Peer-reviewed article
Trends of attrition from HIV care and its predictors among adolescent girls and young women with inconsistent viral load suppression results in Mainland Tanzania, 2016-2024.
Kavindi AC, Ebeneezer JF, Nyongoli AK, Yuda P, William N et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined why adolescent girls and young women in Tanzania drop out of HIV care, particularly those with inconsistent viral suppression. Using national data from 2016-2024, researchers found that 11.8 per 1,000 girls and young women per year left care. Older girls (20-24 years), those in rural areas, those in public health facilities, and those with high initial viral loads were most likely to drop out. Protective factors included staying on second-line treatment and living in specific regions.
Key points
- Overall attrition rate was 11.8 per 1,000 person-years among AGYW with inconsistent viral load suppression
- AGYW aged 20-24 years had 58% higher attrition risk compared to those aged 15-19 years
- Rural residence increased attrition risk by 15%, and public facility attendance increased risk by 79%
- Second-line ART reduced attrition risk by 37%, and ART duration of 4+ years reduced risk by 57%
- Early attrition is most common in the first year after care initiation
Limitations
This study uses retrospective data from a national database and cannot determine causal mechanisms for attrition or explore unmeasured factors such as psychosocial stressors, stigma, or individual barriers. The findings are specific to Tanzania and may not generalise to other settings.
Abstract
Adolescent Girls and Young Women (AGYW) in Tanzania Mainland are disproportionately affected by HIV. They are at high risk of attrition from HIV care, undermining efforts to achieve the UNAIDS 95-95-95 targets by 2030. AGYW with inconsistent viral load suppression are particularly vulnerable, leading to suboptimal treatment outcomes and continued transmission risks. This study aims to assess attrition in care and identify factors associated with persistent unsuppressed viral load after ART initiation among adolescent girls and young women in Tanzania Mainland from 2016 to 2024. This study utilized retrospective data from the National AIDS Control Programme (NACP) CTC database, covering the period from 2016 to 2024. Data were accessed for research purposes on 19/05/2025. Survival analysis techniques were employed to estimate attrition rates and identify predictors among AGYW with inconsistent viral load suppression results. The overall attrition rate was 11.8 per 1,000 person-years. Attrition was higher among AGYW aged 20-24 years (AHR: 1.58; 95% CI: 1.31-1.91; p < 0.001) compared to those aged 15-19 years, and among those residing in rural areas (AHR: 1.15; 95% CI: 1.05-1.26; p = 0.002). Participants with an initial viral load ≥1,000 cp/mL had an increased risk of attrition (AHR: 1.28; 95% CI: 1.16-1.42; p < 0.001), as did those attending public facilities (AHR: 1.79; 95% CI: 1.23-2.61; p = 0.002). Protective factors included second-line ART (AHR: 0.63; 95% CI: 0.55-0.73; p < 0.001), ART duration ≥4 years (AHR: 0.43; 95% CI: 0.29-0.64; p < 0.001), and residence in the Lake Zone (AHR: 0.64; 95% CI: 0.54-0.76; p < 0.001). Early attrition from HIV care is common among AGYW with inconsistent viral load suppression, particularly in the first year. Tailored interventions targeting at-risk groups-based on age, residence, ART regimen, and facility type are urgently needed to improve retention and treatment outcomes in this population.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Tailored retention interventions targeting at-risk groups based on age, residence, ART regimen, and facility type (as identified by survival analysis of predictors)
- Population
- Adolescent girls and young women (aged 15-24 years) with HIV in mainland Tanzania with inconsistent viral load suppression results
Key finding
Overall attrition rate: 11.8 per 1,000 person-years
AC et al. · Europe PMC · 11 Feb 2026