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Many teens with HIV put off treatment, study finds

Group of healthy teenagersAlarming findings from a Johns Hopkins Children’s Center study indicate that almost half of HIV-positive teens and young adults are delaying treatment until the disease becomes advanced. The results are particularly unsettling since more and more HIV experts are calling for earlier intervention to prevent serious health complications.

Part of the problem stems from teens being unaware of their HIV status. According to the U.S. Centers for Disease Control and Prevention, nearly one in five people with the virus don’t know they’re infected.

“There’s also this youthful invincibility where [teens] don’t think they’re at risk and, therefore, don’t get tested,” said lead investigator Dr. Allison Agwu, infectious disease specialist and HIV expert at the Johns Hopkins Children’s Center. “This is especially true for those who are asymptomatic and don’t really feel sick.”

Agwu and her team examined the records of almost 1,500 HIV-positive people across the United States aged 12 to 24 between 2002 and 2010. Of these participants, 30 to 45 percent waited until the disease was at an advanced stage before seeking treatment. Patients who had fewer than 350 CD4 cells per cubic millimeter of blood were considered to be at an advanced stage.

A CD4 count below 200 is considered full-blown AIDS.

“I think we’re doing a poor job in assessing HIV risk in youth,” said Agwu.

She added that the risk is especially high among heterosexual males, who are emerging as a sort of fall-through-the-cracks group. She attributes this to the possibility that the strongest HIV outreach in recent years has been pushed on men who have sex with men. As a result, heterosexual males may falsely perceive themselves as low risk.

The study found that males and members of racial and ethnic minorities were the least likely to seek HIV treatment at an early stage. In fact, the chances of visiting a clinic with advanced HIV were twice as high among black youth when compared to white participants. Similarly, Hispanic youth were more than one and a half times more likely to put off treatment.

“I think it’s about making sure that we are inclusive in terms of how we send the message so that people don’t opt themselves out of the risk pool,” said Agwu. “It’s how we put our message out there and how we reinforce that message, especially in high-risk areas like Baltimore and D.C. where pretty much everyone is at risk if they are having sex.”

While the CDC recommends HIV testing for everyone aged 13 to 64, Agwu believes that health care providers really need to emphasize the importance of screening to all patients and to make it a part of routine medical care.

By Marianne Hayes