Determinants of retention into HIV care among adolescents living with HIV in two selected districts in Copperbelt Province of Zambia
Soko John, Kaonga Patrick, Jacobs ChoolweIntroduction
Retention into Active Antiretroviral Therapy (ART) care is critical indicator of HIV treatment success, enabling long and healthy lives. However, adolescents face unique challenges, including low retention rates, high new infection rates, and higher AIDS-related morbidity and mortality. This study investigated factors affecting retention in HIV care among adolescents in two selected districts in the Copperbelt Province in Zambia.
Methods
A cross-sectional study was carried out in two public health facilities, one in Ndola and the other in Masaiti District, in the Copperbelt Province of Zambia between July 2023 and May 2024. Data were collected using a pre-tested, validated questionnaire administered to adolescents living with HIV aged 10 to 19 years, and their responses were linked to their medical records. Multivariable logistic regression was used to identify factors associated with retention in HIV care. All analyses were conducted using Stata version 16.
Results
Out of 237 participants, majority were females (55.3%). Retention in HIV care was 91.1%, with Ndola district at 94.2% and Masaiti district at 88.0%. Key factors associated with retention included suppressed viral load (AOR 10.41, 95% CI:1.83, 59.01) and having a treatment supporter (AOR 10.91, 95% CI:1.71, 69.55).
Conclusions
Adolescent retention on ART in the Copperbelt Province was 91.1%, indicating generally strong program performance, though some gaps remain. Adolescents in rural areas faced greater barriers and showed higher levels of attrition. Retention was higher among those with treatment supporters and among those with sustained viral suppression, underscoring the value of strong adherence support systems. To build on these gains, there is a need to strengthen adolescent-centred, context-specific interventions; particularly in rural settings where health system challenges are more pronounced. Improving support for adherence and engagement in care will be key to sustaining viral suppression and advancing broader HIV control efforts by 2030.