More Adolescents Acquiring HIV through Risk Behaviors
Walsh, Nancy, Clinical Psychiatry News
BOSTON -- The adolescent HIV-1 epidemic as reflected in a multisite cohort of U.S. youth is changing from one of vertically transmitted infection to one where infection is acquired through risk behaviors, posing new challenges for providers and the health care system, Dr. Allison L. Agwu reported in a poster session at the 15th Conference on Retroviruses and Opportunistic Infections.
The HIV Research Network, a consortium of 21 clinical sites that provide primary HIV care, includes 684 patients aged 12-24 years. Vertical transmission was the source of infection in 227 patients, while risk behaviors account for 457 cases, according to Dr. Agwu of Johns Hopkins University, Baltimore.
Analysis of data from this cohort showed that patients infected through risk behaviors are older, with a median age of 22 years, compared with a median age of 15 years among vertical-transmission patients. They also are more likely to be male. A total of 292 (64%) of the risk-behavior patients are male, as are 108 (48%) of the vertical-transmission patients.
Risk behaviors comprised men having sex with men (51%), unprotected heterosexual activity (45%), and intravenous drug use (4%).
The median CD4 count in the risk-behavior group was 492 cells/m[m.sup.3], while that in the vertical-transmission group was 660 cells/m[m.sup.3].
The median HIV RNA level in the risk-behavior group was 6,700 copies/mL, compared with 400 copies/mL in the vertical-transmission group.
Despite this worse immune suppression and higher levels of viremia among the risk-behavior patients, they were less likely to be on highly active antiretroviral therapy (HAART) (43% vs. …