Incidence of AIDS-defining Conditions among Adults with Perinatally Acquired HIV after Transition to Adult HIV Care in the United States and Canada, 2000-2022.

BACKGROUND

Little is known about the incidence of AIDS-defining conditions (ADCs) among people with perinatally acquired HIV (PHIV) who transitioned to adult HIV care in the United States and Canada. We described the incidence among PHIV and compared it with non-PHIV and across calendar era.

METHODS

Using data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) from 2000-2022, we estimated weighted mean cumulative counts (MCC) of ADCs comparing people with PHIV and non-PHIV acquisition risk groups aged 18-40 engaged in adult HIV care. The weights accounted for differences in characteristics among HIV acquisition risk groups as well as informative censoring. We calculated 95% confidence intervals (CI) using bootstrapping. We stratified results before and after 2012, when immediate start of ART was recommended.

RESULTS

There were 5,429 ADCs among 22,950 people with HIV. Among people with PHIV, the MCC of ADCs by three years in adult HIV care was 26 per 100 persons (95% CI: 15, 40) in 2000-2011 and 16 per 100 persons (95% CI: 5, 21) in 2012-2022. Within each calendar era, weighted MCCs of ADCs among people with PHIV were similar or lower than non-PHIV groups. Within each HIV acquisition risk group, weighted MCCs of ADCs were lower between 2000-2011 vs. 2012-2022.

CONCLUSION

People with PHIV who transitioned to adult HIV care did not experience a greater ADC incidence than people with non-PHIV. This emphasizes the importance of continued engagement in adult HIV care, as it provides critical opportunities for ADC prevention and management.