Greater than ¼ of all new HIV infections in the US occur in youth. These infections are disproportionately distributed among ethnic/racial minorities and men who have sex with men (MSM), with more than ½ of new infections occurring in young African American and Hispanic populations and over 70% in young MSM populations. These groups are also unique compared to all others because longitudinal trends of infection over the last decade have increased. The Centers for Disease Control and Prevention guidelines for routine HIV testing across the US have increased the numbers of people identified with undiagnosed HIV infection; however, up to 80% of youth are unaware of their infection. Additionally, establishing a durable linkage to care, an activity associated with improved outcomes, remains an elusive goal for many providers. This issue is especially important in vulnerable populations like youth, who may encounter more obstacles and challenges when attempting to access and stay in care.
The ATN research program aims to defeat the rising HIV epidemic among adolescents and young adults in the US. The objective and overarching goal of this initiative is to increase the numbers of at-risk youth who are aware of their serostatus, and for those who are diagnosed with HIV, to increase the numbers in each segment of the care continuum to 95% and to bend the infection rate curve downward toward zero through the research efforts of the ATN.
The ATN research agenda has two foci: the HIV prevention cascade and the HIV treatment/care cascade. Regarding the prevention cascade, the ATN seeks to develop and examine the feasibility and potential impact of the delivery of novel services, delivery of services in novel settings, and the use of novel engagement strategies for reaching high risk youth and promoting uptake of essential services such as, HIV testing, STI testing, risk screening, condom distribution, PrEP, and PEP. Regarding the HIV treatment/care cascade, the ATN seeks to determine the most effective strategy or set of strategies for linking positive youth to care, promoting retention in care, and obtaining and sustaining viral suppression.