We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Viewpoint |

Time to Improve the Global Human Immunodeficiency Virus/AIDS Care Continuum for Adolescents A Generation at Stake

Sarah M. Wood, MD, AAHIVS1; Nadia Dowshen, MD, AAHIVS1,2; Elizabeth Lowenthal, MD, MSCE, AAHIVS3,4
[+] Author Affiliations
1Craig-Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
2Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia
3Departments of Pediatrics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia
4Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
JAMA Pediatr. 2015;169(7):619-620. doi:10.1001/jamapediatrics.2015.58.
Text Size: A A A
Published online


This Viewpoint discusses the importance of improving care globally for adolescents with human immunodeficiency virus (HIV)/AIDS.

Pediatricians have an obligation to protect the health of children and adolescents. Human immunodeficiency virus (HIV)/AIDS remains the second leading cause of death for adolescents worldwide and the leading cause for adolescents in sub-Saharan Africa.1 Youth aged 15 to 24 years represent one-third of new infections.2 While AIDS-related mortality declined for adults and children from 2005 to 2012, there was a 50% increase in mortality among HIV-infected adolescents.2 For perinatally HIV-infected youth, worse outcomes largely reflect developmental struggles with treatment adherence they face as they enter adolescence. For adolescents with behaviorally acquired HIV, late diagnosis, poor linkage to and retention in care, low rates of antiretroviral therapy (ART) prescription, and inadequate treatment adherence all affect mortality.2 In the United States, nearly 60% of HIV-infected youth do not know they are infected.3 In sub-Saharan Africa, only 1 in 5 HIV-infected young women knows her status.2

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Adult and Youth HIV Treatment Continuum in the Total US Population and Specific to Youth

Estimated proportions of the human immunodeficiency virus (HIV)–infected US population as compared with youth at the various stages of the HIV treatment continuum. ART indicates antiretroviral therapy. Created based on data from the Centers for Disease Control and Prevention.4 Of note, youth estimates do not include adolescents younger than 18 years. Zanoni and Mayer5 estimate the rate of virologic suppression among youth aged 13 to 29 years to be 6%.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

Care at the Close of Life: Evidence and Experience
Overcoming the False Dichotomy of Curative vs Palliative Care for Late-Stage HIV/AIDS: "Let Me Live the Way I Want to Live, Until I Can't"

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update