Gebrezgi Merhawi T, Sheehan Diana M, Mauck Daniel E, Fennie Kristopher P, Ibanez Gladys E, Spencer Emma C, Maddox Lorene M, Trepka Mary J
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA.
Int J STD AIDS. 2019 Oct;30(11):1095-1104. doi: 10.1177/0956462419857302. Epub 2019 Sep 24.
Youth aged 13‒24, are less likely to be retained in HIV care and be virally suppressed than older age groups. This study aimed to assess predictors of retention in HIV care and viral suppression among a population-based cohort of youth (N=2,872) diagnosed with HIV between 1993 and 2014 in Florida. We used generalized estimating equations (GEE) to estimate prevalence ratios (PRs). Retention in care was defined as evidence of engagement in care (at least one laboratory test, physician visit, or antiretroviral therapy prescription refill), two or more times, at least three months apart during 2015. Viral suppression was defined as having evidence of a viral load <200 copies/mL among those in care during 2015. Among the 2,872 youth, 65.4% were retained in care, and among those in care, 65.0% were virally suppressed. Older youth (18‒24 years-old) and non-Hispanic Blacks (NHBs) were less likely to be retained in care; whereas those with male-to-male sexual HIV transmission, perinatal HIV transmission, living in low socioeconomic neighborhoods, and those diagnosed with AIDS before 2016 were more likely be retained in care. Those diagnosed with AIDS before 2016 and NHBs were less likely to be virally suppressed; whereas those with male-to-male sexual HIV transmission and foreign-born persons were more likely to be virally suppressed. Results suggest the need for targeted retention and viral suppression interventions for NHB youth, and older youth (18‒24 years-age).
13至24岁的青少年比其他年龄组更不容易坚持接受艾滋病毒治疗并实现病毒抑制。本研究旨在评估1993年至2014年在佛罗里达州确诊感染艾滋病毒的2872名青少年人群中坚持接受艾滋病毒治疗和病毒抑制的预测因素。我们使用广义估计方程（GEE）来估计患病率比（PR）。坚持接受治疗的定义为在2015年期间有两次或更多次参与治疗的证据（至少一次实验室检查、医生就诊或抗逆转录病毒治疗处方续签），且每次间隔至少三个月。病毒抑制的定义为在2015年接受治疗的人群中，有证据表明病毒载量<200拷贝/毫升。在这2872名青少年中，65.4%的人坚持接受治疗，在接受治疗的人群中，65.0%的人实现了病毒抑制。年龄较大的青少年（18至24岁）和非西班牙裔黑人（NHB）坚持接受治疗的可能性较小；而通过男男性行为传播艾滋病毒、围产期传播艾滋病毒、生活在社会经济地位较低社区的青少年，以及在2016年前被诊断为艾滋病的青少年更有可能坚持接受治疗。在2016年前被诊断为艾滋病的青少年和NHB实现病毒抑制的可能性较小；而通过男男性行为传播艾滋病毒的青少年和外国出生的人实现病毒抑制的可能性较大。结果表明，需要针对NHB青少年和年龄较大的青少年（18至24岁）开展有针对性的坚持治疗和病毒抑制干预措施。
