Assessment on Uptake of Self-Care Services among Adolescents and Young People Living With HIV: A Case of Four Facilities in Kitwe District, Zambia.

Abstract

Adolescents and young people living with HIV (AYPLHIV) face persistent challenges related to stigma, autonomy, and sustained engagement in care. Self-care services including tools and practices that enable individuals to manage their health play a critical role in HIV prevention and treatment by promoting adherence, empowerment, quality of life, and improved health outcomes. Despite their importance, evidence on the uptake and determinants of self-care services among AYPLHIV in Zambia remains limited. This study assessed the level of self-care service utilization and associated factors among adolescents and young people receiving HIV care in selected health facilities in Kitwe District. A facility-based cross-sectional study was conducted between September 2024 and April 2025 among 485 adolescents and young people aged 15–24 years attending four health facilities in Kitwe. Data were collected using structured, pre-tested questionnaires administered by trained research assistants. Data were analysed using Stata version 17. Overall, uptake of self-care services was suboptimal. Slightly more than half of participants (58%) reported ever using self-care services, while a substantial proportion (42%) had never utilized them. Awareness was generally low, with over half (56%) reporting no knowledge of available self-care interventions. Multivariable analysis showed that adolescents with secondary education had significantly lower odds of utilizing self-care services compared to those with no formal education (AOR = 0.54, p = 0.048). Accessibility was positively associated with utilization (AOR = 1.67, p = 0.031), whereas moderate and high levels of stigmatization were strongly associated with reduced uptake (AOR = 0.53, p = 0.022; AOR = 0.63, p = 0.029). Age, gender, peer influence, and provider support were not significantly associated with self-care service utilization. In conclusion, self-care service uptake among AYPLHIV in Kitwe District remains low, largely driven by limited awareness, accessibility barriers, and persistent stigma. Strengthening awareness campaigns, improving service availability, and implementing stigma-reduction strategies are essential to enhance self-care engagement and optimize HIV outcomes among adolescents and young people in Zambia.