Youth with HIV Less Likely than Adults to Achieve Viral Suppression

A study funded by the National Institutes of Health (NIH) found that despite similar rates of enrollment into medical care, youth with HIV have much lower rates of viral suppression compared with adults.

Among more than 1000 youth with HIV, most of whom were newly enrolled in care at treatment centers throughout the United States, 12% had attained viral suppression. This rate is lower than the 32% to 63% observed in studies of adults over the age of 24. The findings suggest that after they enroll in an HIV treatment program, a low proportion of youth adhere to care regimens, according to the study authors.

The researchers analyzed data from the Adolescent Medicine Trials Network for HIV/AIDS interventions (ATN), an NIH-supported network of 13 sites dedicated to the health and care of youth with and at risk for HIV. The youth were enrolled in care through the Strategic Multisite Initiative for the Identifcation, Linkage, and Engagement in Care of Youth (SMILE), which includes a network of clinics at each ATN site that offers diagnositc services and referral to treatment facilities.

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“Our findings indicate an urgency for research on how best to tailor HIV intervention services to the needs of youth,” said Bill G. Kapogiannis, MD, of the Maternal and Pediatric Infectious Diseases Branch at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development in a prepared statement.

The study included 1411 individuals with HIV aged 12 to 24 years, 75% of whom were enrolled in care and were referred to the ATN sites. Thirty-four percent remained in care and began anti-HIV treatment and 12% achieved viral suppression after a median interval of approximately 5 months. Maintaining viral suppression for at least 6 months after a person's first test shows no detectable levels of the virus can prevent the sexual transmission of HIV and allows people with HIV to remain healthy.

Youth who were referred to care within a shorter time frame after an HIV diagnosis were more likely to achieve viral suppression. Compared with youth referred to care after 3 months, those referred within 1 to 6 weeks were 2.5 times more likely to achieve viral suppression. Those who were referred from 6 weeks to 3 months were roughly twice as likely to reach viral suppression.

The study authors emphasized the importance of enlisting trained peer counselors and of maintaining frequent contact with youth through text and social media messages. The authors concluded that additional strategies to ensure that youth enroll and remain in care are urgently needed.

REFERENCE

Youth with HIV less likely than adults to achieve viral suppression. NIH. https://www.nih.gov/news-events/news-releases/youth-hiv-less-likely-adults-achieve-viral-suppression. Published February 10, 2020. Accessed February 18, 2020.