Human immunodeficiency virus-infected adolescents: a descriptive study of older children in New York City, Los Angeles County, Massachusetts and Washington, DC

Background. Children infected with HIV are entering adolescence with challe nging and changing medical and social needs. Through chart review we descri be certain medical and social characteristics of adolescents who acquired H IV as children. Methods, HIV-infected children 12 years of age and older in 1995 were monit ored through the Pediatric Spectrum of HPV Disease study from four US sites . In addition to standard 6-month medical chart reviews, a special chart ab straction in 1997 collected available psychosocial and sexual history infor mation, Results. A total of 131 adolescents HIV-infected as children were studied: 52 infected perinatally; 44 infected through a contaminated blood transfusi on; 30 through receipt of contaminated blood products for hemophilia; and 5 with unknown transmission mode, Mean age at last medical contact was 15.5 years, 67% were Hispanic or African-American, 12% were employed, 66% attend ed regular school, 66% knew their HIV status and 48% (8% for the perinatall y infected) lived with their biologic mother. Information on sexual activit y showed that 18% had sexual relations, 28% did not and for 53% sexual acti vity was not recorded in the medical chart. Four percent used illicit drugs , which along with sexual activity showed a positive association with age. Forty-two percent had an AIDS-defining opportunistic infection, and 56% had a recent CD4(+) lymphocyte count <200 cell/mu l. Conclusions. Adolescents in this study represent a heterogeneous group of s urviving HIV-infected children some of whom are sexually active and potenti al sources of HPV transmission. Clinicians who treat HIV-infected and high risk adolescents face the challenges of providing care and prevention servi ces appropriate to adolescent development.