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Closing the HIV Treatment Gap for Adolescents in Windhoek, Namibia: A Retrospective Analysis of Predictors of Viral Non-Suppression

Author

Listed:
  • Farai Kevin Munyayi

    (School of Public Health, University of the Western Cape, Cape Town 7535, South Africa)

  • Brian van Wyk

    (School of Public Health, University of the Western Cape, Cape Town 7535, South Africa)

Abstract

Windhoek joined the Fast-Track Cities Initiative in 2017 to optimize HIV service delivery for adolescents, promoting adherence and sustaining viral suppression. Recent surveys and programmatic data show that the treatment gap remains greatest among children and adolescents living with HIV. A retrospective cohort analysis of adolescents living with HIV (ALHIV) receiving antiretroviral therapy (ART) at Windhoek healthcare facilities was conducted. Routine clinical data were extracted from the electronic Patient Monitoring System (ePMS). The SPSS statistical package was used to determine viral non-suppression and perform inferential statistics. 695 ALHIV were analysed with median age of 16 years (IQR = 13–18). Viral non-suppression at 1000 copies/mL threshold was 12%. Viral non-suppression was associated with age at ART initiation, duration on ART, current ART regimen and WHO Clinical Stage. In multivariate analysis, longer duration on ART was a protective factor for viral non-suppression (13–24 months vs. >24 months: aOR = 8.92, 95% CI 2.60–30.61), while being on third line regimen (vs. first line) was protective against viral non-suppression (aOR = 0.11, 95% CI 0.03–0.49). A significant treatment gap is evident for ALHIV with high viral non-suppression levels. Interventions are required to counter treatment fatigue to keep adolescents engaged in ART, and timely switching to rescue regimens for failing adolescents.

Suggested Citation

  • Farai Kevin Munyayi & Brian van Wyk, 2022. "Closing the HIV Treatment Gap for Adolescents in Windhoek, Namibia: A Retrospective Analysis of Predictors of Viral Non-Suppression," IJERPH, MDPI, vol. 19(22), pages 1-10, November.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:22:p:14710-:d:967493
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    Cited by:

    1. Onai Diura-Vere & Mathildah M. Mokgatle & Oluwafemi O. Oguntibeju, 2023. "Sexual Behaviour and Attitudes towards Safe Sex of Youth Receiving Antiretroviral Care at Public Health Facilities in Palapye District, Botswana," IJERPH, MDPI, vol. 20(5), pages 1-20, February.

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