       Document 0749
 DOCN  M9590749
 TI    Comparison of HIV+ and HIV- adolescents: risk factors and psychosocial
       determinants.
 DT    9509
 AU    Hein K; Dell R; Futterman D; Rotheram-Borus MJ; Shaffer N; Adolescent
       AIDS Program, Bronx, New York, USA.
 SO    Pediatrics. 1995 Jan;95(1):96-104. Unique Identifier : AIDSLINE
       MED/95288139
 AB    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 <
       .05), engage in anal sex and survival sex (32 vs 4%, P < .01),
       unprotected sex with casual partners (42 vs 23%, P < .05), have had sex
       under the influence of drugs (52 vs 27%, P < .01), have a sexually
       transmitted disease (59 vs 28%, P < .01), use multiple drugs (43 vs 9%,
       P < .01) and engage in multiple problem behaviors (72 vs 30%, P < .01)
       than HIV- young people. HIV+ females reported more oral (69 vs 45%, P <
       .01) and/or anal (42 vs 12%, P < .01) intercourse compared to HIV-
       females. HIV+ males reported significantly higher rates of both
       insertive (82 vs 46%, P < .05) and receptive (51 vs 4%, P < .01) oral
       and anal (53 vs 13%, P < .01) intercourse than HIV- males. Protective
       factors were not significantly different for HIV+ and HIV- young people.
       CONCLUSIONS. Routine, confidential HIV counseling and testing should be
       considered for adolescents having unprotected sexual intercourse when
       age-specific services are available for HIV+ youth. Prevention programs
       should consider adolescents' history of abuse, homelessness, and other
       social as well as psychological dimensions in designing comprehensive
       care strategies to address HIV+ adolescents' multiple problem behaviors
       and living situations. Current theoretical models of health behaviors
       should be reconsidered, given the lack of their association to HIV risk
       acts of HIV+ youth. Age-specific services and interventions for HIV+
       youth are urgently needed as HIV is spreading among youth worldwide.
 DE    Acquired Immunodeficiency Syndrome/ETIOLOGY/PREVENTION & CONTROL
       Adolescence  *Adolescent Behavior  Adult  Case-Control Studies  Female
       Health Behavior  Health Education/METHODS  Human  HIV Seronegativity
       HIV Seropositivity/*PSYCHOLOGY  Logistic Models  Male  Models,
       Psychological  Risk Factors  Risk-Taking  *Sex Behavior  Substance
       Abuse/*EPIDEMIOLOGY  Support, U.S. Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

