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Review
. 2018 May;13(3):170-178.
doi: 10.1097/COH.0000000000000449.

The global epidemiology of adolescents living with HIV: time for more granular data to improve adolescent health outcomes

Amy L Slogrove  1 , Annette H Sohn  2
Affiliations
Review

The global epidemiology of adolescents living with HIV: time for more granular data to improve adolescent health outcomes

Amy L Slogrove et al. Curr Opin HIV AIDS. 2018 May.

Abstract

Purpose of review: The aim of this study was to summarize recent evidence on the global epidemiology of adolescents (age 10-19 years) living with HIV (ALHIV), the burden of HIV on the health of adolescents and HIV-associated mortality.

Recent findings: In 2016, there were an estimated 2.1 million (uncertainty bound 1.4-2.7 million) ALHIV; 770 000 younger (age 10-14 years) and 1.03 million older (age 15-19 years) ALHIV, 84% living in sub-Saharan Africa. The population of ALHIV is increasing, as more peri/postnatally infected ALHIV survive into older ages; an estimated 35% of older female ALHIV were peri/postnatally infected, compared with 57% of older male ALHIV. Although the numbers of younger ALHIV deaths are declining, deaths among older ALHIV have remained static since peaking in 2012. In 2015, HIV-associated mortality was the eighth leading cause of adolescent death globally and the fourth leading cause in African low and middle-income countries.

Summary: Needed investments into characterizing and improving adolescent HIV-related health outcomes include strengthening systems for nationally and globally disaggregated data by age, sex and mode of infection; collecting more granular data within routine programmes to identify structural, social and mental health challenges to accessing testing and care; and prioritizing viral load monitoring and adolescent-focused differentiated models of care.

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Conflict of interest statement

Conflicts of interest:

ALS has no conflicts of interest to declare.

Figures

Fig 1
Fig 1. Trends in numbers of younger (age 10–14 years) and older (age 15–19 years) adolescents living with HIV and HIV-associated deaths between 2000 and 2016 (UNAIDS 2017 Spectrum Model estimates)
Legend: The primary y-axis (left) displays number of younger (black dashed line) and older (black solid line) adolescents living with HIV. The secondary left axis (right) displays the number of younger (grey dashed line) and older (grey solid line) adolescent deaths.
Fig 2
Fig 2. Numbers of older adolescents (age 15–19 years) living with HIV globally by sex and mode of transmission: 2000–2016 (Additional analysis of UNAIDS 2017 estimates by John Stover)
Legend: This figure displays the number of female (panel a) and male (panel b) older adolescents (age 15–19 years) globally living with HIV by mode of transmission (peri/postnatally infected in grey and horizontally infected in black)
Fig 3
Fig 3. Numbers of older adolescents (age 15–19 years) living with HIV in Eastern & Southern Africa by sex and mode of transmission: 2000–2016 (Additional analysis of UNAIDS 2017 estimates by John Stover)
Legend: This figure displays the number of female (panel a) and male (panel b) older adolescents (age 15–19 years) in Eastern & Southern Africa living with HIV by mode of transmission (peri/postnatally infected in grey and horizontally infected in black)
See this image and copyright information in PMC

References

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    1. UNAIDS. [cited 2017 November 17];UNAIDS 2017 Estimates. 2017 Available from: http://aidsinfo.unaids.org/. Publicly available resource of UNAIDS estimates for key HIV indicators at regional, national and global levels.
    1. Slogrove AL, Mahy M, Armstrong A, Davies MA. Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic. J Int AIDS Soc. 2017;20(Suppl 3):4–15. This review summarized nationally-representative population-based survey prevalence data on adolescents living with HIV in the 15 highest adolescent HIV burden countries in 2016 and describes helpful examples of national case-based surveillance systems including adolescents living with HIV. - PMC - PubMed
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