April 10 is a day that commemorates a population group that is emerging in terms of increased incidence rates, and needs help with inherent challenges including medication adherence and understanding of the disease.
According to the Centers for Disease Control and Prevention (CDC), approximately 50,000 people are infected with HIV each year, and that 1 in 4 people are between the ages of 13 to 24 years. Young people make up 7% of the more than 1 million people in the US living with HIV.
“We know that young people especially in that adolescent and young adult age range really do much worse when compared with adults and younger children in terms of their HIV outcomes,” Aimalohi (Aima) Ahonkhai, MD, MPH assistant professor of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center (VUMC), codirector, Center for AIDS Research Scientific Working Group on Social Determinants of Health, and codirector, HIV Adolescent Transition Clinic, said. “…being at a really very challenging developmental stage—we all know that about adolescents—but managing a chronic disease, that is also a stigmatizing disease, they tend to have a lot of challenges with medication adherence, which we know is the single most important thing for doing well with HIV, and not having complications from infection.”
In addition, about 60% of young people with HIV do not know they have it, so they do not seek treatment—which can not only put them at risk for severe illness and death—but they can unknowingly transmit HIV to others.
With all of these issues, Ahonkhai says this is an important population to highlight.
And in thinking about this group, April 10 is National Youth HIV and AIDS Awareness Day (NYHAAD). This annual day is an opportunity to recognize this population across the country in high schools, colleges, places of worship, and more.
“This day is a call and cause for celebration. We have made tremendous strides in both the HIV pandemic in the United States and globally,” Ahonkhai, said.
Still, challenges remain. According to the CDC, the largest amount of infections occur among gay and bisexual youth. Nearly half of all new infections among young people occur in African American males. Ahonkhai points out that teens are often dealing with not only the social determinants of health but all that goes with the illness itself.
“They are managing HIV in a context of circumstances that might be quite difficult that may be due to social circumstances, parental support—which may or may not be there—dealing with poverty...dealing with coming out with sexuality…so there might be a lot of difficult transitions that young people are facing at the same time [they] might be dealing with this stigmatizing illness,” Ahonkhai, said.
One constant with most youth today is the importance of cell phones, and VUMC has been involved in this area using its mHealth (mobile) interventions to help with medication adherence and add a social peer aspect to a disease that can be isolating to teens and young adults.
“We are using the positive aspect of peer pressure...by having a leaderboard where you see what your [medication] adherence is relative to your peers, so that you can have a little bit of healthy competition, so that peers can promote each other,” Ahonkhai, said. “And then also importantly is making sure youth don’t feel alone. The apps we are working with also incorporate peer support.”
Contagion spoke to Ahonkhai who offered some insights into this day, how mHeath can help young people, understanding the challenges associated with health equity, and how newer HIV therapies geared for the younger populations can help with quality of life and adherence issues.
For those who are interested in learning more about this day and obtaining resources, providers and people can go here.