Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar;74(3):573-581.
doi: 10.1016/j.jadohealth.2023.09.017. Epub 2023 Dec 3.

Demographics of Youth With Newly Diagnosed Acute/Recent HIV Infection in Adolescent Trials Network 147: Early Treatment of Acute HIV Infection

Tara Kerin  1 , Ruth Cortado  2 , Sophia G Paiola  2 , Justine Ceballos  2 , Sue Ellen Abdalian  3 , Risa Flynn  4 , Robert Bolan  4 , Yetunde V Adebambo  5 , Myung Shin Sim  5 , Dallas Swendeman  6 , Manuel A Ocasio  3 , Jasmine Fournier  3 , Bonnie Ank  2 , Yvonne Bryson  2 , Karin Nielsen-Saines  2
Affiliations

Demographics of Youth With Newly Diagnosed Acute/Recent HIV Infection in Adolescent Trials Network 147: Early Treatment of Acute HIV Infection

Tara Kerin et al. J Adolesc Health. 2024 Mar.

Abstract

Purpose: Gay, bisexual, and other cisgender men who have sex with men, and racial minority youth are at elevated risk of acquiring HIV infection. The Adolescent Trials Network 147 recruited youth with acute/recent HIV-infection for early antiretroviral treatment. The cohort make-up is described here.

Methods: Treatment-naïve, recently identified HIV + youth, aged 12-24 years, from Los Angeles and New Orleans were recruited from community centers, clinics, social media, and a high-risk seronegative cohort (n = 1,727, the Adolescent Trials Network 149) using point-of-care assays. Acute HIV infection was determined by Fiebig staging. HIV RNA viral load (VL) and CD4 cell counts, along with demographic and behavioral data were assessed at enrollment.

Results: Between July 2017 and July 2021, 103 newly diagnosed youth were enrolled, initiating antiretroviral treatment within a week. Mean age was 20.8 years (standard deviation: 2.4); 90.3% identified as cis male, 83.5% were single or in casual relationships, 71.8% were gay, bisexual, and other cisgender men who have sex with men; 60.2% were Black. One-fourth (24.3%) reported homelessness ever; 10.7% within last 4 months. At enrollment, median plasma VL was 37,313 HIV RNA copies/ml (interquartile range: 5,849-126,162) and median CD4 count 445.5 cells/mm3 (interquartile range: 357-613). 40% of youth reported acute retroviral symptoms before or at enrollment. Acutely infected, seroconverting youth had the highest VL. Sexually transmitted coinfections were present at enrollment in 56% of the cohort, with syphilis being most frequent (39%).

Discussion: Early identification and treatment of HIV can increase positive HIV outcomes. A high sexually transmitted infection burden was present in recently HIV-infected youth. Acute retroviral symptoms were not reported by most participants, demonstrating that broad universal HIV screening is needed for identification of recent infection in youth.

Keywords: Acute HIV infection; HIV; youth HIV.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Sexually transmitted coinfections at baseline.
See this image and copyright information in PMC

References

    1. Stricof RL, Kennedy JT, Nattell TC, et al. HIV seroprevalence in a facility for runaway and homeless adolescents. Am J Public Health 1991;81(Suppl): 50–3. - PMC - PubMed
    1. Bekker LG, Johnson L, Wallace M, Hosek S. Building our youth for the future. J Int AIDS Soc 2015;18(2 Suppl 1):20027. - PMC - PubMed
    1. Nielsen-Saines K, Mitchell K, Kerin T, et al. Acute HIV infection in youth: Protocol for the adolescent trials network 147 (ATN147) comprehensive adolescent research and engagement studies (CARES) study. JMIR Res Protoc 2019;8:e10807. - PMC - PubMed
    1. Cotton MF, Violari A, Otwombe K, et al. Early time-limited antiretroviral therapy versus deferred therapy in South African infants infected with HIV: Results from the children with HIV early antiretroviral (CHER) randomised trial. Lancet 2013;382:1555–63. - PMC - PubMed
    1. Shiau S, Abrams EJ, Arpadi SM, Kuhn L. Early antiretroviral therapy in HIV-infected infants: Can it lead to HIV remission? Lancet HIV 2018;5:e250e8. - PMC - PubMed

Publication types