Determination of factors influencing the retention in HIV care of adolescents during the Covid-19 pandemic in Lusaka Zambia
Authors: - Jane Kalenga Nkatya , - Alice Ngoma Hazemba 
Published: April 2024

Background: Adolescents (ages 18-24) living with HIV are prone to disengagement from care, risking health deterioration and viral transmission. Identifying key barriers to adolescent retention is crucial for intervention development. This study aims to explore barriers and facilitators to adolescent HIV care retention. In Zambia, where 32% of 15–17-year-olds and 60% of 18–19-year-olds are sexually active, with low condom use rates, the risk of HIV and STIs is high. Despite Ministry of Health strategies, many HIV-positive adolescents in Zambia struggle with adherence. This study sought to investigate how various factors interact to influence HIV retention among adolescents in Lusaka, Zambia, employing an adapted Andersen framework. Its objectives include understanding factors impacting HIV retention, analysing predisposing factors, and examining health system influences on adolescent HIV care retention in Lusaka, Zambia.
Methods: The study was conducted at University Teaching Hospital (UTH), Chilenje Hospital, and Chawama, Mtendere, and Kalingalinga) clinics in Lusaka, Zambia. Non-probability sampling, specifically purposive sampling, was employed. Semi-structured questionnaires were used for data collection and the quantitative data was analyzed using STATA 16.0. Findings will be disseminated through healthcare community, policy circles, among stakeholders and shared with UNZA's library. Ethical approval was obtained from The University of Zambia Biomedical Research Ethics Committee (UNZABREC) and permission from the Zambia National Health Research Authority (ZNHRA). Informed consent was obtained from participants, emphasizing voluntariness and the right to withdraw. Anonymity, confidentiality, and privacy was strictly upheld throughout the study.
Results: The results highlight the nuanced nature of factors influencing adolescent retention in HIV care, emphasizing the importance of predictors such as education level, alcohol intake, belief in HIV cure through prayers, and perception of HIV as a significant life problem. The findings align with prior studies, warranting further exploration of support networks and experiences of non-engaged adolescents.
Conclusion: In summary, this study makes a significant contribution to public health research by delving into the intricate factors impacting adolescent retention in HIV care in Lusaka, Zambia. The findings, aligned with research inquiries and existing literature, shed light on education, substance use, and psychosocial aspects. These insights lay the groundwork for tailored interventions, highlighting the significance of patient-centered strategies. Moreover, the study emphasizes the necessity for continued exploration of support networks, disclosure challenges, and broader societal dynamics affecting healthcare engagement. This insight informs future research endeavors aimed at enhancing the well-being of adolescents living with HIV. Recommendations include improve medication access through mobile services, provide financial aid integrated with counseling, personalize adherence plans, involve social networks, respect religious beliefs, address geographic disparities, monitor long-term health, and pilot targeted interventions. Policies should establish guidelines for medication access and financial assistance.