{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:18:50Z","timestamp":1787800730138,"version":"build-2784847793"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":75,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Fogarty International Centre, the National Institute of Mental Health, and the Office of AIDS Research of the U.S. National Institutes of Health","award":["Award Number: D43 TW010037."],"award-info":[{"award-number":["Award Number: D43 TW010037."]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["AIDS Res Ther"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescents and young people living with HIV continue to experience disproportionately high rates of virological non-suppression despite scale-up of enhanced adherence interventions such as Intensive Adherence Counselling (IAC). While prior research has quantified post-IAC suppression outcomes, there remains limited empirical evidence regarding the multilevel factors that shape virological response in this population. This study investigated multilevel factors associated with viral load suppression among adolescents and young people (AYP) with prior non-suppression who were enrolled in IAC in East-Central Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A facility-based analytical cross-sectional study was conducted using routinely collected programmatic data from 580 AYP aged 10\u201324 years with documented unsuppressed viral load who were enrolled in IAC across 32 health facilities. Eligible participants had a repeat viral load measurement following completion of the adherence intervention. Multivariable analysis was performed using modified Poisson regression with robust variance estimation to determine factors independently associated with virological suppression, accounting for clustering at the facility level. Adjusted prevalence ratios (aPRs) with corresponding 95% confidence intervals were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study population had a median age of 16.4 years (interquartile range [IQR]: 12.9\u201321.2), with females comprising 62.8% of participants. Overall, over half of the cohort achieved virological suppression following the intervention. Engagement in peer-led support was associated with a higher likelihood of suppression (aPR\u2009=\u20091.71, 95% CI: 1.36\u20132.15), as was prior disclosure of HIV status (aPR\u2009=\u20091.43, 95% CI: 1.02\u20132.11). Conversely, participants enrolled in differentiated antiretroviral therapy (ART) delivery models based on community drug distribution prior to IAC had lower suppression compared to those managed through facility-based individualized care (aPR\u2009=\u20090.51, 95% CI: 0.35\u20130.74).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Virological outcomes among AYP receiving enhanced adherence support are shaped by a combination of individual and service delivery factors. Interventions that strengthen peer engagement and facilitate safe disclosure, alongside careful alignment of differentiated service delivery models with adherence needs, may improve treatment outcomes in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12981-026-00901-5","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T09:04:19Z","timestamp":1781341459000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multilevel factors associated with virological suppression among adolescents and young people with prior non-suppression receiving intensive adherence counselling in East-Central Uganda"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1828-6046","authenticated-orcid":false,"given":"David Livingstone","family":"Ejalu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Namutundu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean Steven","family":"Puleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Acen","family":"Joy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziadah","family":"Nankinga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella Immaculate","family":"Akech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanita","family":"Nangendo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Bakeera-Kitaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achilles","family":"Katamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne R.","family":"Katahoire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Kalyango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adithya","family":"Cattamanchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred C.","family":"Semitala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses R.","family":"Kamya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"901_CR1","unstructured":"UNAIDS, Global HIV, AIDS statistics\u2014Fact sheet. UNAIDS. 2025. https:\/\/www.unaids.org\/en\/resources\/fact-sheet. Accessed 26 Dec 2025."},{"key":"901_CR2","unstructured":"UNICEF, Adolescent HIV, treatment., UNICEF DATA. 2025. https:\/\/data.unicef.org\/topic\/hivaids\/adolescent-hiv-treatment\/. Accessed 26 Dec 2025."},{"key":"901_CR3","unstructured":"UAC, Uganda AIDS, Commission. 2025. Fact sheets on HIV & AIDS Epidemic in Uganda. https:\/\/uac.go.ug\/index.php\/easy-customization\/custom-404-page-and-offline-page. Accessed 2026 Apr 29."},{"key":"901_CR4","unstructured":"UNICEF, Adolescent HIV, treatment., UNICEF DATA. 2025. https:\/\/data.unicef.org\/topic\/hivaids\/adolescent-hiv-treatment\/. Accessed 27 Apr 2026."},{"issue":"12","key":"901_CR5","doi-asserted-by":"publisher","first-page":"e766","DOI":"10.1016\/S2352-3018(21)00265-4","volume":"8","author":"WM Han","year":"2021","unstructured":"Han WM, Law MG, Egger M, Wools-Kaloustian K, Moore R, McGowan C, et al. Global estimates of viral suppression in children and adolescents and adults on antiretroviral therapy adjusted for missing viral load measurements: a multiregional, retrospective cohort study in 31 countries. Lancet HIV. 2021;8(12):e766\u201375. https:\/\/doi.org\/10.1016\/S2352-3018(21)00265-4.","journal-title":"Lancet HIV"},{"issue":"6","key":"901_CR6","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1097\/COH.0000000000000880","volume":"19","author":"N Rakhmanina","year":"2024","unstructured":"Rakhmanina N, Foster C, Agwu A. Adolescents and young adults with HIV and unsuppressed viral load: where do we go from here? Curr Opin HIV AIDS. 2024;19(6):368\u201376. https:\/\/doi.org\/10.1097\/COH.0000000000000880.","journal-title":"Curr Opin HIV AIDS"},{"key":"901_CR7","unstructured":"UNAIDS, UNAIDS. 2021 UNAIDS Global AIDS Update\u2014Confronting inequalities\u2014Lessons for pandemic responses from 40 years of AIDS. 2021. https:\/\/www.unaids.org\/en\/resources\/documents\/2021\/2021-global-aids-update. Accessed 31 Mar 2022."},{"issue":"6","key":"901_CR8","doi-asserted-by":"publisher","first-page":"e0000418","DOI":"10.1371\/journal.pgph.0000418","volume":"2","author":"J Villiera","year":"2022","unstructured":"Villiera J, Katsabola H, Bvumbwe M, Mhango J, Khosa J, Silverstein A, et al. Factors associated with antiretroviral therapy adherence among adolescents living with HIV in the era of isoniazid preventive therapy as part of HIV care. PLOS Glob Public Health. 2022;2(6):e0000418. https:\/\/doi.org\/10.1371\/journal.pgph.0000418.","journal-title":"PLOS Glob Public Health"},{"key":"901_CR9","unstructured":"UPHIA. UPHIA_Final_Report_Revise_07.11.2019_Final_for-web.pdf. 2019. https:\/\/phia.icap.columbia.edu\/wp-content\/uploads\/2019\/07\/UPHIA_Final_Report_Revise_07.11.2019_Final_for-web.pdf. Accessed 30 Mar 2022."},{"key":"901_CR10","unstructured":"Uganda Population-Based UPHIA, Impact Assessment HIV. UPHIA 2020-2021-Summary-Sheet. 2022. https:\/\/phia.icap.columbia.edu\/wp-content\/uploads\/2022\/08\/UPHIA-Summary-Sheet-2020.pdf. Accessed 8 Oct 2023."},{"key":"901_CR11","unstructured":"MOH. Consolidated Guidelines for Prevention and Treatment of HIV in Uganda. Ministry of Health Knowledge Management Portal. 2020. http:\/\/library.health.go.ug\/publications\/hivaids\/consolidated-guidelines-prevention-and-treatment-hiv-uganda. Accessed 31 Mar 2022."},{"key":"901_CR12","doi-asserted-by":"publisher","first-page":"553","DOI":"10.2147\/HIV.S393093","volume":"14","author":"H Beja","year":"2022","unstructured":"Beja H, Daisy N, Edek MT, Kobusinge V, Akaki O, Owachgiu IO, et al. Barriers and Facilitators to Successful Intensive Adherence Counseling in Rural Northern Uganda: An Exploratory Interview with HIV-Positive Clients Using the COM-B Framework. HIVAIDS Auckl NZ. 2022;14:553\u201363. https:\/\/doi.org\/10.2147\/HIV.S393093.","journal-title":"HIVAIDS Auckl NZ"},{"key":"901_CR13","doi-asserted-by":"publisher","unstructured":"Izudi J, Castelnuovo B, King R, Cattamanchi A. Impact of intensive adherence counseling on viral load suppression and mortality among people living with HIV in Kampala, Uganda: A regression discontinuity design. Zakumumpa H, editor. PLOS Glob Public Health. 2023;3(8):e0002240. https:\/\/doi.org\/10.1371\/journal.pgph.0002240.","DOI":"10.1371\/journal.pgph.0002240"},{"issue":"1","key":"901_CR14","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1186\/s12879-021-06862-6","volume":"21","author":"Z Lukyamuzi","year":"2021","unstructured":"Lukyamuzi Z, Etajak S, Katairo T, Mukunya D, Tetui M, Ssenyonjo A, et al. Effect and implementation experience of intensive adherence counseling in a public HIV care center in Uganda: a mixed-methods study. BMC Infect Dis. 2021;21(1):1168. https:\/\/doi.org\/10.1186\/s12879-021-06862-6.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"901_CR15","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1186\/s12913-024-11528-5","volume":"24","author":"SP Okot","year":"2024","unstructured":"Okot SP, Izudi J, Ssenyonga R, Babirye JN. Factors associated with completion of intensive adherence counseling among people living with HIV at a large referral hospital in Uganda: a retrospective analysis. BMC Health Serv Res. 2024;24(1):1093. https:\/\/doi.org\/10.1186\/s12913-024-11528-5.","journal-title":"BMC Health Serv Res"},{"key":"901_CR16","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.ijid.2021.08.057","volume":"112","author":"B Kikaire","year":"2021","unstructured":"Kikaire B, Ssemanda M, Asiimwe A, Nakanwagi M, Rwegyema T, Seruwagi G, et al. HIV viral load suppression following intensive adherence counseling among people living with HIV on treatment at military-managed health facilities in Uganda. Int J Infect Dis. 2021;112:45\u201351. https:\/\/doi.org\/10.1016\/j.ijid.2021.08.057.","journal-title":"Int J Infect Dis"},{"issue":"1","key":"901_CR17","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s12913-019-3963-y","volume":"19","author":"E Nasuuna","year":"2019","unstructured":"Nasuuna E, Kigozi J, Muwanguzi PA, Babirye J, Kiwala L, Muganzi A, et al. Challenges faced by caregivers of virally non-suppressed children on the intensive adherence counselling program in Uganda: a qualitative study. BMC Health Serv Res. 2019;19(1):150. https:\/\/doi.org\/10.1186\/s12913-019-3963-y.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"901_CR18","doi-asserted-by":"publisher","first-page":"2294","DOI":"10.1186\/s12889-021-12366-4","volume":"21","author":"G Ndikabona","year":"2021","unstructured":"Ndikabona G, Alege JB, Kirirabwa NS, Kimuli D. Unsuppressed viral load after intensive adherence counselling in rural eastern Uganda: a case of Kamuli district, Uganda. BMC Public Health. 2021;21(1):2294. https:\/\/doi.org\/10.1186\/s12889-021-12366-4.","journal-title":"BMC Public Health"},{"issue":"1","key":"901_CR19","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s12981-023-00513-3","volume":"20","author":"C Nakaye","year":"2023","unstructured":"Nakaye C, Mukiza N, Mawanda D, Kataike H, Kaganzi H, Ahimbisibwe GM, et al. Viral load suppression after intensive adherence counselling among adult people living with HIV at Kiswa health centre, Kampala: a retrospective cohort study. Secondary data analysis. AIDS Res Ther. 2023;20(1):18. https:\/\/doi.org\/10.1186\/s12981-023-00513-3.","journal-title":"AIDS Res Ther"},{"key":"901_CR20","doi-asserted-by":"crossref","unstructured":"Apio A, Soita DJ, Masaba JP, Matovu JKB, Mukunya D, Ojera S. Factors associated with Virological non-suppression among adult PLHIV after receiving Intensive Adherence Counseling at Taso Mbale, Eastern Uganda: A Cross-sectional Study. Res Square. 2024. https:\/\/doi.org\/10.21203\/rs.3.rs-3975082\/v1. https:\/\/www.researchsquare.com\/article\/rs-3975082\/v1. Accessed 14 Jun 2025.","DOI":"10.21203\/rs.3.rs-3975082\/v1"},{"key":"901_CR21","unstructured":"WHO. Adherence to Long-term Therapies: Evidence for Action. World Health Organization; 2003. p. 232."},{"key":"901_CR22","unstructured":"UPHIA. Uganda Population Based Impact Assessment (UPHIA): 2020 Preliminary Results. 2022. https:\/\/www.mediacentre.go.ug\/media\/release-preliminary-results-2020-uganda-population-based-hiv-impact-assessment"},{"key":"901_CR23","unstructured":"MOH. Consolidated guidelines for the prevention and treatment of HIV and AIDS in Uganda. 2022. 2023. https:\/\/dsduganda.com\/wp-content\/uploads\/2023\/05\/Consolidated-HIV-and-AIDS-Guidelines-20230516.pdf"},{"issue":"9","key":"901_CR24","doi-asserted-by":"publisher","first-page":"e049452","DOI":"10.1136\/bmjopen-2021-049452","volume":"11","author":"FK Munyayi","year":"2021","unstructured":"Munyayi FK, van Wyk B. Interventions for improving treatment outcomes in adolescents on antiretroviral therapy with unsuppressed viral loads: a systematic review protocol. BMJ Open. 2021;11(9):e049452. https:\/\/doi.org\/10.1136\/bmjopen-2021-049452.","journal-title":"BMJ Open"},{"key":"901_CR25","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1186\/s12879-015-1265-5","volume":"15","author":"N Nabukeera-Barungi","year":"2015","unstructured":"Nabukeera-Barungi N, Elyanu P, Asire B, Katureebe C, Lukabwe I, Namusoke E, et al. Adherence to antiretroviral therapy and retention in care for adolescents living with HIV from 10 districts in Uganda. BMC Infect Dis. 2015;15:520. https:\/\/doi.org\/10.1186\/s12879-015-1265-5.","journal-title":"BMC Infect Dis"},{"key":"901_CR26","volume-title":"progress towards the 90-90-90 targets","author":"AIDS Ending","year":"2017","unstructured":"UNAIDS, Ending AIDS. progress towards the 90-90-90 targets. Geneva: Joint United Nations Programme on HIV. AIDS. Geneva. 2017."},{"key":"901_CR27","doi-asserted-by":"crossref","unstructured":"UNAIDS. Young people and HIV. 2021;20.","DOI":"10.12968\/cypn.2021.7.20"},{"key":"901_CR28","unstructured":"UNICEF, Adolescent HIV, prevention. UNICEF DATA. 2021. https:\/\/data.unicef.org\/topic\/hivaids\/adolescents-young-people\/"},{"issue":"6","key":"901_CR29","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/j.jped.2014.04.007","volume":"90","author":"MLS Cruz","year":"2014","unstructured":"Cruz MLS, Cardoso CAA, Darmont MQ, Souza E, Andrade SD, D\u2019Al Fabbro MM, et al. Viral suppression and adherence among HIV-infected children and adolescents on antiretroviral therapy: results of a multicenter study. J Pediatr (Rio J). 2014;90(6):563\u201371. https:\/\/doi.org\/10.1016\/j.jped.2014.04.007.","journal-title":"J Pediatr (Rio J)"},{"issue":"1","key":"901_CR30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4102\/curationis.v45i1.2312","volume":"45","author":"S Mabizela","year":"2022","unstructured":"Mabizela S, van Wyk B. Viral suppression among adolescents on HIV treatment in the Sedibeng District, Gauteng province. Curationis. 2022;45(1):1\u20138. https:\/\/doi.org\/10.4102\/curationis.v45i1.2312.","journal-title":"Curationis"},{"issue":"1","key":"901_CR31","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s41182-019-0135-z","volume":"47","author":"J Natukunda","year":"2019","unstructured":"Natukunda J, Kirabira P, Ong KIC, Shibanuma A, Jimba M. Virologic failure in HIV-positive adolescents with perfect adherence in Uganda: a cross-sectional study. Trop Med Health. 2019;47(1):8. https:\/\/doi.org\/10.1186\/s41182-019-0135-z.","journal-title":"Trop Med Health"},{"issue":"3","key":"901_CR32","first-page":"98","volume":"44","author":"S Bennett","year":"1991","unstructured":"Bennett S, Woods T, Liyanage WM, Smith DL. A simplified general method for cluster-sample surveys of health in developing countries. World Health Stat Q Rapp Trimest Stat Sanit Mond. 1991;44(3):98\u2013106.","journal-title":"World Health Stat Q Rapp Trimest Stat Sanit Mond"},{"issue":"2","key":"901_CR33","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/j.0361-3666.2006.00315.x","volume":"30","author":"R Kaiser","year":"2006","unstructured":"Kaiser R, Woodruff BA, Bilukha O, Spiegel PB, Salama P. Using Design Effects From Previous Cluster Surveys to Guide Sample Size Calculation in Emergency Settings. Disasters. 2006;30(2):199\u2013211. https:\/\/doi.org\/10.1111\/j.0361-3666.2006.00315.x.","journal-title":"Disasters"},{"issue":"Suppl 1","key":"901_CR34","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1007\/s11524-006-9106-x","volume":"83","author":"MJ Salganik","year":"2006","unstructured":"Salganik MJ, Variance, Estimation. Design Effects, and Sample Size Calculations for Respondent-Driven Sampling. J Urban Health Bull N Y Acad Med. 2006;83(Suppl 1):98\u2013112. https:\/\/doi.org\/10.1007\/s11524-006-9106-x.","journal-title":"J Urban Health Bull N Y Acad Med"},{"issue":"6","key":"901_CR35","doi-asserted-by":"publisher","first-page":"e0305129","DOI":"10.1371\/journal.pone.0305129","volume":"19","author":"GA Namayanja","year":"2024","unstructured":"Namayanja GA, Silva J, de FD, Elur B, Nasirumbi PM, Raizes E, Ssempiira J, et al. High viral suppression rates among PLHIV on dolutegravir who had an initial episode of viral non-suppression in Uganda September 2020\u2013July 2021. PLoS ONE. 2024;19(6):e0305129. https:\/\/doi.org\/10.1371\/journal.pone.0305129.","journal-title":"PLoS ONE"},{"issue":"1","key":"901_CR36","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s12982-025-00386-z","volume":"22","author":"HM Bakari","year":"2025","unstructured":"Bakari HM, Alo O, Mbwana MS, Salim SM, Ally ZM, Musoke R, et al. Enhanced adherence counselling completion rates, viral load suppression in people with HIV in Africa: systematic review and meta-analysis. Discov Public Health. 2025;22(1):12. https:\/\/doi.org\/10.1186\/s12982-025-00386-z.","journal-title":"Discov Public Health"},{"issue":"1","key":"901_CR37","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1186\/s12889-018-5964-x","volume":"18","author":"E Nasuuna","year":"2018","unstructured":"Nasuuna E, Kigozi J, Babirye L, Muganzi A, Sewankambo NK, Nakanjako D. Low HIV viral suppression rates following the intensive adherence counseling (IAC) program for children and adolescents with viral failure in public health facilities in Uganda. BMC Public Health. 2018;18(1):1048. https:\/\/doi.org\/10.1186\/s12889-018-5964-x.","journal-title":"BMC Public Health"},{"issue":"1","key":"901_CR38","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1186\/s12981-024-00661-0","volume":"21","author":"Z Lukyamuzi","year":"2024","unstructured":"Lukyamuzi Z, Ibanda H, Ggita J, Mawanda D, Gati BM, Nakalega R, et al. Brief communication: The extent and determinants of viral suppression among patients on protease inhibitor-based Anti-retro-viral therapy undergoing intensive adherence counselling in a public HIV care center in Uganda. AIDS Res Ther. 2024;21(1):74. https:\/\/doi.org\/10.1186\/s12981-024-00661-0.","journal-title":"AIDS Res Ther"},{"issue":"1","key":"901_CR39","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1093\/jpepsy\/jsy076","volume":"44","author":"V Dinaj-Koci","year":"2019","unstructured":"Dinaj-Koci V, Wang B, Naar-King S, MacDonell KK. A Multi-Site Study of Social Cognitive Factors Related to Adherence Among Youth Living With HIV in the New Era of Antiretroviral Medication. J Pediatr Psychol. 2019;44(1):98\u2013109. https:\/\/doi.org\/10.1093\/jpepsy\/jsy076.","journal-title":"J Pediatr Psychol"},{"issue":"11","key":"901_CR40","doi-asserted-by":"publisher","first-page":"141","DOI":"10.5539\/gjhs.v11n11p141","volume":"11","author":"BF Mayeye","year":"2019","unstructured":"Mayeye BF, Goon DT, Yako EM. An Exploratory Study of the Determinants of Adherence to Antiretroviral Therapy by Adolescents and Youths in the Eastern Cape, South Africa. Glob J Health Sci. 2019;11(11):141. https:\/\/doi.org\/10.5539\/gjhs.v11n11p141.","journal-title":"Glob J Health Sci"},{"key":"901_CR41","doi-asserted-by":"publisher","unstructured":"Kamangu JWN, Mboweni SH. Factors impacting ART adherence among HIV-positive older adolescents and younger adults in Namibia: a qualitative analysis. 2024. https:\/\/doi.org\/10.2174\/0118749445299654240402033559.","DOI":"10.2174\/0118749445299654240402033559"},{"key":"901_CR42","doi-asserted-by":"publisher","unstructured":"Gordon TP, Talbert M, Mugisha MK, Herbert AE. Factors associated with HIV viral suppression among adolescents in Kabale district, South Western Uganda. Byrareddy SN, editor. PLOS ONE. 2022;17(8):e0270855. https:\/\/doi.org\/10.1371\/journal.pone.0270855","DOI":"10.1371\/journal.pone.0270855"},{"key":"901_CR43","doi-asserted-by":"publisher","first-page":"71","DOI":"10.2147\/HIV.S401611","volume":"15","author":"C Nimwesiga","year":"2023","unstructured":"Nimwesiga C, Taremwa IM, Nakanjako D, Nasuuna E. Factors Associated with Retention in HIV Care Among HIV-Positive Adolescents in Public Antiretroviral Therapy Clinics in Ibanda District, Rural South Western Uganda. HIVAIDS - Res Palliat Care. 2023;15:71\u201381. https:\/\/doi.org\/10.2147\/HIV.S401611.","journal-title":"HIVAIDS - Res Palliat Care"},{"issue":"04","key":"901_CR44","doi-asserted-by":"publisher","first-page":"685","DOI":"10.4236\/aid.2022.124048","volume":"12","author":"AN Agbornkwai","year":"2022","unstructured":"Agbornkwai AN, Bita AIG, Mabouna SA, Esa I, Ngongheh AB, Ketum AS, et al. Enhanced Adherence Counselling, Support Groups and Viral Load Suppression amongst HIV-Positive Adolescents in a Tertiary Health Care Facility in Cameroon. Adv Infect Dis. 2022;12(04):685\u2013702. https:\/\/doi.org\/10.4236\/aid.2022.124048.","journal-title":"Adv Infect Dis"},{"issue":"10","key":"901_CR45","doi-asserted-by":"publisher","first-page":"1468","DOI":"10.1097\/QAD.0000000000003945","volume":"38","author":"A Wasilwa","year":"2024","unstructured":"Wasilwa A, Amadi E, Ramadhani HO, Lascko T, Ndaga A, Makokha V, et al. Impact of enhanced adherence counselling on viral re-suppression among adolescents and young persons with persistent viremia. AIDS. 2024;38(10):1468\u201375. https:\/\/doi.org\/10.1097\/QAD.0000000000003945.","journal-title":"AIDS"},{"issue":"S5","key":"901_CR46","doi-asserted-by":"publisher","first-page":"e25570","DOI":"10.1002\/jia2.25570","volume":"23","author":"S Bernays","year":"2020","unstructured":"Bernays S, Tshuma M, Willis N, Mvududu K, Chikeya A, Mufuka J, et al. Scaling up peer-led community\u2010based differentiated support for adolescents living with HIV: keeping the needs of youth peer supporters in mind to sustain success. J Int AIDS Soc. 2020;23(S5):e25570. https:\/\/doi.org\/10.1002\/jia2.25570.","journal-title":"J Int AIDS Soc"},{"issue":"4","key":"901_CR47","doi-asserted-by":"publisher","first-page":"e0230703","DOI":"10.1371\/journal.pone.0230703","volume":"15","author":"JA Denison","year":"2020","unstructured":"Denison JA, Burke VM, Miti S, Nonyane BAS, Frimpong C, Merrill KG, et al. Project YES! Youth Engaging for Success: A randomized controlled trial assessing the impact of a clinic-based peer mentoring program on viral suppression, adherence and internalized stigma among HIV-positive youth (15\u201324 years) in Ndola, Zambia. PLoS ONE. 2020;15(4):e0230703. https:\/\/doi.org\/10.1371\/journal.pone.0230703.","journal-title":"PLoS ONE"},{"issue":"2","key":"901_CR48","doi-asserted-by":"publisher","first-page":"2","DOI":"10.52088\/ijesty.v5i2.765","volume":"5","author":"MY Tahir","year":"2025","unstructured":"Tahir MY, Taslim M, Wardani D. Analysis of Viral Load Values in PLHIV Receiving Peer Support During Six Months of Treatment. Int J Eng Sci Inf Technol. 2025;5(2):2. https:\/\/doi.org\/10.52088\/ijesty.v5i2.765.","journal-title":"Int J Eng Sci Inf Technol"},{"key":"901_CR49","doi-asserted-by":"publisher","first-page":"116595","DOI":"10.1016\/j.socscimed.2024.116595","volume":"343","author":"J Izudi","year":"2024","unstructured":"Izudi J, Cattamanchi A, Castelnuovo B, King R. Barriers and facilitators to viral load suppression among people living with HIV following intensive adherence counseling in Kampala, Uganda: A qualitative study. Soc Sci Med. 2024;343:116595. https:\/\/doi.org\/10.1016\/j.socscimed.2024.116595.","journal-title":"Soc Sci Med"},{"key":"901_CR50","doi-asserted-by":"publisher","unstructured":"Simms V, Chinoda S. Accessed. Effectiveness of a peer-led adolescent mental health intervention on HIV virological suppression and mental health in Zimbabwe: Baseline and Endline questionnaires [Data Collection]. London, United Kingdom: London School of Hygiene & Tropical Medicine: 2021 https:\/\/doi.org\/10.17037\/DATA.00002142","DOI":"10.17037\/DATA.00002142"},{"issue":"40","key":"901_CR51","doi-asserted-by":"publisher","first-page":"e30624","DOI":"10.1097\/MD.0000000000030624","volume":"101","author":"RO Masaba","year":"2022","unstructured":"Masaba RO, Woelk G, Herrera N, Siamba S, Simiyu R, Ochanda B, et al. Standardized enhanced adherence counseling for improved HIV viral suppression among children and adolescents in Homa Bay and Turkana Counties, Kenya. Med (Baltim). 2022;101(40):e30624. https:\/\/doi.org\/10.1097\/MD.0000000000030624.","journal-title":"Med (Baltim)"},{"key":"901_CR52","doi-asserted-by":"crossref","unstructured":"Olagunju FA, Oninla SO, Agelebe E, Ayeni TO, Akinleye CA, Omoboyeje AO, et al. Impact of Enhanced Adherence Counselling on PLHIV with Unsuppressed Viral Load and Prevalence of Virological Failure in Osogbo, Nigeria: A Quasi-experimental Study. Rev. 2025. https:\/\/doi.org\/10.21203\/rs.3.rs-7990487\/v1. https:\/\/www.researchsquare.com\/article\/rs-7990487\/v1. Accessed 25 May 2026.","DOI":"10.21203\/rs.3.rs-7990487\/v1"},{"key":"901_CR53","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/4887202","volume":"2022","author":"MT Mutambanengwe-Jacob","year":"2022","unstructured":"Mutambanengwe-Jacob MT, Maponga CC, Amico KR, Ngara B, Yende-Zuma N, Chawana TD, et al. Impact of Motivational Enhanced Adherence Counseling and Point-of-Care Viral Load Monitoring on Viral Load Outcome in Women on Life-Long ART: A Randomized Pilot Study. AIDS Res Treat. 2022;2022:1\u201313. https:\/\/doi.org\/10.1155\/2022\/4887202.","journal-title":"AIDS Res Treat"},{"issue":"10","key":"901_CR54","doi-asserted-by":"publisher","first-page":"e1305","DOI":"10.1016\/S2214-109X(20)30313-2","volume":"8","author":"RV Barnabas","year":"2020","unstructured":"Barnabas RV, Szpiro AA, van Rooyen H, Asiimwe S, Pillay D, Ware NC, et al. Community-based antiretroviral therapy versus standard clinic-based services for HIV in South Africa and Uganda (DO ART): a randomised trial. Lancet Glob Health. 2020;8(10):e1305\u201315. https:\/\/doi.org\/10.1016\/S2214-109X(20)30313-2.","journal-title":"Lancet Glob Health"},{"key":"901_CR55","doi-asserted-by":"publisher","unstructured":"Brian J, Waiswa S, Balinaine J, Lomuria R, Nabutanyi GG, Ongala E et al. Impact of Differentiated Service Delivery Models on Retention and Viral Load Suppression among Art Clients in Communities in Eastern Uganda. In Review: 2022. https:\/\/www.researchsquare.com\/article\/rs-1427840\/v1https:\/\/doi.org\/10.21203\/rs.3.rs-1427840\/v1. Accessed 13 Apr 2025.","DOI":"10.21203\/rs.3.rs-1427840\/v1"},{"key":"901_CR56","doi-asserted-by":"publisher","unstructured":"Midtb\u00f8 V, Shirima,Violeth, Skovdal, Morten, and, Daniel M. How disclosure and antiretroviral therapy help HIV-infected adolescents in sub-Saharan Africa cope with stigma. Afr J AIDS Res. 2012;11(3):261\u201371. https:\/\/doi.org\/10.2989\/16085906.2012.734987","DOI":"10.2989\/16085906.2012.734987"},{"key":"901_CR57","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00772","author":"P Nabunya","year":"2020","unstructured":"Nabunya P, Byansi W, Sensoy Bahar O, McKay M, Ssewamala FM, Damulira C. Factors Associated With HIV Disclosure and HIV-Related Stigma Among Adolescents Living With HIV in Southwestern Uganda. Front Psychiatry. 2020. https:\/\/doi.org\/10.3389\/fpsyt.2020.00772.","journal-title":"Front Psychiatry"},{"issue":"sup1","key":"901_CR58","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1080\/09540121.2015.1051501","volume":"27","author":"C N\u00f6stlinger","year":"2015","unstructured":"N\u00f6stlinger C, Bakeera-Kitaka. Sabrina, Buyze, Jozefien, Loos, Jasna, and Buv\u00e9 A. Factors influencing social self-disclosure among adolescents living with HIV in Eastern Africa. AIDS Care. 2015;27(sup1):36\u201346. https:\/\/doi.org\/10.1080\/09540121.2015.1051501.","journal-title":"AIDS Care"}],"container-title":["AIDS Research and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12981-026-00901-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12981-026-00901-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12981-026-00901-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T02:41:21Z","timestamp":1787798481000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12981-026-00901-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["901"],"URL":"https:\/\/doi.org\/10.1186\/s12981-026-00901-5","relation":{},"ISSN":["1742-6405"],"issn-type":[{"value":"1742-6405","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]},"assertion":[{"value":"24 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study complies with the Declaration of Helsinki. The study protocol received ethical clearance and a waiver of informed consent for retrospective review of patient records from the Makerere University School of Medicine Research and Ethics Committee (SOMREC), under approval reference Mak-SOMREC 2022\u2009\u2212\u2009396, and from the Uganda National Council for Science and Technology (UNCST), under approval number HS3807ES. Additionally, formal administrative authorization was obtained from the Chief Administrative Officers and District Health Officers of the respective districts in which data collection was conducted.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"80"}}