With ideal care and medication adherence, the life expectancy gap between adolescents living with HIV and those who do not have the disease diminishes. Harvard Public Health spoke with Anne Neilan, an infectious disease physician at Massachusetts General Hospital in Boston, Massachusetts, about her research team’s findings.
Why study this topic?
Adolescents with HIV do more poorly at each step of care compared to adults. Some adolescents acquired HIV at birth, and some acquired HIV later. And they’re often combined in studies. So one of our goals in this project was to consider these individuals as different groups, because while they share that common developmental time period of adolescence, they have a different history of HIV, both in terms of duration and in terms of their interaction with the medical system.
What did you find?
We found that there were life expectancy losses for youth with HIV compared to youth without HIV. But in a simulation, we found that if you’re someone who has excellent access and adherence, life expectancy approaches those without HIV. That’s a very hopeful message.
For youth who acquired HIV later in life, there were other factors that led them, as a population, to still have a life expectancy gap. For example, for HIV acquired through injection drug use, the mortality of that condition drives the life expectancy gap, more than the HIV-related conditions.
What would you like to see happen based on the results of this study?
I hope the study will draw attention to this group as a whole because adolescents require different interventions than children and adults. They have unique data associated with them, and they have distinct outcomes. I also hope this study can provide some data and some optimism for both patients and providers.
—Leah Rosenbaum
(Study in JAMA Health Forum, May 2024)
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