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Identifying adolescents at highest risk of ART non-adherence, using the World Health Organization-endorsed HEADSS and HEADSS+ checklists

Cluver, Lucie D., Shenderovich, Yulia ORCID:, Seslija, Marko, Zhou, Siyanai, Toska, Elona, Armstrong, Alice, Gulaid, Laurie A., Ameyan, Wole, Cassolato, Matteo, Kuo, Caroline C., Laurenzi, Christina and Sherr, Lorraine 2024. Identifying adolescents at highest risk of ART non-adherence, using the World Health Organization-endorsed HEADSS and HEADSS+ checklists. AIDS and Behavior 28 , pp. 141-153. 10.1007/s10461-023-04137-6

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Brief tools are necessary to identify adolescents at greatest risk for ART non-adherence. From the WHO’s HEADSS/HEADSS+ adolescent wellbeing checklists, we identify constructs strongly associated with non-adherence (validated with viral load). We conducted interviews and collected clinical records from a 3-year cohort of 1046 adolescents living with HIV from 52 South African government facilities. We used least absolute shrinkage and selection operator variable selection approach with a generalized linear mixed model. HEADSS constructs most predictive were: violence exposure (aOR 1.97, CI 1.61; 2.42, p < 0.001), depression (aOR 1.71, CI 1.42; 2.07, p < 0.001) and being sexually active (aOR 1.80, CI 1.41; 2.28, p < 0.001). Risk of non-adherence rose from 20.4% with none, to 55.6% with all three. HEADSS+ constructs were: medication side effects (aOR 2.27, CI 1.82; 2.81, p < 0.001), low social support (aOR 1.97, CI 1.60; 2.43, p < 0.001) and non-disclosure to parents (aOR 2.53, CI 1.91; 3.53, p < 0.001). Risk of non-adherence rose from 21.6% with none, to 71.8% with all three. Screening within established checklists can improve identification of adolescents needing increased support. Adolescent HIV services need to include side-effect management, violence prevention, mental health and sexual and reproductive health.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Subjects: H Social Sciences > H Social Sciences (General)
Publisher: Springer
ISSN: 1090-7165
Date of First Compliant Deposit: 23 August 2023
Date of Acceptance: 11 July 2023
Last Modified: 05 Feb 2024 15:33

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