HIV infection: a retrospective analysis of adolescent high-risk behaviors.

INTRODUCTION: The purpose of this study was to retrospectively ascertain behaviors and activities that may constitute high risk during the adolescent years (ages 12-18) of young adults (ages 20-25) who are infected with human immunodeficiency virus (HIV). METHODS: Subjects (n = 44) from 1 of 5 clinics in a large midwestern city completed a survey form, developed by the investigators, which examined 6 areas of behavior and activities that the literature suggested may be associated with high-risk behaviors. RESULTS: The adolescent high-risk profile of an HIV-infected young man includes sexual abuse before the age of 12 years, heavy consumption of alcohol, heavy consumption of a variety of illicit drugs, a wide variety of sexual experiences at very young ages, and multiple sexual partners. The adolescent high-risk profile of an HIV-infected young woman in this study includes heavy consumption of alcohol, heavy consumption of a variety of illicit drugs, and unprotected vaginal intercourse at very young ages as evidenced by a high number of sexually transmitted diseases at very young ages. DISCUSSION: Although the small number of participants in this study restricts interpretation of the results, adolescent health initiatives should be examined in light of these findings. Programs and services must consider the context of psychosocial situations, as well as past experiences, and incorporate this knowledge into prevention strategies.

Diagnosis of Trichomonas vaginalis in adolescent females: InPouch TV culture versus wet-mount microscopy.

PURPOSE: This study compared the InPouch TV culture to wet-mount, Diamond's culture medium, and Papanicolaou (Pap) smear for the diagnosis of trichomonas infection in sexually active adolescents. METHODS: A total of 467 subjects were recruited among 12-18-year-old girls who received pelvic examinations at two urban adolescent clinics. All girls were tested by wet-mount and InPouch TV. In addition 339 of 467 had cultures in Diamond's medium and 366 of 467 had Pap smears. Specimens were collected for InPouch TV and Diamond's cultures and read at 24-48 h and 5 days, and in the case of Diamond's cultures, also at 7 days. In a subset of subjects (268 of 467) who had all four tests done, sensitivities and specificities were calculated using Diamond's culture as the "gold standard." RESULTS: In the 467 subjects, 73 (15.6%) tested positive for trichomonas by at least one method. In the subset with all four tests done, sensitivities of the wet-mount and InPouch TV were 36% and 81%, respectively; while that of the Pap smear was 56%. The culture media were equally efficient in identifying Trichomonas vaginalis. There were no differences found between subjects with or without trichomonas infections in gynecological symptoms, previous history of sexually transmitted diseases, or use of a condom at last intercourse. CONCLUSIONS: InPouch TV culture is a good diagnostic method for T. vaginalis because of its long shelf-life, relatively low expense, and high sensitivity (over twice as sensitive as wet-mount).

Sexual histories of adolescent girls: comparison between interview and chart.

PURPOSE: The purpose of this study is to determine the reliability of sexual histories obtained from adolescents and the adequacy of chart documentation by providers of adolescent health care. METHODS: Responses to an interview by a female research assistant about sexual activity were compared to chart-documented sexual histories taken by physicians and nurse practitioners. The setting was an urban, hospital-based adolescent clinic. The subjects were 106 females, 15-18 years old; 82% were African-American and 18% Caucasian. RESULTS: Significant correlations between interview and chart were seen for information about menarche, age at first intercourse, number of sexually transmitted diseases (STDs), and number of sexual partners. Accuracy of reporting sexually transmitted infections varied according to the organism; HPV infection was underreported more than other infections. Chart documentation of sexual histories was inadequate. CONCLUSIONS: Adolescents generally provide reliable sexual histories, but health care providers may not be documenting these histories adequately.