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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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dc.contributor.author Auld, A. F.
dc.contributor.author Agolory, S. G.
dc.contributor.author Shiraishi, R. W.
dc.contributor.author Wabwire-Mangen, F.
dc.contributor.author Kwesigabo, G.
dc.contributor.author Mulenga, M.
dc.contributor.author Hachizovu, S.
dc.contributor.author Asadu, E.
dc.contributor.author Tuho, M. Z.
dc.contributor.author Ettiegne-Traore, V.
dc.contributor.author Mbofana, F.
dc.contributor.author Okello, V.
dc.contributor.author Azih, C.
dc.contributor.author Denison, J. A.
dc.contributor.author Tsui, S.
dc.contributor.author Koole, O.
dc.contributor.author Kamiru, H.
dc.contributor.author Nuwagaba-Biribonwoha, H.
dc.contributor.author Alfredo, C.
dc.contributor.author Jobarteh, K.
dc.contributor.author Odafe, S.
dc.contributor.author Onotu, D.
dc.contributor.author Ekra, K. A.
dc.contributor.author Kouakou, J. S.
dc.contributor.author Ehrenkranz, P.
dc.contributor.author Bicego, G.
dc.contributor.author Torpey, K.
dc.contributor.author Mukadi, Y. D.
dc.contributor.author Praag, E.
dc.contributor.author Menten, J.
dc.contributor.author Mastro, T.
dc.contributor.author Hamilton, C. D.
dc.contributor.author Swaminathan, M.
dc.contributor.author Dokubo, E. K.
dc.contributor.author Baughman, A. L.
dc.contributor.author Spira, T.
dc.contributor.author Colebunders, R.
dc.contributor.author Bangsberg, D.
dc.contributor.author Marlink, R.
dc.contributor.author Zee, A.
dc.contributor.author Kaplan, J.
dc.contributor.author Ellerbrock, T. V.
dc.date.accessioned 2014-12-03T15:34:25Z
dc.date.available 2014-12-03T15:34:25Z
dc.date.issued 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.identifier.uri http://hdl.handle.net/10390/8156
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.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/25426651
dc.citation.jabbreviation MMWR. Morb Mortal Wkly Rep en_US


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