DOI: 10.5061/dryad.cnp5hqc5n
title: Adolescent clubs and self-efficacy linked to better HIV outcomes

description: Adolescents living with HIV (ALHIV) face psychosocial challenges that
 could affect HIV treatment outcomes. Peer support networks and aspects of
 well-being, including self-efficacy, self-esteem, and social capital,
 could ameliorate these challenges. This retrospective analysis describes
 participation in existing facility-based adolescent clubs and the
 associations between club attendance, adolescent well-being, and HIV
 treatment outcomes. Data were collected through interviews with a
 sub-sample of adolescents aged 10-19 years and medical record abstraction
 of all adolescents attending HIV services at seven clinics in Tanzania.
 Independent variables included adolescent club attendance, self-efficacy,
 self-esteem, symptoms of depression/anxiety, social capital, and other
 health utilization or HIV experience characteristics. Study outcomes
 included visit adherence, viral suppression (&lt;1000 cp/ml), and
 retention. Of 645 adolescents, 75% attended clubs at least once, with a
 median of eight club sessions attended over a two-year period. Mental
 distress, or symptoms of depression and anxiety, was prevalent, with 67%
 of the adolescents scoring above a recognized cut-off of &gt;5.
 Adolescents who attended 10 or more clubs, compared to those not attending
 any clubs over a two-year period, were at an almost three-fold increased
 odds of having good visit adherence (odds ratio [OR] 2.72, 95% confidence
 interval [CI]: 1.25, 5.94). Club attendance was also strongly associated
 with retention in the following year, with adolescents attending some
 clubs (&lt;10) having three-times the odds of being retained (OR 3.01;
 95%CI: 1.86, 4.87) and adolescents attending more frequently (10+) having
 over seven-times the odds (OR 7.29; 95%CI: 4.34, 12.22). Among the
 sub-sampled adolescents who were interviewed, being in the top
 self-efficacy tertile was positively associated with viral suppression (OR
 3.04, 95%CI: 1.08, 8.60) and retention (OR 4.44, 95%CI: 1.19, 17.40).
 Attending the HIV clinic with a guardian/treatment supporter (OR 3.29,
 95%CI: 1.17, 9.22) was also associated with viral suppression, and social
 capital was associated with club attendance (B1 3.24, 95%CI 0.64, 5.85).
 This study points to the need for comprehensive psychosocial support
 interventions for ALHIV. Self-efficacy, social capital, and treatment
 support are important characteristics that facilitate better health
 outcomes among adolescents. However, many ALHIV either never attended or
 did not regularly attend clubs, mitigating the real-world impact of such
 interventions. Further research is needed to identify barriers to club
 attendance and interventions that promote adolescent well-being,
 resilience, and guardian/treatment supporter engagement.
description: Data were collected through interviews with a sub-sample of
 adolescents aged 10-19 years and medical record abstraction of all
 adolescents attending HIV services at seven clinics in Tanzania. Data were
 analyzed using STATA 16.1.
description: # Adolescent clubs and self-efficacy linked to better HIV outcomes Dataset
 DOI: [10.5061/dryad.cnp5hqc5n](10.5061/dryad.cnp5hqc5n) ## Description of
 the data and file structure We conducted a retrospective analysis of
 adolescents living with HIV attending seven health facilities with
 well-established adolescent clubs as part of their HIV clinical services.
 Data sources included (1) abstracted data on HIV/ART clinical visits from
 2015 to 2019, (2) abstracted data on club attendance records from 2016 to
 2018, and (3) data collected from structured interviews with a subset of
 attending adolescents in 2018. Participant and siteid IDs are unlinkable
 to any personal identifiers. Neither ID alone nor in combination with
 other variables in the dataset can be used to identify any individual or
 geographic location within the study country, Tanzania. Two age variables,
 while treated as continuous in the analyses, were binned to declassify
 them as "indirect identifiers." The remaining indirect
 identifiers are HIV status, years on ART, and gender. The data dictionary
 describes where there are missing values, and which variables were
 obtained from interviews versus medical record abstraction. The related
 manuscript describes in more detail how variables were defined. ##
 Code/software Stata (version 16.1,
 [https://www.stata.com/](https://www.stata.com/)) was used for analysis.
 Data are deposited here in csv files. ## Access information NA ## Human
 subjects data Among those recruited for an interview, caregivers of minors
 and adolescents who were either emancipated or age 18 years or older
 provided written informed consent. Adolescent minors (age 10–17) provided
 verbal assent. For adolescents whose medical record information was
 included in the analysis but who were not recruited for interview, a
 waiver of informed consent was granted under a separate protocol approved
 by the National Research Ethics Committee of the National Institute for
 Medical Research in Tanzania and the US-based IRB, Advarra. All data were
 fully anonymized using participant and site ID numbers unlinked to any
 personal identifiers.