Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa
<p>Objectives: HIV-positive adolescents have low-ART adherence, with consequent increased risks of mortality, morbidity, and viral resistance. Despite high rates of violence against children in the Africa region, no known studies have tested impacts on HIV-positive adolescents. We examine asso...
| Main Authors: | , , , , , |
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| Format: | Journal article |
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Lippincott, Williams and Wilkins
2018
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| _version_ | 1797087739969011712 |
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| author | Cluver, L Meinck, F Toska, E Orkin, M Hodes, R Sherr, L |
| author_facet | Cluver, L Meinck, F Toska, E Orkin, M Hodes, R Sherr, L |
| author_sort | Cluver, L |
| collection | OXFORD |
| description | <p>Objectives: HIV-positive adolescents have low-ART adherence, with consequent increased risks of mortality, morbidity, and viral resistance. Despite high rates of violence against children in the Africa region, no known studies have tested impacts on HIV-positive adolescents. We examine associations of ART adherence with adolescent violence victimization by caregivers, teachers, peers, community members, and healthcare providers. Design and methods: HIV-positive adolescents were interviewed (n = 1060), and clinic biomarker data collected. We sampled all 10–19-year olds ever ART-initiated within 53 clinics in 180 South African communities (90.1% reached). Analyses examined associations between nonadherence and nine violence types using sequential multivariate logistic regressions. Interactive and additive effects were tested with regression and marginal effects. Results: Past-week self-reported ART nonadherence was 36%. Nonadherence correlated strongly with virologic failure (OR 2.3, CI 1.4–3.8) and symptomatic pulmonary tuberculosis (OR 1.49, CI 1.18–2.05). Four violence types were independently associated with nonadherence: physical abuse by caregivers (OR 1.5, CI 1.1–2.1); witnessing domestic violence (OR 1.8, CI 1.22–2.66); teacher violence (OR 1.51, CI 1.16–1.96,) and verbal victimization by healthcare staff (OR 2.15, CI 1.59–2.93). Past-week nonadherence rose from 25% with no violence to 73.5% with four types of violence exposure. Conclusion: Violence exposures at home, school, and clinic are major and cumulating risks for adolescent antiretroviral nonadherence. Prevention, mitigation, and protection services may be essential for the health and survival of HIV-positive adolescents.</p> |
| first_indexed | 2024-03-07T02:39:59Z |
| format | Journal article |
| id | oxford-uuid:aa1818a1-2203-46b4-aa29-b26e4ada4d11 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T02:39:59Z |
| publishDate | 2018 |
| publisher | Lippincott, Williams and Wilkins |
| record_format | dspace |
| spelling | oxford-uuid:aa1818a1-2203-46b4-aa29-b26e4ada4d112022-03-27T03:13:00ZMultitype violence exposures and adolescent antiretroviral nonadherence in South AfricaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:aa1818a1-2203-46b4-aa29-b26e4ada4d11Symplectic Elements at OxfordLippincott, Williams and Wilkins2018Cluver, LMeinck, FToska, EOrkin, MHodes, RSherr, L<p>Objectives: HIV-positive adolescents have low-ART adherence, with consequent increased risks of mortality, morbidity, and viral resistance. Despite high rates of violence against children in the Africa region, no known studies have tested impacts on HIV-positive adolescents. We examine associations of ART adherence with adolescent violence victimization by caregivers, teachers, peers, community members, and healthcare providers. Design and methods: HIV-positive adolescents were interviewed (n = 1060), and clinic biomarker data collected. We sampled all 10–19-year olds ever ART-initiated within 53 clinics in 180 South African communities (90.1% reached). Analyses examined associations between nonadherence and nine violence types using sequential multivariate logistic regressions. Interactive and additive effects were tested with regression and marginal effects. Results: Past-week self-reported ART nonadherence was 36%. Nonadherence correlated strongly with virologic failure (OR 2.3, CI 1.4–3.8) and symptomatic pulmonary tuberculosis (OR 1.49, CI 1.18–2.05). Four violence types were independently associated with nonadherence: physical abuse by caregivers (OR 1.5, CI 1.1–2.1); witnessing domestic violence (OR 1.8, CI 1.22–2.66); teacher violence (OR 1.51, CI 1.16–1.96,) and verbal victimization by healthcare staff (OR 2.15, CI 1.59–2.93). Past-week nonadherence rose from 25% with no violence to 73.5% with four types of violence exposure. Conclusion: Violence exposures at home, school, and clinic are major and cumulating risks for adolescent antiretroviral nonadherence. Prevention, mitigation, and protection services may be essential for the health and survival of HIV-positive adolescents.</p> |
| spellingShingle | Cluver, L Meinck, F Toska, E Orkin, M Hodes, R Sherr, L Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa |
| title | Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa |
| title_full | Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa |
| title_fullStr | Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa |
| title_full_unstemmed | Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa |
| title_short | Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa |
| title_sort | multitype violence exposures and adolescent antiretroviral nonadherence in south africa |
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