Impact of orphan status on HIV treatment outcomes and retention in care of children and adolescents in Asia

Abstract


An analysis of the impact of orphanhood at antiretroviral therapy (ART) initiation on HIV outcomes in Asia included 4300 children; 51% were male. At ART initiation, 1805 (42%) were non-orphans (median age: 3 years), 1437 (33%) were single orphans (6 years) and 1058 (25%) were double orphans (7 years). Ten-year post-ART survival was 93.4–95.2% across orphan categories. Clinic transfers were higher among single and double orphans than non-orphans (41% vs 11%, P<0.001). On multivariate analysis, children ≥3 years at ART initiation (hazard ratio 1.58 vs <3 years, 95% confidence interval: 1.11–2.24) were more likely to be lost to follow-up. Although post-ART mortality and retention did not differ by orphan status, orphans were at greater risk of starting ART at older ages, and with more severe immunosuppression and poorer growth.



Other articles

kenya’s cash transfer program: pro- tecting the health and human rights of orphans and vulnerable children

In Kenya, as in other countries of sub-Saharan Africa heavily burdened by HIV/ AIDS, orphans and vulnerable children (OVC)…

Read more

Poorer health and nutritional outcomes in orphans and vulnerable young children not explained by greater exposure to extreme poverty in Zimbabwe

objective To describe patterns of association between different groups of young orphans and vulnerable children (OVC) and…

Read more

A meta-analysis of the relationship between parental death in childhood and subsequent psychiatric disorder

Objective To systematically review evidence for an association between parental death in childhood, and the subsequent development…

Read more

Community Participation In Community Day Secondary Schooling for Orphaned and Vulnerable Students in Malawi in an Era of Shrinking Community

The purpose of this dissertation is to interrogate the meanings of “community” “participation,” and “community participation”…

Read more