Socio-Behavioural Barriers to Viral Suppression in the Older Adult Population in Rural South Africa

• Published in: AIDS and behavior Vol. 28; no. 7; pp. 2307 - 2313
• Main Authors: Chinogurei, Chido, Manne-Goehler, J., Kahn, K., Kabudula, C. W., Cornell, M., Rohr, J. K.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2024; Springer Nature B.V
• Subjects: Adult; Adults; Aged; Aging; Anti-HIV Agents - therapeutic use; Antiretroviral therapy; Community health care; Cross-Sectional Studies; Female; Health care facilities; Health Psychology; Health services; Health Services Accessibility; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - psychology; Households; Human immunodeficiency virus; Humans; Infectious Diseases; Intervention; Low income groups; Male; Medical personnel; Medication Adherence - psychology; Medication Adherence - statistics & numerical data; Medicine; Medicine & Public Health; Middle Aged; Older people; Original Paper; Public Health; Rural Population; Social environment; Socioeconomic Factors; South Africa - epidemiology; Surveillance; Viral Load; World population; South Africa; Internalized stigma; Socio-behavioral; Detectable viral load; Older adults; Viral suppression
• ISSN: 1090-7165; 1573-3254; 1573-3254
• DOI: 10.1007/s10461-024-04328-9

South Africa has the largest share of people living with HIV in the world and this population is ageing. The social context in which people seek HIV care is often ignored. Apart from clinical interventions, socio-behavioural factors impact successful HIV care outcomes for older adults living with HIV. We use cross-sectional data linked with demographic household surveillance data, consisting of HIV positive adults aged above 40, to identify socio-behavioural predictors of a detectable viral load. Older adults were more likely to have a detectable viral load if they did not disclose their HIV positive status to close family members (aOR 2.56, 95% CI 1.89-3.46), resided in the poorest households (aOR 1.98, 95% CI 1.23-3.18), or were not taking medications other than ART (aOR 1.83, 95% CI 1.02-1.99) likely to have a detectable. Clinical interventions in HIV care must be supported by understanding the socio-behavioural barriers that occur outside the health facility. The importance of community health care workers in bridging this gap may offer more optimum outcomes for older adults ageing with HIV.