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

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.