arm cluster-randomized trial conducted in 12 communities in Zambia and nine communities in South Africa which was implemented from November 2013 to December 2017 (13).…”

“…In Africa, HIV/AIDS is now the leading cause of death among adolescents, notably among girls, and is ranked second globally next to unintentional injuries (1,2). Furthermore, an estimated 250,000 adolescents aged [15][16][17][18][19] become newly HIV-positive annually (3). Compared to adults, older adolescents, and children/infants, little is known about the burden of HIV and AIDS among young adolescents (aged 10-14 years) as data on them are rarely collected, and the statistics that are reported aggregate them with older youth.…”

Impact of low-level viremia with drug resistance on CD4 cell counts among people living with HIV on antiretroviral treatment in China

“…The use of antiretroviral therapy (ART) has resulted in substantial reductions in HIV/AIDS-related morbidity and mortality worldwide [ 1 – 4 ]. Maintaining plasma HIV RNA suppression below the limit of quantification is the goal of ART, which induces persistent suppression of HIV replication and gradual recovery of CD4 cell counts [ 3 – 5 ].…”

Putting youth at the centre: co-design of a community-based intervention to improve HIV outcomes among youth in Zimbabwe

“…Community-based HIV testing strategies may be more accessible, resulting in earlier HIV diagnosis, and can be effective at improving virological suppression (Ferrand et al, 2017;Mavhu et al, 2020). Furthermore, approaches that address the entire cascade of HIV care (HIV testing; linkage to care and ART initiation; and adherence support to improve viral suppression) (Figure 1) may reduce attrition that occurs at each step of the care cascade (Shanaube et al, 2021).…”