Rates and correlates of antiretroviral therapy use and virologic suppression among perinatally and behaviorally HIV-infected youth linked to care in the United States.

TitleRates and correlates of antiretroviral therapy use and virologic suppression among perinatally and behaviorally HIV-infected youth linked to care in the United States.
Publication TypePublication
Year of Publication2015
AuthorsKahana SY, Fernandez MIsabel, Wilson PA, Bauermeister JA, Lee S, Wilson CM, Hightow-Weidman LB
JournalJ Acquir Immune Defic Syndr
Volume68
Issue2
Pagination169-77
Date Published2015 Feb 01
ISSN1944-7884
KeywordsAdolescent, Adult, Anti-Retroviral Agents, Cross-Sectional Studies, Female, HIV Infections, Humans, Interviews as Topic, Male, Medication Adherence, Treatment Outcome, United States, Viral Load, Young Adult
Abstract

<p><b>OBJECTIVE: </b>To measure rates of antiretroviral therapy (ART) use and virologic suppression among perinatally HIV-infected youth (PIY) and behaviorally HIV-infected youth (BIY) linked to care in the United States and examine the effects of demographic, biomedical, and psychosocial factors on those rates.</p><p><b>METHODS: </b>Between 2009 and 2012, 649 PIY and 1547 BIY in 20 Adolescent Medicine Trials Network for HIV/AIDS Interventions sites completed cross-sectional surveys through audio computer-assisted self-interviews. Viral load data were collected from chart abstraction or blood draw.</p><p><b>RESULTS: </b>Overall 82.4% of PIY and 49.1% of BIY reported current ART use. Only 37.0% of PIY and 27.1% of BIY were virologically suppressed. Virologic suppression rates did not vary as a function of time since HIV diagnosis in either group. Consistent HIV care and no current substance abuse were significant correlates of ART use among PIY. These variables and non-African American race were some factors associated with virologic suppression for PIY [odds ratios (ORs) P < 0.05]. Among BIY, older age, heterosexuals, employment, and education were significantly related to ART use (ORs: P < 0.05); suppression was related to ART use ≥6 months, ≥90% ART adherence, and consistent HIV care (ORs: P < 0.05). Nearly 75% (n = 498) of nonsuppressed youth reported unprotected sex in the past 3 months.</p><p><b>CONCLUSIONS: </b>There are continued challenges with successfully treating youth even once diagnosed and linked to HIV care. Strategies targeting barriers to ART access, use, and virologic suppression are needed to optimize the impact of the "Treatment as Prevention" paradigm among PIY and BIY.</p>

DOI10.1097/QAI.0000000000000408
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID25590270
PubMed Central IDPMC4312477
Grant ListU01 HD 040533 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD 040474 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
P30 MH043520 / MH / NIMH NIH HHS / United States
UL1 TR001082 / TR / NCATS NIH HHS / United States