Social Determinants of Health and Unmet Needs for Services Among Young Adults With HIV: Medical Monitoring Project, 2018-2021.

BACKGROUND

Persons aged 13-24 years are a priority population in the National HIV/AIDS Strategy. Young adults with HIV have poorer health outcomes-including not being retained in care, antiretroviral nonadherence, and not being virally suppressed-than other persons with HIV.

SETTING

Centers for Disease Control and Prevention's Medical Monitoring Project data collected June 2018 through May 2022.

METHODS

We compared demographic characteristics, social determinants of health, and mental health between persons aged 18-24 years with HIV versus persons aged ≥25 years with HIV. Among those aged 18-24 years, we analyzed total and unmet needs for ancillary services, defined as those that support care engagement, viral suppression, and overall health and well-being among people with HIV.

RESULTS

Persons aged 18-24 years were more likely to have a household income <100% of the federal poverty level (48% vs. 39%), and experience unstable housing or homelessness (37% vs. 18%) or hunger/food insecurity (29% vs. 18%) than those aged ≥25 years. Persons aged 18-24 years had higher median HIV stigma scores (40 vs. 29) and were more likely to experience symptoms of generalized anxiety disorder (21% vs. 15%) than those aged ≥25 years. Of persons aged 18-24 years, 96% had a need for ≥1 ancillary service, of whom 56% had ≥1 unmet need; unmet needs were highest for subsistence services (53%) and non-HIV medical services (41%).

CONCLUSIONS

Addressing unmet needs for subsistence and non-HIV medical services could help reduce disparities in social determinants of health and mental health that drive inequities in health outcomes among persons with HIV aged 18-24 years.