From 2005 to 2012, the numbers of HIV-related deaths among adolescents living with HIV (ALHIV) increased by 50%, while the global number for all ages decreased by 30%. The World Health Organization attributes this astounding growth in mortality in the context of increasing antiretroviral therapy (ART) accessibility in part to “a lack of support for adolescents to remain in care and to adhere to antiretroviral therapy.” Moreover, one-seventh of all new global infections occur during adolescence, and young people age 15 to 24 years old account for 42% of all new, non-pediatric HIV infections worldwide. Effective interventions to bolster adherence to ART and retention in care among adolescents are sorely needed.
YouthPower Action carried out research on how to improve adherence and retention for adolescents living with HIV and produced two manuscripts. The first, Improving Retention in HIV Care among adolescents and adults in low- and middle-income countries (LMICs): A Systematic Review of the Literature reviewed studies of interventions to improve retention in care of HIV-positive patients who are initiating or already receiving antiretroviral therapy in low- and middle-income countries. The second journal article, Interventions to improve antiretroviral therapy adherence among adolescents in low- and middle-income countries: A systematic review of the literature was conducted to identify interventions designed to improve antiretroviral adherence among adults and adolescents in low- and middle-income countries.
Building on the evidence reviewed, YouthPower Action designed an intervention to meet the needs of adolescents living with HIV to improve adolescent adherence and retention on HIV care. The intervention consists of a mobile health (mHealth) intervention to support adolescents living with HIV in in Nigeria through private Facebook groups that are facilitated by a trained provider who is successfully living with HIV using the Positive Connections support group curriculum to support young people living with HIV. YouthPower carried out a feasibility study of the intervention that found a high level of acceptability among participants. Results from this feasibility study have been published in the Journal of Medical Internet Research – Public Health and Surveillance. Based on the results, YouthPower Action launched an outcome evaluation study to test the effectiveness of the intervention to improve retention among youth living with HIV initiating ART.
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