Building our youth for the future

Bekker, Linda‐Gail; Johnson, Leigh F.; Wallace, Melissa; Hosek, Sybil

doi:10.7448/ias.18.2.20027

Cited by 102 publications

(106 citation statements)

References 54 publications

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“…Younger adolescents are more often living at home, are in early stages of puberty and fewer have reached sexual debut compared with older adolescents. During older adolescence, gender differences in HIV acquisition risk become apparent with risk higher among older adolescent girls than boys and additional vulnerabilities arise for adolescent key populations (young men who have sex with men, transgender people, young sex workers and those who inject drugs) [10]. Since all-cause mortality rates in the general adolescent population are lower than in other age groups, adolescents have been regarded as a healthy population not requiring much attention of healthcare services [11,12].…”

Section: Introductionmentioning

confidence: 99%

Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic

Slogrove

Mahy

Armstrong

et al. 2017

Journal of the International AIDS Society

122

101

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Introduction: With increasing survival of vertically HIV‐infected children and ongoing new horizontal HIV infections, the population of adolescents (age 10–19 years) living with HIV is increasing. This review aims to describe the epidemiology of the adolescent HIV epidemic and the ability of national monitoring systems to measure outcomes in HIV‐infected adolescents through the adolescent transition to adulthood.Methods: Differences in global trends between younger (age 10–14 years) and older (age 15–19 years) adolescents in key epidemic indicators are interrogated using 2016 UNAIDS estimates. National population‐based survey data in the 15 highest adolescent HIV burden countries are evaluated and examples of national case‐based surveillance systems described. Finally, we consider the potential impact of adolescent‐specific recommendations in the 2016 WHO Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection.Discussion: UNAIDS estimates indicate the population of adolescents living with HIV is increasing, new HIV infections in older adolescents are declining, and while AIDS‐related deaths are beginning to decline in younger adolescents, they are still increasing in older adolescents. National population‐based surveys provide valuable estimates of HIV prevalence in older adolescents and recent surveys include data on younger adolescents. Only a few countries have nationwide electronic case‐based HIV surveillance, with the ability to provide population‐level data on key HIV outcomes in the diagnosed population living with HIV. However, in the 15 highest adolescent HIV burden countries, there are no systems tracking adolescent transition to adulthood or healthcare transition. The strength of the 2016 WHO adolescent‐specific recommendations on antiretroviral therapy and provision of HIV services to adolescents was hampered by the lack of evidence specific to this age group.Conclusions: Progress is being made in national surveillance and global monitoring systems to specifically identify trends in adolescents living with HIV. However, HIV programmes responsive to the evolving HIV prevention and treatment needs of adolescents can be facilitated further by: data disaggregation to younger and older adolescents and mode of HIV infection where feasible; implementation of tools to achieve expanded national case‐based surveillance; streamlining consent/assent procedures in younger adolescents and consensus on indicators of adolescent healthcare transition and transition to adulthood.

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Section: Introductionmentioning

confidence: 99%

Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic

Slogrove

Mahy

Armstrong

et al. 2017

Journal of the International AIDS Society

122

101

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“…Based on prior research on barriers to engaging in the HIV Care Continuum, we controlled for social network size, family social support, self-efficacy, HIV stigma, and criminal justice involvement when examining intervention effects (31–33). …”

Section: Introductionmentioning

confidence: 99%

Project nGage: Results of a Randomized Controlled Trial of a Dyadic Network Support Intervention to Retain Young Black Men Who Have Sex With Men in HIV Care

et al. 2017

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HIV-positive young Black MSM (YBMSM) experience poor outcomes along the HIV Care Continuum, yet few interventions have been developed expressly for YBMSM retention in care. Project nGage was a randomized controlled trial conducted across five Chicago clinics with 98 HIV-positive YBMSM aged 16–29 between 2012 and 2015. The intervention used a social network elicitation approach with index YBMSM (n=45) to identify and recruit a support confidant (SC) to the study. Each index-SC dyad met with a social worker to improve HIV-care knowledge, activate dyadic social support, and develop a retention in care plan. Each index and SC also received four mini-booster sessions. Control participants (n=53) received treatment as usual. Surveys and medical records at baseline, 3-, and 12-months post-intervention assessed visit history (3 or more visits over 12 months; primary outcome), and sociodemographic, network, social-psychological, and behavioral factors. At baseline, there were no differences in age (M=23.8 years), time since diagnosis (M≤2 years), clinic visits in the previous 12 months (M=4.1), and medication adherence (68.6%≥90% adherence). In multivariate logistic regression analysis, intervention participants were 3.01 times more likely to have had at least 3 provider visits (95% CI: 1.0–7.3) than were control participants over 12 months. Project nGage demonstrates preliminary efficacy in improving retention in care among YBMSM. Results suggest that engaging supportive network members may improve key HIV Care Continuum outcomes.

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“…Reducing HIV incidence among adolescents represents an urgent global priority, given the high individual and societal costs of the epidemic on youth populations (Bekker et al 2015). In the United States, adolescents make up a disproportionate share of new HIV infections, accounting for approximately 17 % of the population and 26 % of new infections in 2010 (Centers for Disease Control and Prevention 2014).…”

Section: Introductionmentioning

confidence: 99%

Creating Youth-Supportive Communities: Outcomes from the Connect-to-Protect® (C2P) Structural Change Approach to Youth HIV Prevention

Miller

Janulis

Reed

et al. 2015

J Youth Adolescence

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Reducing HIV incidence among adolescents represents an urgent global priority. Structural change approaches to HIV prevention may reduce youth risk by addressing the economic, social, cultural, and political factors that elevate it. We assessed whether achievement of structural changes made by eight Connect-to-Protect (C2P) coalitions were associated with improvements in youth’s views of their community over the first 4 years of coalitions’ mobilization. We recruited annual cross-sectional samples of targeted youth from each C2P community. We sampled youth in neighborhood venues. We interviewed a total of 2461 youth over 4 years. Males (66 %) and youth of color comprised the majority (52 % Hispanic/Latinos; 41 % African Americans) of those interviewed. By year 4, youth reported greater satisfaction with their community as a youth-supportive setting. They reported their needs were better met by available community resources compared with year 1. However, these findings were moderated by risk population such that those from communities where C2P focused on young men who have sex with men (YMSM) reported no changes over time whereas those from communities focused on other at-risk youth reported significant improvements over time in satisfaction and resource needs being met. Internalized HIV stigma increased over time among those from communities serving other at-risk youth and was unchanged among those from YMSM communities. The very different results we observe over time between communities focused on YMSM versus other at-risk youth may suggest it is unreasonable to assume identical chains of structural causality across youth populations who have such different historical relationships to HIV and who encounter very different kinds of entrenched discrimination within their communities.

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Building our youth for the future

Cited by 102 publications

References 54 publications

Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic

Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic

Project nGage: Results of a Randomized Controlled Trial of a Dyadic Network Support Intervention to Retain Young Black Men Who Have Sex With Men in HIV Care

Creating Youth-Supportive Communities: Outcomes from the Connect-to-Protect® (C2P) Structural Change Approach to Youth HIV Prevention

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