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The status of adolescent testing and treatment in PEPFAR-supported programs, October 2017-September 2020
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5 01 2023
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Source: J Acquir Immune Defic Syndr. 93(1):15-24
[PDF-754.89 KB]
Details:
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Alternative Title:J Acquir Immune Defic Syndr
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Description:Background:
Adolescents have poorer outcomes across the HIV cascade compared to adults. We aimed to assess progress in HIV case-finding, antiretroviral treatment (ART), viral load coverage (VLC), and viral load suppression (VLS) among adolescents enrolled in the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)-supported programs over a three-year period that included the beginning of the COVID-19 pandemic.
Methods:
We analyzed PEPFAR program data in 28 countries/regions for adolescents 10–19 years between year 1 (October 2017-September 2018), year 2 (October 2018-September 2019), and year 3 (October 2019-September 2020). We calculated the number and percent change for HIV tests, HIV-positive tests, and total number on ART. Calculated indicators included positivity, percent of positives newly initiated on ART (ART linkage), VLC (percent of ART patients on ART for ≥6 months with a documented viral load result within the past 12 months), and VLS (percent of viral load tests with <1000 copies/mL).
Results:
Between Years 1 and 3, the number of HIV tests conducted decreased by 44.2%, with a 29.1% decrease in the number of positive tests. Positivity increased from 1.3% to 1.6%. The number of adolescents receiving ART increased by 10.4%. Additionally, ART linkage increased (77.8% to 86.7%) as did VLC (69.4% to 79.4%) and VLS (72.8% to 81.5%).
Conclusions:
Our findings demonstrate PEPFAR’s success in increasing the adolescent treatment cohort. We identified ongoing gaps in adolescent case-finding, linkage, VLC, and VLS that could be addressed with a strategic mix of testing strategies, optimal ART regimens, and adolescent-focused service delivery models.
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Pubmed ID:36716723
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Pubmed Central ID:PMC10079578
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