How does learning one’s HIV status relate to viral suppression? an analysis among perinatally infected adolescents and young adults in Ndola, Zambia

Little data exist on how 15-to-24-year-old perinatally infected youth living with HIV (p-YLHIV) learn their HIV status, and how those disclosure experiences may relate to current viral suppression (VS). Cross-sectional analyses were conducted using baseline data from a randomized controlled trial testing a peer mentoring program in Ndola, Zambia. Analyses were restricted to self-reported p-YLHIV to assess associations between disclosure experiences and VS using logistic regression models, adjusted for sex, age, time on treatment and enrolment site. Of 198 p-YLHIV, 55% knew their HIV status by age 12. The odds of VS was 3.43 greater among p-YLHIV who learned their HIV status through a healthcare provider (HCP) and caregiver together compared to learning from either a HCP or caregiver alone [95% CI:1.02,11.54]. P-YLHIV who had people to talk with about living with HIV after disclosure were twice as likely to have VS compared to peers who did not [OR: 1.87, 95% CI: 1.0, 3.45]. These findings highlight the importance of disclosure support and having a HCP-caregiver team handle disclosure with perinatally infected children and youth, indicating strong service delivery opportunities that may support future VS in youth. Future studies should examine youth peer mentors living with HIV’s support during disclosure processes.