Factors associated with failure to initiate ART amongst youth aged 15-24 years inSouth Africa: A secondary analysis

Abstract

Background Antiretroviral therapy (ART) is made available to anyone living with HIV. Despite this, young people in Southern Africa experience poor ART outcomes compared to adults. In order to meet the 95-95-95 target for 2030, effective ART use is an important component. The aim of this study is to determine the proportion of HIV- infected youth aged 15-24 who are not on ART, the factors associated with not being on ART and the spatial distribution of ART non-use amongst this population. Methodology This study is a secondary analysis of a cross-sectional, population-based household survey conducted in 2017. The target population consisted of participants aged 15- 24 years who completed individual interviews and provided blood samples which were tested for HIV. The outcome of the study was ART non-use based on negative test results of antiretroviral drugs from the HIV positive samples. Non-spatial (univariable and multivariable) logistic regression models as well as spatial logistic regression models were fitted Results The majority (59.2%) of the participants were not on ART. Most of the results for non-spatial and spatial logistic regression were similar. The odds of ART non-use were higher among those who tested for HIV more than a year ago compared to those who tested less than a year ago. The odds of ART non-use were statistically lower among participants from rural areas compared to those from urban areas. Conclusion The study highlighted the need for HIV testing and knowing one’s status. More interventions should be aimed at young people who are students/employed as well as those residing in urban areas. More attention is still needed for females where the odds of ART non-use were higher. Young people also need to understand the need vi to delay sexual activity at a young age and practice safe sexual behaviour when they become sexually active.