Adolescent and young adult research across the HIV prevention and care continua: an international programme analysis and targeted review

Abstract Introduction Human immunodeficiency virus (HIV) continues to rise in young people among low‐ and middle‐income countries (LMIC). The US National Institutes of Health (NIH) supports the largest public investment in HIV research globally. Despite advancements in the last decade, adolescents a...

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Main Authors: Samantha Calabrese, Matt Perkins, Sonia Lee, Susannah Allison, Gina Brown, Patrick Jean‐Philippe, Nahida Chakhtoura, Jack Moye, Bill G. Kapogiannis
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Journal of the International AIDS Society
Subjects:
Online Access:https://doi.org/10.1002/jia2.26065
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author Samantha Calabrese
Matt Perkins
Sonia Lee
Susannah Allison
Gina Brown
Patrick Jean‐Philippe
Nahida Chakhtoura
Jack Moye
Bill G. Kapogiannis
author_facet Samantha Calabrese
Matt Perkins
Sonia Lee
Susannah Allison
Gina Brown
Patrick Jean‐Philippe
Nahida Chakhtoura
Jack Moye
Bill G. Kapogiannis
author_sort Samantha Calabrese
collection DOAJ
description Abstract Introduction Human immunodeficiency virus (HIV) continues to rise in young people among low‐ and middle‐income countries (LMIC). The US National Institutes of Health (NIH) supports the largest public investment in HIV research globally. Despite advancements in the last decade, adolescents and young adults (AYA) remain underrepresented in research to improve HIV prevention and care. We undertook a programme analysis of NIH grants and conducted a targeted review of linked publications on international AYA research across the HIV prevention and care continuum (HPCC) to inform new initiatives to address the needs of AYA in these settings. Methods NIH‐funded grants from 2012 to 2017, pertaining to AYA in LMIC, and evaluating areas of HIV prevention, care and/or treatment were identified. A systematic review of publications limited to funded grants was performed in two waves: 2012–2017 and 2018–2021. The review included a landscape assessment and an evaluation of NIH‐defined clinical trials, respectively. Data on outcomes across the HPCC were abstracted and analysed. Results Among grant applications, 14% were funded and linked to 103 publications for the analytic database, 76 and 27 from the first and second waves, respectively. Fifteen (15%) wave 1 and 27 (26%) wave 2 publications included an NIH‐defined clinical trial. Among these, 36 (86%) did not target a key population (men who have sex with men, drug users and sex workers) and 37 (88%) were exclusively focused on sub‐Saharan Africa. Thirty (71%) publications addressed at least one HPCC milestone. Specific focus was on milestones in HIV prevention, care or both, for 12 (29%), 13 (31%) and five (12%) of publications, respectively. However, few addressed access to and retention in HIV care (4 [14%]) and none included microbicides or treatment as prevention. More focus is needed in crucial early steps of the HIV care continuum and on biomedical HIV prevention interventions. Discussion and Conclusions Research gaps remain in this portfolio across the AYA HPCC. To address these, NIH launched an initiative entitled Prevention and Treatment through a Comprehensive Care Continuum for HIV‐affected Adolescents in Resource Constrained Settings (PATC3H) to generate needed scientific innovation for effective public health interventions for AYA affected by HIV in LMIC.
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spelling doaj.art-406dad3ded024413afc0a38f288de9e32023-03-29T06:48:29ZengWileyJournal of the International AIDS Society1758-26522023-03-01263n/an/a10.1002/jia2.26065Adolescent and young adult research across the HIV prevention and care continua: an international programme analysis and targeted reviewSamantha Calabrese0Matt Perkins1Sonia Lee2Susannah Allison3Gina Brown4Patrick Jean‐Philippe5Nahida Chakhtoura6Jack Moye7Bill G. Kapogiannis8Maternal and Pediatric Infectious Disease Branch Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Bethesda Maryland USAOffice of Portfolio Analysis, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director National Institutes of Health Bethesda Maryland USAMaternal and Pediatric Infectious Disease Branch Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Bethesda Maryland USADevelopmental and Clinical Neuroscience of HIV Prevention and Treatment Branch National Institute of Mental Health National Institutes of Health Bethesda Maryland USAOffice of AIDS Research National Institutes of Health Bethesda Maryland USADivision of AIDS National Institute of Allergy and Infectious Diseases National Institutes of Health Bethesda Maryland USAMaternal and Pediatric Infectious Disease Branch Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Bethesda Maryland USAMaternal and Pediatric Infectious Disease Branch Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Bethesda Maryland USAMaternal and Pediatric Infectious Disease Branch Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Bethesda Maryland USAAbstract Introduction Human immunodeficiency virus (HIV) continues to rise in young people among low‐ and middle‐income countries (LMIC). The US National Institutes of Health (NIH) supports the largest public investment in HIV research globally. Despite advancements in the last decade, adolescents and young adults (AYA) remain underrepresented in research to improve HIV prevention and care. We undertook a programme analysis of NIH grants and conducted a targeted review of linked publications on international AYA research across the HIV prevention and care continuum (HPCC) to inform new initiatives to address the needs of AYA in these settings. Methods NIH‐funded grants from 2012 to 2017, pertaining to AYA in LMIC, and evaluating areas of HIV prevention, care and/or treatment were identified. A systematic review of publications limited to funded grants was performed in two waves: 2012–2017 and 2018–2021. The review included a landscape assessment and an evaluation of NIH‐defined clinical trials, respectively. Data on outcomes across the HPCC were abstracted and analysed. Results Among grant applications, 14% were funded and linked to 103 publications for the analytic database, 76 and 27 from the first and second waves, respectively. Fifteen (15%) wave 1 and 27 (26%) wave 2 publications included an NIH‐defined clinical trial. Among these, 36 (86%) did not target a key population (men who have sex with men, drug users and sex workers) and 37 (88%) were exclusively focused on sub‐Saharan Africa. Thirty (71%) publications addressed at least one HPCC milestone. Specific focus was on milestones in HIV prevention, care or both, for 12 (29%), 13 (31%) and five (12%) of publications, respectively. However, few addressed access to and retention in HIV care (4 [14%]) and none included microbicides or treatment as prevention. More focus is needed in crucial early steps of the HIV care continuum and on biomedical HIV prevention interventions. Discussion and Conclusions Research gaps remain in this portfolio across the AYA HPCC. To address these, NIH launched an initiative entitled Prevention and Treatment through a Comprehensive Care Continuum for HIV‐affected Adolescents in Resource Constrained Settings (PATC3H) to generate needed scientific innovation for effective public health interventions for AYA affected by HIV in LMIC.https://doi.org/10.1002/jia2.26065adolescentsadolescent healthglobal healthhealthcare deliveryHIVreview
spellingShingle Samantha Calabrese
Matt Perkins
Sonia Lee
Susannah Allison
Gina Brown
Patrick Jean‐Philippe
Nahida Chakhtoura
Jack Moye
Bill G. Kapogiannis
Adolescent and young adult research across the HIV prevention and care continua: an international programme analysis and targeted review
Journal of the International AIDS Society
adolescents
adolescent health
global health
healthcare delivery
HIV
review
title Adolescent and young adult research across the HIV prevention and care continua: an international programme analysis and targeted review
title_full Adolescent and young adult research across the HIV prevention and care continua: an international programme analysis and targeted review
title_fullStr Adolescent and young adult research across the HIV prevention and care continua: an international programme analysis and targeted review
title_full_unstemmed Adolescent and young adult research across the HIV prevention and care continua: an international programme analysis and targeted review
title_short Adolescent and young adult research across the HIV prevention and care continua: an international programme analysis and targeted review
title_sort adolescent and young adult research across the hiv prevention and care continua an international programme analysis and targeted review
topic adolescents
adolescent health
global health
healthcare delivery
HIV
review
url https://doi.org/10.1002/jia2.26065
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