Behavioral risks for human immunodeficiency virus infection in adolescent medical patients

This paper is an examination of the extent to which adolescents in primary care indicated behavioral risk for human immunodeficiency virus infection, and the degree to which their clinic records reflected either awareness of such conditions or interventions for them. Levels of risk were assigned to the youths based on known risk factors in adult populations and arbitrarily selected natural breaks in the frequency of sexual behaviors. Of the sample, 3% were at high risk for human immunodeficiency virus infection because the adolescents engaged in prostitution, injectable drug use, male homosexual behavior, or had a sexually transmitted disease associated with genital ulcers or sores; 16% were at moderate risk because the youths had more than six sexual partners in the year preceding the interview or had nonulcerative forms of sexually transmitted disease; and the remainder were at low risk. Fewer than half of the youths at risk for human immunodeficiency virus infection sought or received help for any of their problem behaviors, while virtually all sought and received help for sexually transmitted diseases. Because a high proportion of the youths engaging in risky behaviors had sexually transmitted diseases, the most promising approach for prevention of human immunodeficiency disease infection is through health clinics that treat sexually transmitted diseases. These clinics could screen the youths for associated behavioral risk factors, and then offer preventive or interventive services.