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

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Show simple item record Auld, A. F. Agolory, S. G. Shiraishi, R. W. Wabwire-Mangen, F. Kwesigabo, G. Mulenga, M. Hachizovu, S. Asadu, E. Tuho, M. Z. Ettiegne-Traore, V. Mbofana, F. Okello, V. Azih, C. Denison, J. A. Tsui, S. Koole, O. Kamiru, H. Nuwagaba-Biribonwoha, H. Alfredo, C. Jobarteh, K. Odafe, S. Onotu, D. Ekra, K. A. Kouakou, J. S. Ehrenkranz, P. Bicego, G. Torpey, K. Mukadi, Y. D. Praag, E. Menten, J. Mastro, T. Hamilton, C. D. Swaminathan, M. Dokubo, E. K. Baughman, A. L. Spira, T. Colebunders, R. Bangsberg, D. Marlink, R. Zee, A. Kaplan, J. Ellerbrock, T. V. 2014-12-03T15:34:25Z 2014-12-03T15:34:25Z 2014
dc.identifier.issn 0149-2195
dc.identifier.other ITG-C16B
dc.identifier.other ITG-C29A
dc.identifier.other ITG-C35A
dc.identifier.other DCS
dc.identifier.other U-STDCLI
dc.identifier.other U-CTU
dc.identifier.other U-HIVCLI
dc.identifier.other FTA
dc.identifier.other Abstract
dc.identifier.other UPD57
dc.description.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<0.001), employed (p<0.001), and married, (p<0.05 in five countries). Compared with older adults, adolescents and young adults had higher LTFU rates in all seven countries, reaching statistical significance in three countries in crude and multivariable analyses. Evidence-based interventions to reduce LTFU for adolescent and young adult ART enrollees could help reduce mortality and HIV incidence in this age group. en_US
dc.language English en_US
dc.subject Viral diseases en_US
dc.subject HIV en_US
dc.subject AIDS en_US
dc.subject HAART en_US
dc.subject Antiretrovirals en_US
dc.subject Adolescents en_US
dc.subject Adults en_US
dc.subject Retention en_US
dc.subject Barriers en_US
dc.subject Eligibility en_US
dc.subject Enrolment en_US
dc.subject Age distribution en_US
dc.subject Gender en_US
dc.subject Pregnancy en_US
dc.subject Socioeconomic status en_US
dc.subject Côte d'Ivoire en_US
dc.subject Nigeria en_US
dc.subject Africa, West en_US
dc.subject Swaziland en_US
dc.subject Mozambique en_US
dc.subject Zambia en_US
dc.subject Africa, Southern en_US
dc.subject Uganda en_US
dc.subject Tanzania en_US
dc.subject Africa, East en_US
dc.title Antiretroviral therapy enrollment characteristics and outcomes among HIV-infected adolescents and young adults compared with older adults - seven African countries, 2004-2013 en_US
dc.type Article en_US
dc.citation.issue 47 en_US
dc.citation.jtitle MMWR. Morbidity and Mortality Weekly Report en_US
dc.citation.volume 63 en_US
dc.citation.pages 1097-1103 en_US
dc.citation.jabbreviation MMWR. Morb Mortal Wkly Rep en_US

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