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Objective:

Preventing secondary HIV transmission from adolescents and young people living with HIV (AYPLHIV) to their partners and children is critical to interrupting the HIV infection cycle in sub-Saharan Africa. We investigated predictors of secondary HIV transmission risk (past-year sexual risk combined with past-year viremia) among AYPLHIV in South Africa.

Design:

A prospective cohort of AYLPHIV in South Africa recruited n= 1046 participants in 2014–2015, 93.6% of whom were followed up in 2016–2017 (1.5% mortality). Questionnaires used validated scales where available and biomarkers were extracted from n= 67 health facilities.

Methods:

Multivariate logistic regressions tested baseline factors associated with secondary HIV transmission risk, controlling for covariates, with marginal effect modelling combinations.

Results:

About 14.2% of AYPLHIV reported high secondary HIV transmission risk. High-risk …