Roughly 20 percent of youth who have had HIV since birth did not know their HIV status when they first became sexually active, according to a study by a National Institutes of Health-supported research network.
The study also found that, of those youth who knew they had HIV and who were asked about disclosure of their HIV status to their first sexual partners, most reported that they had not told their partner prior to sexual activity.
Moreover, most of these sexually active youth reported some sexual activity without condom use.
In the study of 330 HIV-positive 10- to 18-year-olds, the youth completed a computer-guided questionnaire twice a year and provided confidential answers to survey questions about their sexual experiences. Their responses included answers to questions about when they first had sex, whether they used condoms, and whether they revealed their HIV status to potential partners.
On average, participants who had initiated sexual activity reported having their first sexual experience at age 14. One-third of these said they had disclosed their HIV status to their first partner. The researchers also found that 62 percent of those who were sexually active reported at least one sexual act without use of a condom. The researchers noted that young people who did not take anti-HIV medication regularly were more likely to subsequently initiate sexual activity than were those who took their medication as prescribed.
“Adolescence introduces many complications into children’s lives, and those of HIV-positive youth especially,” said co-author Susannah Allison, Ph.D., of the Infant, Child and Adolescent HIV Prevention Program at NIMH. “As more HIV-positive infants survive childhood and become sexually active teens, it becomes increasingly important to emphasize how healthy behaviors can protect these teens, as well as their partners.”
The study authors recommend that families and caregivers inform children about their HIV status before they reach adolescence and become sexually active. The authors also urge physicians and other health care providers to make sure that youth living with HIV understand the importance of safer sex practices and of disclosing HIV status to prospective partners.
Study authors also noted that caregivers vary as to when they tell children about their HIV status, often waiting until the teen years, when they believe the youth will more mature and better able to cope emotionally with their diagnoses. The American Academy of Pediatrics recommends that health care providers discuss with parents and caregivers the issue of disclosing a child’s HIV status.
Youth living with HIV who do not use condoms risk spreading HIV to prospective partners, as well as acquiring sexually transmitted infections from their partners. Like other youth, they also increase their own risk for other sexually transmitted infections.
“Our findings show that these young people act very much like their HIV-negative counterparts across the country,” said Rohan Hazra, M.D., of the Pediatric, Adolescent and Maternal AIDS Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “However, because of their HIV status, it is extremely important for health care providers, school counselors and family members to reinforce the importance of practicing safe sex, taking medication regularly and disclosing HIV status to potential partners.”