Socioclinical and behavioural characteristics of adolescents and young adults living with HIV in a tertiary care facility in Owerri, Nigeria: a cross-sectional survey

Abstract

Adolescents and young adults (AYA) living with HIV, perinatally-acquired or behaviorally-acquired HIV, represent a priority population with unique clinical and psychosocial needs. This group of people living with HIV experience worse care outcomes; this study, therefore, aimed to describe the sociodemographic, behavioral, and clinical characteristics of AYA receiving HIV care in a tertiary facility in Owerri, Nigeria, to inform the development of targeted support services. We conducted a cross-sectional study between May and August 2025 at the HIV care centre of a Federal Teaching Hospital in Owerri, Nigeria. A total of 92 AYA aged 10–22 years receiving antiretroviral therapy (ART) for ≥ 6 months were enrolled consecutively. Data on sociodemographic, risk behaviors, HIV knowledge and disclosure, substance use, sexual behavior, ART adherence (self-reported using a visual analogue scale), and treatment history were collected using a pretested structured questionnaire and medical records extraction. Viral load (VL) was extracted from medical records. Data were analysed using SPSS version 25, and Chi-square tests to examine gender differences in risk behaviour. Among the 92 participants, 51 (55.4%) were male with a mean age of 15.7 ± 2.7 years, 82 (83.7%) were in or had completed secondary school, and 48 (52.2%) belonged to the low socioeconomic class. While 69 (75.0%) knew about HIV, only 63 (68.5%) were aware of their own positive status, and a mere 12 (13.0%) had ever disclosed their status to anyone. Knowledge of transmission routes was suboptimal: only 42 (45.7%) identified mother-to-child transmission, and 30 (17.5%) could not identify any mode of transmission. ART adherence was 92.4% by self-report, and viral suppression (<1000 copies/mL) was achieved in 96.4% of those with available data (n=83). Substance use and sexual activity were low, with alcohol use reported by 12 (13.0%; and 10 (10.9%) having ever had sex, with no significant gender differences (p>0.05 for all behaviors). This group displays high adherence to ART, low disclosure of HIV status mainly to family, sub-optimal knowledge of HIV transmission route, exposing a critical gap. There is successful virological control attributable to high adherence to modern ART regimens. These findings highlight the need for integrated multi-sectoral AYA-friendly interventions that address psychosocial needs, disclosure counseling, and comprehensive sexual health education within adolescent HIV care programs.