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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Aging and Loss to Follow-up Among Youth Living With Human Immunodeficiency Virus in the HIV Research Network</title>
<author><name sortKey="Agwu, Allison L" sort="Agwu, Allison L" uniqKey="Agwu A" first="Allison L." last="Agwu">Allison L. Agwu</name>
<affiliation><nlm:aff id="A1">Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Lana" sort="Lee, Lana" uniqKey="Lee L" first="Lana" last="Lee">Lana Lee</name>
<affiliation><nlm:aff id="A3">Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fleishman, John A" sort="Fleishman, John A" uniqKey="Fleishman J" first="John A." last="Fleishman">John A. Fleishman</name>
<affiliation><nlm:aff id="A4">Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Voss, Cindy" sort="Voss, Cindy" uniqKey="Voss C" first="Cindy" last="Voss">Cindy Voss</name>
<affiliation><nlm:aff id="A2">Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Yehia, Baligh R" sort="Yehia, Baligh R" uniqKey="Yehia B" first="Baligh R." last="Yehia">Baligh R. Yehia</name>
<affiliation><nlm:aff id="A5">Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Althoff, Keri N" sort="Althoff, Keri N" uniqKey="Althoff K" first="Keri N." last="Althoff">Keri N. Althoff</name>
<affiliation><nlm:aff id="A6">Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rutstein, Richard" sort="Rutstein, Richard" uniqKey="Rutstein R" first="Richard" last="Rutstein">Richard Rutstein</name>
<affiliation><nlm:aff id="A7">Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mathews, W Christopher" sort="Mathews, W Christopher" uniqKey="Mathews W" first="W. Christopher" last="Mathews">W. Christopher Mathews</name>
<affiliation><nlm:aff id="A8">Department of Clinical Medicine, University of California San Diego Medical Center, San Diego, California</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nijhawan, Ank" sort="Nijhawan, Ank" uniqKey="Nijhawan A" first="Ank" last="Nijhawan">Ank Nijhawan</name>
<affiliation><nlm:aff id="A9">Department of Internal Medicine, UT Southwestern Medical Center, Dallas Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Moore, Richard D" sort="Moore, Richard D" uniqKey="Moore R" first="Richard D." last="Moore">Richard D. Moore</name>
<affiliation><nlm:aff id="A10">Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gaur, Aditya H" sort="Gaur, Aditya H" uniqKey="Gaur A" first="Aditya H." last="Gaur">Aditya H. Gaur</name>
<affiliation><nlm:aff id="A11">Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gebo, Kelly A" sort="Gebo, Kelly A" uniqKey="Gebo K" first="Kelly A." last="Gebo">Kelly A. Gebo</name>
<affiliation><nlm:aff id="A2">Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25703322</idno>
<idno type="pmc">4378241</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378241</idno>
<idno type="RBID">PMC:4378241</idno>
<idno type="doi">10.1016/j.jadohealth.2014.11.009</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">001E65</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001E65</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Aging and Loss to Follow-up Among Youth Living With Human Immunodeficiency Virus in the HIV Research Network</title>
<author><name sortKey="Agwu, Allison L" sort="Agwu, Allison L" uniqKey="Agwu A" first="Allison L." last="Agwu">Allison L. Agwu</name>
<affiliation><nlm:aff id="A1">Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Lana" sort="Lee, Lana" uniqKey="Lee L" first="Lana" last="Lee">Lana Lee</name>
<affiliation><nlm:aff id="A3">Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fleishman, John A" sort="Fleishman, John A" uniqKey="Fleishman J" first="John A." last="Fleishman">John A. Fleishman</name>
<affiliation><nlm:aff id="A4">Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Voss, Cindy" sort="Voss, Cindy" uniqKey="Voss C" first="Cindy" last="Voss">Cindy Voss</name>
<affiliation><nlm:aff id="A2">Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Yehia, Baligh R" sort="Yehia, Baligh R" uniqKey="Yehia B" first="Baligh R." last="Yehia">Baligh R. Yehia</name>
<affiliation><nlm:aff id="A5">Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Althoff, Keri N" sort="Althoff, Keri N" uniqKey="Althoff K" first="Keri N." last="Althoff">Keri N. Althoff</name>
<affiliation><nlm:aff id="A6">Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rutstein, Richard" sort="Rutstein, Richard" uniqKey="Rutstein R" first="Richard" last="Rutstein">Richard Rutstein</name>
<affiliation><nlm:aff id="A7">Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mathews, W Christopher" sort="Mathews, W Christopher" uniqKey="Mathews W" first="W. Christopher" last="Mathews">W. Christopher Mathews</name>
<affiliation><nlm:aff id="A8">Department of Clinical Medicine, University of California San Diego Medical Center, San Diego, California</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nijhawan, Ank" sort="Nijhawan, Ank" uniqKey="Nijhawan A" first="Ank" last="Nijhawan">Ank Nijhawan</name>
<affiliation><nlm:aff id="A9">Department of Internal Medicine, UT Southwestern Medical Center, Dallas Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Moore, Richard D" sort="Moore, Richard D" uniqKey="Moore R" first="Richard D." last="Moore">Richard D. Moore</name>
<affiliation><nlm:aff id="A10">Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gaur, Aditya H" sort="Gaur, Aditya H" uniqKey="Gaur A" first="Aditya H." last="Gaur">Aditya H. Gaur</name>
<affiliation><nlm:aff id="A11">Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gebo, Kelly A" sort="Gebo, Kelly A" uniqKey="Gebo K" first="Kelly A." last="Gebo">Kelly A. Gebo</name>
<affiliation><nlm:aff id="A2">Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journal of adolescent health : official publication of the Society for Adolescent Medicine</title>
<idno type="ISSN">1054-139X</idno>
<idno type="eISSN">1879-1972</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P1">In the United States, 21 years is a critical age of legal and social transition, with changes in social programs such as public insurance coverage. Human immunodeficiency virus (HIV)–infected youth have lower adherence to care and medications and may be at risk of loss to follow-up (LTFU) at this benchmark age. We evaluated LTFU after the 22nd birthday for HIV-infected youth engaged in care. LTFU was defined as having no primary HIV visits in the year after the 22nd birthday.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">All HIV-infected 21-year-olds engaged in care (2002–2011) at the HIV Research Network clinics were included. We assessed the proportion LTFU and used multivariable logistic regression to evaluate demographic and clinical characteristics associated with LTFU after the 22nd birthday. We compared LTFU at other age transitions during the adolescent/young adult years.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Six hundred forty-seven 21-year-olds were engaged in care; 91 (19.8%) were LTFU in the year after turning 22 years. Receiving care at an adult versus pediatric HIV clinic (adjusted odds ratio [AOR], 2.91; 95% confidence interval [CI],1.42–5.93), having fewer than four primary HIV visits/year (AOR, 2.72; 95% CI, 1.67–4.42), and antiretroviral therapy prescription (AOR, .50; 95% CI, .41–.60) were independently associated with LTFU. LTFU was prevalent at each age transition, with factors associated with LTFU similar to that identified for 21-year-olds.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Although 19.8% of 21-year-olds at the HIV Research Network sites were LTFU after their 22nd birthday, significant proportions of youth of all ages were LTFU. Fewer than four primary HIV care visits/year, receiving care at adult clinics and not prescribed antiretroviral therapy, were associated with LTFU and may inform targeted interventions to reduce LTFU for these vulnerable patients.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9102136</journal-id>
<journal-id journal-id-type="pubmed-jr-id">1030</journal-id>
<journal-id journal-id-type="nlm-ta">J Adolesc Health</journal-id>
<journal-id journal-id-type="iso-abbrev">J Adolesc Health</journal-id>
<journal-title-group><journal-title>The Journal of adolescent health : official publication of the Society for Adolescent Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">1054-139X</issn>
<issn pub-type="epub">1879-1972</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25703322</article-id>
<article-id pub-id-type="pmc">4378241</article-id>
<article-id pub-id-type="doi">10.1016/j.jadohealth.2014.11.009</article-id>
<article-id pub-id-type="manuscript">NIHMS655480</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Aging and Loss to Follow-up Among Youth Living With Human Immunodeficiency Virus in the HIV Research Network</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Agwu</surname>
<given-names>Allison L.</given-names>
</name>
<degrees>M.D., Sc.M.</degrees>
<xref ref-type="aff" rid="A1">a</xref>
<xref ref-type="aff" rid="A2">b</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Lana</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="A3">c</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fleishman</surname>
<given-names>John A.</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="A4">d</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Voss</surname>
<given-names>Cindy</given-names>
</name>
<degrees>M.A.</degrees>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Yehia</surname>
<given-names>Baligh R.</given-names>
</name>
<degrees>M.D., M.P.P., M.S.P.H.</degrees>
<xref ref-type="aff" rid="A5">e</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Althoff</surname>
<given-names>Keri N.</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="A6">f</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rutstein</surname>
<given-names>Richard</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="A7">g</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mathews</surname>
<given-names>W. Christopher</given-names>
</name>
<degrees>M.D., M.S.P.H.</degrees>
<xref ref-type="aff" rid="A8">h</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nijhawan</surname>
<given-names>Ank</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="A9">i</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Moore</surname>
<given-names>Richard D.</given-names>
</name>
<degrees>M.D., M.H.S.</degrees>
<xref ref-type="aff" rid="A10">j</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gaur</surname>
<given-names>Aditya H.</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="A11">k</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gebo</surname>
<given-names>Kelly A.</given-names>
</name>
<degrees>M.D., M.P.H.</degrees>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>a</label>
Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland</aff>
<aff id="A2"><label>b</label>
Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</aff>
<aff id="A3"><label>c</label>
Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland</aff>
<aff id="A4"><label>d</label>
Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland</aff>
<aff id="A5"><label>e</label>
Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</aff>
<aff id="A6"><label>f</label>
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</aff>
<aff id="A7"><label>g</label>
Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</aff>
<aff id="A8"><label>h</label>
Department of Clinical Medicine, University of California San Diego Medical Center, San Diego, California</aff>
<aff id="A9"><label>i</label>
Department of Internal Medicine, UT Southwestern Medical Center, Dallas Texas</aff>
<aff id="A10"><label>j</label>
Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland</aff>
<aff id="A11"><label>k</label>
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee</aff>
<author-notes><corresp id="cor1"><label>*</label>
Address correspondence to: Allison L. Agwu, M.D., Sc.M., Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins Medical Institutions, 200 N. Wolfe Street, Room 3145, Baltimore, MD 21287. <email>ageorg10@jhmi.edu</email>
(A.L. Agwu)</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>23</day>
<month>3</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>3</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>3</month>
<year>2016</year>
</pub-date>
<volume>56</volume>
<issue>3</issue>
<fpage>345</fpage>
<lpage>351</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.jadohealth.2014.11.009</pmc-comment>
<permissions><copyright-statement>© 2015 Society for Adolescent Health and Medicine. All rights reserved.</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Purpose</title>
<p id="P1">In the United States, 21 years is a critical age of legal and social transition, with changes in social programs such as public insurance coverage. Human immunodeficiency virus (HIV)–infected youth have lower adherence to care and medications and may be at risk of loss to follow-up (LTFU) at this benchmark age. We evaluated LTFU after the 22nd birthday for HIV-infected youth engaged in care. LTFU was defined as having no primary HIV visits in the year after the 22nd birthday.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">All HIV-infected 21-year-olds engaged in care (2002–2011) at the HIV Research Network clinics were included. We assessed the proportion LTFU and used multivariable logistic regression to evaluate demographic and clinical characteristics associated with LTFU after the 22nd birthday. We compared LTFU at other age transitions during the adolescent/young adult years.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Six hundred forty-seven 21-year-olds were engaged in care; 91 (19.8%) were LTFU in the year after turning 22 years. Receiving care at an adult versus pediatric HIV clinic (adjusted odds ratio [AOR], 2.91; 95% confidence interval [CI],1.42–5.93), having fewer than four primary HIV visits/year (AOR, 2.72; 95% CI, 1.67–4.42), and antiretroviral therapy prescription (AOR, .50; 95% CI, .41–.60) were independently associated with LTFU. LTFU was prevalent at each age transition, with factors associated with LTFU similar to that identified for 21-year-olds.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Although 19.8% of 21-year-olds at the HIV Research Network sites were LTFU after their 22nd birthday, significant proportions of youth of all ages were LTFU. Fewer than four primary HIV care visits/year, receiving care at adult clinics and not prescribed antiretroviral therapy, were associated with LTFU and may inform targeted interventions to reduce LTFU for these vulnerable patients.</p>
</sec>
</abstract>
<kwd-group><kwd>Adolescents</kwd>
<kwd>Youth</kwd>
<kwd>Young adults</kwd>
<kwd>Loss to follow-up</kwd>
<kwd>Attrition</kwd>
<kwd>Care</kwd>
<kwd>HIV Research Network</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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