HIV-infected Youths Continue Risky Behavior
NEW YORK, Jan 03 (Reuters Health) -- HIV-infected male and female youths are twice as likely as adults to practice unsafe sex or to share needles following diagnosis, according to Seattle researchers.
The results of the study of HIV-positive patients show that, despite prevalent messages warning people about the dangers of sharing needles for illicit drugs and having unprotected sex, young people tend to believe the precautions do not apply to them.
"Many people assume HIV-positive youths have more knowledge about the risks than they do," the study's lead author Dr. Catherine Diamond, an epidemiologist at the University of Washington (UW), told Reuters Health.
"When healthcare providers see an HIV-positive youth, they tend to focus on treatment and not on prevention. We may need to more carefully target public health messages to certain subgroups of people," she said.
The study, published in the January issue of the American Journal of Public Health, compared risky behaviors of 139 young HIV patients with those of 2,880 adult patients. Half of the youths were younger than 20 when diagnosed with HIV and half were older, but under 22. Among the adults in the study, the median age was 32 when diagnosed with HIV, meaning half were older than that and half were younger than 34 but older than 22.
Diamond, who is now at the University of California at Irvine, and her UW colleague, Dr. Susan Buskin, reviewed the medical records of the study participants in Seattle and its surrounding King County area for the period between 1990 and 1998.
Evidence of risky behavior included documented incidences of unprotected sex, needle sharing without disinfecting, contracting sexually transmitted disease, exchanging sex for money, and pregnancy within 6 months after a positive HIV test.
Among the HIV-positive young women, 66% exhibited evidence of risky behavior as compared to 46% of adult women. When pregnancy was excluded, the ratios dropped to 46% and 34% for the youths versus adults. Among the HIV-positive males, 28% engaged in risky behavior compared to 16% of adult males.
While the study was not designed to explain why the young women appeared to engage in more risky behaviors, the researchers theorize that more frequent screening for sexually transmitted disease and the inclusion of pregnancy might have skewed the number of documented incidences of such behavior.
The investigators note that their findings represented only information obtained from people under medical care, which may represent an underestimate of the extent of risky behavior among all HIV-infected people.
They add that because most of the study period predated the advent of the protease inhibitors, which have successfully checked the advance of the disease in many people, further study of risky behavior among HIV-infected people is more urgent than ever.
"Most of the public health messages are aimed at prevention among non-infected people," Diamond said. "The risky behaviors of HIV-positive people are not being adequately addressed. It is important to continue to try to intervene with prevention measures among HIV-infected people because of the potential for infecting others."