The Status of Adolescent Testing and Treatment in PEPFAR-Supported Programs, October 2017 to September 2020. (1st May 2023)

• Record Type: Journal Article
• Authors: Hrapcak, Susan; Hast, Marisa; Okegbe, Tishina; Gross, Jessica; Williams, Jessica; Patel, Monita; Wolf, Hilary; Siberry, George; Lee, Lana; Wiersma, Steven; Agaba, Patricia; Carpenter, Deborah; Rivadeneira, Emilia
• Other Names: Neto Zoraima E. collaborator.; Makwepa Daphne collaborator.; Dokubo Emily K. collaborator.; Mayer Magdalene collaborator.; Shang Judith collaborator.; Wright Janell collaborator.; Prao Aka K. collaborator.; Longuma Henri O. collaborator.; Kabwe Constantin collaborator.; Mndzebele Phumzile collaborator.; Teferi Wondimu collaborator.; Jean-Louis Reginald collaborator.; Agarwal Reshu collaborator.; Allam Ramesh R. collaborator.; Mutisya Immaculate collaborator.; Nyabiage Lennah collaborator.; Ts'oeu Mamorapeli collaborator.; Kayira Dumbani collaborator.; Deus Maria Ines collaborator.; Battey Katherine collaborator.; Ene Uzoma collaborator.; Musoni Canisious collaborator.; Kindra Gurpreet collaborator.; Mondi John collaborator.; Machage Edward collaborator.; Sethaputra Chuenkamol collaborator.; Nazziwa Esther collaborator.; Barzilay Ezra J. collaborator.; Le Yen collaborator.; Musokotwane Kebby collaborator.; Maphosa Talent collaborator.; Baramperanye Evelyne collaborator.; Nzima Valery collaborator.; Tilahun Tsegaye collaborator.; Meheretu Walelign collaborator.; Prasad Rita collaborator.; Zomba Gerald collaborator.; Pokeya Percy collaborator.; Kalimunda Jacqueline collaborator.; Maguwu Onesimo collaborator.; Akao Juliet N. collaborator.; Njeru Dorothy collaborator.; Adamu Yakubu collaborator.; Mwambona Janet collaborator.; Birabwa Estella collaborator.;
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 93:Number 1(2023)
• Page Start: 15
• Page End: 24
• Publication Date: 2023-05-01
• Subjects: adolescent -- HIV -- treatment -- testing -- viral load; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000003166
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Supplemental Digital Content is Available in the Text. Abstract : Background: Adolescents have poorer outcomes across the HIV cascade compared with adults. We aimed to assess progress in HIV case finding, antiretroviral treatment (ART), viral load coverage (VLC), and viral load suppression (VLS) among adolescents enrolled in the US President's Emergency Plan for AIDS Relief (PEPFAR)–supported programs over a 3-year period that included the beginning of the COVID-19 pandemic. Methods: We analyzed PEPFAR program data in 28 countries/regions for adolescents aged 10–19 years between year 1 (October 2017to September 2018), year 2 (October 2018 to September 2019), and year 3 (October 2019 to September 2020). We calculated the number and percent change for HIV tests, HIV-positive tests, and total number on ART. Calculated indicators included positivity, percent of positives newly initiated on ART (ART linkage), VLC (percent of ART patients on ART for ≥6 months with a documented viral load result within the past 12 months), and VLS (percent of viral load tests with <1000 copies/mL). Results: Between years 1 and 3, the number of HIV tests conducted decreased by 44.2%, with a 29.1% decrease in the number of positive tests. Positivity increased from 1.3%–1.6%. The number of adolescents receiving ART increased by 10.4%. In addition, ART linkage increased (77.8%–86.7%) as did VLC (69.4%–79.4%) and VLS (72.8%–81.5%). Conclusions: Our findings demonstrate PEPFAR's success in increasing the adolescent treatment cohort. We identified ongoing gaps in adolescent case finding, linkage, VLC, and VLS that could be addressed with a strategic mix of testing strategies, optimal ART regimens, and adolescent-focused service delivery models.