HIV Continuum of Care for Youth in the United States.

TitleHIV Continuum of Care for Youth in the United States.
Publication TypePublication
Year of Publication2018
AuthorsLally MA, van den Berg JJ, Westfall AO, Rudy BJ, Hosek SG, J Fortenberry D, Monte D, Tanney MR, McFarland EJ, Xu J, Kapogiannis BG, Wilson CM
Corporate AuthorsAdolescent Medicine Trials Network for HIV/AIDS Interventions(ATN)
JournalJ Acquir Immune Defic Syndr
Date Published2018 Jan 01
KeywordsAdolescent, Case Management, Cohort Studies, Continuity of Patient Care, Counseling, Female, HIV Infections, Humans, Male, Patient Compliance, Sexual and Gender Minorities, United States, Young Adult

<p><b>BACKGROUND: </b>Beneficial HIV treatment outcomes require success at multiple steps along the HIV Continuum of Care. Youth living with HIV are a key population, and sites in the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) are known for modeling optimum HIV adolescent care.</p><p><b>METHODS: </b>A longitudinal cohort study conducted at 14 network sites across the United States assessed how the later steps of the Continuum of Care were achieved among the youth: engagement, treatment, and viral load (VL) suppression. Youth aged 13-24 who were behaviorally infected with HIV and linked to care at an ATN-affiliated site were eligible to participate.</p><p><b>RESULTS: </b>A total of 467 youth were enrolled and had 1 year of available data. Most were aged 22-24 (57%), male (79%), and black/non-Hispanic (71%). Most used alcohol (81%) and marijuana (61%) in the 3 months before enrollment, and 40% had a history of incarceration. Among this cohort of youth, 86% met criteria for care engagement; among these, 98% were prescribed antiretroviral therapy and 89% achieved VL suppression. Sustained VL suppression at all measured time points was found among 59% with initial suppression. Site characteristics were notable for the prevalence of adherence counseling (100%), case management (100%), clinic-based mental health (93%), and substance use (64%) treatment.</p><p><b>CONCLUSIONS: </b>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.</p>

Alternate JournalJ Acquir Immune Defic Syndr
PubMed ID28991884
PubMed Central IDPMC5774627
Grant ListP30 AI042853 / AI / NIAID NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U54 GM115677 / GM / NIGMS NIH HHS / United States