HIV risk behaviors among adolescents at a sexually transmitted disease clinic in New York City

Abstract

Purpose: The purpose of this study was to describe human immunodeficiency virus (HIV)-associated risk behaviors among adolescents attending a clinic for the treatment of sexually transmitted disease in New York City.

Methods: A total of 4,585 volunteers were interviewed and HIV-tested, including 456 adolescents (aged 13-19 years), of whom 220 were women (48%) and 236 men (52%).

Results: Fewer than 1% of the 456 adolescents said they injected drugs. Unprotected vaginal sex was the most common sexual behavior, with 93% of adolescents reporting "always" having vaginal sex, and 57% "rarely or never" using condoms. Anal sex was reported by 18%. Twenty percent of adolescent men had paid for sex, compared to just 1% of women, whereas 3% of men and 4% of women had traded sex for money or drugs. Nine women and three men tested HIV seropositive. All three HIV-positive men reported having had receptive anal sex with men. Among women, HIV seropositivity was most strongly associated with crack cocaine use and trading sex for money or drugs.

Conclusions: HIV prevalence was high, with most infections owing to sexual transmission rather than intravenous drugs. The increased risk of HIV infection in adolescent women was associated with high-risk sex related to crack use and the exchange of sex for money or drugs.