Time to Improve the Global Human Immunodeficiency Virus/AIDS Care Continuum for Adolescents: A Generation at Stake
This Viewpoint discusses the importance of improving care globally for adolescents with human immunodeficiency virus (HIV)/AIDS.
Pediatricians have an obligation to protect the health of children and adolescents. Human immunodeficiency virus (HIV)/AIDS remains the second leading cause of death for adolescents worldwide and the leading cause for adolescents in sub-Saharan Africa. Youth aged 15 to 24 years represent one-third of new infections. While AIDS-related mortality declined for adults and children from 2005 to 2012, there was a 50% increase in mortality among HIV-infected adolescents. For perinatally HIV-infected youth, worse outcomes largely reflect developmental struggles with treatment adherence they face as they enter adolescence. For adolescents with behaviorally acquired HIV, late diagnosis, poor linkage to and retention in care, low rates of antiretroviral therapy (ART) prescription, and inadequate treatment adherence all affect mortality. In the United States, nearly 60% of HIV-infected youth do not know they are infected. In sub-Saharan Africa, only 1 in 5 HIV-infected young women knows her status.