Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic

Slogrove, Amy L.; Mahy, Mary; Armstrong, Alice; Davies, Mary‐Ann

doi:10.7448/ias.20.4.21520

Cited by 123 publications

(116 citation statements)

References 24 publications

Supporting

Mentioning

101

Contrasting

Order By: Relevance

“…Considering that these women exhibit low adherence to antiretroviral therapy (ART), are of childbearing age, and, if pregnant, are less likely to seek antenatal care, HIV infection in this age group also impedes the prevention of mother-to-child transmission of HIV with current standards of care. The fact that HIV infection in young women has remained relatively stable over the past decade underlines the importance of developing an HIV vaccine that can protect against sexual acquisition of HIV in adolescence (3). The stigma, the costs of lifelong ART in HIV-infected individuals, and the implementation and scale-up challenges of PrEP and PEP (4,5) further enforce the need for a preadolescence HIV vaccine to stop the pandemic (6).…”

Section: Importancementioning

confidence: 99%

HIV Env-Specific IgG Antibodies Induced by Vaccination of Neonatal Rhesus Macaques Persist and Can Be Augmented by a Late Booster Immunization in Infancy

Curtis

Dennis

Eudailey

et al. 2020

mSphere

View full text Add to dashboard Cite

The HIV epidemics in infants and adolescent women are linked. Young women of childbearing age are at high risk for HIV infection and, due to poor HIV testing rates and low adherence to antiretroviral therapy, are at high risk for mother-to-infant transmission. We hypothesize that HIV vaccine regimens initiated in early life would provide the necessary time frame to induce mature and highly functional Env-specific antibody responses that could potentially also protect against HIV acquisition later in life. The present study was designed to test two vaccine regimens, a clade C HIV Env protein vaccine (Env only) alone or combined with a modified vaccinia Ankara (MVA) vector expressing HIV Env (MVA/Env) for the induction and persistence of Env-specific antibody responses in an infant nonhuman primate model. Vaccination was initiated within the first week of life, with booster immunizations at weeks 6, 12, and 32. We demonstrate that both vaccine strategies were able to elicit durable Env-specific antibody responses that were enhanced by a late boost in infancy. Furthermore, we confirmed earlier data that intramuscular administration of the Env protein with the Toll-like receptor 7/8 (TLR7/8)-based adjuvant 3M-052 in stable emulsion (3M-052-SE) induced higher Env-specific antibody responses than vaccination with Env adjuvanted in Span85-Tween 80-squalene (STS) tested in a previous study. These results support the concept of early vaccination as a means to induce durable immune responses that may prevent HIV infection in adolescence at the onset of sexual debut. IMPORTANCE The majority of new HIV-1 infections occur in young adults, with adolescent women being 3 times more likely to acquire HIV than young men. Implementation of HIV prevention strategies has been less successful in this age group; thus, a vaccine given prior to adolescence remains a high priority. We propose that instead of starting HIV vaccination during adolescence, an HIV vaccine regimen initiated in early infancy, aligned with the well-accepted pediatric vaccine schedule and followed with booster immunizations, will provide an alternative means to reduce HIV acquisition in adolescence. Importantly, the long window of time between the first infant vaccine dose and the adolescence vaccine dose will allow for the maturation of highly functional HIV Env-specific antibody responses. Our study provides evidence that early life vaccination induces durable Env-specific plasma IgG responses that can be boosted to further improve the quality of the antibody response.

show abstract

Section: Importancementioning

confidence: 99%

HIV Env-Specific IgG Antibodies Induced by Vaccination of Neonatal Rhesus Macaques Persist and Can Be Augmented by a Late Booster Immunization in Infancy

Curtis

Dennis

Eudailey

et al. 2020

mSphere

View full text Add to dashboard Cite

show abstract

“…Second, findings show high rates of severe health deficiency among a large sample of ART‐initiated adolescents recruited from over 50 health facilities in South Africa. With substantial global populations of adolescents living with HIV and a youth explosion within Africa reaching 435 million adolescents by 2050 , addressing adolescent HIV will be essential if we are to protect the most vulnerable in the region. Third, findings show that access to key SDG‐aligned provisions – social protection, caregiver health, household employment and protection from violence – has the potential to improve critical aspects of health among adolescents living with HIV.…”

Section: Discussionmentioning

confidence: 99%

Sustainable Survival for adolescents living withHIV: doSDG‐aligned provisions reduce potential mortality risk?

et al. 2018

View full text Add to dashboard Cite

IntroductionThe Sustainable Development Goals (SDGs) present a groundbreaking global development agenda to protect the most vulnerable. Adolescents living with HIV in Sub‐Saharan Africa continue to experience extreme health vulnerabilities, but we know little about the impacts of SDG‐aligned provisions on their health. This study tests associations of provisions aligned with five SDGs with potential mortality risks.MethodsClinical and interview data were gathered from N = 1060 adolescents living with HIV in rural and urban South Africa in 2014 to 2015. All ART‐initiated adolescents from 53 government health facilities were identified, and traced in their communities to include those defaulting and lost‐to‐follow‐up. Potential mortality risk was assessed as either: viral suppression failure (1000+ copies/ml) using patient file records, or adolescent self‐report of diagnosed but untreated tuberculosis or symptomatic pulmonary tuberculosis. SDG‐aligned provisions were measured through adolescent interviews. Provisions aligned with SDGs 1&2 (no poverty and zero hunger) were operationalized as access to basic necessities, social protection and food security; An SDG 3‐aligned provision (ensure healthy lives) was having a healthy primary caregiver; An SDG 8‐aligned provision (employment for all) was employment of a household member; An SDG 16‐aligned provision (protection from violence) was protection from physical, sexual or emotional abuse. Research partners included the South African national government, UNICEF and Pediatric and Adolescent Treatment for Africa.Results20.8% of adolescents living with HIV had potential mortality risk – i.e. viral suppression failure, symptomatic untreated TB, or both. All SDG‐aligned provisions were significantly associated with reduced potential mortality risk: SDG 1&2 (OR 0.599 CI 0.361 to 0.994); SDG 3 (OR 0.577 CI 0.411 to 0.808); SDG 8 (OR 0.602 CI 0.440 to 0.823) and SDG 16 (OR 0.686 CI 0.505 to 0.933). Access to multiple SDG‐aligned provisions showed a strongly graded reduction in potential mortality risk: Among adolescents living with HIV, potential mortality risk was 38.5% with access to no SDG‐aligned provisions, and 9.3% with access to all four.Conclusions SDG‐aligned provisions across a range of SDGs were associated with reduced potential mortality risk among adolescents living with HIV. Access to multiple provisions has the potential to substantially improve survival, suggesting the value of connecting and combining SDGs in our response to paediatric and adolescent HIV.

show abstract

“…Almost one third of new HIV infections occur among individuals aged 15-25 years, mostly in females [1,2]. AYPLHIV is the only population group for whom HIV-related mortality continues to increase and they are more likely to drop out of HIV care, and have overall worse health outcomes than all other age groups, especially in rural areas [3][4][5][6][7]. AYPLHIV face particular challenges in accessing and adhering to ART.…”

Section: Introductionmentioning

confidence: 99%

PEBRA trial – effect of a peer-educator coordinated preference-based ART service delivery model on viral suppression among adolescents and young adults living with HIV: protocol of a cluster-randomized clinical trial in rural Lesotho

Lejone¹,

Kopo²,

Bachmann

et al. 2020

BMC Public Health

View full text Add to dashboard Cite

Background: Despite tremendous progress in controlling the HIV epidemic in sub-Saharan Africa, HIV-related mortality continues to increase among adolescents and young people living with HIV (AYPLHIV). Globally, sub-Saharan Africa accounts for 85% of the AYPLHIV. Overall outcomes along the HIV care cascade are worse among AYPLHIV as compared to all other age groups due to various challenges in accessing and adhering to antiretroviral therapy (ART). New, innovative multicomponent packages of differentiated service delivery (DSD) models, are required to address the specific needs of AYPLHIV. This study aims to evaluate the feasibility and effectiveness of a multicomponent DSD model (PEBRA model) designed for AYPLHIV and coordinated by a peer-educator.

show abstract

Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic

Cited by 123 publications

References 24 publications

HIV Env-Specific IgG Antibodies Induced by Vaccination of Neonatal Rhesus Macaques Persist and Can Be Augmented by a Late Booster Immunization in Infancy

HIV Env-Specific IgG Antibodies Induced by Vaccination of Neonatal Rhesus Macaques Persist and Can Be Augmented by a Late Booster Immunization in Infancy

Sustainable Survival for adolescents living withHIV: doSDG‐aligned provisions reduce potential mortality risk?

PEBRA trial – effect of a peer-educator coordinated preference-based ART service delivery model on viral suppression among adolescents and young adults living with HIV: protocol of a cluster-randomized clinical trial in rural Lesotho

Contact Info

Product

Resources

About