%0 Journal Article
%T Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
%A Helen Bygrave
%A Judith Mtangirwa
%A Kwenzakwenkosi Ncube
%A Nathan Ford
%A Katharina Kranzer
%A Dhodho Munyaradzi
%J PLOS ONE
%D 2012
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0052856
%X Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10每30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10每15 (young adolescents) 15.1每19 years (adolescents), 19.1每24 years (young adults) and 24.1每29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17每4.35). Young adults and adolescents had a 2每3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62每4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0052856