Authors

Andrew F. Auld, Division of Global HIV/AIDS, Center for Global Health
Simon G. Agolory, Division of Global HIV/AIDS, Center for Global Health
Ray W. Shiraishi, Division of Global HIV/AIDS, Center for Global Health
Fred Wabwire-Mangen, Makerere University College of Health SciencesFollow
Gideon Kwesigabo, Muhimbili University of Health and Allied Sciences
Modest Mulenga, Tropical Diseases Research Center, Zambia
Sebastian Hachizovu, Tropical Diseases Research Center, Zambia
Emeka Asadu, Ministry of Health, Nigeria
Moise Zanga Tuho, Ministry of Health, Côte d’Ivoire
Virginie Ettiegne-Traore, Ministry of Health, Côte d’Ivoire
Francisco Mbofana, National Institute of Health, Mozambique
Velephi Okello, Ministry of Health, Swaziland
Charles Azih, Ministry of Health, Swaziland
Julie A. Denison, Social and Behavioral Health Sciences, FHI 360, Washington, DC
Sharon Tsui, Social and Behavioral Health Sciences, FHI 360, Washington, DC
Olivier Koole, Institute of Tropical Medicine
Harrison Kamiru, International Center for AIDS Care and Treatment Programs-Columbia University
Harriet Nuwagaba-Biribonwoha, International Center for AIDS Care and Treatment Programs-Columbia University
Charity Alfredo, Center for Global Health, CDC, Mozambique
Kebba Jobarteh, Center for Global Health, CDC, Mozambique
Solomon Odafe, Center for Global Health, CDC, Nigeria
Dennis Onotu, Center for Global Health, CDC, Nigeria
Kunomboa A. Ekra, Center for Global Health, CDC, Côte d’Ivoire
Joseph S. Kouakou, Center for Global Health, CDC, Côte d’Ivoire
Peter Ehrenkranz, Center for Global Health, CDC, SwazilandFollow
George Bicego, Center for Global Health, CDC, Swaziland
Kwasi Torpey, FHI 360, Zambia
Ya Diul Mukadi, FHI 360, Haiti
Eric van Praag, FHI 360, Tanzania
Joris Menten, Institute of Tropical Medicine
Timothy Mastro, Global Health, Population and Nutrition, FHI 360, Durham, NC
Carol Dukes Hamilton, Global Health, Population and Nutrition, FHI 360, Durham, NC
Mahesh Swaminathan, Division of Global HIV/AIDS, Center for Global Health
E. Kainne Dokubo, Division of Global HIV/AIDS, Center for Global Health
Andrew L. Baughman, Division of Global HIV/AIDS, Center for Global Health
Thomas Spira, Division of Global HIV/AIDS, Center for Global Health
Robert Colebunders, Institute of Tropical Medicine
David Bangsberg, Portland State UniversityFollow
Richard Marlink, Harvard School of Public Health
Aaron Zee, Division of Global HIV/AIDS, Center for Global Health
Jonathan Kaplan, Division of Global HIV/AIDS, Center for Global Health
Tedd V. Ellerbrock, Division of Global HIV/AIDS, Center for Global Health

Publication Title

Morbidity and Mortality Weekly Report

Document Type

Article

Publication Date

11-2014

Subjects

Antiretroviral agents, AIDS (Disease) -- Epidemiology, AIDS (Disease) -- Treatment -- Statistics, AIDS (Disease) -- Sub-Saharan Africa -- Longitudinal studies

Physical Description

7 pages

Abstract

Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to a decline of about 30% in the global annual number of human immunodeficiency (HIV)–related deaths and declines in global HIV incidence, estimated annual HIV-related deaths among adolescents have increased by about 50%, and estimated adolescent HIV incidence has been relatively stable. In 2012, an estimated 2,500 (40%) of all 6,300 daily new HIV infections occurred among persons aged 15–24 years. Difficulty enrolling adolescents and young adults in ART and high rates of loss to follow-up (LTFU) after ART initiation might be contributing to mortality and HIV incidence in this age group, but data are limited.

Age-related differences in enrollment characteristics and outcomes were analyzed among 16,421 patients aged ≥15 years starting ART in seven African countries (Côte d’Ivoire, Nigeria, Swaziland, Mozambique, Zambia, Uganda, and Tanzania) during 2004–2012. Patient characteristics and outcomes were compared across three age groups: adolescents and young adults (15–24 years), middle-aged adults (25–49 years), and older adults (≥50 years). Compared with older adults, adolescents and young adults had higher LTFU rates in all seven countries, reaching statistical significance in three countries (Côte d’Ivoire, Mozambique, and Tanzania) in both crude and multivariable analyses.

The higher risk for LTFU among adolescent and young adult ART enrollees, compared with older adults, increases their risk for death and increases the risk they will transmit HIV to seronegative sex partners. Effective interventions to reduce LTFU for adolescent and young adult ART enrollees could help reduce mortality and lower HIV incidence in this age group.

Description

David Bangsberg was affiliated with Massachusetts General Hospital at the time of writing.

Originally appeared in Morbidity and Mortality Weekly Report, published by the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA.

Persistent Identifier

http://archives.pdx.edu/ds/psu/18445

Publisher

Centers for Disease Control and Prevention (CDC)

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