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Frequent Sexual Activity by Brooklyn Teens Infected With HIV at Birth
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48th ICAAC
October 25-28, 2008
Washington, DC
Mark Mascolini
A small chart study of US teens infected with HIV at birth found that more than half had sexual experience, often with multiple partners [1]. Nearly one third of the girls studied got pregnant once or twice, but none of their children had HIV.
Although small, the study underlines gaps in how much is known about a growing population of teens infected with HIV since birth. Results in this small group suggest that HIV education and prevention efforts for these adolescents are failing, even though all these children received consistent care from the same clinicians for 14 years or more.
Researchers in Brooklyn, New York, analyzed records of 15 boys and 14 girls with perinatal HIV infection; 4 had died by the time of the study. Of the remaining 25 teenagers, median age stood at 17 years. The group's age averaged 11.6 years when they learned they had HIV infection, and an average 5.8 years passed between diagnosis and this study.
When diagnosed with HIV, 16 children (55%) did not have or no longer lived with a biological parent. Three children (10%) were not being cared for by parents, relatives, foster families, or adoptive families. Five of 29 children had graduated from high school by the time of the study, and 21 of 25 living children were still in school. Three of 25 teens were working toward a Graduate Equivalent Degree. Twenty-four of 29 youth (83%) had one or more problems reported from school.
Of the 25 surviving children, 5 (20%) smoked cigarettes, 7 (28%) smoked marijuana, 3 (12%) drank alcohol, and 2 (8%) used other drugs. These proportions may not be unusual among Brooklyn teens in general, or they may be lower than in the general population. The researchers did not report population-based rates.
Sixteen of 29 teens (55%) had sex at least once, and 12 (41%) had 5 or more sex partners. Four of the 15 girls (27%) had been pregnant, 2 of them (13%) twice. Two pregnancies ended in abortion. None of the 4 children born had HIV. Most of the HIV-infected teens reported using some form of protection during sex.
Again, the researchers did not report sex or pregnancy rates for a general population of Brooklyn teens. A citywide study found a pregnancy rate of 10% among 15-to 19-year-olds in the year 2000 [2], considerably lower than the 27% in this small study of HIV-infected teens. Regardless of comparative statistics, however, the high frequency of sexual intercourse in these HIV-infected teens clearly places them and their sex partners at risk of pregnancy and complicating sexually transmitted diseases, while posing a risk of HIV transmission to uninfected sex mates.
The investigators proposed that "innovative modalities need to be used to enhance sexual responsibility and substance use counseling to this group." They called for "mental health support and behavior monitoring and modification."
References
1. Desai N, Abraham M, Cambridge-Phillip R. Long-term follow-up of teens with perinatal HIV infection after disclosure of diagnosis. 48th Annual International Conference on Antimicrobial Agents and Chemotherapy (ICAAC). October 25-28, 2008. Washington, DC. Abstract H-461.
2. New York City Department of Health and Mental Hygiene. Who is at risk? Teen pregnancy in New York City. December 2002
http://home2.nyc.gov/html/doh/downloads/pdf/fhs/tpreport.pdf.
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