Youth at risk. Sex, drugs, and human immunodeficiency virus
D. A. Wendell, I. M. Onorato, E. McCray, D. M. Allen and P. A. Sweeney
Division of HIV/AIDS, Centers for Disease Control, Atlanta, GA 30333.
Adolescents and young adults are at risk for human immunodeficiency virus
type 1 infection due to unprotected sexual intercourse and drug use. In
1988 and 1989, blinded surveys were conducted in 84 sexually transmitted
disease clinics, 115 women's health clinics, and 19 drug treatment centers
in 38 metropolitan areas. Blood specimens from 153,242 clients, aged 15 to
24 years, were tested for human immunodeficiency virus type 1 antibodies
after all client identifiers were removed. In sexually transmitted disease
clinics, the median rate was 0.4% among 15- to 19-year-olds, compared with
1.4% among 20- to 24-year-olds. Among heterosexual adolescents, rates in
females were significantly higher than in males (Wilcoxon signed rank
test). Rates in heterosexuals were highest in the northeastern and
southeastern United States and in Puerto Rico. In 20- to 24-year-old male
clients in sexually transmitted disease clinics who had sex with males,
rates ranged from 9.7% to 55.6%. In drug treatment centers, the median rate
among 20- to 24-year-old men and women was 8.3% (range, 0% to 33.3%). Rates
in women's health clinics were much lower (median, 0.1%). The high rates of
infection in certain groups of adolescents and young adults indicate the
need for improved care, education, and outreach targeted toward those at
high risk.
