PDF(Pubmed)
Abstract：
Adolescents and young adults living with HIV (AYLHIV) in sub-Saharan Africa experience poorer HIV outcomes than adults, including lower ART adherence and virologic suppression. They also have high rates of unprotected sex, increasing the risk of adverse sexual health outcomes and onward transmission. This one-arm, pre-post study investigates a structured 14-session support group aiming to boost treatment adherence and sexual protective behavior for AYLHIV in South Africa. Logistic and Poisson regression analyses were performed on self-reported pre- and post-intervention survey data collected approximately 7.5 months apart from a cohort of 548 AYLHIV. Participants were significantly more likely to report at least 95% adherence at follow-up and rate their health as \"good;\" they also demonstrated greater treatment knowledge and had fewer absences from school overall and due to illness. Among sexually active AYLHIV, contraception use at last sex increased significantly, while condom use did not. Effects were small, and greater programmatic emphasis on adherence and multifaceted service packages is likely necessary to promote viral suppression. Nonetheless, the intervention addresses an important gap in service provision for AYLHIV in South Africa. Findings denote the potential for incorporating care and treatment components into sexual and reproductive health interventions tailored for AYLHIV.
摘要：
撒哈拉以南非洲地区的青少年和感染艾滋病毒的年轻人（AYLHIV）的艾滋病毒结果比成年人差。包括较低的ART依从性和病毒学抑制。他们也有很高的无保护性行为率，增加不良性健康结果和继续传播的风险。这个单臂，研究前调查了一个有组织的14次支持小组,旨在提高南非AYLHIV的治疗依从性和性保护行为.在548个AYLHIV队列中收集了大约7.5个月的干预前和干预后的自我报告调查数据，进行了Logistic和Poisson回归分析。参与者在随访时报告至少95％的依从性，并将他们的健康状况评为“良好”；他们还表现出更多的治疗知识，并且总体上由于疾病而缺课较少。在性活跃的AYLHIV中，最后一次性行为避孕的使用显着增加，而避孕套没有使用。影响很小，和更多的方案强调坚持和多方面的服务包可能是必要的，以促进抑制病毒。尽管如此，该干预措施解决了南非AYLHIV服务提供方面的一个重要差距。研究结果表明，将护理和治疗内容纳入为AYLHIV量身定制的性健康和生殖健康干预措施的潜力。
