title: Increasing Uptake of HIV, Sexually Transmitted Infection, and Family Planning Services, and Reducing HIV-Related Risk Behaviors Among Youth Living With HIV in Uganda.
abstract: OBJECTIVE
  To address barriers to care for youth living with HIV (YLHIV), the Link Up project implemented a peer-led intervention model that provided a comprehensive package of HIV and sexual and reproductive health and rights services through community-based peer support groups for YLHIV. Peer educators delivered targeted counseling and health education, and referred YLHIV to antiretroviral therapy (ART), and reproductive health services that were available at youth-oriented sexual and reproductive health and rights facilities.
  
  
  METHODS
  At baseline (October to November 2014), 37 peer support groups for YLHIV were established in Luwero and Nakasongola districts. During this same time period, we recruited a cohort of 473 support group members, aged 15-24 years. After a 9-month intervention period (January to September 2015), we completed the end-line survey with 350 members of the original cohort. Multivariate logistic regression analysis applied to longitudinal data was used to assess changes in key outcomes from baseline to end line.
  
  
  RESULTS
  Multivariate analyses showed significant increases at end line, compared with baseline, in self-efficacy (adjusted odds ratio [AOR]: 1.8 [1.3-2.6]), comprehensive HIV knowledge [AOR: 1.8 [1.3-2.6]), HIV disclosure (AOR: 1.6 [1.01-2.6]), condom use at last sex (AOR: 1.7 [1.2-2.5]), sexually transmitted infection uptake (AOR: 2.1 [1.5-2.9]), ART uptake (AOR: 2.5 [1.6-4.0]), ART adherence (AOR: 2.5 [1.3-4.9]), CD4 testing (AOR: 2.4 [1.5-3.6]), and current use of a modern contraceptive method (AOR: 1.7 [1.1-2.7]).
  
  
  CONCLUSIONS
  Link Up's intervention strategy likely contributed to observed increases in self-efficacy, knowledge of HIV, condom use, HIV disclosure ART utilization and adherence, CD4 testing, STI testing uptake, and use of modern family planning methods. This model shows promise and should be adapted for use among YLHIV in similar settings and evaluated further.
authors.affiliation: Population Council, Washington, DC. Electronic address: lvu@popcouncil.org.
authors.forename: Lung
authors.initials: L
authors.lastname: Vu
authors.affiliation: Population Council, Washington, DC.
authors.forename: Brady
authors.initials: B
authors.lastname: Burnett-Zieman
authors.affiliation: Child Health and Development Center, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Cecily
authors.initials: C
authors.lastname: Banura
authors.affiliation: Population Council, Nairobi, Kenya.
authors.forename: Jerry
authors.initials: J
authors.lastname: Okal
authors.affiliation: Community Health Alliance Uganda (CHAU), Kampala, Uganda.
authors.forename: Margret
authors.initials: M
authors.lastname: Elang
authors.affiliation: Community Health Alliance Uganda (CHAU), Kampala, Uganda.
authors.forename: Rodgers
authors.initials: R
authors.lastname: Ampwera
authors.affiliation: International HIV/AIDS Alliance, Cape Town, South Africa.
authors.forename: Georgina
authors.initials: G
authors.lastname: Caswell
authors.affiliation: Marie Stopes International, Uganda (MSIU), Kampala, Uganda.
authors.forename: Diana
authors.initials: D
authors.lastname: Amanyire
authors.affiliation: Uganda Network of Young People Living with HIV and AIDS, Kampala, Uganda.
authors.forename: Jacquelyne
authors.initials: J
authors.lastname: Alesi
authors.affiliation: Population Council, Washington, DC.
authors.forename: Eileen
authors.initials: E
authors.lastname: Yam
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005193:Family Planning Services / Q000193:education*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D012309:Risk-Taking; D020377:Self Efficacy; D057566:Self Report; D012749:Sexually Transmitted Diseases / Q000523:psychology*; D014454:Uganda; D055815:Young Adult
keywords: ART; Link up; Peer education; People living with HIV (PLHIV); Sexual and reproductive health and rights (SRHR); Youth