HIV Continuum of Care for Youth in the United States

Lally, Michelle; Berg, Jacob J. van den; Westfall, Andrew O.; Rudy, Bret J.; Hosek, Sybil; Fortenberry, J. Dennis; Monte, Dina; Tanney, Mary; McFarland, Elizabeth J.; Xu, Jiahong; Kapogiannis, Bill G.; Wilson, Craig M.; Interventions, Aids

doi:10.1097/qai.0000000000001563

Cited by 49 publications

(37 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One study of 525 children with perinatal HIV aged <18 years across the Netherlands in 2016 reported very high success rates with 96% on treatment, of whom 97% were virally suppressed ≤ 100 copies/mL . A study of 467 youth with horizontally acquired HIV aged 13 to 24 years in care across the USA during 2015 (of whom half had been diagnosed for less than 3 years) found 86% were engaged in care, of whom 98% were on ART, and of these 89% were suppressed <200 copies/mL . The proportion engaged in care in the USA study is substantially lower than in our cohort, this is possibly due to the difference in mode of infection and shorter duration since HIV diagnosis.…”

Section: Discussioncontrasting

confidence: 69%

The cascade of care for children and adolescents with HIV in the UK and Ireland, 2010 to 2016

et al. 2019

View full text Add to dashboard Cite

Introduction The UNAIDS 90‐90‐90 targets for the cascade of care are widely used to monitor the success of HIV care programmes but there are few studies in children. We assessed the cascade for children and adolescents living with HIV in the national Collaborative HIV Paediatric Study (CHIPS) in the UK and Ireland. Methods Utilizing longitudinal data from CHIPS we compared the cascade of care for 2010, 2013 and 2016. Among children diagnosed with HIV and not known to be lost to follow‐up at the start of each calendar year, we summarized the proportion in active paediatric care during that year (defined as having ≥1 clinic visit, CD4 or viral load measurement, or change to antiretroviral therapy (ART) regimen), and of these, the proportion on ART at last visit in that year. Among those on ART, the proportion with viral suppression (<200 copies/mL) and good immune status (WHO immunological stage none‐/mild‐for‐age) at last visit in the year were summarized. Among those in care in 2016, outcomes were compared by current age, place of birth (born abroad vs. UK/Ireland) and sex. Results Of children in paediatric HIV care at the start of 2010, 2013 and 2016 (n = 1249, 1157, 905 respectively), the proportion in active care during that calendar year was high throughout at 97 to 99%. Of those in active care, the proportion on ART increased from 79% to 85% and 92% respectively (p < 0.001). Among those on ART, the proportion with viral suppression and good immune status was stable at 83% to 86% and 85% to 88%, respectively, across the years. Among children in care in 2016, those aged ≥15 years were less likely to be virally suppressed (79% vs. 91%, p < 0.001) or to have good immune status (78% vs. 94%, p < 0.001) compared to younger children; there were no differences by place of birth or sex. Conclusions Children and adolescents in the UK and Ireland national cohort had high retention in care. The proportion on ART increased significantly over time although there was no change in viral suppression or good immune status. Poorer outcomes among adolescents highlight the need for targeted support for this population.

show abstract

Section: Discussioncontrasting

confidence: 69%

The cascade of care for children and adolescents with HIV in the UK and Ireland, 2010 to 2016

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The details of the study have been published elsewhere 17. Adolescents were approached at one of their scheduled clinic visits by trained clinic research staff.…”

Section: Methodsmentioning

confidence: 99%

A cross-sectional study examining associations between substance use frequency, problematic use and STIs among youth living with HIV

et al. 2017

View full text Add to dashboard Cite

Objectives This study sought to examine the prevalence of sexually transmitted infections (STIs) and whether substance use frequency and/or problematic use—specifically alcohol, marijuana, and other drugs—was associated with having an STI diagnosis among youth living with HIV (YLWH) Methods A sample of 823 YLWH were recruited at 14 adolescent HIV clinics through the Adolescent Medicine Trials Network for HIV Interventions. Study staff abstracted STI data from medical records for up to 26 weeks prior to participants’ completing a cross-sectional survey including the ASSIST, which measures substance use frequency and consequences. Results Almost one-third of youth had been diagnosed with an STI (30.5%) at the time of their baseline assessment. In multivariable analyses, those who engaged in weekly or greater marijuana use (AOR=10.66, 95% CI: 4.39, 25.87, p<0.001) had an increased odds of being diagnosed with an STI. Additionally, youth who met alcohol use criteria for moderate (AOR = 5.23, 95% CI: 2.50, 10.93, p<0.001) and high risk (AOR = 6.53, 95% CI: 1.20, 35.68, p<0.05) alcohol use had an increased odds of being diagnosed with an STI compared with low risk alcohol users. Conclusions Study findings underscore the need to investigate the role of greater frequency of marijuana use and problematic alcohol use in STI incidence among YLWH. Given the associations between both substance use frequency and problematic use in STI diagnoses among youth living with HIV seen in HIV care settings, clinicians should use validated substance use screening tools which capture both frequencies and consequences in order to identify YLWH who may need further evaluation and treatment.

show abstract

“…From 1 of the largest national samples of adolescents and young adults living with HIV, distinct patterns of risk behaviors were identified, pointing to the importance of tailoring clinical and preventive interventions. A more recent longitudinal cohort study at 14 ATN sites across the United States also reported demographic and psychosocial characteristics of 467 youth living with HIV and assessed how the later steps of the HIV continuum of care were achieved over a 1-year period [14]. Among 32 studies with completed analyses, the ATN has published over 214 manuscripts and presented over 156 abstracts at various domestic and international scientific conferences.…”

Section: Methodsmentioning

confidence: 99%

“…Numerous studies have documented the challenges that youth experience maintaining adherence to their antiretroviral regimens, including side effects, medication dosing schedules, unstable living situations, disclosure of HIV status, co-occurring illnesses, and lack of health insurance [11-13]. Recent data, however, suggest that youth can be successfully treated at health care sites that have expertise in treating youth [14], whereby 59% of youth achieved sustained viral load suppression over the course of a year. Health care delivery and other interventions tailored to the unique needs of youth and their effects on HIV continuum of care outcomes need to be investigated further [15].…”

Section: Introductionmentioning

confidence: 99%

Improving the Youth HIV Prevention and Care Continuums: The Adolescent Medicine Trials Network for HIV/AIDS Interventions

2019

View full text Add to dashboard Cite

Background Epidemiologic and clinical information in the United States indicate that HIV transmission and acquisition among adolescents and young adults (youth) remain unchanged, without improvement. Interventions to prevent HIV transmission among youth are critically needed, as are interventions to improve adherence to all components of the continuum of care for youth living with HIV. Objective The primary mission of the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) is to conduct both independent and collaborative research that explores promising behavioral, microbicidal, prophylactic, therapeutic, and vaccine modalities in HIV-infected and at-risk youth aged between 12 and 24. Methods Through the ATN, the National Institutes of Health is supporting HIV interventional research for youth in the United States. Results The ATN comprises 3 cooperative multiproject research programs and a coordinating center. Each program is led by a network hub and has well-defined research themes to assist, guide, and coordinate HIV research project activities. Conclusions ATN activities encompass the full spectrum of research needs for youth, from HIV primary prevention for at-risk youth in the community to secondary and tertiary prevention with clinical management of HIV infection among youth living with HIV experiencing adherence challenges.

show abstract

HIV Continuum of Care for Youth in the United States

Abstract: Youth living with HIV in the United States can be successfully treated at health care sites with experience, excellence, and important resources and services. Sustained VL suppression may be an important step to add to the Continuum of Care for youth.

Cited by 49 publications

References 17 publications

The cascade of care for children and adolescents with HIV in the UK and Ireland, 2010 to 2016

The cascade of care for children and adolescents with HIV in the UK and Ireland, 2010 to 2016

A cross-sectional study examining associations between substance use frequency, problematic use and STIs among youth living with HIV

Improving the Youth HIV Prevention and Care Continuums: The Adolescent Medicine Trials Network for HIV/AIDS Interventions

Contact Info

Product

Resources

About