title: Challenges to HIV management among youth engaged in HIV care.
abstract: Regardless of medical advancements, new HIV infections persist. Young adults are most often newly infected, thus research is needed to assess medication adherence barriers specific to young adults with HIV. The data were abstracted from medical charts to include both self-reported behavioral and psychological distress data and HIV parameters in 2013 among patients aged 18-30 years. Descriptive and logistic regression analyses were conducted to identify factors related to viral suppression and sexually transmitted infection (STI) status. A total of 335 individuals presented for care during a 12-month period at a single clinic. The majority were African American and had a mean age of 25.6 years. Nearly all had current prescriptions of antiretroviral therapy (ART). Among those receiving ART, almost three-quarters were virally suppressed, as measured by 200 copies/mL. STI tests are conducted annually and by assessed need; 30% of this sample had at least 1 bacterial STI diagnosis within the last year. Psychological distress symptoms were more common among individuals who were not virally suppressed, compared to those who were virally suppressed. Women and individuals with moderate to severe symptoms of depression had higher odds of having unsuppressed viral loads. The independent factors associated with having any STIs were being African American or other minorities and having two or more sex partners. Our findings related to how young adults are managing their HIV care suggest that increased efforts aimed to prevent additional STIs and manage psychological distress will likely reduce transmission risks.
authors.affiliation: a Department of Behavioral Science and Health Education , College for Public Health and Social Justice, Saint Louis University , St. Louis , MO , USA.
authors.forename: Enbal
authors.initials: E
authors.lastname: Shacham
authors.affiliation: a Department of Behavioral Science and Health Education , College for Public Health and Social Justice, Saint Louis University , St. Louis , MO , USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Estlund
authors.affiliation: b Department of Public Health Education , School of Health & Human Sciences, University of North Carolina Greensboro , Greensboro , NC , USA.
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Tanner
authors.affiliation: c Division of Infectious Diseases, Department of Medicine , Washington University School of Medicine , St. Louis , MO , USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Presti
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology* / Q000635:transmission; D006801:Humans; D008297:Male; D055118:Medication Adherence; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D013315:Stress, Psychological / Q000209:etiology; D000072230:Sustained Virologic Response; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV management; HIV/AIDS; Youth; adolescents; mental illness; psychiatric disorders; psychological distress; young adults