Role of self-management among virally suppressed and unsuppressed adolescents living with HIV in Dar es Salaam, Tanzania.

Globally, significant progress toward ending the HIV/AIDS epidemic includes advances in HIV treatment, converting a fatal infection to a chronic disease. Adolescents living with HIV (AWHIV) continue to underachievein HIV viral suppression (VS) needed to remain healthy. This cross-sectional study aimed to examine the role of self-management and related factors in VS among AWHIV aged 15-19 years in Dar es Salaam, Tanzania. A total of 658 AWHIV from ten large HIV care and treatment sites were assessed on HIV-related self-management, depression, HIV stigma, physical quality of life and social support. HIV viral load was abstracted from clinical records. Generalized linear models were used to examine unadjusted and adjusted mean differences in self-management scores between the two groups. Over half of the AWHIV, 403(78%), had achieved VS. Overall, sub-scale self-management scores did not differ significantly between groups (p > .05); however, three self-management items significantly differed by VS status: health self-efficacy (p = 0.049), life ambitions/goals (p = 0.031) and ART administration knowledge (p = 0.044). Adjusted models attenuated self-efficacy and ambition differences while ART knowledge differences persisted (p = 0.005). Physical quality of life, social support and stigma significantly moderated relationships between self-management items and VS. These findings suggest that focusing on targeted self-management behaviors may provide a more accurate understanding of their influence on VS than aggregated self-management scores.