Although it is often thought of as a disease occurring in adults, nearly 25% of all new HIV cases in the United States are diagnosed in people aged 13 to 24 years, who also have some of the poorest HIV Care Continuum (HCC) outcomes. A new study in the Journal of Acquired Immune Deficiency Syndrome looked at the rate of viral suppression (VS) in these young patients.
Researchers used the Strategic Multisite Initiative for the Identification, Linkage and Engagement in Care of HIV-infected youth (SMILE) to find 1411 adolescents and young adults aged 12 to 24 years who were infected with HIV, most newly diagnosed with the disease. The SMILE program recorded the number of HIV-infected patients who were referred, linked, engaged, and retained in care along with their demographic information. The definition for viral suppression was ≥1 HIV viral load below the level of detection.
Viral suppression more likely in patients linked quickly to care
Over the course of the study, 1053 of the participants were linked to care; 859 were engaged in care; and 473 were retained in care at an adolescent health care site; 474 patients started antiretroviral therapy, and 166 achieved viral suppression.
The following were found to be predictors for viral suppression: a lower viral load at baseline (adjusted hazard ration [aHR], 1.56; 95% CI,1.32-1.89, P<0.0001); recently receiving antiretroviral therapy (aHR, 3.10; 95% CI, 1.86-5.18, P<0.0001); and less time between HIV testing and referral to a linkage coordinator (aHR, 2.52; 95% CI, 1.50-4.23), P=0.0005 for 7 days to 6 weeks and aHR, 2.08; 95% CI, 1.08-4.04, P=0.0294 for 6 weeks to 3 months compared to >3 months).
The researchers concluded that interventions targeted to adolescents and young adults are urgently needed to improve HCC outcomes and help young patients achieve viral suppression.
1. Kapogiannis B, Koenig L, Xu J, et al. The HIV continuum of care for adolescents and young adults attending 13 urban US HIV care centers of the NICHD-ATN-CDC-HRSA SMILE collaborative. JAIDS. January 28, 2020. Epub ahead of print.