For every 100 youth with HIV, 36 percent receive some HIV care, 27 percent were retained in care, and only 25 percent were virally suppressed, according to the CDC. A person with HIV who takes HIV medicine as prescribed and achieves viral suppression (undetectable HIV) can stay healthy and has effectively no risk of sexually transmitting HIV to HIV-negative partners (untransmittable HIV). Undetectable HIV = untransmittable HIV (U = U).
Treatment challenges remain for youth living with HIV:
Medication Adherence is Difficult for Youth with HIV
Medication adherence is taking HIV medications every day, exactly as they are prescribed. Good medication adherence is vital for effective HIV treatment outcomes. There are several reasons why adherence may be more difficult for children and adolescents with HIV:
- A child may refuse to take an HIV medication because it tastes bad
- Negative attitudes and beliefs about HIV (stigma) may cause adolescents to skip medicine doses to hide their HIV-positive status from their peers
- A busy schedule (extracurriculars, homework, etc.) makes it hard to take HIV medications on time each day
- Unpleasant side effects from HIV medications
- Household or family issues, such as physical or mental illness, unstable housing situations, or alcohol/drug abuse
- Lack of health insurance to cover the cost of HIV medicines
Lack of medication adherence also makes achieving viral suppression more difficult and increases the chances that a person living with HIV can transmit HIV to another person, especially thorough unprotected sex.
Staying in Care
Staying in HIV care, or retention in care, is defined as having two visits during a calendar year – spaced two to six months apart – with an HIV doctor, or medical provider. It’s important for all people living with HIV to make these visits, adhere to their HIV medication and treatment plans, and achieve retention in care. Most youth with HIV do not receive regular care, unfortunately, according to the CDC
Mental Health Conditions
Mental health conditions affect about one in five Americans. These conditions are even more common among people living with HIV. Data from the Illinois Department of Public Health (IDPH) show that about 40 percent of case-managed clients living with HIV in Illinois have a mental health condition in their medical history. IDPH data also indicate that HIV-positive individuals with mental health conditions have a more difficult time achieving medication adherence and viral suppression – a low level of HIV in the blood associated with optimal health for people living with HIV.
Social and economic determinants of health
Among people with HIV who are receiving medical care, young people aged 18 to 24 are more likely than older people to be living in households with low income levels, or to have been recently homeless, recently incarcerated, or uninsured. All of these factors pose barriers to achieving viral suppression. Research shows that the social and economic conditions in which you live, learn and work have a tremendous impact on your health, as well. These conditions are known as “social determinants of health.”