Meeting complex needs: young people with HIV in London

Area of Science:

• Public Health
• Infectious Diseases
• Adolescent Medicine

Background:

• Young individuals diagnosed with HIV present unique challenges in healthcare.
• Understanding their service use and characteristics is crucial for effective intervention design.

Purpose of the Study:

• To examine the service use and characteristics of individuals under 25 diagnosed with HIV.
• To inform the development of appropriate healthcare services for this demographic.

Main Methods:

• Retrospective review of medical records for individuals under 25 diagnosed with HIV at Chelsea and Westminster Hospital.
• Inclusion of demographic, clinical, social, and behavioral data.
• Tracing of individuals lost to follow-up by the Health Protection Agency.

Main Results:

• The majority (91%) of the 100 young people diagnosed with HIV acquired it sexually, with a median age of diagnosis at 21.
• Significant proportions were born outside the UK (59%) and diagnosed outside specialized genitourinary medicine settings (20%).
• High rates of concurrent sexually transmitted infections (26%), documented HIV transmission risk (34%), psychiatric comorbidity (23%), and loss to follow-up (20%) were observed, alongside low cervical screening rates.

Conclusions:

• Young people with sexually acquired HIV have complex medical and psychosocial needs, often leading to disengagement from health services.
• Existing services are inadequate for the needs of this population.
• Specialized young people's HIV clinics are proposed as a means to improve care standards for this vulnerable group.