The status of adolescent testing and treatment in PEPFAR-supported programs, October 2017-September 2020

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  Hrapcak, Susan ; Hast, Marisa ; Okegbe, Tishina ; Gross, Jessica ; Williams, Jessica ; Patel, Monita ; Wolf, Hilary ; Siberry, George ; Lee, Lana ; Wiersma, Steven ; Agaba, Patricia ; Carpenter, Deborah ; Rivadeneira, Emilia
• Corporate Authors:
  PEPFAR Adolescent Group
• 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.
  
  
• Subjects:
  Adolescent Adult Anti-Retroviral Agents COVID-19 HIV Infections Humans Longitudinal Studies Pandemics
• Keywords:
  HIV Testing Treatment Viral Load
• Source:
  J Acquir Immune Defic Syndr. 93(1):15-24
• Pubmed ID:
  36716723
• Pubmed Central ID:
  PMC10079578
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/
• Volume:
  93
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bbd9b33d11e2bc1d2dc25ecfe6fe212cc9753ec7c513dc02b874fede22cd4382
• Download URL:
  https://stacks.cdc.gov/view/cdc/126816/cdc_126816_DS1.pdf
• File Type:
  [PDF - 754.89 KB ]