Sexual Risk-Taking by Muscovite Youth Attending School

By Westhoff, Wayne W.; Klein, Klaus et al. | Journal of School Health, March 1996 | Go to article overview

Sexual Risk-Taking by Muscovite Youth Attending School

Westhoff, Wayne W., Klein, Klaus, McDermott, Robert J., Schmidt, Wolf-Dieter, Holcomb, Derek R., Journal of School Health

Heterosexual intercourse will account for a projected 75% to 80% of all infections worldwide related to the human immunodeficiency virus (HIV) by the year 2000.[1] This shift in rates of occurrence for AIDS and new HIV infections from the homosexual to the heterosexual population places adolescents at high risk of disease.[2] Although infrequently diagnosed with HIV/AIDS, adolescents are in a high-risk situation due to their young age at first intercourse their number of partners; their high rates of other sexually transmissible infections; their experimentation with intravenous drugs; their other substance use; and their limited HIV/AIDS knowledge.[3] Primary causes of illness and death among adolescents related directly to risk behavior, a characteristic endemic to this age group.[4] In addition, adolescents who engage in health-compromising behavior, such as high-risk sexual practices, also are less likely to engage in health-enhancing behavior.[5]

According to the National Commission on AIDS,[6] HIV infection is spreading rapidly among adolescents in the United States. Although the reported number of HIV/AIDS cases among those ages 13-19 is relatively small (1,768 cases as of December 1994), the number of cases increased by 40% in a recent year.[6-8] Twenty percent of all AIDS cases occurred among those ages 20-29.[6,9,10] Given the incubation period of up to 10 years from the onset of the HIV infection to full-blown AIDS, one can infer that many HIV infections were introduced by sexual practices during adolescence.

As of mid-1994, the World Health Organization estimated that internationally, 17 million individuals were infected with HIV, and more than 985,000 AIDS cases were reported.[11] An additional 1 million cases of AIDS are expected by 1997.[12] More than half of reported cases are from the United States, but this pattern may change.

For example, the United States had a 1991 global ranking of 30th of 149 national data sets for new AIDS cases (16.84/100,000).[13] This incidence rate is far below some countries in the Caribbean basin of Latin America and Africa. The Bahamas ranked first at 90.04/100,000, Malawi ranked second at 81.28/100,000, and Uganda ranked third at 57.72/100,000, but the United States ranks above all European countries. The Federal Republic of Germany ranked 74th at 1.88/100,000, and the Russian Federation ranked 140th at 0.02/100,000. The Bahamian AIDS case rate is the highest recorded rate according to official 1991 government reports. However, Haiti has a reported rate assigned by the Pan American Health Organization in Washington, D.C., of 509.56/100,000.

The different patterns of HIV infection and annual incidence rates of AIDS in the United States and in the European community is interesting considering the relatively close personal interactions between the people through businesses and tourism. In addition, recent political reforms have brought an increase of foreigners into urban areas of eastern Europe such as St. Petersburg, Russia.[14]

The relatively low Russian rate may not last long. According to Pokrovskii, Savchonko, Suvorova et al,[15] the point prevalence rate of HIV infection among homosexuals increased from 22.4 per hundred to 47.8 per hundred during 1990-1991, characterizing a new stage of the epidemic. As of 1993, however, the number of new infections had not shown the type of dramatic increase noted in the United States among men having sex with men in the early 1980s.[14] A more likely scenario will be an increase in the epidemic occurring among the heterosexual population due to the lack of sexuality information, low condom use, and the high rate of traditional methods of birth control such as withdrawal, douche, and abortion. Visser, Pavlenko, Remmenick et al[16] noted that earlier surveys showed couples used unreliable birth control methods, but little is known about the latest trends since the recent general liberalization of the Russian society, including more open attitudes about sex. …

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