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AIDS and Behavior
Published in: AIDS and Behavior 2/2019

01-02-2019 | Original Paper

Virological Non-suppression and Its Correlates Among Adolescents and Young People Living with HIV in Southern Malawi

Authors: Eric Umar, Judith A. Levy, Robert C. Bailey, Geri Donenberg, Ronald C. Hershow, Mary Ellen Mackesy-Amiti

Published in: AIDS and Behavior | Issue 2/2019

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Abstract

We examined virological non-suppression (VLN) among youth ages 13–24 years receiving HIV treatment in public health facilities in six southern Malawi districts. We also tested three ART adherence measures to determine how well each identified VLN: pill counts, a Likert scale item, and a visual analogue scale. VLN was defined as HIV RNA > 1000 copies/ml. Of the 209 youth, 81 (39%) were virally non-suppressed. Male gender and stigma were independently associated with VLN; social support and self-efficacy were independently protective. Pill count had the highest positive predictive value (66.3%). Using a pill count cut-off of < 80% nonadherence, 36 (17%) of the youth were non-adherent. Of the adherent, 120 (69%) were viral suppressed. Results indicate the need to address HIV-related stigma and to bolster social support and selfefficacy in order to enhance viral suppression. In the absence of viral load testing, pill count appears the most accurate means to assess VLN.
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Metadata
Title
Virological Non-suppression and Its Correlates Among Adolescents and Young People Living with HIV in Southern Malawi
Authors
Eric Umar
Judith A. Levy
Robert C. Bailey
Geri Donenberg
Ronald C. Hershow
Mary Ellen Mackesy-Amiti
Publication date
01-02-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue 2/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-018-2255-6

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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