Characteristics and Care Outcomes Among Persons Living With Perinatally Acquired HIV Infection in the United States, 2015

Kristen Mahle Gray, MPH; Xiao Wang, MPH; Jianmin Li, DPE; Steven R. Nesheim, MD

Disclosures

J Acquir Immune Defic Syndr. 2019;82(1):17-23. 

In This Article

Results

By year-end 2015, 11,747 persons were living with diagnosed PHIV in the United States and 6 dependent areas (Table 1). The median age was 21 years with an age range from 0 to 37 years (Figure 1). Persons aged 18–25 years accounted for the largest percentage of persons living with diagnosed PHIV (48.7%), followed by persons aged ≥26 years (20.6%), and persons aged 13–17 years (14.7%) (Table 1). At year-end 2015, most persons resided in the South (39.5%) or the Northeast (36.6%) and were female (52.6%), black (58.3%), and born in the United States or US dependent areas (85.1%).

Figure 1.

Age distribution of persons living with diagnosed perinatally acquired HIV infection at year-end 2015, the United States and 6 dependent areas.

A total of 9562 persons had diagnosed PHIV by year-end 2014 and were alive at year-end 2015 in the 40 jurisdictions with complete laboratory reporting (Table 2). Of these, 7207 (75.4%) persons had at least 1 CD4 or VL test during 2015 (ie, received any HIV care) and 5843 (61.1%) had at least 2 CD4 or VL tests taken at least 3 months apart in 2015 (ie, were retained in HIV care).

The proportion of persons who received any HIV care differed by age and was highest for persons aged <6 years (82.5%) and lowest for persons aged ≥26 years (70.7%) (Table 2). The proportion of persons who were retained in care also differed by age. Compared with persons aged 18–25 years, persons aged <6 years (PR = 1.3, 95% CI = 1.2 to 1.4), 6–12 years (PR = 1.3, 95% CI: = 1.2 to 1.3), and 13–17 years (PR = 1.2, 95% CI: = 1.1 to 1.2) had a significantly higher prevalence of being retained in care. By sex, females had a significantly higher prevalence (PR = 1.1, 95% CI = 1.1 to 1.2) of being retained in care than males. By race, Hispanics/Latinos had a significantly higher prevalence (PR = 1.1, 95% CI: = 1.1 to 1.2) of being retained in care than whites. By country of birth, non–US-born persons had a significantly higher prevalence (PR = 1.1, 95% CI: = 1.1 to 1.2) of being retained in care than US-born persons. Retention in care did not vary by the US region of residence.

Of the 9562 persons living with PHIV at year-end 2015, 6968 (72.9%) had at least 1 VL test during 2015 (data not shown) and 4689 (49.0%) had suppressed VLs at the most recent VL test during 2015 (Table 2). At the most recent VL test during 2015, VLs were suppressed in 65.1% of persons who were alive at year-end 2015 and received any care in 2015 and 67.3% of persons who had ≥1 VL tests during 2015.

By age, persons aged ≤17 years had a significantly higher prevalence (<6 years: PR = 1.4, 95% CI: = 1.3 to 1.5; 6–12 years: PR = 1.5, 95% CI: = 1.4 to 1.6; 13–17 years: PR = 1.3, 95% CI: = 1.2 to 1.4) of being virally suppressed than persons aged 18–25 years (Table 2 and Figure 2). By race/ethnicity, blacks had a significantly lower prevalence (PR = 0.8, 95% CI: = 0.7 to 0.8) of being virally suppressed than whites (Table 2). By region of residence, persons in the West had a significantly higher prevalence (PR = 1.2, 95% CI: = 1.1 to 1.3) of being virally suppressed than persons residing in the Northeast. By country of birth, non–US-born persons had a significantly higher prevalence (PR = 1.3, 95% CI: = 1.3 to 1.4) of being virally suppressed than US-born persons. No differences were observed by sex.

Figure 2.

Percentage of viral suppression among persons with perinatally acquired HIV infection, diagnosed by year-end 2014 and alive at year-end 2015, by age, 39 states and the District of Columbia.

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