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Temporal Trends in Age at HIV Diagnosis in Cohorts in the United States, the Caribbean, and Central and South America

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Abstract

In the United States (USA), the age of those newly diagnosed with HIV is changing, particularly among men who have sex with men (MSM). A retrospective analysis included HIV-infected adults from seven sites in the Caribbean, Central and South America network (CCASAnet) and the Vanderbilt Comprehensive Care Clinic (VCCC-Nashville, Tennessee, USA). We estimated the proportion of patients <25 years at HIV diagnosis by calendar year among the general population and MSM. 19,466 (CCASAnet) and 3,746 (VCCC) patients were included. The proportion <25 years at diagnosis in VCCC increased over time for both the general population and MSM (p < 0.001). Only in the Chilean site for the general population and the Brazilian site for MSM were similar trends seen. Subjects <25 years of age at diagnosis were less likely to be immunocompromised at enrollment at both the VCCC and CCASAnet. Recent trends in the USA of greater numbers of newly diagnosed young patients were not consistently observed in Latin America and the Caribbean. Prevention efforts tailored to young adults should be increased.

Resumen

En EUA, recientemente se han reportado cambios en la edad al diagnóstico de VIH, particularmente en hombres que tienen sexo con hombres (HSH). Este estudio es un análisis retrospectivo de la cohorte CCASAnet, constituida por adultos viviendo con VIH de 7 sitios en Latinoamérica y el Caribe, y un sitio en EUA (Clínica VCCC, Nashville, Tennessee). Estimamos la proporción de <25 años de edad al diagnóstico de VIH por año calendario en la población general y HSH. Incluimos 19 466 sujetos de CCASAnet y 3 746 de VCCC. La proporción de <25 años, en población general y en HSH se incrementó en el tiempo en VCCC (p < 0.001). Una tendencia similar se observó en la población general chilena y en los HSH brasileños. En toda la cohorte los <25 años, significativamente estaban menos inmunocomprometidos a su ingresoa la atención médica. Nuestros resultados sugieren enfocar los esfuerzos de prevención de VIH de acuerdo a las características de la epidemia de cada sitio.

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Acknowledgments

We gratefully acknowledge all patients, caregivers, and data managers involved in the CCASAnet and Vanderbilt Comprehensive Care Clinic cohorts. This work was supported by the National Institute of Allergy and Infectious Diseases (NIAID), the National Cancer Institute (NCI) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) as part of the International epidemiologic Databases to Evaluate AIDS (IeDEA): U01 AI069923 and the National Institutes of Health: K24 AI65298.

Conflict of interest

All authors report no conflicts of interest.

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Authors and Affiliations

  1. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Brenda Crabtree-Ramírez & Yanink Neried Caro Vega

  2. Vanderbilt University Medical Center, One Hundred Oaks, 719 Thompson Lane, Suite 37189, Nashville, TN, 37204, USA

    Bryan E. Shepherd, Megan Turner, Karu Jayathilake, Catherine C. McGowan & Anna K. Person

  3. Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru

    Gabriela Carriquiry

  4. Fundación Huésped, Buenos Aires, Argentina

    Valeria Fink

  5. Instituto de Pesquisa Clinica Evandro Chagas-Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

    Paula M. Luz

  6. Universidad de Chile, Santiago, Chile

    Claudia P. Cortes

  7. Le Groupe Haïtien d’Etude du Sarcome de Kaposi et des Infections Opportunistes, Port-au-Prince, Haiti

    Vanessa Rouzier

  8. Instituto Hondureño de Seguro Social and Hospital Escuela, Tegucigalpa, Honduras

    Denis Padgett

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  1. Brenda Crabtree-Ramírez
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  9. Vanessa Rouzier
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  12. Catherine C. McGowan
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Correspondence to Anna K. Person.

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Crabtree-Ramírez, B., Vega, Y.N.C., Shepherd, B.E. et al. Temporal Trends in Age at HIV Diagnosis in Cohorts in the United States, the Caribbean, and Central and South America. AIDS Behav 19, 1599–1608 (2015). https://doi.org/10.1007/s10461-014-0974-x

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  • DOI: https://doi.org/10.1007/s10461-014-0974-x

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