{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:52:36Z","timestamp":1779324756142,"version":"3.51.4"},"reference-count":74,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T00:00:00Z","timestamp":1619395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["UG3HD096926"],"award-info":[{"award-number":["UG3HD096926"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Adolescents living with HIV (ALHIV) 15\u201319 years of age are a growing proportion of all people living with HIV globally and the population includes adolescents with vertically acquired HIV (AVH) and behaviorally acquired HIV (ABH).<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We conducted a survey to measure sociodemographic characteristics, educational status, health history, and antiretroviral therapy (ART) adherence among a convenience sample of ALHIV at three government health facilities in 2019 in Nampula, Mozambique. ALHIV 15\u201319 years on ART, including females attending antenatal care, were eligible. Routine HIV care data were extracted from medical charts. Classification of ALHIV by mode of transmission was based on medical charts and survey data. ALHIV who initiated ART &lt;15 years or reported no sex were considered AVH; all others ABH. Frequencies were compared by sex, and within sex, by mode of transmission (AVH vs. ABH) using Chi-square, Fishers exact tests and Wilcoxon rank-sum tests.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Among 208 ALHIV, 143 (69%) were female and median age was 18 years [interquartile range (IQR) 16\u201319]. Just over half of ALHIV (53%) were in or had completed secondary or higher levels of education; the most common reason for not being in school reported by 36% of females was pregnancy or having a child. Of all ALHIV, 122 (59%) had VL data, 62% of whom were &lt;1000 copies\/mL. Almost half (46%) of ALHIV reported missing ARVs \u2265 1 day in the past month (62% of males vs. 39% of females; p = 0.003). Just over half (58%) of ALHIV in relationships had disclosed their HIV status: 13% of males vs. 69% of females (p&lt;0.001). Among sexually active males, 61% reported using a condom at last sex compared to 26% of females (p&lt;0.001). Among female ALHIV, 50 (35%) were AVH and 93 (65%) were ABH, 67% of whom were not in school compared to 16% of ABH, (p&lt;0.001).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Discussion<\/jats:title><jats:p>Data from our study underscore the high level of deprivation among ALHIV enrolled in HIV care in Mozambique, as well as important disparities by sex and mode of transmission. These data can inform the development of effective interventions for this complex and important population.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0250218","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T18:22:33Z","timestamp":1619461353000},"page":"e0250218","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Characteristics of adolescents aged 15-19 years living with vertically and horizontally acquired HIV in Nampula, Mozambique"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-8972","authenticated-orcid":true,"given":"Chloe A.","family":"Teasdale","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsty","family":"Brittain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Zerbe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claude Ann","family":"Mellins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joana","family":"Falcao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleny","family":"Couto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduarda","family":"Pimentel De Gusmao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirriah","family":"Vitale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bill","family":"Kapogiannis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa Beatriz","family":"Simione","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Landon","family":"Myer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0748-5974","authenticated-orcid":true,"given":"Joanne","family":"Mantell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Desmond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine J.","family":"Abrams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"key":"pone.0250218.ref001","unstructured":"UNAIDS. Global AIDS Update 2020: Seizing the moment. Geneva, Switzerland: UNAIDS; 2020."},{"issue":"3","key":"pone.0250218.ref002","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.pec.2005.05.006","article-title":"HIV treatment-related knowledge and self-efficacy among caregivers of HIV-infected children","volume":"61","author":"O Nicholson","year":"2006","journal-title":"Patient education and counseling"},{"issue":"4","key":"pone.0250218.ref003","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/QAD.0000000000000054","article-title":"High attrition before and after ART initiation among youth (15\u201324 years of age) enrolled in HIV care","volume":"28","author":"MR Lamb","year":"2014","journal-title":"Aids"},{"issue":"18","key":"pone.0250218.ref004","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.1097\/QAD.0000000000000473","article-title":"Characteristics and outcomes of HIV-infected youth and young adolescents enrolled in HIV care in Kenya","volume":"28","author":"E Koech","year":"2014","journal-title":"Aids"},{"issue":"1","key":"pone.0250218.ref005","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/QAI.0b013e318199072e","article-title":"Antiretroviral therapy adherence, virologic and immunologic outcomes in adolescents compared with adults in southern Africa","volume":"51","author":"JB Nachega","year":"2009","journal-title":"Journal of acquired immune deficiency syndromes"},{"issue":"6","key":"pone.0250218.ref006","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1089\/aid.2012.0215","article-title":"Treatment outcomes of HIV-infected adolescents attending public-sector HIV clinics across Gauteng and Mpumalanga, South Africa","volume":"29","author":"D Evans","year":"2013","journal-title":"AIDS research and human retroviruses"},{"key":"pone.0250218.ref007","doi-asserted-by":"crossref","unstructured":"Low A, Teasdale CA, Brown K, Barradas DT, Mugurungi O, Sachathep K, et al. Epidemiology of HIV infection in adolescents in Southern Africa, and the burden of the undiagnosed: a multinational analysis of population-based survey data. 2020.","DOI":"10.1093\/cid\/ciab031"},{"issue":"3","key":"pone.0250218.ref008","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/COH.0000000000000449","article-title":"The global epidemiology of adolescents living with HIV: time for more granular data to improve adolescent health outcomes","volume":"13","author":"AL Slogrove","year":"2018","journal-title":"Current opinion in HIV and AIDS"},{"key":"pone.0250218.ref009","unstructured":"UNAIDS AIDS Data Repository 2020 [October 25, 2020]. https:\/\/adr.unaids.org\/naomi-data-package\/mozambique-naomi-data-2020."},{"key":"pone.0250218.ref010","unstructured":"UNAIDS. Women and HIV: A spotlight on adolescent girls and young women. Geneva, Switzerland2019."},{"issue":"Suppl 3","key":"pone.0250218.ref011","doi-asserted-by":"crossref","first-page":"S105","DOI":"10.1097\/QAI.0b013e31825cf4f5","article-title":"PEPFAR scale-up of pediatric HIV services: innovations, achievements, and challenges","volume":"60","author":"EJ Abrams","year":"2012","journal-title":"Journal of acquired immune deficiency syndromes"},{"key":"pone.0250218.ref012","unstructured":"UNAIDS. Start Free Stay Free: 2020 Progress Report. Geneva, Switzerland: UNAIDS; 2020."},{"key":"pone.0250218.ref013","unstructured":"UNAIDS. Start Free Stay Free AIDS Free. In: HIV\/AIDS JUNPo, editor. Geneva, Switzerland: UNAIDS; 2019."},{"issue":"11","key":"pone.0250218.ref014","doi-asserted-by":"crossref","first-page":"e1470","DOI":"10.1016\/S2214-109X(19)30404-8","article-title":"HIV incidence rates in adolescent girls and young women in sub-Saharan Africa","volume":"7","author":"SSA Karim","year":"2019","journal-title":"The Lancet Global health"},{"issue":"2","key":"pone.0250218.ref015","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.tics.2004.12.005","article-title":"Cognitive and affective development in adolescence","volume":"9","author":"L Steinberg","year":"2005","journal-title":"Trends Cogn Sci"},{"key":"pone.0250218.ref016","doi-asserted-by":"crossref","first-page":"18466","DOI":"10.7448\/IAS.16.1.18466","article-title":"Disclosure of HIV status to children in resource-limited settings: a systematic review","volume":"16","author":"RC Vreeman","year":"2013","journal-title":"Journal of the International AIDS Society"},{"key":"pone.0250218.ref017","doi-asserted-by":"crossref","first-page":"18650","DOI":"10.7448\/IAS.16.1.18650","article-title":"The challenges of success: adolescents with perinatal HIV infection","volume":"16","author":"LM Mofenson","year":"2013","journal-title":"Journal of the International AIDS Society"},{"issue":"Suppl 1","key":"pone.0250218.ref018","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1080\/09540121.2015.1071775","article-title":"Sex and secrecy: How HIV-status disclosure affects safe sex among HIV-positive adolescents","volume":"27","author":"E Toska","year":"2015","journal-title":"AIDS care"},{"issue":"Suppl 3","key":"pone.0250218.ref019","doi-asserted-by":"crossref","first-page":"21497","DOI":"10.7448\/IAS.20.4.21497","article-title":"Mental health challenges among adolescents living with HIV","volume":"20","author":"RC Vreeman","year":"2017","journal-title":"Journal of the International AIDS Society"},{"issue":"7","key":"pone.0250218.ref020","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/S1473-3099(13)70363-3","article-title":"Perinatally acquired HIV infection in adolescents from sub-Saharan Africa: a review of emerging challenges","volume":"14","author":"ED Lowenthal","year":"2014","journal-title":"The Lancet infectious diseases"},{"issue":"9","key":"pone.0250218.ref021","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/S2352-4642(20)30037-7","article-title":"Chronic comorbidities in children and adolescents with perinatally acquired HIV infection in sub-Saharan Africa in the era of antiretroviral therapy","volume":"4","author":"LJ Frigati","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"issue":"12","key":"pone.0250218.ref022","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1080\/1744666X.2018.1532290","article-title":"Adherence to medication in children and adolescents with asthma: methods for monitoring and intervention","volume":"14","author":"CJ Pearce","year":"2018","journal-title":"Expert Rev Clin Immunol"},{"key":"pone.0250218.ref023","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.yebeh.2017.12.013","article-title":"Adherence to antiepileptic drugs in adolescents with epilepsy","volume":"80","author":"AW Smith","year":"2018","journal-title":"Epilepsy & behavior: E&B"},{"issue":"4","key":"pone.0250218.ref024","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/MOP.0b013e32833a46a7","article-title":"Adherence challenges in the management of type 1 diabetes in adolescents: prevention and intervention","volume":"22","author":"JS Borus","year":"2010","journal-title":"Curr Opin Pediatr"},{"issue":"3","key":"pone.0250218.ref025","doi-asserted-by":"crossref","first-page":"e0229874","DOI":"10.1371\/journal.pone.0229874","article-title":"Awareness of HIV-positive status and linkage to treatment prior to pregnancy in the \"test and treat\" era: A national antenatal sentinel survey, 2017, South Africa","volume":"15","author":"S Woldesenbet","year":"2020","journal-title":"PloS one"},{"issue":"1","key":"pone.0250218.ref026","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/QAI.0000000000001176","article-title":"Gaps in Adolescent Engagement in Antenatal Care and Prevention of Mother-to-Child HIV Transmission Services in Kenya","volume":"74","author":"K Ronen","year":"2017","journal-title":"Journal of acquired immune deficiency syndromes"},{"issue":"1","key":"pone.0250218.ref027","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1186\/s12879-018-3480-3","article-title":"Utilization of \"prevention of mother-to-child transmission\" of HIV services by adolescent and young mothers in Mulago Hospital, Uganda","volume":"18","author":"M Mustapha","year":"2018","journal-title":"BMC infectious diseases"},{"issue":"6","key":"pone.0250218.ref028","doi-asserted-by":"crossref","first-page":"e0217693","DOI":"10.1371\/journal.pone.0217693","article-title":"\"I would love if there was a young woman to encourage us, to ease our anxiety which we would have if we were alone\": Adapting the Mothers2Mothers Mentor Mother Model for adolescent mothers living with HIV in Malawi","volume":"14","author":"NB Carbone","year":"2019","journal-title":"PloS one"},{"issue":"11","key":"pone.0250218.ref029","doi-asserted-by":"crossref","first-page":"e760","DOI":"10.1016\/S2352-3018(19)30234-6","article-title":"Adolescent HIV treatment in South Africa\u2019s national HIV programme: a retrospective cohort study","volume":"6","author":"M Maskew","year":"2019","journal-title":"The lancet HIV"},{"issue":"sup2","key":"pone.0250218.ref030","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1080\/09540121.2018.1476664","article-title":"Differing psychological vulnerabilities among behaviourally and perinatally HIV infected adolescents in South Africa\u2014implications for targeted health service provision","volume":"30","author":"L Sherr","year":"2018","journal-title":"AIDS care"},{"issue":"8","key":"pone.0250218.ref031","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1177\/0956462418758115","article-title":"Modes of HIV transmission among adolescents and young adults aged 10\u201324 years in Kenya","volume":"29","author":"BN Ng\u2019eno","year":"2018","journal-title":"International journal of STD & AIDS"},{"key":"pone.0250218.ref032","unstructured":"Eunice Kennedy Shriver National Institute of Child NIoH. Prevention and Treatment through a Comprehensive Care Continuum of HIV-affected Adolescents in Resource Contrained Settings, website. 2020 [https:\/\/www.nichd.nih.gov\/research\/supported\/PATC3H."},{"key":"pone.0250218.ref033","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1186\/1471-2458-13-482","article-title":"Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics","volume":"13","author":"S Baral","year":"2013","journal-title":"BMC public health"},{"key":"pone.0250218.ref034","first-page":"284","volume-title":"Psychological interventions and research with Latino populations","author":"JG Garc\u00eda","year":"1997"},{"issue":"11","key":"pone.0250218.ref035","doi-asserted-by":"crossref","first-page":"2700","DOI":"10.1007\/s10461-016-1406-x","article-title":"Validation of a New Three-Item Self-Report Measure for Medication Adherence","volume":"20","author":"IB Wilson","year":"2016","journal-title":"AIDS and behavior"},{"issue":"12","key":"pone.0250218.ref036","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.1007\/s10461-013-0610-1","article-title":"Cognitive and field testing of a new set of medication adherence self-report items for HIV care","volume":"18","author":"IB Wilson","year":"2014","journal-title":"AIDS and behavior"},{"issue":"Suppl 1","key":"pone.0250218.ref037","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1097\/QAD.0000000000000695","article-title":"\u2019HIV is like a tsotsi. ARVs are your guns\u2019: associations between HIV-disclosure and adherence to antiretroviral treatment among adolescents in South Africa","volume":"29","author":"LD Cluver","year":"2015","journal-title":"Aids"},{"issue":"1","key":"pone.0250218.ref038","doi-asserted-by":"crossref","first-page":"50","DOI":"10.2307\/2676360","article-title":"The dimensionality of stigma: a comparison of its impact on the self of persons with HIV\/AIDS and cancer","volume":"41","author":"BL Fife","year":"2000","journal-title":"J Health Soc Behav"},{"issue":"Suppl 1","key":"pone.0250218.ref039","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1080\/09540121.2015.1051501","article-title":"Factors influencing social self-disclosure among adolescents living with HIV in Eastern Africa","volume":"27","author":"C Nostlinger","year":"2015","journal-title":"AIDS care"},{"issue":"2","key":"pone.0250218.ref040","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1007\/s10865-012-9485-2","article-title":"Self-disclosure of serostatus by youth who are HIV-positive: a review","volume":"37","author":"CA Thoth","year":"2014","journal-title":"J Behav Med"},{"key":"pone.0250218.ref041","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1186\/1471-2393-13-200","article-title":"Understanding pregnancy planning in a low-income country setting: validation of the London measure of unplanned pregnancy in Malawi","volume":"13","author":"J Hall","year":"2013","journal-title":"BMC pregnancy and childbirth"},{"key":"pone.0250218.ref042","unstructured":"Program UND. UNDP Inequalities in human development in the 21st Century: Mozambique. New York, NY: UN; 2019."},{"key":"pone.0250218.ref043","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/s12889-016-2854-y","article-title":"\u2019Everyone has a secret they keep close to their hearts\u2019: challenges faced by adolescents living with HIV infection at the Kenyan coast","volume":"16","author":"A Abubakar","year":"2016","journal-title":"BMC public health"},{"issue":"6","key":"pone.0250218.ref044","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1089\/apc.2018.0320","article-title":"Recent Interventions to Improve Retention in HIV Care and Adherence to Antiretroviral Treatment Among Adolescents and Youth: A Systematic Review","volume":"33","author":"M Casale","year":"2019","journal-title":"AIDS patient care and STDs"},{"issue":"2","key":"pone.0250218.ref045","doi-asserted-by":"crossref","first-page":"e0228370","DOI":"10.1371\/journal.pone.0228370","article-title":"The long-term effects of a family based economic empowerment intervention (Suubi+Adherence) on suppression of HIV viral loads among adolescents living with HIV in southern Uganda: Findings from 5-year cluster randomized trial","volume":"15","author":"FM Ssewamala","year":"2020","journal-title":"PLoS One"},{"issue":"11","key":"pone.0250218.ref046","doi-asserted-by":"crossref","first-page":"3763","DOI":"10.1007\/s10461-018-2173-7","article-title":"Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda","volume":"22","author":"LG Bermudez","year":"2018","journal-title":"AIDS Behav"},{"issue":"10","key":"pone.0250218.ref047","doi-asserted-by":"crossref","first-page":"2797","DOI":"10.1007\/s10461-020-02822-4","article-title":"Interventions to Improve Antiretroviral Therapy Adherence Among Adolescents and Youth in Low- and Middle-Income Countries: A Systematic Review 2015\u20132019","volume":"24","author":"LK Reif","year":"2020","journal-title":"AIDS and behavior"},{"key":"pone.0250218.ref048","article-title":"Service delivery interventions to improve adolescents\u2019 linkage, retention and adherence to antiretroviral therapy and HIV care","author":"P MacPherson","year":"2015","journal-title":"Tropical medicine & international health: TM & IH"},{"issue":"1","key":"pone.0250218.ref049","doi-asserted-by":"crossref","first-page":"21771","DOI":"10.7448\/IAS.20.1.21771","article-title":"HIV, violence, blame and shame: pathways of risk to internalized HIV stigma among South African adolescents living with HIV","volume":"20","author":"M Pantelic","year":"2017","journal-title":"Journal of the International AIDS Society"},{"issue":"3","key":"pone.0250218.ref050","doi-asserted-by":"crossref","first-page":"261","DOI":"10.2989\/16085906.2012.734987","article-title":"How disclosure and antiretroviral therapy help HIV-infected adolescents in sub-Saharan Africa cope with stigma","volume":"11","author":"V Midtbo","year":"2012","journal-title":"Afr J AIDS Res"},{"key":"pone.0250218.ref051","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.puhe.2017.12.010","article-title":"Factors impacting antiretroviral therapy adherence among human immunodeficiency virus-positive adolescents in Sub-Saharan Africa: a systematic review","volume":"157","author":"N Ammon","year":"2018","journal-title":"Public Health"},{"key":"pone.0250218.ref052","doi-asserted-by":"crossref","first-page":"7375831","DOI":"10.1155\/2018\/7375831","article-title":"Health Risk Behaviour among Adolescents Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-Analysis","volume":"2018","author":"D Ssewanyana","year":"2018","journal-title":"Biomed Res Int"},{"issue":"9","key":"pone.0250218.ref053","doi-asserted-by":"crossref","first-page":"2746","DOI":"10.1007\/s10461-016-1539-y","article-title":"School, Supervision and Adolescent-Sensitive Clinic Care: Combination Social Protection and Reduced Unprotected Sex Among HIV-Positive Adolescents in South Africa","volume":"21","author":"E Toska","year":"2017","journal-title":"AIDS and behavior"},{"issue":"1","key":"pone.0250218.ref054","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1186\/s12889-018-5544-0","article-title":"Prevalence and correlates of HIV testing among adolescents 10\u201319 years in a post-conflict pastoralist community of Karamoja region, Uganda","volume":"18","author":"RN Ssebunya","year":"2018","journal-title":"BMC public health"},{"issue":"10","key":"pone.0250218.ref055","doi-asserted-by":"crossref","first-page":"e0186316","DOI":"10.1371\/journal.pone.0186316","article-title":"Reaching the \u2019first 90\u2019: Gaps in coverage of HIV testing among people living with HIV in 16 African countries","volume":"12","author":"S Staveteig","year":"2017","journal-title":"PloS one"},{"issue":"Suppl 3","key":"pone.0250218.ref056","doi-asserted-by":"crossref","first-page":"21520","DOI":"10.7448\/IAS.20.4.21520","article-title":"Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic","volume":"20","author":"AL Slogrove","year":"2017","journal-title":"Journal of the International AIDS Society"},{"issue":"6","key":"pone.0250218.ref057","doi-asserted-by":"crossref","first-page":"913","DOI":"10.3851\/IMP1644","article-title":"Self-reported adherence is more predictive of virological treatment response among patients with a lower tendency towards socially desirable responding","volume":"15","author":"PT Nieuwkerk","year":"2010","journal-title":"Antiviral therapy"},{"issue":"1","key":"pone.0250218.ref058","doi-asserted-by":"crossref","first-page":"21437","DOI":"10.7448\/IAS.20.1.21437","article-title":"High self-reported non-adherence to antiretroviral therapy amongst adolescents living with HIV in Malawi: barriers and associated factors","volume":"20","author":"MH Kim","year":"2017","journal-title":"Journal of the International AIDS Society"},{"issue":"7","key":"pone.0250218.ref059","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1007\/s10461-018-2155-9","article-title":"Beyond Social Desirability Bias: Investigating Inconsistencies in Self-Reported HIV Testing and Treatment Behaviors Among HIV-Positive Adults in North West Province, South Africa","volume":"22","author":"AC Mooney","year":"2018","journal-title":"AIDS and behavior"},{"issue":"1","key":"pone.0250218.ref060","doi-asserted-by":"crossref","first-page":"21218","DOI":"10.7448\/IAS.20.1.21218","article-title":"Adherence to antiretroviral therapy for HIV in sub-Saharan Africa and Asia: a comparative analysis of two regional cohorts","volume":"20","author":"R Bijker","year":"2017","journal-title":"Journal of the International AIDS Society"},{"issue":"Suppl 6","key":"pone.0250218.ref061","doi-asserted-by":"crossref","first-page":"20260","DOI":"10.7448\/IAS.18.7.20260","article-title":"Social protection: potential for improving HIV outcomes among adolescents","volume":"18","author":"LD Cluver","year":"2015","journal-title":"Journal of the International AIDS Society"},{"issue":"1","key":"pone.0250218.ref062","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1186\/s12889-018-5051-3","article-title":"Determinants of HIV infection among adolescent girls and young women aged 15\u201324 years in South Africa: a 2012 population-based national household survey","volume":"18","author":"M Mabaso","year":"2018","journal-title":"BMC public health"},{"issue":"1","key":"pone.0250218.ref063","doi-asserted-by":"crossref","first-page":"e0115290","DOI":"10.1371\/journal.pone.0115290","article-title":"Poverty, food insufficiency and HIV infection and sexual behaviour among young rural Zimbabwean women","volume":"10","author":"SJ Pascoe","year":"2015","journal-title":"PloS one"},{"issue":"1","key":"pone.0250218.ref064","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1089\/jwh.2008.1200","article-title":"Gender and poverty in South Africa in the era of HIV\/AIDS: a quantitative study","volume":"19","author":"O Shisana","year":"2010","journal-title":"Journal of women\u2019s health"},{"issue":"1","key":"pone.0250218.ref065","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/14681811.2017.1370368","article-title":"HIV Knowledge and Risk among Zambian Adolescent and Younger Adolescent Girls: Challenges and Solutions","volume":"18","author":"SA Butts","year":"2018","journal-title":"Sex Educ"},{"key":"pone.0250218.ref066","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12905-016-0326-2","article-title":"\"It is challenging\u2026 oh, nobody likes it!\": a qualitative study exploring Mozambican adolescents and young adults\u2019 experiences with contraception","volume":"16","author":"R Capurchande","year":"2016","journal-title":"BMC women\u2019s health"},{"issue":"8","key":"pone.0250218.ref067","doi-asserted-by":"crossref","first-page":"e0236352","DOI":"10.1371\/journal.pone.0236352","article-title":"Predictors of unmet need for contraception among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis","volume":"15","author":"BO Ahinkorah","year":"2020","journal-title":"PloS one"},{"key":"pone.0250218.ref068","unstructured":"UNESCO. Global School-based Student Health Survey: Mozambique 2015 Fact Sheet. Geneva, Switzerland2015."},{"issue":"Suppl 1","key":"pone.0250218.ref069","doi-asserted-by":"crossref","first-page":"e12721","DOI":"10.1111\/mcn.12721","article-title":"Rethinking integrated nutrition-health strategies to address micronutrient deficiencies in children under five in Mozambique","volume":"15","author":"M Picolo","year":"2019","journal-title":"Matern Child Nutr"},{"key":"pone.0250218.ref070","unstructured":"UNFPA. Adolescents and Youth Dashboard\u2014Mozambique 2020 [https:\/\/www.unfpa.org\/data\/adolescent-youth\/MZ."},{"issue":"7","key":"pone.0250218.ref071","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1086\/656361","article-title":"Undiagnosed HIV infection among adolescents seeking primary health care in Zimbabwe","volume":"51","author":"RA Ferrand","year":"2010","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"8","key":"pone.0250218.ref072","doi-asserted-by":"crossref","first-page":"e70447","DOI":"10.1371\/journal.pone.0070447","article-title":"Increasing adolescent HIV prevalence in Eastern Zimbabwe\u2014evidence of long-term survivors of mother-to-child transmission?","volume":"8","author":"JW Eaton","year":"2013","journal-title":"PloS one"},{"issue":"Suppl 3","key":"pone.0250218.ref073","doi-asserted-by":"crossref","first-page":"21591","DOI":"10.7448\/IAS.20.4.21591","article-title":"HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries","volume":"20","author":"D Mark","year":"2017","journal-title":"Journal of the International AIDS Society"},{"issue":"4","key":"pone.0250218.ref074","doi-asserted-by":"crossref","first-page":"e0231667","DOI":"10.1371\/journal.pone.0231667","article-title":"Expansion and scale-up of HIV care and treatment services in four countries over ten years","volume":"15","author":"CA Teasdale","year":"2020","journal-title":"PloS one"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0250218","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T13:20:04Z","timestamp":1619961604000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0250218"}},"subtitle":[],"editor":[{"given":"Claudia","family":"Marotta","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,4,26]]},"references-count":74,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0250218","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,26]]}}}