HIV-infected teens often delay treatment, increasing risk of complications

Nearly half of HIV-infected teenagers and young adults delay care until their disease has advanced, which puts them at risk for dangerous infections and long-term complications, according to a study led by the Johns Hopkins Children's Center.

The researchers say their findings, published this month in JAMA Pediatrics, are particularly troubling in light of mounting evidence that starting treatment as early as possible can go long way toward keeping the virus in check. Early treatment can prevent the cardiovascular, renal, and neurological damage characteristic of poorly controlled HIV infection over time.

The study found that those most likely to show up in clinics with advanced infections were male and members of a minority group.

While the researchers did not study specifically why patients were showing up in clinics with advanced infections, they believe some youth were simply unaware of their HIV status, while others had been diagnosed earlier but, for a variety of reasons, did not seek care.

"These are decidedly disappointing findings that underscore the need to develop better ways to diagnose teens sooner and, just as importantly, to get them into care and on therapy sooner," says lead investigator Allison Agwu, an HIV expert at the Johns Hopkins Children's Center.

Though the U.S. Centers for Disease Control and Prevention recommends HIV testing for everyone between the ages of 13 and 64, many infected people continue to slip through the cracks, due to unwillingness to get tested, fear, stigma, and clinicians' biases.

Those diagnosed with HIV should start therapy early and be followed vigilantly, the researchers say, to ensure that the virus is under control, to prevent complications, and to reduce the risk of spreading the infection to others.