As young people infected at birth with HIV enter adolescence and some, like other adolescents, begin having sex, it would be wise to offer interventions to promote healthy behaviors, say Harvard School of Public Health (HSPH) researchers and colleagues in a new study. The findings indicate that some young people infected perinatally with HIV report having unprotected sex or not disclosing their HIV status to sexual partners. Others may not have been aware in the first place that they were infected with the virus the first time they had sex.
The study was led by Katherine Tassiopoulos, research scientist in the HSPH Department of Epidemiology, and was published online November 7, 2012 and will appear in the January 15, 2013 print edition of Clinical Infectious Diseases. The team of researchers found that, among 330 perinatally infected youth from 15 sites across the United States, 28% reported having had sexual intercourse. Most of these reported having unprotected sex and HIV nondisclosure to their first partners. The researchers also found that youth who didn’t adhere to their antiretroviral (ARV) drug regimens were more likely to subsequently initiate sexual activity.
This is the first longitudinal analysis exploring HIV-specific and behavioral factors that might influence initiation of sexual activity among perinatally HIV-infected youth.
“HIV infection adds another level of complexity to the adolescence of youth who are infected and has implications for both their own health and that of their sexual partners,” said Tassiopoulos, as reported in Infection Control Today in early November 2012. “Researchers may want to consider interventions that take advantage of adolescents’ growing desire for independent decision-making and autonomy as a way to frame medication adherence, disclosure to sexual partners, and condom use as behaviors that protect not only their own health, but that of their partners,” Tassiopoulos said. Senior author George Seage, HSPH professor of epidemiology, said one critical step in encouraging youth to adhere to drug regimens may be to tell them “that ARV can dramatically reduce the likelihood of sexual transmission of HIV.”
Eighteen percent of youth in the study didn’t know they were HIV-infected at the time of their first sexual experience. Given this fact, Tassiopoulos said clinicians “can ensure that the published guidelines for disclosure to children and adolescents are followed and help their patients make choices that reduce risks to themselves and their partners.” The guidelines recommend that pediatricians inform adolescents, and school-age children when possible and appropriate, about their HIV status.
Deborah Kacanek, research scientist in the HSPH Department of Biostatistics, also participated in the study.