How does learning one’s HIV status relate to viral suppression? an analysis among perinatally infected adolescents and young adults in Ndola, Zambia

Figures & data

Table 1. Socio-demographic characteristics of study participants (N = 198)

Characteristics	n (%)
Sex Male Female	86 (43.43) 112 (56.57)
Age 15–19 years 20–24 years	134 (67.68) 64 (32.32)
Marital Status Single, never married Married	195 (98.48) 3 (1.52)
Completed Primary school Yes No	184 (92.93) 14 (7.07)
Orphan status Both biological parents living One biological parent deceased Both biological parents deceased	43 (21.72) 84 (42.42) 71 (35.86)
How many families/households youth have lived in One Two Three or more Missing	59 (29.80) 71 (35.86) 67 (33.84) 1 (0.51)
Enrolment Site Pediatric setting Adult setting	114 (57.78) 84 (42.42)
HIV Suppressed Yes No Missing	123 (62.12) 74 (37.37) 1 (0.51)
ART Adherent Yes No	119 (60.10) 79 (39.90)
Time on ART <3 yrs 3–6 yrs >6 yrs Missing	29 (14.65) 30 (15.15) 136 (68.69) 3 (1.52)

n is the number of participants in each category

Table 2. Perinatally infected Youth’s disclosure experiences (N = 198)

	n (%)
Characteristic/experience	TOTAL (n = 198)	MALE(n = 86)	FEMALE (n = 112)
Age at diagnosis (from medical chart)
12 years and below	102 (51.52)	52 (60.47)	50 (44.64)
Above 12 years	55 (27.78)	19 (22.09)	36 (32.14)
Missing	41 (20.71)	15 (17.44)	26 (23.21)
Age youth learned their HIV status
12 years and below	108 (54.55)	42 (48.84)	66 (58.93)
Above 12 years	87 (43.94)	42 (48.84)	45 (40.18)
*Don’t know &refused to answer	3 (1.52)	2 (2.33)	1 (0.89)
How youth first learned their HIV status
Directly informed	166 (83.84)	67 (77.91)	99 (88.39)
Figured it out on their own	32 (16.16)	19 (22.09)	13 (11.61)
Was someone with youth when youth first learned they were living with HIV?
Yes	188 (94.95)	81 (94.19)	107 (95.54)
No	10 (5.05)	5 (5.81)	5 (4.46)
Who directly told youth their HIV status the first time they learned of it?
Both HCP and Caregiver together	21 (10.61)	9 (10.47)	12 (10.71)
HCP only	76 (38.38)	25 (29.07)	51 (45.54)
Caregiver only	85 (42.93)	47(54.65)	38 (33.93)
Other (figured it out themselves, other adult family member, etc)	16 (8.08)	5 (5.81)	11 (9.82)
Location where youth learned HIV status
Health facility	115 (58.08)	45 (52.33)	70 (62.50)
Other (Home, School, Community)	83 (41.92)	41(47.67)	42 (37.50)
Youth had people they could talk with about living with HIV after they found out their HIV status?
Yes	101 (51.01)	38 (44.19)	63 (56.25)
No	97 (48.99)	48 (55.81)	49 (43.75)
Youth wish their parent/caregiver had told them their HIV status earlier?
Yes	53 (26.77)	25 (29.07)	28 (25.00)
No	138 (69.70)	58 (67.44)	80 (71.43)
Missing	7 (3.54)	3 (3.49)	4 (3.57)
Age youth wish their parent/caregiver had told them their HIV status (Out of those who wish their parent/caregiver had told them their HIV status earlier;n = 53)
12 years and below	44 (22.22)	20 (23.26)	24 (21.43)
Above 12 years	7 (3.54)	5 (5.81)	2 (1.79)
Missing	2 (1.01)	0 (0.00)	2 (1.79)
Youth wish they had more time with counsellor at facility when learnt their HIV
Yes	114 (57.58)	47 (54.65)	67 (59.82)
No	69 (34.85)	29 (33.72)	40 (35.71)
Not applicable (learned status themselves or outside of facility)	15 (7.58)	10 (11.63)	5 (4.46)
Did youth wish they belonged to peer support group immediately after learning HIV status?
Yes	159 (80.30)	67 (77.91)	92 (82.14)
No	32 (16.16)	16 (18.60)	16 (14.29)
Already belonged to one	7 (3.54)	3 (3.49)	4 (3.57)

n is the number of participants in each category

** Average age youth learnt their HIV status is 11.9 years (standard deviation =3.11, age range 4 to 21 years).

Table 3. Percentage of perinatally infected Youth with viral suppression and bivariate odds ratios (95% confidence intervals) N = 198

Characteristic/experience	n with VS/ n in sub-category	%	Bivariate OR (95% CI)	P value
Age 15–19 years 20–24 years	86/134 37/64	64.18 57.81	1 0.79 (0.43,1.46)	0.46
Sex Male Female	52/86 71/112	60.47 63.39	1 1.10 (0.61,1.97)	0.75
Time on ART <3 yrs 3–6 yrs >6 yrs Missing	20/29 21/30 82/136 0/3	68.97 70.00 60.29 0.00	1.44 (0.61,3.39) 1.51 (0.64,3.54) 1	0.41 0.35
How youth first learned their HIV status Directly informed Figured it out on their own	101/166 22/32	60.84 68.75	1 1.39 (0.62,3.14)	0.42
Age at diagnosis 12 years and below Above 12 years Missing	60/102 38/55 25/41	58.82 69.09 60.98	0.65 (0.33,1.31) 1 1.07 (0.51,2.24)	0.23 0.41
Youth learnt HIV status by age 12? Yes No	69/108 54/87	63.89 62.07	1.05 (0.58,1.78) 1	0.88
Who directly told youth their HIV status the first time they learned of it? Both HCP and Caregiver together HCP only Caregiver only Other (figured it out themselves, other adult family member, etc)	17/21 43/76 53/85 10/16	80.95 56.58 62.35 62.50	3.16 (0.97,10.3) 1 1.23 (0.65,2.32) 1.24 (0.41,3.77)	0.06 0.52 0.70
Location where youth learned HIV status Health facilityOther (Home, School, Community)	70/115 53/83	60.87 63.86	1 1.11 (0.62,2.00)	0.73
Youth had people they could talk with about living with HIV after they found out their HIV status? Yes No	71/101 52/97	70.30 53.61	2.11 (1.18,3.82) 1	0.01
Enrolment Site Pediatric setting Adult setting	67/114 56/84	58.77 66.67	1 1.45 (0.81,2.63)	0.21

Note: Controlled for current age, sex, time on ART and enrolment site

n is the number of participants in each category

VS is Viral Suppression

OR is Odds Ratio

Table 4. Percentage of Perinatally Infected Youth with Viral Suppression (<1000 copies/mL) and Multivariable Odds Ratios (95% confidence intervals) N = 198

Characteristic/experience	n with VS/ n in sub Category	%	Adjusted OR (95% CI)	P value
Who directly told youth their HIV status the first time they learned of it? Both HCP and Caregiver together HCP only Caregiver only Other (figured it out themselves, other adult family member, etc)	17/21 43/76 53/85 10/16	80.95 56.58 62.35 62.50	3.43 (1.02,11.54) 1 1.50 (0.73,3.08) 1.46 (0.46,4.63)	0.05 1 0.27 0.52
Youth had people they could talk with about living with HIV after they found out their HIV status? Yes No	71/101 52/97	70.30 53.61	1.87 (1.0,3.45) 1	0.05

Note: Controlled for current age, sex, time on ART and enrolment site

n is the number of participants in each category

VS is Viral Suppression

OR is Odds Ratio

Table 5. Direct, indirect and total effects from the GSEMs evaluating the potential mediation effect of ART adherence on the relationship between VS and disclosure experiences

Disclosure experience	Direct effect	Indirect effect	Total effect
How youth first learned their HIV status	0.44 (−0.34,1.21)	−0.21 (−0.72,0.30)	0.23 (−0.74,1.19)
Who directly told youth their HIV status the first time they learned of it?	1.59 (−0.51,3.69)	0.29 (−0.90,1.49)	1.88 (−0.534,4.30)
Age youth learnt HIV status	−0.06 (−0.67,0.54)	0.17 (−0.21,0.54)	0.10 (−0.59,0.80)
Location where youth learned HIV status	0.04 (−0.56,0.64)	0.21 (−0.19,0.62)	0.25 (−0.46,0.96)
Youth had people they could talk with about living with HIV after they found out their HIV status	0.74 (0.15,1.34)*	0.07 (−0.28,0.41)	0.81 (0.12,1.50)

avalue is significant at 0.05