Adolescents and HIV infection: a clinician's perspective

Increasing concern in the United States has centered on HIV infection in adolescents. While less than 0.4% of all reported cases of AIDS are reported in adolescents 13-19 years of age, it is speculated that upwards of 20% of all AIDS cases have acquired their infection as teenagers. Most cases are now reported to occur among minority youth and most are now related to sexual or drug use behavior. The natural history of HIV infection in adolescents has yet to be defined. Many adolescents have progressed to clinically significant low CD4+ cells by the time their infection is discovered. While traditional risk factors are also risk factors for adolescents, number of sexual partners and noninjection drug use appear to be related to an increased risk of HIV infection in this age group. Prevention efforts must target both techniques as well as one-on-one counselling. Health care providers have a unique role to play in both patient and community education.