title: The adolescent and young adult HIV cascade of care in the United States: exaggerated health disparities.
abstract: Little is known about how adolescents and young adults contribute to the declines in the cascade of care from HIV-1 diagnosis to viral suppression. We reviewed published literature from the Unites States reporting primary data for youth (13-29 years of age) at each stage of the HIV cascade of care. Approximately 41% of HIV-infected youth in the United States are aware of their diagnosis, while only 62% of those diagnosed engage medical care within 12 months of diagnosis. Of the youth who initiate antiretroviral therapy, only 54% achieve viral suppression and a further 57% are not retained in care. We estimate less than 6% of HIV-infected youth in the United States remain virally suppressed. We explore the cascade of care from HIV diagnosis through viral suppression for HIV-infected adolescents and young adults in the United States to highlight areas for improvement in the poor engagement of the infected youth population.
authors.affiliation: 1 The Ragon Institute of Massachusetts General Hospital , Massachusetts Institute of Technology, and Harvard, Charlestown, Massachusetts.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Zanoni
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012698:Serologic Tests; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents