Challenges in management and treatment outcomes of HIV among adolescents and young adults in a county hospital in Kenya

Objective: To evaluate the challenges in management of HIV among adolescents and young adults (AYA) aged 10-24 years and their treatment outcomes in terms of viral load suppression. Design: Cross sectional study with primary and secondary data. Setting: Secondary level health facility in sub-Saharan Africa. Subjects: Data on treatment outcomes was obtained from 106 subjects through abstraction from files. Primary data on challenges in management was obtained from in-depth interviews on 18 subjects, one focused group discussion with seven participants and 10 key informant interviews. Main Outcome Measures: Viral load suppression after at least six months of treatment. Results: Out of 106 eligible adolescents, records on viral suppression were only available for 60 (56.7%). For those who had available records, 85 (80%) had achieved viral suppression, with viral load <1000 copies per ml. Of those who had achieved viral suppression, 80 (75%) had undetectable levels. The viral suppression was associated with the type of treatment, adherence to medication and follow-up status [p= <0.0001, p= <0.0001, p= <0.002,] respectively. The main themes on challenges in management identified from the interviews and focused group discussion were psychosocial and difficulty in taking medication as follows: Conclusions: The main challenges in the management of HIV within this population are psychosocial and medication-use related. Viral suppression was associated with first line of treatment, adherence to medication and active follow up status