The following is a summary of “High Rates of Viral Suppression and Care Retention Among Youth Born Outside of the United States with Perinatally Acquired HIV” published in the December 2022 issue of Pediatric Infectious Disease by Desai et al.
However, there is a lack of information describing the results of care for most children living with HIV in the United States, who are youth born outside the United States with perinatally acquired HIV infection (YBoUS-PHIV). Between October 2018 and February 2019, researchers looked back at the medical records of YBoUS-PHIV patients at 3 distinct clinics in the Southeastern United States. Primary outcomes included patient retention in care and viral suppression, where viral suppression was measured as either a percentage of suppressed viral loads or all suppressed VLs (definition 1 presented in the abstract).
The most significant factors were age, adoption status, and level of disclosure (full, partial, and none/unknown). Associations with care outcomes were tested using multivariable logistic regression and X2 tests. Only children and adolescents aged 12 and older were included in the disclosure status analysis. A total of 111 young adults living with Human immunodeficiency virus infection and acquired immune deficiency syndrome(HIV/AIDS) were part of the cohort. There were 59% females and 79% international adoptees, and the median age was 14 (IQR: 12-18). Overall, 84% of patients were still receiving treatment at each subsequent viral load (VL) assessment, and 88% had their viral load controlled. While there was a statistically significant link between adoption and viral suppression in unadjusted analysis (adjusted OR, 4.26; P=0.07).
The odds of being virally suppressed were higher in adopted than in non-adopted children [odds ratio (OR), 7.08; P<0.01]. The retention rate was not significantly different based on age or adoption status. Of the 89 patients older than 12 years with HIV, 74% had made complete disclosure, 13% had made partial disclosure, and 13% had not begun the disclosure procedure. Disclosed or not, there was no discernible distinction in either viral suppression or retention. YBoUS-PHIV was successful in its aims of viral suppression and retention at high levels. Adopted adolescents may have a higher chance of achieving viral suppression, suggesting that non-adopted youth may benefit from individualized interventions.