Gingaras, C;
Smith, C;
Radoi, R;
Sima, D;
Youle, M;
Ene, L;
(2019)
Engagement in care among youth living with parenterally-acquired HIV infection in Romania.
AIDS Care
, 31
(10)
pp. 1290-1296.
10.1080/09540121.2019.1612010.
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Abstract
Transition from adolescent to adult care can be challenging for youth living with HIV. We describe the level of engagement in care and its impact on HIV outcomes in a group of patients infected in early childhood and followed-up through adolescence (15-19 years) and young adulthood (20-24 years) by the same medical team. We conducted a cohort study of youth born between 1985- 1993 and infected with HIV parenterally, followed at a single tertiary care centre. Individuals were followed from age 15 years or first clinic visit (whichever came last) until age 25 years or 30 Nov 2016 (whichever came first). A longitudinal continuum-of-care was constructed, categorizing individuals' status for each month between the ages of 15-25 years as: engaged in care (EIC); not in care (NIC: no clinic visits within past year); lost-to-follow-up (LTFU: NIC and did not return to clinic); or died. Those EIC were further subdivided by current CD4 count and viral load (VL). 545 individuals (52% male) were followed for 4775 person-years. 64 (12%) became LTFU and 27 (5%) died. At age 15, 92% were EIC, decreasing to 84% at age 20 and 74% at age 25. Of those EIC, HIV markers improved with age: 79% and 52% had a CD4≥200 cells/µl and VL<400 cps/ml at age 15; increasing to 86% and 73% at age 20 and 87% and 80% at age 25. 277 (55.5%) spent their entire adolescence EIC; this decreased to 202 (37%) for the years of young adulthood (p=0.0001). There were no observed demographic differences between those with continuous and intermittent engagement in care. We conclude that youth infected during early childhood tended to disengage from care, even when followed by the same medical team for a lengthy period of time. For those that did engage in care, HIV-related outcomes improved from adolescence through to adulthood.
| Type: | Article |
|---|---|
| Title: | Engagement in care among youth living with parenterally-acquired HIV infection in Romania |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1080/09540121.2019.1612010 |
| Publisher version: | https://doi.org/10.1080/09540121.2019.1612010 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | HIV, youth, adolescents, transition of care, engagement in care |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10078704 |
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