The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

Zanoni, Brian C.; Mayer, Kenneth H.

doi:10.1089/apc.2013.0345

Cited by 354 publications

(334 citation statements)

References 94 publications

(120 reference statements)

Supporting

Mentioning

315

Contrasting

Unclassified

Order By: Relevance

“…Data on the cascade of care in adolescents and young adults suggests that only 6% of youth infected with HIV in the United States have suppression of viral load, 24 thus intervention costs are more than compensated by the potential for reductions in HIV transmission due to suppressed or reduced HIV viral loads. The current conundrum for most clinical sites involves how to obtain funding for cell phones and plans.…”

Section: Cell Phone Support Interventionmentioning

confidence: 99%

Acceptability and Feasibility of a Cell Phone Support Intervention for Youth Living with HIV with Nonadherence to Antiretroviral Therapy

Belzer

MacDonell

Clark

et al. 2015

AIDS Patient Care and STDs

View full text Add to dashboard Cite

A pilot randomized clinical trial of youth ages 15-24 nonadherent to antiretroviral therapy (ART) utilizing daily cell phone support was found to have significant improvement in self-reported adherence and HIV RNA. Understanding acceptability and feasibility is critical for future implementation in clinic settings. Exit interviews were obtained from participants and adherence facilitators (AF). Acceptability was assessed from content analysis of exit interviews. Feasibility was assessed via intervention retention and study retention rates. Thirtyseven eligible youth were enrolled with 19 assigned to the intervention. Seven (37%) discontinued the intervention either due to missing over 20% of calls for two consecutive months (N = 5) or missing 10 consecutive calls (N = 2). Sixteen participants completed exit interviews, 15 reported the call length was just right, 13 reported they would have liked to continue calls after the 24-week intervention, and all participants reported they would recommend the intervention to friends. Scheduling and making calls required less than 1 h per week per participant. Providing cell phone support to youth nonadherent to ART was acceptable and feasible. While the cost is low compared to the price of ART, healthcare systems will need to explore how to cover the cost of providing cell phones (incentive).

show abstract

Section: Cell Phone Support Interventionmentioning

confidence: 99%

Acceptability and Feasibility of a Cell Phone Support Intervention for Youth Living with HIV with Nonadherence to Antiretroviral Therapy

Belzer

MacDonell

Clark

et al. 2015

AIDS Patient Care and STDs

View full text Add to dashboard Cite

show abstract

“…YLHIV are more likely to disengage from care, delay initiation of antiretroviral therapy (ART), and have lower rates of virologic suppression on ART. [3][4][5][6][7][8][9] YLHIV face barriers to care that are unique to the developmental period of adolescence and young adulthood. 10,11 Like many youth with chronic illness, YLHIV must learn to cope with a chronic medical condition at a time when most peers are healthy.…”

mentioning

confidence: 99%

“…6,7,[12][13][14] These challenges, along with others commonly faced by all people living with HIV (e.g., stigma, substance abuse, mental illness, lack of social support), likely impact the degree to which young people engage in care. 8 As a result, YLHIV require targeted services and structures within clinical care settings that can accommodate and support their unique developmental needs.…”

mentioning

confidence: 99%

The Impact of Youth-Friendly Structures of Care on Retention Among HIV-Infected Youth

Lee

Yehia

Gaur

et al. 2016

AIDS Patient Care and STDs

View full text Add to dashboard Cite

Limited data exist on how structures of care impact retention among youth living with HIV (YLHIV). We describe the availability of youth-friendly structures of care within HIV Research Network (HIVRN) clinics and examine their association with retention in HIV care. Data from 680 15-to 24-year-old YLHIV receiving care at 7 adult and 5 pediatric clinics in 2011 were included in the analysis. The primary outcome was retention in care, defined as completing ‡2 primary HIV care visits ‡90 days apart in a 12-month period. Sites were surveyed to assess the availability of clinic structures defined a priori as 'youth-friendly'. Univariate and multivariable logistic regression models assessed structures associated with retention in care. Among 680 YLHIV, 85% were retained. Nearly half (48%) of the 680 YLHIV attended clinics with youth-friendly waiting areas, 36% attended clinics with evening hours, 73% attended clinics with adolescent health-trained providers, 87% could email or text message providers, and 73% could schedule a routine appointment within 2 weeks. Adjusting for demographic and clinical factors, YLHIV were more likely to be retained in care at clinics with a youth-friendly waiting area (AOR 2.47, 95% CI [1.11-5.52]), evening clinic hours (AOR 1.94; 95% CI [1.13-3.33]), and providers with adolescent health training (AOR 1.98; 95% CI [1.01-3.86]). Youth-friendly structures of care impact retention in care among YLHIV. Further investigations are needed to determine how to effectively implement youth-friendly strategies across clinical settings where YLHIV receive care.

show abstract

“…age, sex or gender, income, immigration status) [6][7][8][9][10][11][12], psychosocial factors (e.g. mental health status, substance use, homelessness) [13][14][15], and geographic factors (e.g.…”

Section: Introductionmentioning

confidence: 99%

Assessing Timely Presentation to Care Among People Diagnosed with HIV During Hospital Admission: A Population-Based Study in Ontario, Canada

et al. 2018

View full text Add to dashboard Cite

Timely presentation to care for people newly diagnosed with HIV is critical to optimize health outcomes and reduce onward HIV transmission. Studies describing presentation to care following diagnosis during a hospital admission are lacking. We sought to assess the timeliness of presentation to care and to identify factors associated with delayed presentation. We conducted a population-level study using health administrative databases. Participants were all individuals older than 16 and newly diagnosed with HIV during hospital admission in Ontario, Canada, between April 1, 2007 and March 31, 2015. We used modified Poisson regression models to derive relative risk ratios for the association between sociodemographic and clinical variables and the presentation to out-patient HIV care by 90 days following hospital discharge. Among 372 patients who received a primary HIV diagnosis in hospital, 83.6% presented to care by 90 days. Following multivariable analysis, we did not find associations between patient sociodemographic or clinical characteristics and presentation to care by 90 days. In a secondary analysis of 483 patients diagnosed during hospitalization but for whom HIV was not recorded as the principal reason for admission, 73.1% presented to care by 90 days. Following multivariable adjustment, we found immigrants from countries with generalized HIV epidemics (RR 1.265, 95% CI 1.133-1.413) were more likely to present to care, whereas timely presentation was less likely for people with a mental health diagnosis (RR 0.817, 95% CI 0.742-0.898) and women (RR 0.748, 95% CI 0.559-1.001). Future work should evaluate mechanisms to facilitate presentation to care among these populations.

show abstract

The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

Cited by 354 publications

References 94 publications

Acceptability and Feasibility of a Cell Phone Support Intervention for Youth Living with HIV with Nonadherence to Antiretroviral Therapy

Acceptability and Feasibility of a Cell Phone Support Intervention for Youth Living with HIV with Nonadherence to Antiretroviral Therapy

The Impact of Youth-Friendly Structures of Care on Retention Among HIV-Infected Youth

Assessing Timely Presentation to Care Among People Diagnosed with HIV During Hospital Admission: A Population-Based Study in Ontario, Canada

Contact Info

Product

Resources

About