Southern African Journal of Hiv Medicine最新文献

{"title":"COVID-19 severity and in-hospital mortality in an area with high HIV prevalence.","authors":"Michael T Boswell,&nbsp;Tshegofatso Maimela,&nbsp;Dan Hameiri-Bowen,&nbsp;George Riley,&nbsp;Albertus Malan,&nbsp;Nickietta Steyn,&nbsp;Nomonde Nolutshungu,&nbsp;Talita R de Villiers,&nbsp;Zelda de Beer,&nbsp;John Mathabathe,&nbsp;Khanyisile Tshabalala,&nbsp;Fareed Abdullah,&nbsp;Rajiev Ramlall,&nbsp;Marthinus Heystek,&nbsp;Debashis Basu,&nbsp;Paul Rheeder,&nbsp;Veronica Ueckermann,&nbsp;Wesley van Hougenhouck-Tulleken","doi":"10.4102/sajhivmed.v24i1.1412","DOIUrl":"https://doi.org/10.4102/sajhivmed.v24i1.1412","url":null,"abstract":"<p><strong>Background: </strong>HIV infection causes immune dysregulation affecting T-cell and monocyte function, which may alter coronavirus disease 2019 (COVID-19) pathophysiology.</p><p><strong>Objectives: </strong>We investigated the associations among clinical phenotypes, laboratory biomarkers, and hospitalisation outcomes in a cohort of people hospitalised with COVID-19 in a high HIV prevalence area.</p><p><strong>Method: </strong>We conducted a prospective observational cohort study in Tshwane, South Africa. Respiratory disease severity was quantified using the respiratory oxygenation score. Analysed biomarkers included inflammatory and coagulation biomarkers, CD4 T-cell counts, and HIV-1 viral loads (HIVVL).</p><p><strong>Results: </strong>The analysis included 558 patients, of whom 21.7% died during admission. The mean age was 54 years. A total of 82 participants were HIV-positive. People living with HIV (PLWH) were younger (mean age 46 years) than HIV-negative people; most were on antiretroviral treatment with a suppressed HIVVL (72%) and the median CD4 count was 159 (interquartile range: 66-397) cells/µL. After adjusting for age, HIV was not associated with increased risk of mortality during hospitalisation (age-adjusted hazard ratio = 1.1, 95% confidence interval: 0.6-2.0). Inflammatory biomarker levels were similar in PLWH and HIV-negative patients. Detectable HIVVL was associated with less severe respiratory disease. In PLWH, mortality was associated with higher levels of inflammatory biomarkers. Opportunistic infections, and other risk factors for severe COVID-19, were common in PLWH who died.</p><p><strong>Conclusion: </strong>PLWH were not at increased risk of mortality and those with detectable HIVVL had less severe respiratory disease than those with suppressed HIVVL.</p><p><strong>What this study adds: </strong>This study advances our understanding of severe COVID-19 in PLWH.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"24 1","pages":"1412"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-onset efavirenz toxicity: A descriptive study from Pretoria, South Africa.","authors":"Lyneshree Munsami,&nbsp;Clara M Schutte,&nbsp;Maryke de Villiers,&nbsp;Juliane Hiesgen","doi":"10.4102/sajhivmed.v24i1.1439","DOIUrl":"https://doi.org/10.4102/sajhivmed.v24i1.1439","url":null,"abstract":"<p><strong>Background: </strong>The neuropsychiatric side effects of efavirenz occur mainly early during treatment and are usually mild. A lesser-known and serious complication is late-onset efavirenz toxicity causing ataxia and encephalopathy. Data regarding this condition are limited.</p><p><strong>Objectives: </strong>We describe the clinical picture of late-onset efavirenz toxicity, investigate co-morbidities and report outcomes.</p><p><strong>Method: </strong>This descriptive study of all patients with late-onset efavirenz toxicity was conducted over three years at Kalafong Provincial Tertiary Hospital, Pretoria, South Africa.</p><p><strong>Results: </strong>Forty consecutive patients were identified. Mean age was 42.1 years, three patients (7.5%) were male and the mean efavirenz level was 49.0 μg/mL (standard deviation [s.d.]: 24.8). Cerebellar ataxia (82.5%) and encephalopathy (47.5%) were the most common presenting features (40.0% had both); four patients presented with psychosis. Presence of encephalopathy and/or cerebellar ataxia was associated with higher efavirenz levels compared with psychosis (52.1 μg/mL, s.d.: 24.1 vs 25.0 μg/mL, s.d.: 17.1). In most patients, symptoms resolved, but four patients (10.0%) died, and one patient remained ataxic.</p><p><strong>Conclusion: </strong>Late-onset efavirenz toxicity typically presented with ataxia and encephalopathy, but psychosis can be the presenting feature. The outcome after withdrawal was good, but the mortality of 10.0% is concerning. Recent changes in guidelines favour dolutegravir, but many patients remain on efavirenz, and awareness of the condition is vital.</p><p><strong>What this study adds: </strong>This large, single-centre study contributes to the limited data of HIV-positive patients with late-onset efavirenz toxicity and emphasises its ongoing relevance in clinical practice.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"24 1","pages":"1439"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10672220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV.","authors":"Enkosi Mondleki, Clifford G Banda, Nomathemba C Chandiwana, Simiso Sokhela, Lubbe Wiesner, Francois Venter, Gary Maartens, Phumla Z Sinxadi","doi":"10.4102/sajhivmed.v23i1.1452","DOIUrl":"10.4102/sajhivmed.v23i1.1452","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir, a component of the preferred first-line antiretroviral therapy regimen, has been associated with increased weight gain. South Africa has a high prevalence of obesity, especially among women. Understanding dolutegravir exposure in patients with obesity is important for dose optimisation.</p><p><strong>Objectives: </strong>We compared the pharmacokinetic parameters of dolutegravir in Southern African adults living with HIV with and without obesity.</p><p><strong>Method: </strong>Blood samples were collected at various time points over a 24 h-period for dolutegravir assays. Non-compartmental analysis was conducted and geometric mean ratios (GMRs), with 90% confidence intervals (CIs), were generated to compare dolutegravir pharmacokinetic parameters between the groups. Regression analyses to assess predictors of dolutegravir exposure were done.</p><p><strong>Results: </strong>Forty participants were enrolled, 26 were women and 10 had obesity. Dolutegravir area under the concentration-time curve to 24-h and the maximum concentrations were not statistically significantly lower in participants with obesity: GMR 0.91 (90% CI: 0.71-1.16) and GMR 0.86 (90% CI: 0.68-1.07), respectively. In a multivariate linear regression analysis adjusting for age, gender, body mass index, creatinine clearance and randomisation arm (tenofovir alafenamide or tenofovir disoproxil fumarate), a unit increase in body mass index was associated with 1.2% lower dolutegravir area under the concentration-time curve to 24-h (<i>P</i> = 0.035).</p><p><strong>Conclusion: </strong>Dolutegravir exposure was marginally lower in participants with obesity, but this is not clinically significant. Our findings suggest that there is no need to dose adjust dolutegravir in people with obesity.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"23 1","pages":"1452"},"PeriodicalIF":1.6,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10733074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and HIV viral load suppression in children and adolescents in Durban, South Africa.","authors":"Asandile Mathamo, Kimesh L Naidoo, Jienchi Dorward, Thashir Archary, Christian Bottomley, Moherndran Archary","doi":"10.4102/sajhivmed.v23i1.1424","DOIUrl":"10.4102/sajhivmed.v23i1.1424","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic poses challenges to paediatric and adolescent HIV treatment programme. Modelling exercises raised concerns over potential impact of disruptions.</p><p><strong>Objectives: </strong>To describe the impact of the COVID-19 pandemic on viral load (VL) testing among infants, children and adolescents on antiretroviral treatment (ART) in Durban, South Africa.</p><p><strong>Method: </strong>Routinely collected, aggregated data of monthly VL counts done on all those less than 19 years old from January 2018 to January 2022 was analysed. An interrupted time series analysis using a Prais-Winsten linear regression model, including terms for lockdowns and excess mortality determined VL trends.</p><p><strong>Results: </strong>The unadjusted mean VL was 2166 (confidence interval [CI]: 252.2) and 2016 (CI: 241.9), <i>P</i> = 0.039, and percentage VL suppression rates (72.9%, CI: 2.4% vs 73.6%, CI: 1.8%) across COVID and pre-COVID periods, showing no significant difference, <i>P</i> = 0.262. In the interrupted time series analysis, modelled monthly VL counts did not differ significantly by lockdown level (e.g., level 5 lockdown: -210.5 VLs, 95% CI: -483.0 to +62.1, <i>P</i> = 0.138) or excess mortality (-0.1, 95% CI: -6.3 to 6.1, <i>P</i> = 0.969). A significant downward trend in VL testing over time, including during the pre-COVID-19 period (-6.6 VL per month, 95% CI: -10.4 to -2.7, <i>P</i> = 0.002), was identified.</p><p><strong>Conclusion: </strong>Viral load suppression for children and adolescents were not negatively affected by COVID-19. A trend of decrease in VL testing predated COVID-19.</p><p><strong>What this study adds: </strong>Evidence presented that HIV VL testing and suppression rates in children and adolescents in a high burden setting were sustained through the COVID pandemic.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"23 1","pages":"1424"},"PeriodicalIF":1.6,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9477982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences in receiving financial incentives to access HIV care in Johannesburg, South Africa.","authors":"Sara Rachel Schlehr, Leanne Singh, Athini Nyatela, Sizwe Nqakala, Samanta T Lalla-Edward","doi":"10.4102/sajhivmed.v23i1.1426","DOIUrl":"10.4102/sajhivmed.v23i1.1426","url":null,"abstract":"<p><strong>Background: </strong>Financial incentivisation has been used to improve all steps of the HIV cascade with varying results. Most studies conducted on the matter are of a quantitative nature, not giving enough space for in-depth understanding as to why financial incentives work or do not work.</p><p><strong>Objectives: </strong>To describe experiences with, and opinions on, the use of financial incentives to promote linkage to and retention in care from the perspective of people living with HIV.</p><p><strong>Method: </strong>We performed a qualitative cross-sectional study. In-depth interviews were conducted with adult men and women with HIV accessing health services or research study visits. After codebook development, NVivo 12 software was used to code and analyse the data.</p><p><strong>Results: </strong>Through the provision of financial incentives, participants were able to cover basic needs. However, some deemed financial incentives as a form of income rather than a nudge to spark interest in changing their health behaviour. Participants communicated that a need for some type of incentive exists and recommended food vouchers as the best possible solution.</p><p><strong>Conclusion: </strong>Financial incentivisation can facilitate engagement in the HIV care continuum through providing support to people living with HIV.</p><p><strong>What this study adds: </strong>This study complements the body of research that explores the feasibility of using incentives and which of them may be most beneficial in encouraging patients with HIV to enter into and sustain HIV care.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"23 1","pages":"1426"},"PeriodicalIF":1.6,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10722540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COP27 Climate Change Conference: Urgent action needed for Africa and the world.","authors":"Lukoye Atwoli, Gregory E Erhabor, Aiah A Gbakima, Abraham Haileamlak, Jean-Marie Kayembe Ntumba, James Kigera, Laurie Laybourn-Langton, Robert Mash, Joy Muhia, Fhumulani M Mulaudzi, David Ofori-Adjei, Friday Okonofua, Arash Rashidian, Maha El-Adawy, Siaka Sidibé, Abdelmadjid Snouber, James Tumwine, Sahar Yassien Mohammad, Paul Yonga, Lilia Zakhama, Chris Zielinski","doi":"10.4102/sajhivmed.v23i1.1467","DOIUrl":"10.4102/sajhivmed.v23i1.1467","url":null,"abstract":"","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"23 1","pages":"1467"},"PeriodicalIF":1.6,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo.","authors":"Gulzar H Shah,&nbsp;Gina D Etheredge,&nbsp;Stacy W Smallwood,&nbsp;Lievain Maluantesa,&nbsp;Kristie C Waterfield,&nbsp;Osaremhen Ikhile,&nbsp;John Ditekemena,&nbsp;Elodie Engetele,&nbsp;Elizabeth Ayangunna,&nbsp;Astrid Mulenga,&nbsp;Bernard Bossiky","doi":"10.4102/sajhivmed.v23i1.1421","DOIUrl":"https://doi.org/10.4102/sajhivmed.v23i1.1421","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.</p><p><strong>Objectives: </strong>To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.</p><p><strong>Method: </strong>Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.</p><p><strong>Results: </strong>After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55-4.01; <i>P</i> < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02-1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47-2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07-2.11).</p><p><strong>Conclusion: </strong>Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals.</p><p><strong>What this study adds: </strong>This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1421"},"PeriodicalIF":1.7,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40454222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delays in third-line antiretroviral therapy and outcomes in North West province.","authors":"Babalwa Majova, Ebrahim Variava, Neil Martinson","doi":"10.4102/sajhivmed.v23i1.1394","DOIUrl":"10.4102/sajhivmed.v23i1.1394","url":null,"abstract":"<p><strong>Background: </strong>Rapid switching from second-line to third-line antiretroviral therapy (TLART) is crucial for achieving viral suppression and reducing illness related to ART failure.</p><p><strong>Objectives: </strong>This retrospective cohort study quantified the waiting periods for TLART initiation after virological failure on second-line therapy was detected, assessed factors associated with delays and assessed the outcomes of patients started on TLART.</p><p><strong>Method: </strong>Data were abstracted from records of individuals eligible for TLART, and the time to TLART initiation was calculated. Reasons for delays were categorised according to patient, clinician and administrative processes.</p><p><strong>Results: </strong>Fifty-four patients were eligible for TLART. The median delay from the date of first viral load > 1000 copies/mL on second-line therapy to the start of TLART was 640 days (interquartile range [IQR]: 451-983 days). Of the patients that failed second-line and had an application for TLART, 41 (75.6%) were eventually initiated on TLART, and 11 (20.4%) died while waiting. Delays were primarily due to non-response to the first unsuppressed viral load while on second-line ART: 467 days (IQR: 232-803 days).</p><p><strong>Conclusion: </strong>This study showed a prolonged waiting period for TLART initiation mainly between detected high viral load to requesting of resistance tests; many factors could have contributed, including clinicians' delayed responses to elevated viral loads. Mortality was high before TLART could be initiated. The process of TLART initiation needs to be made more efficient. Healthcare services should be strengthened to (1) recognise and manage virological failure early and identify those eligible for resistance testing, (2) ensure access to resistance testing and appropriately skilled clinicians, and (3) streamline approvals and delivery of TLART.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"23 1","pages":"1394"},"PeriodicalIF":1.6,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10433290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-level viraemia despite emergence of dolutegravir-resistant variants.","authors":"Johannes C Botha,&nbsp;Kim Steegen,&nbsp;Mariam Edoo,&nbsp;Jeremy Nel,&nbsp;Gert U van Zyl","doi":"10.4102/sajhivmed.v23i1.1398","DOIUrl":"https://doi.org/10.4102/sajhivmed.v23i1.1398","url":null,"abstract":"Dolutegravir (DTG), an integrase strand transfer inhibitor (INSTI)-based HIV-1 therapy, is widely recommended in first-line and second-line regimens.1,2 Integrase strand transfer inhibitor resistance mutations associated with DTG-containing regimens have been well described, most often occurring after DTG monotherapy or in INSTI-experienced patients.3Although rare, emergence of these mutations has also been described in patients on DTG-containing triple-drug regimens4 and INSTInaïve patients.5,6 The R263K mutation is commonly associated with the emergence of DTG resistance but reduces viral fitness and DNA integration.7,8 Here we describe a case of very slow viral decline (~42 months) in a treatment-experienced, INSTI-naïve patient on a DTG-based triple therapy regimen.","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1398"},"PeriodicalIF":1.7,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sexual and reproductive health needs of young people living with HIV in Gauteng, South Africa.","authors":"Bandile E Ndlazi,&nbsp;Thembekile Masango","doi":"10.4102/sajhivmed.v23i1.1377","DOIUrl":"https://doi.org/10.4102/sajhivmed.v23i1.1377","url":null,"abstract":"<p><strong>Background: </strong>HIV has been the focus of health systems strengthening in South Africa for the past two decades. Despite progress, sexual and reproductive health (SRH) challenges such as contraception, condom usage and HIV disclosure of young people living with HIV (YPLHIV) remain inadequately addressed. Therefore, the purpose of the study was to describe the SRH needs of YPLHIV and make recommendations to address identified gaps.</p><p><strong>Objectives: </strong>To explore and describe the SRH needs and potential systemic gaps of YPLHIV with an aim to make recommendations for improvement and contribute to the development of an integrated approach to SRH care in HIV programming.</p><p><strong>Method: </strong>A quantitative cross-sectional research design with purposive sampling was utilised. YPLHIV were recruited from five healthcare facilities in Gauteng, South Africa, for face-to-face interviews.</p><p><strong>Results: </strong>One hundred and six YPLHIV with a median age of 18 years were enrolled. A large proportion (57/106; 53.8%) of respondents reported being either single or double orphaned. Sex-related discussions with parents were reported by only 36/106 (34.0%). History of teenage pregnancy was reported in 39/70 (56.0%) of female respondents. A high prevalence of multiple sexual partnerships 41/97 (42.2%) was noted. Consensual partner HIV disclosure was low at 47/97 (48.4%) and the male gender was associated with low 10/35 (28.6%) disclosure of serostatus to sexual partners.</p><p><strong>Conclusion: </strong>Multiple SRH needs were identified. Interventions are needed to improve parental guidance on SRH issues, increase contraception knowledge and access, and provide better male-centred care.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1377"},"PeriodicalIF":1.7,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}