{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T07:16:32Z","timestamp":1771658192050,"version":"3.50.1"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Suboptimal utilization of antiretroviral therapy (ART) services remains a problem among adolescents in low- and middle-income countries, which has a negative impact on their response to treatment and increases the risk of developing resistance. Optimal use is essential to enhancing treatment efficacy. We investigated the optimal use of ART service and predictors among adolescents living with HIV (ALHIV) in northern Uganda.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We used a cross-sectional study design to collect quantitative data from 293 ALHIV at three health facilities in Lira municipality, northern Uganda. We used an interviewer-administered questionnaire and data abstraction form. Data were analysed using SPSS version 23 software. Descriptive analysis and logistic regressions were performed to determine the relationship between the predictor and outcome variables. Statistical significance was determined at P-value&lt;0.05 and the adjusted odds ratio with a 95% confidence interval was used.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The level of utilization of ART services was suboptimal among 27.6% (81\/293) of the participants, and only 63.1% (185\/293) were virally suppressed. Of the participants who were optimally utilizing ART services, the majority 86.8% (184\/212) were virally suppressed. Age 10\u201314 years (aOR = 3.34), the presence of both parents (aOR = 1.85), parental and peer reminders (aOR = 2.91) and (aOR = 0.49) respectively, and being on ART for five years or less were the characteristics related with optimal utilization of ART services.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions and recommendations<\/jats:title>\n<jats:p>Not all ALHIV used ART services to their full potential. However, factors such as participants\u2019 age, the presence of both parents, reminders from parents and peers, and being on ART for some time were all related to the optimal use of ART services. There is a need for developing strategies to increase family and peer support with a focus on older adolescents if the 95-95-95 goal is to be achieved in this age group.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0288410","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T17:35:58Z","timestamp":1689269758000},"page":"e0288410","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Utilization of antiretroviral therapy services and associated factors among adolescents living with HIV in northern Uganda: A cross-sectional study"],"prefix":"10.1371","volume":"18","author":[{"given":"Innocent","family":"Odongo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Arim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Ayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Murungi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Akullo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Docus","family":"Aceng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Oboke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Kumakech","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celestino","family":"Obua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Grace","family":"Auma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3859-349X","authenticated-orcid":true,"given":"Richard","family":"Nyeko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"pone.0288410.ref001","volume-title":"UNAIDS 2020 Global Report","author":"UNAIDS Data,","year":"2020"},{"key":"pone.0288410.ref002","author":"UNAIDS","year":"2015","journal-title":"\u2018UNAIDS terminology guidelines"},{"key":"pone.0288410.ref003","unstructured":"UNICEF: Adolescent HIV prevention. To ramp up our efforts in the fight against AIDS, there is a need for a more concentrated focus on adolescents and young people. Available at: https:\/\/data.unicef.org \u203a HIV and AIDS Reports. July 2022."},{"key":"pone.0288410.ref004","year":"2021","journal-title":"UNAIDS DATA"},{"key":"pone.0288410.ref005","first-page":"1","author":"Elizabeth Glaser Pediatric AIDS Foundation","year":"2015","journal-title":"Adolescent and HIV: Prioritization For Elizabeth Glaser Pediatric AIDS Foundation Programs Advocacy and Research"},{"key":"pone.0288410.ref006","first-page":"1","article-title":"Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings","volume":"5","author":"M. L Scanlon","year":"2013","journal-title":"HIV\/AIDS (Auckland, NZ)"},{"issue":"4","key":"pone.0288410.ref007","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 (London, England)"},{"issue":"1","key":"pone.0288410.ref008","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1097\/QAI.0000000000001390","article-title":"Predictors of retention in HIV care among youth (15\u201324) in a universal test-and-treat setting in Rural Kenya.","volume":"76","author":"LB Brown","year":"2017","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0288410.ref009","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1089\/apc.2006.20.418","article-title":"Barriers to antiretroviral adherence: The importance of depression, abuse, and other traumatic events","volume":"20","author":"M Mugavero","year":"2010","journal-title":"AIDS Patient Care STDs"},{"key":"pone.0288410.ref010","first-page":"1177","article-title":"Incidence of acquired immunodeficiency syndrome-associated opportunistic diseases and the effect of treatment on a cohort of 1115 patients infected with human immunodeficiency virus, 1989\u20131997","volume":"200336","author":"J San-Andr\u00e9s F","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0288410.ref011","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1097\/00002030-200106150-00015","article-title":"Nonadherence to highly active antiretroviral therapy predicts progression to AIDS","volume":"15","author":"D. R Bangsberg","year":"2001","journal-title":"AIDS"},{"issue":"1","key":"pone.0288410.ref012","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s12160-011-9271-3","article-title":"Sexual HIV transmission and antiretroviral therapy: A prospective cohort study of behavioural risk factors among men and women living with HIV\/AIDS. Annals of Behavioral Medicine","volume":"42","author":"S.C Kalichman","year":"2011","journal-title":"A Publication of the Society of Behavioral Medicine"},{"key":"pone.0288410.ref013","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1097\/QAD.0b013e328351f5b2","article-title":"J, Boulle A, Ford N: Treatment outcomes of patients on second-line antiretroviral therapy in resource-limited settings: A systematic review and meta-analysis","volume":"26","author":"O Ajose","year":"2012","journal-title":"AIDS"},{"key":"pone.0288410.ref014","author":"Uganda Population-Based HIV Impact Assessment UPHIA 2020\u20132021","year":"2022","journal-title":"SUMMARY SHEET"},{"key":"pone.0288410.ref015","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12879-015-0753-y","article-title":"Determinants of antiretroviral adherence among HIV positive children and teenagers in rural Tanzania: a mixed methods study.","volume":"15","author":"D Nyogea","year":"2015","journal-title":"BMC Infect Dis"},{"issue":"16","key":"pone.0288410.ref016","article-title":"A: Determinants to antiretroviral treatment non-adherence among adult HIV\/AIDS patients in northern Ethiopia","volume":"14","author":"B Gebrezgabher B","year":"2017","journal-title":"AIDS Res Ther"},{"issue":"1","key":"pone.0288410.ref017","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/j.1365-3156.2011.02888.x","article-title":"Factors influencing adherence to antiretroviral treatment in Asian developing countries: a systematic review","volume":"17","author":"S.P Wasti","year":"2012","journal-title":"Trop Med Int Health"},{"key":"pone.0288410.ref018","first-page":"59","volume-title":"Survey Sampling","author":"L Kish","year":"1965"},{"key":"pone.0288410.ref019","article-title":"Retention of HIV-Positive Adolescents in Care: A Quality Improvement Intervention in Mid-Western Uganda.","author":"J Izudi","year":"2018","journal-title":"Hindawi BioMed Research International"},{"issue":"1","key":"pone.0288410.ref020","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1186\/s12978-018-0614-4","article-title":"Risky behaviours and their correlates among adolescents living with HIV in sub-Saharan Africa: a systematic review","volume":"15","author":"M Zgambo","year":"2018","journal-title":"Reproductive Health"},{"issue":"1","key":"pone.0288410.ref021","doi-asserted-by":"crossref","first-page":"20049","DOI":"10.7448\/IAS.18.1.20049","article-title":"Contemporary issues on the epidemiology and antiretroviral adherence of HIV-infected adolescents in sub-Saharan Africa: a narrative review","volume":"18","author":"OA Adejumo","year":"2015","journal-title":"Journal of the International AIDS Society"},{"issue":"7","key":"pone.0288410.ref022","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1080\/09540120701742276","article-title":"The process of HIV status disclosure to HIV-positive youth in Kinshasa, Democratic Republic of the Congo","volume":"20","author":"L Vaz","year":"2008","journal-title":"AIDS Care"},{"issue":"6","key":"pone.0288410.ref023","doi-asserted-by":"crossref","first-page":"e0000418","DOI":"10.1371\/journal.pgph.0000418","article-title":"Factors associated with antiretroviral therapy adherence among adolescents living with HIV in the era of isoniazid preventive therapy as part of HIV care","volume":"2","author":"JB Villiera","year":"2022","journal-title":"PLOS Glob Public Health"},{"key":"pone.0288410.ref024","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1186\/s13643-020-01420-8","article-title":"The association between diagnosis disclosure and adherence to antiretroviral therapy among adolescents living with HIV in sub-Saharan Africa: a protocol for systematic review and meta-analysis","volume":"9","author":"M.M Mengesha","year":"2020","journal-title":"Systematic Reviews"},{"issue":"1","key":"pone.0288410.ref025","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":"J Acquir Immune Defic Syndr"},{"key":"pone.0288410.ref026","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1186\/s12879-018-3480-3","article-title":"Utilization of \u201cprevention of mother-tochild transmission\u201d 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":"2","key":"pone.0288410.ref027","doi-asserted-by":"crossref","first-page":"e0172392","DOI":"10.1371\/journal.pone.0172392","article-title":"Factors influencing antiretroviral treatment suboptimal adherence among perinatally HIV-infected adolescents in Thailand","volume":"12","author":"L Xu","year":"2017","journal-title":"PLoS ONE"},{"issue":"2","key":"pone.0288410.ref028","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4314\/ahs.v22i2.7","article-title":"Perceived barriers and facilitators to antiretroviral therapy adherence among youth aged 15\u201324 years at a regional HIV clinic in South-Western Uganda: a qualitative study","volume":"22","author":"I Jjumba","year":"2022","journal-title":"Afri Health Sci"},{"issue":"2","key":"pone.0288410.ref029","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/17450128.2019.1576960","article-title":"Examining the relationship of social support and family cohesion on ART adherence among HIV-positive adolescents in southern Uganda: baseline findings.","volume":"14","author":"C Damulira","year":"2019","journal-title":"Vulnerable Children and Youth Studies"},{"issue":"6","key":"pone.0288410.ref030","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s11904-019-00470-5","article-title":"Peer Support for Adolescents and Young People Living with HIV in sub-Saharan Africa: Emerging Insights and a Methodological Agenda","volume":"16","author":"D Mark","year":"2019","journal-title":"Curr HIV\/AIDS Rep"},{"key":"pone.0288410.ref031","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1097\/01.aids.0000183124.86335.0a","article-title":"Evaluation of a peer support group therapy for HIV-infected adolescents","volume":"19","author":"I Funck-Brentanoa","year":"2005","journal-title":"AIDS"},{"issue":"9","key":"pone.0288410.ref032","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1093\/cid\/ciu046","article-title":"Lower pill burden and once-daily antiretroviral treatment regimens for HIV infection: a meta-analysis of randomized controlled trials","volume":"58","author":"JB Nachega","year":"2014","journal-title":"Clinical Infectious Diseases"},{"issue":"1","key":"pone.0288410.ref033","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-019-7768-z","article-title":"Factors influencing adherence to antiretroviral treatment among adults accessing care from private health facilities in Malawi","volume":"19","author":"L Chirambo","year":"2019","journal-title":"BMC Public Health"},{"issue":"4","key":"pone.0288410.ref034","doi-asserted-by":"crossref","first-page":"e0249971","DOI":"10.1371\/journal.pone.0249971","article-title":"Transition to adult care: Exploring factors associated with transition readiness among adolescents and young people in adolescent ART clinics in Uganda.","volume":"102116","author":"SN Mbalinda","journal-title":"PLoS ONE"},{"key":"pone.0288410.ref035","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1186\/s12879-020-05168-3","article-title":"HIV patients retention and attrition in care and their determinants in Ethiopia: a systematic review and meta-analysis","volume":"20","author":"N Abebe Moges","year":"2020","journal-title":"BMC Infectious Diseases"},{"issue":"1","key":"pone.0288410.ref036","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s12879-018-2977-0","article-title":"Factors affecting first month adherence due to antiretroviral therapy among HIV-positive adults at Felege Hiwot teaching and specialized hospital, North-Western Ethiopia; a prospective study","volume":"18","author":"AS Tegegne","year":"2018","journal-title":"BMC Infect Dis"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0288410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T17:36:46Z","timestamp":1689269806000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0288410"}},"subtitle":[],"editor":[{"given":"Taurayi A.","family":"Tafuma","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,7,13]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0288410","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,13]]}}}