Changes in HIV/AIDS knowledge among early adolescents in Puerto Rico.

INTRODUCTION: One of the factors that influences HIV risk behavior among early adolescents is their HIV/AIDS knowledge. The objectives of this study were 1) to describe the sociodemographic features and HIV/AIDS knowledge among Puerto Rican early adolescents participating in the ASUMA (A Supportive Model for HIV Risk Reduction in Early Adolescents) project; and 2) to assess changes in the knowledge of HIV/AIDS within the intervention and nonintervention groups after the first year of the study. METHODS: This is a prospective cohort study of 173 early adolescents after 12 months of participation in the ASUMA project. The setting of the study was four junior high schools. Baseline and follow-up self-administered questionnaires were issued to the entire study group. The first workshop was developed directed to increase HIV/AIDS knowledge and decrease vulnerability in the group assigned to the intervention. Descriptive and inferential analyses were performed. RESULTS: 47% of adolescents were cases and 52.6% controls. Most adolescents were 12 years old; 50.3% were boys and 49.7% were girls; 78.6% believe that they could have a good conversation with their parents; and 26.3% reported alcohol use at any time in their lives. A significant increase in HIV/AIDS knowledge was found among adolescents from the intervention group (P < .001), while a nonsignificant increase was found among control adolescents. CONCLUSIONS: An increase in HIV/AIDS knowledge was observed among adolescents who participated in the first year of the ASUMA project. This study illustrates the importance of the creation of culturally appropriate instruments and interventions to reduce HIV infection in adolescents.

Morbidity and mortality profile of human immunodeficiency virus-infected patients with and without hepatitis C co-infection.

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection is an important and frequent scenario, predominantly in injecting drug users (IDUs). The present study evaluated morbidity and mortality variation in HIV-infected patients with and without HCV co-infection. Co-infection prevalence was determined in 356 HIV-infected persons. Their clinical manifestations, laboratory findings, risk factors, HIV therapies, and mortality rates were evaluated. The prevalence of HCV was 54% in the overall group and 81% in IDUs, with a predominance of HCV genotype 1. Mortality rates were similar in patients with and without co-infection; however, co-infected patients had significantly higher liver damage as a cause of mortality when compared with those who were not co-infected. The high prevalence of HCV and an emerging mortality from liver diseases showed the significance of this co-infection in the HIV epidemic. Primary and secondary prevention are necessary to reduce the expanding impact of HCV infection in HIV patients.

A comparison of the sociodemographic, risk-behavior, and substance-abuse profile of young vs older HIV-infected Puerto Rican patients.

INTRODUCTION: As of May 2003, 17% of all reported AIDS cases in Puerto Rico had occurred among those 20-29 years of age. These individuals were likely initially infected with HIV in adolescence. The objectives of this study are to describe and compare the prevalence of the sociodemographic, risk-behavior, and substance-use profile among patients infected with HIV during their adolescence (early) and compare them with patients infected at an older age (non-early). METHODS: This is a cross-sectional study of 3151 HIV/AIDS patients admitted to the retrovirus research center of our institution between 1992 and 2002. The variables we studied include the presence or absence of early infection, sociodemographic variables, risk-behavior variables, and substance-use variables. An early-infected patient was defined as a patient with HIV/AIDS that reported his or her first positive HIV test result before the age of 21 years. Descriptive and differential analyses were performed. RESULTS: Five percent of our patients were early-infected (157/3151). A significantly higher proportion (P < or = .05) among the early-infected patients as compared to the older group was females, required inpatient hospital care at the time of study entry, and had less than a 12th-grade education. In the interview a significantly higher proportion had antisocial behavior, had been in prison at some point in their life, and had used crack-cocaine. CONCLUSIONS: The early HIV-infected patients showed a different sociodemographic, risk-behavior, and substance-use profile. Knowledge of the specific characteristics of early HIV-infected patients could be used to develop primary prevention programs directed toward reducing HIV infection among young Puerto Ricans.

Changing profiles of injecting drug users with AIDS in a Hispanic population.

AIMS: To describe and assess the changing trends in socio-demographic, risk, clinical and immunological parameters in male intravenous drug users (IDU) with AIDS. DESIGN, SETTING AND PARTICIPANTS: Baseline description by year of entry of 610 male IDU with AIDS who entered into a cohort study in Bayamón, Puerto Rico, from 1992 to 2000. Study participants were evaluated at in-patient health-care facilities in the University Hospital Ramón Ruiz Arnau or in the ambulatory immunology clinic facilities. FINDINGS: The median age at which subjects entered the study and the proportion of patients with an educational level lower than a high school degree increased from 1992 to 2000. Upward trends were also observed in the practice of injecting non-prescription drugs during the last 12-month period, the practice of needle sharing and the use of a combination of heroin and cocaine ('speedballs'). Higher proportions of subjects were also diagnosed with wasting syndrome and bacterial pneumonia. The median CD4 count recorded at entry decreased over the course of the study. CONCLUSIONS: Puerto Rican male IDU diagnosed with AIDS are arriving at health-care facilities in the latest stages of the disease. Better and early interventions with different health care approaches need to be developed.