Nkala, B., Khunwane, M., Dietrich, J., et al. AIDS Care (January 2015), Vol. 27 No. 6, pp. 697–702.
This retrospective cross-sectional analysis described HIV testing and prevalence among youth attending the Kganya Adolescent Centre (KMAC), South Africa, and outlined the cascade of care for KMAC's HIV-positive clients. KMAC is a comprehensive HIV management center that works to increase access to HIV care and management for in- and out-of-school adolescents. The study showed that between 2008 and 2012, a total of 11,522 young people (aged 14–24 years) and young adults (25+ years) were tested for HIV at KMAC, the majority (67 percent) female. Of those, 410 (3.6 percent) tested HIV-positive. Of these, 109 (27 percent) had their CD4 cell count measured, and 12 (11 percent) were referred for antiretroviral treatment; 41 participants (25 percent of youth) did not return for their CD4 count results. More young women than young men were HIV-positive (4 percent versus 2 percent). These findings showed that a large number of young people testing positive for HIV were not initiated into care. Reasons for non-retention included stigma, denial, and inability to cover transportation costs. The authors concluded that reaching HIV-positive adolescents but failing to retain them in care defeated the objective of the KMAC program, adding that the program needed to establish proper linkages to ensure that HIV-positive youth can succeed in obtaining care.