Original Research

Adolescent human immunodeficiency virus self-management: Associations with treatment adherence, viral suppression, sexual risk behaviours and health-related quality of life

Talitha Crowley, Anita van der Merwe, Martin Kidd, Donald Skinner
Southern African Journal of HIV Medicine | Vol 21, No 1 | a1054 | DOI: https://doi.org/10.4102/sajhivmed.v21i1.1054 | © 2020 Talitha Crowley, Anita van der Merwe, Martin Kidd, Donald Skinner | This work is licensed under CC Attribution 4.0
Submitted: 10 December 2019 | Published: 29 April 2020

About the author(s)

Talitha Crowley, Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Anita van der Merwe, Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Martin Kidd, Centre for Statistical Consultation, Stellenbosch University, Cape Town, South Africa
Donald Skinner, Department of Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa


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Abstract

Background: With the advent of access to antiretroviral treatment (ART), human immunodeficiency virus (HIV) has become a chronic disease and self-management is an important component of its care. Research to date has not explored associations between adolescent HIV self-management and treatment adherence, viral suppression, sexual risk behaviour and health-related quality of life (HRQoL).

Objectives: To explore the associations between adolescent HIV self-management and treatment adherence, viral suppression, sexual risk behaviour and HRQoL.

Methods: A quantitative cross-sectional study of 385 adolescents living with HIV (ALHIV) aged 13–18 years, who were recruited from 11 healthcare facilities between March and August 2017 in the Cape Metropole of the Western Cape, South Africa, provided the data that were examined in this self-completed questionnaire. Validated scales were used to measure key variables. The most recent viral load (VL) was obtained from the participants’ clinic folder, taking into account that VL is done annually.

Results: Adolescents who reported higher HIV self-management were more likely to be adherent to treatment (t = 4.435 [336], p < 0.01), virally suppressed (t = 2.376 [305], p = 0.02) and to practise consistent condom use (t = 1.947 [95], p = 0.54). Structural equation modelling (SEM) indicated a significant relationship between self-management and HRQoL (r = 0.43, p < 0.01), whilst non-adherent treatment taking behaviour, correlated with elevated VL log values. No significant correlation was found between self-management and sexual risk behaviour.

Conclusion: Targeting adolescents’ skills related to HIV self-management in the clinical setting may improve adolescents’ treatment taking behaviour, viral suppression rates and their HRQoL.


Keywords

HIV; adolescents; self-management; quality of life; antiretroviral treatment

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