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NIH Research Network Finds Many Youth Have High Levels of HIV


According to an article published online in the journal AIDS (23 January 2014), more than 30% of young males who had intimate relationships with other males and who were subsequently enrolled in a government treatment and research network were found to have high levels of HIV. The health status of the study participants, who ranged in age from 12 to 24 years, was monitored as part of their participation in the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). The ATN provides medical care to youth with HIV and offers counseling and, medications, and other preventive measures to youth who are at risk of acquiring HIV. As part of their participation in the network, the youth have the option of taking part in research studies of the latest methods to prevent people from acquiring HIV and to treat those who have become infected.


To conduct the study, authors analyzed the health records of youth with HIV, soon after they enrolled in the ATN. The study authors noted that the high blood levels of the virus seen in the majority of study participants indicated that they were diagnosed early in the course of HIV infection, when the chances for minimizing the health consequences of HIV are greatest. The authors added, however, that the study results suggest that HIV is highly likely to be transmitted among members of this group.


According to the U.S. Centers for Disease Control and Prevention, 1 in 4 new HIV infections occur in young people from 13 to 24 years of age. About 60% of all youth with HIV do not know they are infected, are not getting treated, and can unknowingly pass the virus on to others. Among the groups that the CDC recommends get tested for HIV are those:


1. Who have injected drugs and shared needles and other equipment with others

2. Who have had unprotected relationships with men who have intimate realtionships with men, had multiple partners or anonymous partners

3. Have been diagnosed with hepatitis, tuberculosis, or a STD

4. Had unprotected relationships with someone in the above groups


To conduct the study, the authors measured the viral load and CD4 counts of 852 youth in 14 cities in the United States and Puerto Rico. Viral load is the amount of HIV in the blood. The authors explained that viral levels are highest very early in the course of an HIV infection. CD4 counts measure infection-fighting white blood cells known as T-cells. In the first few weeks, the viral load can be millions of copies, or higher. Then, over the ensuing months, it stabilizes at about 30,000 to 50,000 copies. Normal CD4 counts range from 500 to 1,000, but drop substantially during the infection.


Among the study participants, 34% had CD4+ counts of 350 or less, 27% had counts from 351 to 500, and 39% had counts greater than 500. Male youth who had reported intimate relationships with another male had the highest average viral load, in excess of 115,000. Among all males studied, the viral load averaged more than 106,000. For females, the average viral load count was roughly 48,000. Most of those diagnosed with HIV had been referred for medical care during the course of the study (79%.)


Because of the high viral loads they detected in their study, the authors concluded that efforts to diagnose and treat people with HIV should focus a large share of their efforts on youth, particularly young men who have intimate relationships with men.


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