Where Did Everyone Go? Unpacking Clinic Missed Medical Appointment Rates Among Youth with HIV

Why It Matters

High missed‑appointment rates jeopardize viral suppression among youth with HIV, threatening both individual health outcomes and broader public‑health goals. Implementing youth‑focused scheduling and treatment innovations can close this retention gap.

Key Takeaways

• 45% of eligible youth missed at least one HIV clinic visit.
• Morning appointments cut missed visits by 40% versus afternoons.
• Pediatric clinic shows 51% fewer missed visits than adult clinic.
• Older adolescents more likely to miss appointments than younger teens.
• Undetectable viral load patients still exhibit high missed‑visit rates.

Summary

The Savvy study, presented at the Society of Adolescent Health and Medicine conference, examined missed clinic appointments among youth living with HIV. Researchers found that nearly half (45%) of eligible participants missed at least one visit, highlighting a critical retention challenge for this age group.

Using multivariate regression, the team identified several structural predictors: first‑morning slots reduced missed visits by 40% compared with afternoon appointments, and the pediatric/adolescent clinic experienced 51% fewer missed visits than the adult clinic. Older adolescents and young adults missed appointments more often than younger teens, while paradoxically, patients with undetectable viral loads also showed higher missed‑visit rates, likely reflecting fewer required follow‑ups.

Elise Terza, an adolescent‑medicine fellow at Johns Hopkins, emphasized the surprise of the undetectable‑viral‑load finding and noted that psychosocial factors—work, family responsibilities, and transition to adult care—may drive absenteeism. The analysis reported statistically significant incident‑rate ratios with 95% confidence intervals, underscoring the robustness of the associations.

The findings suggest actionable pathways: redesign scheduling to prioritize morning slots, develop youth‑centered transition protocols, and evaluate long‑acting injectable ART as a means to reduce visit frequency. Addressing these system‑level gaps could improve adherence, sustain viral suppression, and ultimately protect the long‑term health and futures of young people living with HIV.

Original Description

Elise Tirza Ohene-Kyei, M.D., M.P.H., Johns Hopkins adolescent medicine fellow, summarizes her recent presentation examining rates of missed medical appointments (MMA) among adolescents and young adults receiving HIV care. This analysis draws on data from the Strategies to Achieve Viral Suppression for Youth with HIV (SAVVY) study. It was presented at the Society for Adolescent Health and Medicine 2026 Annual Meeting, where it was selected as a finalist for the Charles E. Irwin, Jr. New Investigator Award. #hiv #johnshopkins Visit https://www.hopkinschildrens.org/id and https://www.hopkinschildrens.org/adolescentmed