A PROFILE OF HUMAN IMMUNODEFICIENCY VIRUS-INFECTED ADOLESCENTS RECEIVING HEALTH-CARE SERVICES AT SELECTED SITES IN THE UNITED-STATES

Objective: To determine the demographic/clinical profile of human immu nodeficiency virus (HIV)-infected adolescents in care at selected site s. Methods: We mailed surveys requesting prevalence data from physicia ns in government-funded HIV research and care programs on HIV-infected youth (10-21 years) receiving care. Results: A total of 49% responses yielded information on 978 subjects. Vertical, blood, and sexual were predominant transmission modes. Three-quarters were of an ethnic/raci al minority; 50% were female. The earliest median CD, count was 0.467 x 10(9)/liter (467/mu l). Percent asymptomatic varied by transmission: vertical (16%), blood products (40%), male-male sexual (67%) and fema le-male sexual (M: 73%) (F: 74%). Clinically indicated Pneumocystis ca rinii pneumonia prophylaxis was differentially prescribed: vertical (9 6%), blood (89%), and sexual (male-male-47%) (female-male: M: 36% and F: 56%). Of these youth 78% are not represented in national AIDS case data. Conclusions: Examination of numerator data from selected sites i ndicates three transmission-driven adolescent HIV epidemics with diffe rent characteristics. Minority youth are disproportionately represente d; many vertically infected infants are surviving to adolescence; sexu al activity is a significant transmission avenue. HIV-infected youth a ppear to enter care with considerable immunosuppression. Clinical prof iles and treatment patterns appear to differ by transmission mode. Fur ther study is needed on adolescent HIV disease progression and determi nants of access to care and treatment.