Browsing by Author "Connie Celum"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Interventions addressing the adolescent HIV continuum of care in South Africa: a systematic review and modified Delphi analysis
    (2022-04-29) Brian Zanoni; Moherndran Archary; Thobekile Sibaya; Tatiana Ramos; Geri Donenberg; Maryam Shahmanesh; Connie Celum; Audrey Pettifor; Linda Gail Bekker; Jessica Haberer
    Introduction: Compared with adults, adolescents in South Africa have larger gaps at each step of the HIV continuum of care resulting in low levels of viral suppression. Methods: We conducted a systematic review and modified Delphi analysis of interventions addressing the HIV continuum of care for adolescents in South Africa. We searched PubMed, Science Direct, and Google Scholar and online conference proceedings from the International AIDS Society, the International AIDS Conference, and the Conference on Retrovirology and Opportunistic Infections from 1 January 2010 to 30 September 2020. We then conducted a modified Delphi analysis with 29 researchers involved in the National Institutes of Health's Fogarty International-supported Adolescent HIV Implementation Science Alliance-South Africa to evaluate interventions for efficacy, feasibility and potential for scale-up. Results: We identified nine initial published articles containing interventions addressing the adolescent HIV continuum of care in South Africa, including five interventions focused on HIV diagnosis, two on antiretroviral therapy adherence and two on retention in care. No studies addressed linkage to care or transition from paediatric to adult care. Two studies discussed intervention costs. In-home and HIV self-testing, community-based adherence support, and provision of adolescent-friendly services were the most impactful and scalable interventions addressing the adolescent HIV continuum of care. Conclusion: Future interventions should work comprehensively across the adolescent HIV continuum of care and be tailored to the specific needs of adolescents.
  • Thumbnail Image
    Item
    The Effect of PrEP Use Disclosure on Adherence in a Cohort of Adolescent Girls and Young Women in South Africa
    (2022-04) Danielle Giovenco; Audrey Pettifor; Kimberly A Powers; Lisa Hightow-Weidman; Brian W Pence; Jessie K Edwards; Katherine Gill; Jennifer F Morton; Ariane van der Straten; Connie Celum; Linda-Gail Bekker
    Effective strategies to support PrEP adherence among adolescent girls and young women (AGYW) are needed. We examined PrEP use disclosure and its effect on adherence among 200 AGYW ages 16-25 initiating PrEP in South Africa to help inform these strategies. We estimated the relative prevalence of high adherence (intracellular tenofovir-diphosphate concentration ≥ 700 fmol/punch) 3- and 6-months after PrEP initiation among those who disclosed vs. did not disclose their PrEP use, both overall and by age. Most AGYW disclosed to a parent (58%), partner (58%), or friend (81%) by month 6. We did not observe a strong effect of disclosure on adherence overall; however, among younger AGYW (≤ 18 years), those who disclosed to a parent were 6.8 times as likely to have high adherence at month 6 than those who did not (95% CI 1.02, 45.56). More work is needed to understand parents' roles as allies and identify ways peers and partners can motivate PrEP use for AGYW.