Risk assessment for human immunodeficiency virus among pregnant Hispanic adolescents.

ABSTRACT

Inner-city adolescents are believed to be at increased risk for HIV infection because of their high-risk behaviors, and black and Hispanic teenagers may be at greatest risk as a consequence of these behaviors and inadequate AIDS education. In the present paper, the HIV risk status of pregnant Hispanic adolescents presenting for prenatal care to an inner-city municipal outpatient clinic located in New York City was assessed. The assessment consisted of a confidential structured interview. Based on known adult risk factors, adolescents were identified as being at increased risk or low risk. One-third of the 87 teenagers were identified as being at increased risk for HIV infection. Nobody reported symptoms suggestive of AIDS, had had a transfusion, or reported use of intravenous drugs or crack cocaine. Sexual risk-taking behavior was the most common factor that increased HIV risk. Sixteen adolescents were at increased risk solely because of a sexually transmitted disease and seven others reported an STD with at least one other risk factor. Although 86% of the pregnant teenagers reported the risk-taking behavior of substance use by self or partner, only four were at increased risk based on this factor alone. However, many adolescents were unaware of their partners' past substance use and sexual history and, therefore, may have underestimated their own risk. Birthplace (United States vs. foreign born) and nationality (Puerto Rican vs. non-Puerto Rican Hispanic) were significantly associated with the adolescents' HIV risk assessment via an interaction effect. None of the adolescents had previously considered themselves to be at increased risk for HIV infection. The overwhelming majority who were at increased risk declined referral for further counseling or testing. It is recommended that pregnant Hispanic adolescents be assessed for HIV risk and receive risk reduction counseling as part of their general health care.

ABSTRACT

PIP Blacks and Hispanics have disproportionately higher rates of AIDS than do Whites, and they have the highest rates of heterosexually acquired AIDS. Inner-city teens' high-risk behaviors particularly predispose them to the risk of HIV infection. This paper presents findings from an assessment of HIV risk status of 87 pregnant Hispanic adolescents presenting for prenatal care at an inner-city municipal outpatient clinic in New York city. Participants were aged 13-19 years, of mean age 17.3 years, and evaluated and interviewed from May 1989 through November 1990. Their sexual partners were of average age 20.9 years. 57 (66%) reported never having used any form of contraception; only 3 of the remaining 30 girls used condoms. Only 29 of the 87 girls (33%) were, however, deemed to be at increased risk of HIV infection. It should be noted that lack of some respondent knowledge on partners' past substance use and sex history may result in the overall level of risk being understated. Nobody reported symptoms suggestive of AIDS, had had a transfusion, or reported use of IV drugs or crack cocaine. Sexual risk-taking behavior was the most common factor increasing HIV risk in the sample. 16 girls were at increased risk exclusively due to the presence of sexually transmitted diseases (STD), while 7 others reported an STD with at least one other risk factor. Further, 86% reported risk-taking substance use by themselves or partners, but only 4 were at increased risk due exclusively to this factor. Birthplace and nationality interacted to be significantly associated with the risk of HIV infection. Non-Puerto Rican Hispanics born in the US were more likely to be at increased risk for HIV than were those born in their native land. It is stressed in closing that while none of the girls had previously thought of themselves as being at increased risk for infection, and the majority at increased risk of infection declined referral for further counseling or testing, pregnant Hispanic adolescents should nonetheless be assessed for HIV risk and receive risk reduction counseling as part of their general health care.