Abstract:
:Adolescents account for most undiagnosed HIV infections in the United States. Although the Centers for Disease Control and Prevention (CDC) recommends universal HIV screening for all patients ≥13 years, <10% of adolescents have been tested for HIV. To identify earlier opportunities for adolescent HIV prevention and diagnosis in a region of high HIV prevalence, we sought to describe pediatric emergency department (PED) visits made by a retrospective cohort of adolescents who were later diagnosed with HIV as young adults (<25 years) through an adult emergency department (ED) universal HIV screening program. CD4+ count was used to estimate the time of HIV infection before diagnosis and all PED visits in the 10 years before diagnosis were analyzed. Universal HIV screening in the adult ED diagnosed 193 young adults (median 22 years; 90% men; 29% stage 3); 70% had CD4+ at diagnosis that was used to estimate time of infection (mean 3.8 years). Thirty-eight HIV-infected young adults had a total of 109 PED visits in the 10 years before HIV diagnosis. Sexual history was documented in 12% of PED visits and a sexually transmitted infection test was sent in 6%. Ten HIV-infected young adults had 26 PED visits during the time in which they were likely already infected with HIV, each a potential missed opportunity for earlier diagnosis. HIV-infected and at-risk adolescents are underrecognized in PED visits. Implementation of CDC-recommended universal screening may lead to earlier diagnoses and improve outcomes; the PED may also be critical in identifying adolescents eligible for preexposure prophylaxis.
journal_name
AIDS Patient Care STDSjournal_title
AIDS patient care and STDsauthors
Gutman CK,Middlebrooks L,Camacho-Gonzalez A,Shah B,Belay Z,Morris CRdoi
10.1089/apc.2020.0033subject
Has Abstractpub_date
2020-09-01 00:00:00pages
373-379issue
9eissn
1087-2914issn
1557-7449journal_volume
34pub_type
杂志文章abstract::The objective of this study was to describe the AIDS-defining conditions (ADC) and survival experience of pediatric AIDS cases (< 13 years age) reported in Puerto Rico. A descriptive analysis of the data gathered by the Puerto Rico AIDS Surveillance System was performed. Data for the 377 pediatric AIDS cases reported ...
journal_title:AIDS patient care and STDs
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pub_type: 杂志文章,评审
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journal_title:AIDS patient care and STDs
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journal_title:AIDS patient care and STDs
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