Factors associated with readiness to start antiretroviral therapy (ART) among young people (15-24 years) at four HIV clinics in Mulago Hospital, Uganda

Abstract

Globally, the HIV burden continues to rise among young people despite the discovery of ART. This study assessed demographic and psycho-social factors among young people associated with readiness to be initiated on ART. Aquantitative cross-sectional study was conducted among newly diagnosed HIV positive young people aged 15-24 years at 4 HIV clinics at Mulago Hospital. Readiness was measured as a self-report by the individual to the question, “How ready do you feel to start ART? Of the 231 young people enrolled, the mean age (SD) was 20.7years (+/-2.8) and most were female (66.2%). Majority were very ready (53.3%) and very motivated (51.1%) to start ART. Higher treatment readiness was associated with being female (95% CI [5.62, 8.31], p=0.003), thinking that ART cures HIV (95% CI [0.43, 0.86], p=0.005), history of having unprotected sex (95% CI [0.79, 0.87], p=<0.001), anticipating negative HIV results (95% CI [0.26, 0.88], p=0.017), internalized stigma (95% CI [0.83, 0.98], p=0.018) and knowledge of positive ART effects for others (95% CI [0.84, 0.93], p=<0.001).

Conclusions: Understanding the underlying factors associated with ART readiness among young people can inform strategies to support and increase individuals’ readiness to initiate ART and early engagement in care.