HIV Rates May Be Low In High-Risk Adolescents


NEW YORK — HIV infection may not be a significant risk even among adolescent populations with a high prevalence of other sexually transmitted infections, according to a study of adolescents at a juvenile detention center in Houston.

Although chlamydia and gonorrhea were relatively common among this group of incarcerated teens—28% among girls and 9% among boys—the prevalence of HIV was low among those tested, with only two cases among boys and no cases among girls.

Researchers at the University of Texas evaluated 6,805 sexually active boys and 1,425 sexually active girls who were incarcerated at the Harris County Juvenile Detention Center in 2006 and 2007. The mean age of the population was 15 years old (range 13–16 years) and all identified themselves as heterosexual, Dr. William Risser said at a joint conference sponsored by the American Sexually Transmitted Diseases Association and the British Association for Sexual Health and HIV.

All of the detainees received a physical examination and health history, and a first-catch urine screening for chlamydia and gonorrhea. They also received an HIV and rapid plasma reagin (RPR) test for syphilis if they had suspicious symptoms, had not been tested for more than 1 year, had another sexually transmitted infection, had sold sex, or requested testing.

Among the 6,805 boys evaluated, 78% were sexually active in the month before admission to the facility, 69% had used a condom at last intercourse, and 29% reported that they had a new partner in the previous month. Nearly 8% of the boys tested positive for chlamydia, 0.68% tested positive for gonorrhea, and 1% tested positive for both organisms. Of the 2,524 boys who were tested for HIV, only 2 tested positive (0.08%). Of those who tested positive for HIV, their only admitted risk behavior was heterosexual intercourse, said Dr. Risser, director of the division of adolescent medicine at the university in Houston.

Among the 1,425 girls evaluated in the study, the rates of chlamydia and gonorrhea were higher, but there were no cases of HIV. About 74% reported that they were sexually active in the month before they were admitted to the facility, 49% said they had used a condom at last intercourse, 19% had a new partner in the previous month, and 9% said they had traded sex for drugs or money.

Overall, 17% of the girls tested positive for chlamydia, 5% tested positive for gonorrhea, and 6% were positive for both organisms. Of the 807 who underwent HIV testing, no one tested positive.

One of the factors in the low rates of HIV infection might have been the small amount of high-risk drug use. Other studies on the same population show that almost none used drugs other than marijuana. “I really believe that's true because culturally these kids don't use IV drugs,” Dr. Risser said.

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