Delayed Entry into Care in Younger HIV Infected Individuals
By 2010, young adults, age 13 to 24 years old, accounted for ~7% of persons living with HIV in the U.S. One in 4, new HIV infections in the U.S. occurred in young adults. Almost 60% of young adults with HIV are unaware of their status. South Carolina (SC) ranks amongst the top in new infections in young adults. The aim of this study is to compare characteristics and engagement in care in newly diagnosed HIV individuals in Richland County, SC between those who are <25 years (young adults) and ≥25 years at the time of diagnosis.
Methods: Baseline characteristics, time to engagement in care and time to undetectable HIV viral load (VL) were compared between individuals <25 years to those ≥25 years of age at HIV diagnosis. Means and standard deviations were calculated for all continuous variables and differences between individuals in the two age groups were assessed via two-tailed independent samples t-tests. Frequencies were calculated for all categorical variables and differences between the two age groups were assessed via χ2 tests of independence.
Results: 231 new HIV diagnoses were identified of which 69 (29.9%) were <25 years at the time of diagnosis. Compared to the older group, the young adults were more likely to me male (61.7% versus 87%, p = .001) and report male sex with male (38.5% versus 79.7%, p <.001). There was no difference in race by age group. Compared to the older adults, the young adults had a higher proportion going to college (32.8% versus 64.7%, p = .001). Young adults reported more sexual partners in the past year (41% with >2 partners versus 16%, p < .001). The young adults had marginally higher rates of sexually transmitted infections (STI) at HIV diagnosis (23.1% versus 13%, p = .06). Young adults had a longer mean delay from diagnosis to first kept appointment, (12.9 weeks versus 9.0 weeks, p= .04). The young adults had a longer mean time to initiation of HIV medications (23.1 weeks versus 14.3 weeks, p=.004), and longer time to obtain an undetectable VL (7.6 months versus 5.4 months, p= .03).
Delayed entry into care, higher number of sexual partners and higher rates of STI in the younger individuals with newly diagnosed HIV are factors that may lead to the high rates of new infections in this age group. Prevention efforts need to be tailored to target this age group.
K. Dukes, None
M. Whitmire, None