Risk assessment for human immunodeficiency virus among pregnant Hispanic adolescents

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.