Adolescents and Human Immunodeficiency Virus Infection: The Role of the Pediatrician in Prevention and Intervention

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Abstract
The incidence of human immunodeficiency virus (HIV) infection among adolescents is both significant and rising, and concern about this disease is increasingly evident among adolescents, their parents, and health professionals. Such concern evolves from multiple factors including not only the number of adolescents who have been reported to have the acquired immunodeficiency syndrome (AIDS), but also the uncertainty as to how many youths have been infected with the virus but remain asymptomatic; the risk of becoming infected through either heterosexual behavior, homosexual behavior, or substance abuse; and the need to implement effective preventive strategies. EPIDEMIOLOGY By the end of December 1992, a total of 946 cases of AIDS in persons aged 13 through 19 had been reported to the Centers for Disease Control. Although adolescents account for less than 1% of the total reported cases of AIDS, 20% of total cases occur in young adults aged 20 through 29. The long latency period between infection with HIV and the emergence of clinical AIDS, often in excess of 5 years, suggests that many of these young adults were first infected during their adolescence. For others, who become infected as young adults, the sexual or drug use behaviors that placed them at risk for infection had their onset during adolescence. Although national cross-sectional seroprevalence studies have not been conducted, data from selected populations of adolescents provide some information about the rate of infection among segments of the adolescent population. Since October 1985, the Department of Defense has tested applicants for military service for HIV infection. The Prevalance rate for 17- to 19-years-old screened between October 1985 and March 1989 was 0.34 per 1000.

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