Comparison of HIV+ and HIV- adolescents: risk factors and psychosocial determinants

HIV-positive teenagers and young adults appear significantly more likely to have been sexually abused and to have a higher frequency of problem behaviors than HIV-negative teenagers. A total of 793 teenagers and young adults between 13 and 21 years old were tested for HIV and interviewed about their sexual behavior and background. Seventy-one of the adolescents were HIV positive. Sixty-three percent of the HIV-positive participants were male. Thirty-two percent of the HIV-positive females and 33% of the HIV-positive males had been sexually abused compared with 28% and 9% of the HIV-negative females and males, respectively. Seventy-three percent of the HIV-positive females and 51% of the HIV-positive males had ever had a sexually transmitted disease compared with 38% and 10% of the HIV-negative females and males, respectively. HIV-positive adolescents were also significantly more likely to have sex with casual partners and to have survival sex. There appeared to be no significant differences in self-esteem, emotional distress or HIV-related protective factors between the HIV-negative and HIV-positive participants.
According to the World Health Organization, half of the 14 million people with human immunodeficiency virus (HIV) worldwide were infected between the ages of 15 and 24 years. However, details about HIV-positive (HIV+) youths' risk-related behavior and social context have not been previously reported. Objectives. To outline detailed sexual and drug use practices, social and psychological status of HIV+ youth compared with a cohort of HIV-negative (HIV-) youth; and to examine the ability of the health belief and risk-taking models to predict sexual and drug use acts of HIV+ youth. Methods. HIV testing was conducted on and a 207-item structured interview covering HIV risk-related acts, protective factors and background information was administered to 72 HIV+ and 1142 HIV- adolescents aged 13 through 21 years receiving care in an adolescent clinical care unit of a large medical center in New York City. Data were analyzed for adolescents reporting sexual intercourse (71 HIV+ and 722 HIV-) by logistic regression analysis of five domains to identify variables significantly associated with HIV seropositivity. Results. Logistic regressions indicated significant differences in sexual risk acts based on serostatus and gender. Anonymous, blinded seroprevalence testing identified 11% more HIV+ adolescents than would have been identified by current counseling and testing practices. HIV+ adolescents were significantly more likely to be sexually abused (33 vs 21%, P