High Rates of Viral Suppression and Care Retention Among Youth Born Outside of the United States with Perinatally-Acquired HIV

• Authors: Neerav Desai, Vanderbilt University; Cathy A. Jenkins, Vanderbilt University; Brian Christopher Zanoni, Emory University; Ashley Nmoh, Vanderbilt University; Nehali Patel, St. Jude Children's Research Hospital; Bryan E. Shepard, Vanderbilt University; Sophia A. Hussen, Emory University; Kamini Doraivelu, Emory University; Leslie Pierce, Vanderbilt University; James G. Carlucci, Indiana University, Indianapolis; Aima A. Ahonkhai, Vanderbilt University
• Journal Title: Pediatric Infectious Disease Journal
• Volume: Volume 41, Number 12
• Publisher: Wolters Kluwer Health, Inc. | 2022-09-08, Pages 970-975
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/INF.0000000000003698
• Subjects: Health Sciences, Public Health; Health Sciences, Health Care Management
• Keywords: HIV; HIV status; YBoUS-PHIV; immigrants; refugees

Abstract

Youth born outside of the United States (US) with perinatally-acquired HIV infection (YBoUS-PHIV) represent a steadily growing majority of the pediatric and adolescent HIV cases within the US, now accounting for 70% of children with HIV <13 years of age.1 YBoUS-PHIV are a diverse group comprising international adoptees, refugees, and other immigrants. They and their families face major challenges to accessing quality, holistic healthcare for children with chronic, and sometimes complex healthcare needs.2 Despite the central importance of this population to control the HIV epidemic in the US, little data characterizing experiences of YBoUS-PHIV along the HIV care continuum exists. Learning and understanding one’s HIV status (i.e., disclosure) represent a critical juncture for youth living with HIV (YHIV).3,4 Successful, early, and non-traumatic disclosure of a young person’s HIV status is associated with better medication adherence, improved retention in care, and reduced mortality.5–7 Additionally, as YHIV grow older, they must manage living with a stigmatizing chronic illness, while also navigating the normal “storm and stress” of adolescence that is often accompanied by behaviors that increase the risk for poor adherence to antiretroviral therapy (ART) and virologic failure.4,7–9 It is also during this period that many YHIV face transition from pediatric to adult health services, and not surprisingly as many as 50% become disengaged from HIV care.10,11