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      HIV testing and linkage to services for youth

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          Abstract

          Introduction

          HIV testing is the portal to serostatus knowledge that can empower linkage to care for HIV treatment and HIV prevention. However, young people's access to HIV testing is uneven worldwide. The objective of this paper is to review the context and concerns faced by youth around HIV testing in low- as well as high-income country settings.

          Discussion

          HIV testing is a critical entry point for primary and secondary prevention as well as care and treatment for young people including key populations of vulnerable youth. We provide a framework for thinking about the role of testing in the continuum of prevention and care for young people. Brief case study examples from Kenya and the US illustrate some of the common barriers and issues involved for young people.

          Conclusions

          Young people worldwide need more routine access to HIV testing services that effectively address the developmental, socio-political and other issues faced by young women and men.

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          Adolescent maturity and the brain: the promise and pitfalls of neuroscience research in adolescent health policy.

          Sara Johnson, Robert W. Blum, Jay Giedd (2009)
          Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well into the 20s. This has prompted intense interest in linking neuromaturation to maturity of judgment. Public policy is struggling to keep up with burgeoning interest in cognitive neuroscience and neuroimaging. However, empirical evidence linking neurodevelopmental processes and adolescent real-world behavior remains sparse. Nonetheless, adolescent brain development research is already shaping public policy debates about when individuals should be considered mature for policy purposes. With this in mind, in this article we summarize what is known about adolescent brain development and what remains unknown, as well as what neuroscience can and cannot tell us about the adolescent brain and behavior. We suggest that a conceptual framework that situates brain science in the broader context of adolescent developmental research would help to facilitate research-to-policy translation. Furthermore, although contemporary discussions of adolescent maturity and the brain often use a deficit-based approach, there is enormous opportunity for brain science to illuminate the great strengths and potentialities of the adolescent brain. So, too, can this information inform policies that promote adolescent health and well-being.
          Article 0 comments Cited 125 times – based on 0 reviews     Review now
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            High attrition before and after ART initiation among youth (15-24 years of age) enrolled in HIV care.

            Teresa Alwar, Batya Elul, Matthew Lamb … (2014)
            To compare pre and post-ART attrition between youth (15-24 years) and other patients in HIV care, and to investigate factors associated with attrition among youth. Cohort study utilizing routinely collected patient-level data from 160 HIV clinics in Kenya, Mozambique, Tanzania, and Rwanda. Patients at least 10 years of age enrolling in HIV care between 01/05 and 09/10 were included. Attrition (loss to follow-up or death 1 year after enrollment or ART initiation) was compared between youth and other patients using multivariate competing risk (pre-ART) and traditional (post-ART) Cox proportional hazards methods accounting for within-clinic correlation. Among youth, patient-level and clinic-level factors associated with attrition were similarly assessed. A total of 312,335 patients at least 10 years of age enrolled in HIV care; 147,936 (47%) initiated ART, 17% enrolling in care and 10% initiating ART were youth. Attrition before and after ART initiation was substantially higher among youth compared with other age groups. Among youth, nonpregnant women experienced lower pre-ART attrition than men [sub-division hazard ratio = 0.90, 95% confidence interval (CI): 0.86-0.94], while both pregnant [adjusted hazard ratio (AHR) = 0.85, 95% CI: 0.74-0.97] and nonpregnant (AHR = 0.79, 95% CI: 0.73-0.86) female youth experienced lower post-ART attrition than men. Youth attending clinics providing sexual and reproductive health services including condoms (AHR = 0.47, 95% CI: 0.32-0.70) and clinics offering adolescent support groups (AHR = 0.73, 95% CI: 0.52-1.0) experienced significantly lower attrition after ART initiation. Youth experienced substantially higher attrition before and after ART initiation compared with younger adolescents and older adults. Adolescent-friendly services were associated with reduced attrition among youth, particularly after ART initiation.
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              Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents

              (2007)
              Article 0 comments Cited 96 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Int AIDS Soc
                Journal ID (iso-abbrev): J Int AIDS Soc
                Journal ID (publisher-id): JIAS
                Title: Journal of the International AIDS Society
                Publisher: International AIDS Society
                ISSN (Electronic): 1758-2652
                Publication date (Electronic): 26 February 2015
                Publication date Collection: 2015
                Volume: 18
                Issue: 2Suppl 1
                Electronic Location Identifier: 19433
                Affiliations
                [1 ]College of Nursing and Global Institute of Public Health, New York University, New York, NY, USA
                [2 ]Lifespan Hospital System, Providence, VA, USA
                [3 ]Alpert Medical School, Brown University, Providence, RI, USA
                [4 ]Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
                [5 ]Kenyatta National Hospital, Nairobi, Kenya
                [6 ]Department of Pediatrics, Indiana University, Indianapolis, IN, USA
                Author notes
                [§ ] Corresponding author: Ann E Kurth, New York University, New York, NY 10003, USA. Tel: +212 998 5316. ( akurth@ 123456nyu.edu )
                Article
                Publisher ID: 19433
                DOI: 10.7448/IAS.18.2.19433
                PMC ID: 4344538
                PubMed ID: 25724506
                SO-VID: 4d780936-94f4-4470-8c55-04831d4ee3a5
                Copyright © © 2015 Kurth AE et al; licensee International AIDS Society
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 01 September 2014
                Date revision received : 08 January 2015
                Date accepted : 09 January 2015
                Categories
                Subject: HIV and adolescents: focus on young key populations
                Subject: Commentary

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: hiv testing,hiv continuum of care,youth,adolescents,key populations,development
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: hiv testing, hiv continuum of care, youth, adolescents, key populations, development

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