Frequency and predictors of medically attended injuries in HIV-infected children

The extent to which medically attended injuries complicate the clinical cou rse or HIV-infected (HIV+) children is unknown. In a cohort of HIV+ childre n delivered from 1985 to 1990 and aged less than 60 months, we determined m edically attended injuries per 100 child-years, Injury Severity Scores (ISS ), and predictors of medically attended injuries by using New York State Me dicaid claims from 1986 to 1992 linked to birth certificates. Injury rates and ISS were compared to those of a population of black, inner city childre n aged less than 60 months from emergency room records. HIV+ children had s lightly more injuries (19.3 vs. 16.8/100 child-years) but similar ISS (2.4 vs. 2.3), Predictors of injuries in HIV+ children included younger maternal age (24/100 child years, p=0.008) and delivery outside of New York City (2 9/100 child-years, p=0.02), Illicit drug use and alcohol use were associate d with greater ISS while cocaine use was associated with a higher rate of p ossibly intentional injuries. Medically attended injuries affected one in f ive HIV+ children in our cohort annually, slightly more than the comparison population. Specific maternal and birth characteristics such as substance abuse and younger age at delivery may help target at-risk children.