HIV treatment outcomes and their associated factors among adolescents and youth living with HIV in Tanzania

Introduction:  Despite improvements in access to Ante-Retroviral therapy in Tanzania, low ART initiation rate, low retention rate, lower viral load suppression, high loss to follow up and death rate among adolescents and youth living with HIV remain a challenge.  This study was conducted to identify factors affecting HIV treatment outcomes among adolescents and youths. Methods: A cross-sectional study was done in seven regions in Tanzania. A total of 1124 in and out of school ALYHIV were interviewed using a semi-structured questionnaire. Results: A total of 1120(99.6%) participants were on ART. Of those who were on ART, 606 (53.9%) participants had advanced HIV disease, 423(37.6 %) had switched to the second line of ART and 1761(7.7%) had a virological failure. After adjusting for confounders, death of both parents (APR= 1.3, 95%CI: 1.01-1.8); regions with high HIV prevalence (APR= 1.7, 95%CI: 1.2-2.3) and taking ARVs for three years and less (APR= 2.2, 95%CI: 1.4-3.6) were associated to have advanced HIV. Additionally, HIV regional prevalence level, level of perception, adherence status, ARV storage and supervision of ART use were independently associated with Virological failure.    Conclusion: This study has shown that despite an almost universal utilization of ART among adolescents and youth living with HIV unfavourable clinical ART outcomes such as advanced HIV disease, virological failure and ART switch to the second line remain a challenge, particularly among males and adolescents. Various factors at individual, community and health facility levels contribute to unfavorable ART clinical outcomes among AYLHIV. Therefore, an all-inclusive multidimensional and multi- stakeholders’ approach is needed to ensure the availability of sustainable, effective and quality care and treatment services prioritizing AYLHIV.&nbsp

International collaboration

International collaborations are becoming more common in the field of education, and throughout the academy, as the ease of travel and communication have made it easier to work across national boundaries. In addition, many academic institutions are seeking to internationalize their campuses through expanded study abroad offerings and additional incentives for faculty to develop research programs beyond national borders. The same time-space compression characteristic of globalization in other fields greatly affects higher education, as universities are becoming multinational institutions with campuses in two or more countries and faculty and students engaged in cross-border instruction and knowledge production. Finally, some scholars are committed to efforts to better integrate local expertise and knowledge as they attempt to decolonize or, at a minimum, democratize forms of social research. However, those who have engaged in research that brings together scholars and practitioners from multiple countries are well aware of the obstacles and tensions that frequently emerge as myriad differences in access to resources, demands on faculty time, and discursive conventions become apparent