Adolescent and young adult antiretroviral therapy (ART) enrollees, aged 15-24 years, in seven African countries were mostly female, unemployed, unmarried, commonly pregnant, and had significantly higher rates of loss to follow-up from ART than older adults. Evidence-based interventions to reduce loss to follow-up for adolescent and young adult ART enrollees in Africa are urgently needed as this could help reduce mortality and HIV incidence in this age group. Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to declines in global annual HIV-related deaths, estimated annual HIV-related deaths among adolescents have increased by about 50% with most deaths occurring in Africa.
In addition, in 2012 an estimated 2,500 (40%) of all 6,300 daily new HIV infections occurred among persons aged 15-24 years. Difficulty enrolling HIV-infected adolescents and young adults (aged 15-24 years) in ART and high rates of loss to follow-up (LTFU) after ART initiation might be contributing to mortality and HIV incidence in this age group. To evaluate age-related ART retention challenges, data from retrospective cohort studies conducted in seven African countries among 16,421 adult and adolescent ART patients were analyzed by CDC investigators. Compared with older adults, adolescents and young adults had higher LTFU rates in all seven countries, reaching statistical significance in three countries. Evidence-based interventions to reduce LTFU for adolescent and young adult ART enrollees are urgently needed and could help reduce mortality and HIV incidence in this age group.
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