Predicting Lost to Follow-Up Status Using an Adolescent HIV Psychosocial Attrition Risk Assessment Tool: Results From...

Area of Science:

• Adolescent Health
• HIV/AIDS Research
• Psychosocial Support

Background:

• Low retention in care for adolescents living with HIV (ALHIV) contributes to poor viral load suppression in Uganda.
• Adolescent attrition from HIV care is a significant public health concern, impacting treatment outcomes.
• Understanding psychosocial factors is crucial for improving care engagement among ALHIV.

Purpose of the Study:

• To develop a psychosocial risk assessment tool for adolescents aged 15-19 years living with HIV.
• To evaluate the predictive accuracy of the developed tool for attrition risk in ALHIV.
• To identify psychosocial challenges faced by ALHIV to inform targeted interventions.

Main Methods:

• A mixed-methods prospective cohort study was conducted in 20 facilities in Uganda.
• The Adolescent Psychosocial Attrition Risk Assessment tool was developed and refined through focus groups and interviews.
• Diagnostic accuracy tests were employed to assess the tool's predictive ability for attrition.

Main Results:

• A 20-question tool was created; 6% of 597 enrolled ALHIV were lost to follow-up.
• The tool's predictive performance for attrition showed an Area Under the Curve of 0.58.
• Sensitivity and specificity for predicting attrition were 55% and 61%, respectively, using a cut-off score of 6.

Conclusions:

• The Adolescent Psychosocial Attrition Risk Assessment tool did not effectively predict attrition among ALHIV.
• The tool proved valuable in identifying psychosocial issues experienced by ALHIV.
• The tool may be suitable for routine administration in clinical settings to guide psychosocial support for ALHIV.