Antiretroviral Therapy Enrollment Characteristics and Outcomes Among HIV-Infected Adolescents and Young Adults Compared with Older Adults — Seven African Countries, 2004–2013

Age-related differences in enrollment characteristics and outcomes were analyzed among 16421 patients aged >or=15 years starting ART in seven African countries (Cote d’Ivoire Nigeria Swaziland Mozambique Zambia Uganda and Tanzania) during 2004-2012. Patient characteristics and outcomes were compared across three age groups: adolescents and young adults (15-24 years) middle-aged adults (25-49 years) and older adults (>or=50 years). Compared with older adults adolescents and young adults had higher LTFU (loss to follow-up) rates in all seven countries reaching statistical significance in three countries (Cote d’Ivoire Mozambique and Tanzania) in both crude and multivariable analyses. The higher risk for LTFU among adolescent and young adult ART enrollees compared with older adults increases their risk for death and increases the risk they will transmit HIV to seronegative sex partners. Effective interventions to reduce LTFU for adolescent and young adult ART enrollees could help reduce mortality and lower HIV incidence in this age group.