ABSTRACT

Little data exist on how 15-to-24-year-old perinatally infected youth living with HIV (p-YLHIV) learn their HIV status, and how those disclosure experiences may relate to current viral suppression (VS). Cross-sectional analyses were conducted using baseline data from a randomized controlled trial testing a peer mentoring program in Ndola, Zambia. Analyses were restricted to self-reported p-YLHIV to assess associations between disclosure experiences and VS using logistic regression models, adjusted for sex, age, time on treatment and enrolment site. Of 198 p-YLHIV, 55% knew their HIV status by age 12. The odds of VS was 3.43 greater among p-YLHIV who learned their HIV status through a healthcare provider (HCP) and caregiver together compared to learning from either a HCP or caregiver alone [95% CI:1.02,11.54]. P-YLHIV who had people to talk with about living with HIV after disclosure were twice as likely to have VS compared to peers who did not [OR: 1.87, 95% CI: 1.0, 3.45]. These findings highlight the importance of disclosure support and having a HCP-caregiver team handle disclosure with perinatally infected children and youth, indicating strong service delivery opportunities that may support future VS in youth. Future studies should examine youth peer mentors living with HIV’s support during disclosure processes.

摘要

关于 15 至 24 岁的围产期感染艾滋病毒 (p-YLHIV) 青年如何了解他们的艾滋病毒状况，以及这些披露经历如何与当前的病毒抑制 (VS) 相关的数据很少。使用来自赞比亚恩多拉的同伴指导计划的随机对照试验的基线数据进行横断面分析。分析仅限于自我报告的 p-YLHIV，以使用逻辑回归模型评估披露经验与 VS 之间的关联，并根据性别、年龄、治疗时间和入组地点进行调整。在 198 名 p-YLHIV 中，55% 的人在 12 岁时就知道自己的 HIV 感染状况。与通过医疗保健提供者 (HCP) 和看护人一起了解自己的 HIV 感染状况的 p-YLHIV 中，VS 的几率比从 HCP 或护理人员那里学习高出 3.43。单独看护人 [95% CI:1.02,11.54]。P-YLHIV 在披露后与人谈论感染 HIV 的可能性是没有的同龄人的两倍 [OR: 1.87, 95% CI: 1.0, 3.45]。这些发现强调了信息披露支持的重要性，以及让 HCP 护理团队处理围产期感染儿童和青少年信息披露的重要性，这表明提供强大的服务提供机会可能支持未来的青少年 VS。未来的研究应该检查青年同伴导师在披露过程中对艾滋病毒感染者的支持。表明强大的服务提供机会可能支持未来的青年 VS。未来的研究应该检查青年同伴导师在披露过程中对艾滋病毒感染者的支持。表明强大的服务提供机会可能支持未来的青年 VS。未来的研究应该检查青年同伴导师在披露过程中对艾滋病毒感染者的支持。