As adolescents whose mothers had HIV and who were born with HIV become sexually active, researchers are calling for public health initiatives aimed at preventing them from passing on the virus to their partners.

The recommendation follows an investigation by the Pediatric HIV/AIDS Cohort Study showing that most such HIV-positive youngsters say they have not yet initiated sexual activity, but those who have say they started early and do not consistently use condoms.

“While our data are preliminary and we are still enrolling patients, it is clear that these HIV-positive children and adolescents are starting to become sexually active, and that interventions are needed to help them delay sexual initiation, consistently use condoms once they do become sexually active, and discuss their HIV status with their sexual partners,” Katherine Tassiopoulos said at the meeting of the Pediatric Academic Societies.

With the introduction of potent antiretroviral drugs, children in developed countries who were infected with HIV before birth are surviving into adolescence and adulthood, the investigators wrote in their conference poster.

They also noted that adolescence is often a time of sexual initiation as well as decreased adherence to HIV treatment.

For their study, Tassiopoulos, a research scientist in the Department of Epidemiology at the Harvard School of Public Health in Boston, and her colleagues analyzed responses to sexual behavior questionnaires completed by 153 children and adolescents 10 years of age or older with perinatally acquired HIV infection.

Overall, 124 of them reported no sexual activity. Thirteen reported genital touching only, and 16 reported vaginal, anal or oral sex.

The 10 sexually active boys in this series were on average 12 years old at sexual initiation, and the 6 sexually active girls were 16 years old.

One third of the sexually active subjects reported at least one instance of unprotected vaginal or anal sex. Furthermore, half of them had detectable levels of HIV in their blood, including all of the four males who reported inconsistent condom use.

The investigators were also surprised to find that all of the sexually active individuals who reported giving or receiving oral sex also reported vaginal or anal sex.

“This is contrary to other published and anecdotal evidence that suggests more teens have oral sex rather than penetrative sex, perhaps due to perceptions that it is less risky or more acceptable,” Tassiopoulos said.

By Jill Stein
BALTIMORE (Reuters Health)