Improving HIV care retention among young adults in Kenya

Last year, as part of the SEARCH trial, Bixby researchers demonstrated how a combination of community and home-based outreach could greatly improve HIV testing rates among adolescents in East Africa. Now, in a new study, researchers analyze the care decisions made by adolescents who first discovered their HIV-positive status during SEARCH testing.

Specifically, the study focuses on youth aged 15-24 in rural Kenya who connected to HIV care for the first time within a year of SEARCH testing. The study found that, compared to adults 30-and-older, youth who initiated HIV care after learning their status were far more likely to be female (89 percent vs. 53 percent). Prior SEARCH research has delved further into the potential reasons for lower testing rates among men.

Young adults also had the lowest retention rate (81 percent) one year after first linking to care. However, those living with an HIV-infected household member had a substantially higher retention rate (90 percent). No other variables included in the study were associated with retention among young adults.

The influence of HIV-infected household members on young adults highlights the potential for developing other interventions that harness social connections and peer influence. Other studies in sub-Saharan Africa have also shown that social support can increase medication adherence and care retention among those living with HIV. 

Next, SEARCH researchers intend to analyze qualitative data from this study to better understand which aspects of social support may be most helpful for this particular youth population.