Adolescents and young adults who have been linked to HIV medical care have lower rates of viral suppression than their older counterparts.

Researchers analyzed data on 1,411 HIV-positive youths ages 12 to 24 who were referred to several U.S. HIV treatment sites. Seventy-five percent of the young people were then enrolled in medical care, 34% started antiretroviral treatment and just 12% achieved a fully suppressed viral load. By comparison, among older adults referred to care, other studies have found viral suppression rates ranging from 32% to 63%.

Compared with youths referred to care three months or longer after their HIV diagnosis, those referred within one to six weeks of their diagnosis were 2.5 times more likely to achieve full viral suppression, and those referred within six weeks to three months were nearly twice as likely to have an undetectable viral load.

The study authors called for the use of trained peer counselors and recommended that clinics maintain frequent contact with young HIV-positive individuals through texts or direct messages on social media in order to buttress their adherence to a care and treatment regimen.

“Our findings indicate an urgency for research on how best to tailor HIV intervention services to the needs of youth,” says the study’s first author, Bill G. Kapogiannis, MD, of the Maternal and Pediatric Infectious Diseases Branch at the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.