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

Facilitating HIV testing, care and treatment for orphans and vulnerable children aged five years and younger through community-based early childhood development playcentres in rural Zimbabwe

Introduction: Early diagnosis of children living with HIV is a prerequisite for accessing timely paediatric HIV care and…

Read more

Treatment outcomes among HIV-positive orphaned and non-orphaned children on antiretroviral therapy in Johannesburg, South Africa

Background. Limited research investigating treatment outcomes for HIV-positive orphans compared with non-orphans has shown…

Read more

Risk and protective factors for mental health and wellbeing among adolescent orphans

Background: Research has demonstrated the importance of understanding risk factors for mental health and wellbeing. Less…

Read more

Effect of Cash Transfer Programme on Health Needs of Vulnerable Children and Orphans in Langas, Eldoret, Kenya

Cash transfers are increasingly becoming the best practice in the social protection sector employed to address poverty and…

Read more