Page 380 - HIVMED_v21_i1.indb

Page 5 of 9 Original Research

TABLE 2: The demographic and clinical characteristics of adolescent participants
on antiretroviral therapy at the Intermediate Hospital Katutura Paediatric 1.00 10–14 years 15–19 years
Antiretroviral Therapy Clinic (N = 385).
Characteristic Standard care Teen Club Total p 0.98
n % n %
Sex 0.96
Male 173 56.4 32 41.0 205 0.015*
Female 134 43.6 46 59.0 180 - Cumula ve survival probability 0.94
Age group
10–14 years 171 55.7 26 33.3 197 0.001** 0.92
15–19 years 136 44.3 52 66.7 188 -
Disclosure status (n = 372)
Disclosed 278 94.2 77 100 355 0.031* 0.90
Not disclosed 17 5.8 0 0 17 - 0 100 200 300 400 500 600 700 800
ART regimen Time in days
First-line regimen 226 73.6 53 67.9 279 0.318 FIGURE 3: Kaplan–Meier survival analysis for retention in care among younger
Second-line regimen 81 26.4 25 32.1 106 - and older adolescents over time.
Duration on ART
< 12 months 3 1.0 0 0 3 0.382 TABLE 3: Cox proportional hazard regression model.
≥ 12 months 304 99.0 78 100 382 - coef coef exp(coef) se(coef) z Pr(>|z|)
Retention in care at 24 months Care -0.498589 0.607387 0.669281 -0.745 0.45629
In care 276 89.9 71 91.0 347 0.931 Age 0.266007 1.304744 0.100969 2.635 0.00843 **
Lost to follow-up 18 5.9 4 5.1 22 - Sex -0.467084 0.626828 0.507478 -0.920 0.35736
Transferred out 13 4.2 3 3.9 16 - Disclosure -2.031364 0.131157 0.844418 -2.406 0.01614 *
ART, antiretroviral therapy. Regimen -1.099095 0.333172 0.500542 -2.196 0.02811 *
*, Correlation is significant at 0.05 level (2-tailed). Duration -0.012241 0.987834 0.005798 -2.111 0.03476 *
**, Correlation is significant at 0.01 level (2-tailed).
Note: See Cox Proportional Hazard Regression model calculations in Appendix 1.
Significance codes: ‘**’ 0.01 ‘*’ 0.05 ‘.’ 0.1 ‘ ’ 1.
Concordance = 0.755 (se = 0.07).
1.00 Non-teen club Teen club R-square = 0.044 (max possible = 0.416).
Likelihood ratio test = 16.63 on 6 df, p = 0.01.
Cumula ve survival probability 0.96 and indicated that adolescents on ART for ≥ 12 months had
Wald test = 16.47 on 6 df, p = 0.01.
Score (log-rank) test = 17.99 on 6 df, p = 0.006.
0.98
less chance of being LTFU than those on ART < 12 months at
the beginning of the study, and that ‘disclosed’ adolescents
had less likelihood of being LTFU compared to those not
0.94

0.92
Discussion
0 100 200 300 400 500 600 700 800 disclosed.
Time in days This study found the overall retention in care rates to be
approximately 90.1% at 24 months among all adolescents
FIGURE 2: Kaplan–Meier survival analysis for retention in care among Teen Club
members and adolescents in standard care over time. included in the study. Similar retention rates have been
observed in other studies conducted in South Africa (89%
Table 3 indicates that the hazard ratio for model of care was and 83%). A study in Uganda reported that 90% of
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0.607; that is, the hazard rate for being lost from care among adolescents were retained in care at 12 months after ART
Teen Club members was approximately 40% less compared initiation while another study reported rates of 96%, 90%
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to adolescents in standard care. Nonetheless, no statistically and 83% at 6, 12 and 24 months, respectively. 3
significant difference in hazard rates was confirmed between
the two groups (p = 0.456). The hazard ratio per age group Although the study produced similar retention rates between
was 1.305; that is, the hazard rate for being lost from care adolescents in the Teen Club and those in standard care at
among the older adolescents was approximately 30% higher 24 months, there were better retention rates among the Teen
when compared to the younger adolescents. Retention rates Club members. Comparable rates were reported in South
were higher among younger adolescents. This was significant Africa, although the authors reported bigger differences of
at the 1% level (p = 0.008). 95% retention among adolescents attending a dedicated
adolescent clinic as compared to 85% (odds ratio [OR] = 3.7;
The hazard rate for being lost from care among adolescents 95% CI 1.2, 11.1; p = 0.018) for adolescents in standard care.
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on a first-line ART regimen was approximately 67% less A study in Kenya observed no difference in retention rates at
compared to those on the second-line regimen, with a 6 and 12 months between adolescents accessing youth-
statistically significant difference at the 5% level (p = 0.028). friendly services and those attending selected facilities prior
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Hazard rates for duration on ART (HR = 0.988; p = 0.035) and to the implementation of youth-friendly services. Decreasing
disclosure status (HR = 0.131; p = 0.016) were also significant, retention rates were also observed in our study in both

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