Intervention Strategies Are Needed for HIV-Positive Teens
Study shows healthy behaviors and safer sex practices need to be reinforced.
-- by Alexia Severson
While most teens are already educated on safe sex practices, targeted intervention strategies are needed to reinforce healthy behaviors in adolescents infected with HIV at birth, according to a new study published in Clinical Infectious Diseases.
Researchers found that many of the 330 adolescents who participated in this study admitted to having unprotected sex. When asked whether they disclosed their HIV status to their first sexual partners prior to sexual activity, the majority reported they had not. Eighteen percent of the participants were unaware they were HIV-positive at the time they started sexual activity.
Among the sexually active HIV-positive youth in this study with a high viral load (meaning more than 5,000 HIV copies in a milliliter of blood), researchers also found that 81 percent of them had a drug-resistant virus. Teens who do not disclose their status increase the probability that the resistant virus will be transmitted, thereby limiting treatment options for infected youth.
The Expert Take
"HIV infection adds another level of complexity to the adolescence of youth who are infected and has implications for both their own health and that of their sexual partners," said lead study author Katherine Tassiopoulos of the Harvard School of Public Health.
A link between not following regimens for antiretroviral therapy (ART) medications, known as nonadherence, and risky sexual behaviors is already recognized among HIV-positive adults. However, this link has also become apparent in teens as they become sexually active.
"Among youth, both nonadherence and sexual initiation may be expressions of independence or of the desire to feel accepted by peers," said researchers involved in the study.
Tassiopoulos and her team hope that by implementing successful interventions that encourage medication adherence, disclosure, and condom use, teens will think more carefully before engaging in sexual activity.
Author George R. Seage III, also of the Harvard School of Public Health, said he believes that one critical step in encouraging optimal adherence might be to inform young people "that ART can dramatically reduce the likelihood of sexual transmission of HIV."
Source and Method
For this study, researchers conducted cross-sectional and longitudinal analyses of HIV-positive youth between the ages of 10 and 18, who were enrolled in the US-based Pediatric HIV/AIDS Cohort Study between 2007 and 2009.
Sexual behavior information was collected using audio computer assisted self-interviews.
According to the Center for AIDS Research Education and Services, among young people, teen girls and minorities have been particularly affected by HIV. In 2006, in AIDS cases reported among 13- to 19-year-olds, teen girls represented 39 percent of the group, and black teens represented 69 percent of this group.
These statistics, along with results of this study, emphasize the importance of keeping teens informed of safe sex practices and the risks that come with being sexually active. This includes informing teens who are HIV-positive of their status early on, so they can take the necessary precautions if, and when, they decide to have sex.
According to Planned Parenthood, parents play a big part in their child’s perception of sex, and should begin talking with their children about sex in early childhood.
Numerous studies have looked at teens and their attention to safe sex practices. One study published in the Journal of Adolescent Health in September 2012 compared and described predictors of antiretroviral treatment adherence among adolescents with HIV acquired at the time of birth or through risky behaviors. Based on the results of this study, researchers concluded that “despite differences between groups, nonadherence was associated with severity of illness, difficult medication routine, and forgetfulness.” Researchers also determined that teens would benefit from simplified medication routines and better organizational skills.
Similarly, in a report published in the Maternal and Child Health Journal in June 2012, researchers determined that better understanding of factors influencing the decision-making process of teens infected with HIV at birth is needed to improve treatment and prevention interventions. The authors emphasized that understanding reproductive health and the related decisions of HIV-positive youth is critical, especially considering the potential public health implications of their reproductive decisions.
Another study published online in the Cochrane Database of Systematic Reviews in September 2012 examined whether motivational interviewing could be effective in improving outcomes in youth living with HIV. Researchers concluded that motivational interviewing is effective in reducing short-term viral load and unprotected sexual acts. However, “there is a need for more trials which report on outcomes such as adherence to medication, mortality, and quality of life in youth."