High-risk subgroups for teens at risk for HIV

NEW YORK, July 8 (Reuters Health) Among teens who engage in unsafe sex, there are different patterns of behavior, with some subgroups being much more at risk of HIV infection than others, a new study shows.

The findings suggest that prevention programs tailored to the needs of these subgroups may have a better chance of success, Dr Christopher D Houck of the Bradley/Hasbro Children's Research Center in Providence, Rhode Island, the study's lead author, told Reuters Health.

''If we can develop programs to target adolescents' sexual risk in the context of having mental health crises, or also using substances, those are the ways that we're more likely to have an effect on their risk behavior,'' he said in an interview.

To investigate whether it would be possible to characterize different subgroups among at-risk kids, Houck and his colleagues surveyed 1,153 people aged 15 to 21 who reported having had unprotected sex in the past 90 days.

Among boys, the researchers found, there were three distinct subgroups: those who had mental health crises and engaged frequently in unprotected sex, representing 10 percent of all males; those who used alcohol and marijuana and had unprotected sex, representing about half the group; and a lower-risk group that engaged in unprotected sex much less frequently.

Boys in the first group had an average of about 27 unprotected sex acts in the past 90 days, compared to about 19 for the second group and 7 for the third group.

For girls, risk factors were different. Fourteen per cent reported having had unprotected sex 64 times over the past 90 days, but did not report heavy drug and alcohol use or mental health crises. Eleven per cent reported higher drug and alcohol use and more mental health crises, along with 13 acts of unprotected sex over the past 90 days. The remaining 75 percent of girls had about eight acts of unprotected sex and did not report heavy substance use or mental health crises.

Forty-three percent of the girls in the first group were living with their sexual partner, which may help explain why they had unprotected sex so frequently, Houck said. However, he added, the reasons behind the other patterns he and his colleagues identified are not so easily explained.

Programs to help people reduce their risk of contracting HIV and other sexually transmitted diseases can include individual counseling or group counseling sessions, Houck noted. ''We have to really understand who the audience for these programs is -- the better we understand that audience the more we can target the programs to them.''

REUTERS