Exploring self-reported adherence measures to screen for elevated HIV viral load in adolescents: A South African cohort study
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Date
2023
Authors
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Journal ISSN
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Publisher
Springer
Abstract
The timely identification of ART non-adherence among adolescents living with HIV presents a significant challenge, particularly
in resource-limited settings where virologic monitoring is suboptimal. Using South African adolescent cohort data
(N = 933, mean age 13.6 ± 2.89 years, 55.1% female, follow-up = 2014–2018), we examined the association between elevated
viral load (VL ≥ 1000 copies/mL) and seven self-reported adherence measures on missed doses, and clinic appointments
–with varying recall timeframes. The best performing measures, which were significantly associated with elevated
viral load in covariate-adjusted models are: any missed dose –past 3 days (sensitivity = 91.6% [95%CI: 90.3–92.8], positive
predictive value (PPV) = 78.8% [95%CI: 77.2–80.4]), –past week (sensitivity = 87% [95%CI: 85.4–88.6], PPV = 78.2%
[95%CI: 76.5–79.9]), –past month (sensitivity = 79.5% [95%CI: 77.5–81.4], PPV = 78.2% [95%CI: 76.4–79.9]), any pastmonth
days missed (sensitivity = 86.7% [95%CI: 85.1–88.3], PPV = 77.9% [95%CI:76.2–79.6]), and any missed clinic
appointment (sensitivity = 88.3% [95%CI: 86.8–89.8], PPV = 78.4% [95%CI: 76.8–79.9]).
Description
Keywords
Public health, Adolescents, HIV, South Africa, Statistics studies, Population studies
Citation
Zhou, S. et al. (2023). Exploring self-reported adherence measures to screen for elevated HIV viral load in adolescents: A South African cohort study. AIDS and Behavior. https://doi.org/10.1007/s10461-023-04068-2