Background: In the US, 26% of new HIV infections occur in youth ages 13-24 years. An estimated 61% of youth do not know they are infected. Adolescence is a time of experimentation with sex and substance use, leading to high risk of HIV transmission. We evaluated engagement in care and prevalence of sexually transmitted infections in a cohort of newly HIV-diagnosed adolescents and youth.
Methods: Retrospective chart review of newly HIV-diagnosed individuals ages 13 – 24 years at University of Colorado Hospital and Denver Health and from 2005 – 2009. Charts were reviewed up to 2015 for demographics, visit history, CD4, HIV RNA, and diagnosis of syphilis, gonorrhea, or chlamydia (STIs). Chart review was supplemented using HIV-labs reported to the state health department. Successful linkage to care was defined as patients attending an HIV clinic visit within 90 days of diagnosis. Retention in care was defined as two or more visits at least 3 months apart during the last calendar year of follow-up, 2014.
Results: A total of 111 individuals were included in the cohort, 88% males, median age at diagnosis was 23 years (IQR 21-24 years), 83% were MSM, 42% Hispanic/Latino, 35% Non-Hispanic white, 18% black, 23% foreign-born and 14% undocumented. Median duration of follow-up was 5.1 years. Median initial CD4-lymphocyte count and HIV-RNA were 478 cells/µl (IQR 296-653 cells/ µl) and 15700 copies/ml (IQR 3609-61350 copies/ml), respectively. Linkage to HIV care within 90 days occurred for 68% of the cohort, 17% were retained in care in 2014 and 15% were known to have an undetectable viral load. STIs were diagnosed in 52 individuals (47%) during the study follow-up period. Achieving an undetectable viral load was not associated with any demographic variables or STIs.
Conclusion: Youth in Colorado have lower rates than that of adults for linkage, retention and HIV viral suppression. The high rates of sexually transmitted infections in this cohort demonstrate ongoing risky, condom-less sexual behavior. Given the low retention in care and high rates of STIs and HIV viremia, continued HIV transmission in this cohort is likely.
Sexually Transmitted Infections
D. Reirden, None
S. Johnson, None
E. Connick, None
E. M. Gardner, None