Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV research network

Allison L. Agwu, Lana Lee, John A. Fleishman, Cindy Voss, Baligh R. Yehia, Keri N. Althoff, Richard Rutstein, W. Christopher Mathews, Ank Nijhawan, Richard D. Moore, Aditya H. Gaur, Kelly A. Gebo

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose In the United States, 21 years is a critical age of legal and social transition, with changes in social programs such as public insurance coverage. Human immunodeficiency virus (HIV)-infected youth have lower adherence to care and medications and may be at risk of loss to follow-up (LTFU) at this benchmark age. We evaluated LTFU after the 22nd birthday for HIV-infected youth engaged in care. LTFU was defined as having no primary HIV visits in the year after the 22nd birthday. Methods All HIV-infected 21-year-olds engaged in care (2002-2011) at the HIV Research Network clinics were included. We assessed the proportion LTFU and used multivariable logistic regression to evaluate demographic and clinical characteristics associated with LTFU after the 22nd birthday. We compared LTFU at other age transitions during the adolescent/young adult years. Results Six hundred forty-seven 21-year-olds were engaged in care; 91 (19.8%) were LTFU in the year after turning 22 years. Receiving care at an adult versus pediatric HIV clinic (adjusted odds ratio [AOR], 2.91; 95% confidence interval [CI], 1.42-5.93), having fewer than four primary HIV visits/year (AOR, 2.72; 95% CI, 1.67-4.42), and antiretroviral therapy prescription (AOR,.50; 95% CI,.41-.60) were independently associated with LTFU. LTFU was prevalent at each age transition, with factors associated with LTFU similar to that identified for 21-year-olds. Conclusions Although 19.8% of 21-year-olds at the HIV Research Network sites were LTFU after their 22nd birthday, significant proportions of youth of all ages were LTFU. Fewer than four primary HIV care visits/year, receiving care at adult clinics and not prescribed antiretroviral therapy, were associated with LTFU and may inform targeted interventions to reduce LTFU for these vulnerable patients.

Original languageEnglish (US)
Pages (from-to)345-351
Number of pages7
JournalJournal of Adolescent Health
Volume56
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

HIV
Research
Odds Ratio
Confidence Intervals
Benchmarking
Insurance Coverage
Prescriptions
Young Adult
Logistic Models
Demography
Pediatrics
Therapeutics

Keywords

  • Adolescents
  • Attrition
  • Care
  • HIV
  • Loss to follow-up
  • Network
  • Research
  • Young adults
  • Youth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health

Cite this

Agwu, A. L., Lee, L., Fleishman, J. A., Voss, C., Yehia, B. R., Althoff, K. N., ... Gebo, K. A. (2015). Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV research network. Journal of Adolescent Health, 56(3), 345-351. https://doi.org/10.1016/j.jadohealth.2014.11.009

Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV research network. / Agwu, Allison L.; Lee, Lana; Fleishman, John A.; Voss, Cindy; Yehia, Baligh R.; Althoff, Keri N.; Rutstein, Richard; Mathews, W. Christopher; Nijhawan, Ank; Moore, Richard D.; Gaur, Aditya H.; Gebo, Kelly A.

In: Journal of Adolescent Health, Vol. 56, No. 3, 01.03.2015, p. 345-351.

Research output: Contribution to journalArticle

Agwu, AL, Lee, L, Fleishman, JA, Voss, C, Yehia, BR, Althoff, KN, Rutstein, R, Mathews, WC, Nijhawan, A, Moore, RD, Gaur, AH & Gebo, KA 2015, 'Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV research network', Journal of Adolescent Health, vol. 56, no. 3, pp. 345-351. https://doi.org/10.1016/j.jadohealth.2014.11.009
Agwu, Allison L. ; Lee, Lana ; Fleishman, John A. ; Voss, Cindy ; Yehia, Baligh R. ; Althoff, Keri N. ; Rutstein, Richard ; Mathews, W. Christopher ; Nijhawan, Ank ; Moore, Richard D. ; Gaur, Aditya H. ; Gebo, Kelly A. / Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV research network. In: Journal of Adolescent Health. 2015 ; Vol. 56, No. 3. pp. 345-351.
@article{305283e496474efa9951c5a91bc7ab2f,
title = "Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV research network",
abstract = "Purpose In the United States, 21 years is a critical age of legal and social transition, with changes in social programs such as public insurance coverage. Human immunodeficiency virus (HIV)-infected youth have lower adherence to care and medications and may be at risk of loss to follow-up (LTFU) at this benchmark age. We evaluated LTFU after the 22nd birthday for HIV-infected youth engaged in care. LTFU was defined as having no primary HIV visits in the year after the 22nd birthday. Methods All HIV-infected 21-year-olds engaged in care (2002-2011) at the HIV Research Network clinics were included. We assessed the proportion LTFU and used multivariable logistic regression to evaluate demographic and clinical characteristics associated with LTFU after the 22nd birthday. We compared LTFU at other age transitions during the adolescent/young adult years. Results Six hundred forty-seven 21-year-olds were engaged in care; 91 (19.8{\%}) were LTFU in the year after turning 22 years. Receiving care at an adult versus pediatric HIV clinic (adjusted odds ratio [AOR], 2.91; 95{\%} confidence interval [CI], 1.42-5.93), having fewer than four primary HIV visits/year (AOR, 2.72; 95{\%} CI, 1.67-4.42), and antiretroviral therapy prescription (AOR,.50; 95{\%} CI,.41-.60) were independently associated with LTFU. LTFU was prevalent at each age transition, with factors associated with LTFU similar to that identified for 21-year-olds. Conclusions Although 19.8{\%} of 21-year-olds at the HIV Research Network sites were LTFU after their 22nd birthday, significant proportions of youth of all ages were LTFU. Fewer than four primary HIV care visits/year, receiving care at adult clinics and not prescribed antiretroviral therapy, were associated with LTFU and may inform targeted interventions to reduce LTFU for these vulnerable patients.",
keywords = "Adolescents, Attrition, Care, HIV, Loss to follow-up, Network, Research, Young adults, Youth",
author = "Agwu, {Allison L.} and Lana Lee and Fleishman, {John A.} and Cindy Voss and Yehia, {Baligh R.} and Althoff, {Keri N.} and Richard Rutstein and Mathews, {W. Christopher} and Ank Nijhawan and Moore, {Richard D.} and Gaur, {Aditya H.} and Gebo, {Kelly A.}",
year = "2015",
month = "3",
day = "1",
doi = "10.1016/j.jadohealth.2014.11.009",
language = "English (US)",
volume = "56",
pages = "345--351",
journal = "Journal of Adolescent Health",
issn = "1054-139X",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV research network

AU - Agwu, Allison L.

AU - Lee, Lana

AU - Fleishman, John A.

AU - Voss, Cindy

AU - Yehia, Baligh R.

AU - Althoff, Keri N.

AU - Rutstein, Richard

AU - Mathews, W. Christopher

AU - Nijhawan, Ank

AU - Moore, Richard D.

AU - Gaur, Aditya H.

AU - Gebo, Kelly A.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Purpose In the United States, 21 years is a critical age of legal and social transition, with changes in social programs such as public insurance coverage. Human immunodeficiency virus (HIV)-infected youth have lower adherence to care and medications and may be at risk of loss to follow-up (LTFU) at this benchmark age. We evaluated LTFU after the 22nd birthday for HIV-infected youth engaged in care. LTFU was defined as having no primary HIV visits in the year after the 22nd birthday. Methods All HIV-infected 21-year-olds engaged in care (2002-2011) at the HIV Research Network clinics were included. We assessed the proportion LTFU and used multivariable logistic regression to evaluate demographic and clinical characteristics associated with LTFU after the 22nd birthday. We compared LTFU at other age transitions during the adolescent/young adult years. Results Six hundred forty-seven 21-year-olds were engaged in care; 91 (19.8%) were LTFU in the year after turning 22 years. Receiving care at an adult versus pediatric HIV clinic (adjusted odds ratio [AOR], 2.91; 95% confidence interval [CI], 1.42-5.93), having fewer than four primary HIV visits/year (AOR, 2.72; 95% CI, 1.67-4.42), and antiretroviral therapy prescription (AOR,.50; 95% CI,.41-.60) were independently associated with LTFU. LTFU was prevalent at each age transition, with factors associated with LTFU similar to that identified for 21-year-olds. Conclusions Although 19.8% of 21-year-olds at the HIV Research Network sites were LTFU after their 22nd birthday, significant proportions of youth of all ages were LTFU. Fewer than four primary HIV care visits/year, receiving care at adult clinics and not prescribed antiretroviral therapy, were associated with LTFU and may inform targeted interventions to reduce LTFU for these vulnerable patients.

AB - Purpose In the United States, 21 years is a critical age of legal and social transition, with changes in social programs such as public insurance coverage. Human immunodeficiency virus (HIV)-infected youth have lower adherence to care and medications and may be at risk of loss to follow-up (LTFU) at this benchmark age. We evaluated LTFU after the 22nd birthday for HIV-infected youth engaged in care. LTFU was defined as having no primary HIV visits in the year after the 22nd birthday. Methods All HIV-infected 21-year-olds engaged in care (2002-2011) at the HIV Research Network clinics were included. We assessed the proportion LTFU and used multivariable logistic regression to evaluate demographic and clinical characteristics associated with LTFU after the 22nd birthday. We compared LTFU at other age transitions during the adolescent/young adult years. Results Six hundred forty-seven 21-year-olds were engaged in care; 91 (19.8%) were LTFU in the year after turning 22 years. Receiving care at an adult versus pediatric HIV clinic (adjusted odds ratio [AOR], 2.91; 95% confidence interval [CI], 1.42-5.93), having fewer than four primary HIV visits/year (AOR, 2.72; 95% CI, 1.67-4.42), and antiretroviral therapy prescription (AOR,.50; 95% CI,.41-.60) were independently associated with LTFU. LTFU was prevalent at each age transition, with factors associated with LTFU similar to that identified for 21-year-olds. Conclusions Although 19.8% of 21-year-olds at the HIV Research Network sites were LTFU after their 22nd birthday, significant proportions of youth of all ages were LTFU. Fewer than four primary HIV care visits/year, receiving care at adult clinics and not prescribed antiretroviral therapy, were associated with LTFU and may inform targeted interventions to reduce LTFU for these vulnerable patients.

KW - Adolescents

KW - Attrition

KW - Care

KW - HIV

KW - Loss to follow-up

KW - Network

KW - Research

KW - Young adults

KW - Youth

UR - http://www.scopus.com/inward/record.url?scp=84924050801&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924050801&partnerID=8YFLogxK

U2 - 10.1016/j.jadohealth.2014.11.009

DO - 10.1016/j.jadohealth.2014.11.009

M3 - Article

VL - 56

SP - 345

EP - 351

JO - Journal of Adolescent Health

JF - Journal of Adolescent Health

SN - 1054-139X

IS - 3

ER -