Antiretroviral therapy enrollment characteristics and outcomes among HIV-infected adolescents and young adults compared with older adults - seven African countries, 2004-2013

A.F. Auld, S.G. Agolory, R.W. Shiraishi, F. Wabwire-Mangen, G. Kwesigabo, M. Mulenga, S. Hachizovu, E. Asadu, M.Z. Tuho, V. Ettiegne-Traore, F. Mbofana, V. Okello, C. Azih, J.A. Denison, S. Tsui, Olivier Koole, H. Kamiru, H. Nuwagaba-Biribonwoha, C. Alfredo, K. JobartehS. Odafe, D. Onotu, K.A. Ekra, J.S. Kouakou, P. Ehrenkranz, G. Bicego, K. Torpey, Y.D. Mukadi, E. Praag, Joris Menten, T. Mastro, C.D. Hamilton, M. Swaminathan, E.K. Dokubo, A.L. Baughman, T. Spira, Robert Colebunders, D. Bangsberg, R. Marlink, A. Zee, J. Kaplan, T.V. Ellerbrock

Research output: Contribution to journalA1: Web of Science-article

Abstract

Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to declines 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. To evaluate age-related ART retention challenges, data from retrospective cohort studies conducted in seven African countries among 16,421 patients, aged >/=15 years at enrollment, who initiated ART during 2004-2012 were analyzed. ART enrollment and outcome data were compared among three groups defined by age at enrollment: adolescents and young adults (aged 15-24 years), middle-aged adults (aged 25-49 years), and older adults (aged >/=50 years). Enrollees aged 15-24 years were predominantly female (81%-92%), commonly pregnant (3%-32% of females), unmarried (54%-73%), and, in four countries with employment data, unemployed (53%-86%). In comparison, older adults were more likely to be male (p
Original languageEnglish
JournalMMWR Morbidity and Mortality Weekly Report
Volume63
Issue number47
Pages (from-to)1097-1103
Number of pages7
ISSN0149-2195
Publication statusPublished - 2014

Keywords

  • Viral diseases
  • HIV
  • AIDS
  • HAART
  • Antiretrovirals
  • Adolescents
  • Adults
  • Retention
  • Barriers
  • Eligibility
  • Enrolment
  • Age distribution
  • Gender
  • Pregnancy
  • Socioeconomic status
  • C“te d'Ivoire
  • Nigeria
  • Africa-West
  • Swaziland
  • Mozambique
  • Zambia
  • Africa-Southern
  • Uganda
  • Tanzania
  • Africa-East

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