Browsing by Author "van Wyk, Brian E."

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    Determinants and rates of retention in HIV care among adolescents receiving antiretroviral therapy in Windhoek, Namibia: A baseline cohort analysis
    (BMC, 2022) Munyayi, Farai K.; van Wyk, Brian E.
    Long-term engagement in HIV care is essential to achieving and maintaining viral suppression. Adolescents living with HIV (ALHIV) experience many barriers to remaining engaged in care and treatment programs. Higher attrition among adolescents compared to adults remains a huge concern due to unique psychosocial and health systems challenges adolescents face, and recently the COVID-19 pandemic effects. We report on determinants and rates of retention in care in adolescents aged 10–19 years enrolled on antiretroviral therapy (ART) in Windhoek, Namibia. A retrospective cohort analysis of routine clinical data of 695 adolescents aged 10–19 years enrolled for ART at 13 Windhoek district public healthcare facilities, between January 2019 and December 2021 was conducted. Anonymized patient data were extracted from an electronic database and registers. Bivariate and Cox proportional hazards analysis were performed to determine factors associated with retention in care among ALHIV at 6, 12, 18, 24 and 36 months. Retention in care trends were also described using the Kaplan-Meier survival analysis.
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    Factors associated with viral suppression among adolescents on antiretroviral therapy in Free State province, South Africa
    (AOSIS, 2022) Elashi, Balsam A.Y.; van Wyk, Brian E.
    In 2019, about 1.7 million adolescents between the ages of 10 and 19 years were living with HIV worldwide, of which 170000 were newly infected with HIV in 2019. South Africa has the highest number of persons living with HIV. Although there has been major improvement in access to antiretroviral therapy (ART), it is still unclear what proportion of adolescents (aged 10–19 years) are virally suppressed in the provinces of South Africa. To determine the prevalence of and the factors associated with viral suppression among adolescents (10–19 years) on ART in the Thabo Mofutsanyane District Municipality of the Free State province of South Africa.
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    Policy and programming towards addressing treatment gaps in adolescents living with HIV: A content analysis of policy and programme documents in Namibia
    (SAGE Publications Inc., 2024) Munyayi, Farai Kevin; van Wyk, Brian E.
    Adolescents living with HIV (ALHIV) face unique challenges resulting in persistent treatment gaps, particularly viral non-suppression. Country programs adopt policies, guidelines, and innovations, based on WHO recommendations and best practices from elsewhere. However, it is unclear to what extent these tools address the management of adolescents with viral non-suppression. We report on a review of guidelines for the provision of HIV services to ALHIV in Namibia. We conducted a systematic document review using Content Analysis and Thematic Analysis methodology, and the READ approach. We identified seven relevant policy documents, four of which somewhat addressed viral non-suppression (treatment gap) in ALHIV and outlined interventions to improve treatment outcomes in adolescents considering their lived experience and unique challenges. The persistent treatment gap may reflect policy implementation gaps in specifically addressing viral non-suppression. It may be worthwhile to leverage existing documents to develop specific operational guidance for ALHIV with unsuppressed viral loads.