TEENAGERS AT RISK OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION - RESULTS FROM SEROPREVALENCE SURVEYS IN THE UNITED-STATES

Objective: To describe the seroprevalence of human immunodeficiency vi rus type 1 (HIV-1) and risk factors for HIV-1 infection among teenager s attending selected clinics. Design: Anonymous, cross-sectional seros urveys conducted in 130 clinics in 24 cities. Settings: Adolescent med icine clinics, sexually transmitted disease clinics, clinics in juveni le detention and correctional facilities, and homeless and runaway you th centers. Patients: Teenagers in whom serum samples were drawn as pa rt of routine medical services. Main Outcome Measures: Prevalence of H IV-1 infection and reported HIV risk behaviors. Results: From January 1, 1990 through December 31, 1992, serum specimens were collected from 79802 teenagers; 591 of these specimens were positive for HIV-1 antib ody. Seropositive test results were found in all 24 cities surveyed, a nd in 95 (73%) of the 130 clinics surveyed. The median clinic-specific prevalence was 0.2% (range, 0% to 1.4%) in 22 adolescent medicine cli nics, 0.3% (range, 0% to 6.8%) in 33 correctional facilities, 0.5% (ra nge, 0% to 3.5%) in 70 sexually transmitted disease clinics, and 1.1% (range, 0% to 4.1%) in five homeless youth centers. Rates exceeded 1% in 37 sites (28%). Excluding sites with many men reporting sex with me n, rates in women were similar or somewhat higher than rates in men. R ates were highest among young men reporting sex with men, with clinic rates ranging from 16% to 17% in two homeless youth sites and 13% to 1 7% in two sexually transmitted disease clinics. Most teenagers with ri sk information reported heterosexual activity as their only potential risk exposure to HIV-1. Conclusions: Seroprevalence of HIV was general ly low but varied by type of clinic and geographic area. The highest r ates were observed among young women and gay men in some settings, sug gesting that targeted prevention messages are needed.