Contextual Factors Influencing Self-Management of Adolescents and Youth Living with HIV: A Cross-Sectional Survey in Lesotho

Int J Environ Res Public Health. 2022 Dec 23;20(1):238. doi: 10.3390/ijerph20010238.

Abstract

Background: HIV treatment outcomes of adolescents and youth living with HIV (AYLWH) are lagging. One way to improve outcomes is through supporting AYLWH to acquire self-management skills. Although self-management is associated with improved health outcomes, condition-specific, individual/family, and social/environmental contextual factors influence self-management. We aimed to describe factors influencing the self-management of AYLWH in Lesotho. Methods: A cross-sectional survey design was used. AYLWH (n = 183) aged 15−24 were conveniently sampled from two HIV treatment sites in Lesotho. Participants completed self-report questionnaires in English or Sesotho. Results: Participants (89.1% female) had high HIV self-management scores (mean 92.7%, SD 5.3%) that corresponded with treatment outcomes (98.9% adherent and 100% viral load < 1000 copies/mL). This might be attributed to condition-specific factors, including once-daily doses (100%) and longer duration of treatment (81.4% on ART for more than 10 years). Participants were older (median age 22), and the majority (61.7%) had stable living conditions. Individual strengths were associated with higher self-management scores (p < 0.01) and mental health problems with lower self-management scores (p < 0.05). Most (97.9%) were satisfied with their health care services. Conclusions: Uncomplicated treatment regimens, longer duration of treatment, stable living conditions, individual strengths, good mental health, and satisfaction with healthcare services have a positive influence on self-management.

Keywords: HIV; adolescents; contextual factors; self-management; youth.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / psychology
  • Humans
  • Lesotho
  • Male
  • Self-Management*
  • Treatment Outcome
  • Young Adult

Grants and funding

This research received no external funding.