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One Third of U.S. Youth Are Slow to Start Antiretrovirals, and Many Quit or Switch

March 2011

Nearly one third of HIV-positive 12- to 24-year-olds in a large US study did not start antiretroviral therapy even though treatment guidelines said they should.1 More than half of those who started antiretrovirals stopped or had to switch drugs, usually within a year of starting. Factors that affected late starting or early stopping included poor appointment keeping, a CD4 count under 200, and treatment at an adult clinic.


The rate of new infections in adolescents and young adults is rising in the United States. Young people from 15 to 24 make up the fastest-growing HIV-positive group in the United States2,3 and many other countries. Youngsters have low HIV testing rates.4 And when they test positive, they are often slow to enter care, start antiretroviral therapy, and stay on antiretroviral therapy.4

Many obstacles prevent young people from getting tested and treated, including fear of others knowing they have HIV and fear of discrimination and harassment because they have HIV. But rates of delayed treatment and early dropout remain poorly understood, as do the precise reasons for these problems. To learn more about these issues, HIV Research Network investigators planned this study of young people infected because of risky behavior, mainly unsafe sex.


  1. Agwu A, Rutstein R, Gaur A, et al. Starting late and stopping early: disparities in HAART utilization for behaviorally HIV-infected youth. 18th Conference on Retroviruses and Opportunistic Infections. February 27-March 2, 2011. Boston. Abstract 692.
  2. Centers for Disease Control and Prevention. Diagnoses of HIV infection and AIDS in the United States and dependent areas, 2008. HIV Surveillance Report, Volume 20. Accessed March 5, 2011.
  3. Centers for Disease Control and Prevention. HIV/AIDS surveillance report: cases of HIV Infection and AIDS in the United States and dependent areas, 2007. February 18, 2009. Accessed March 5, 2011.
  4. Mascolini M. Finding solutions for HIV's lost generation: adolescents and young adults. RITA! 2010;15(2). Accessed March 5, 2011.

This article was provided by The Center for AIDS Information & Advocacy. It is a part of the publication HIV Treatment ALERTS!. You can find this article online by typing this address into your Web browser:

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