A significant number of sexually active U.S. teens who were born with HIV either didn't know their own status when they started having sex, or they knew it but didn't disclose it to their first sex partners, a new study says.
These findings underscore the need for counseling on sex practices to youth who have been living with HIV since birth, said the study, which appears in the Dec. 1 issue of Clinical Infectious Diseases.
It is "extremely important for health-care providers, school counselors and family members to reinforce the importance of practicing safe sex, taking medication regularly and disclosing HIV status to potential partners," said Dr. Rohan Hazra, study co-author and researcher at the pediatric, adolescent and maternal AIDS branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.
The new study is the first to focus on factors associated with the initial sexual activity of young people who acquired HIV before, during or soon after birth.
The Centers for Disease Control and Prevention estimates that some 10,000 children and teens are living with HIV after being infected with the virus before or at birth. Medical advancements are making mother-child transmission of HIV rare in the U.S., but dozens of perinatal infections still occur each year, often because the mother doesn't know she has HIV.
The study involved 330 HIV-positive children and teens, ages 10 to 18, in the federally funded Pediatric HIV/AIDS Cohort Study.
From 2007 to2009, these youth were asked several times about their sexual experiences through computer-assisted self-interviews.
Ninety-two young people, or 28 percent, said they had sexual intercourse at least once, with debut typically around their 14th birthday. More than half of these youth said they had unprotected sex at least once.
Of 67 who answered questions about whether they disclosed their HIV status to their first sexual partners, about 12 didn't know they were HIV positive before they first had sex. Of the rest, two-thirds didn't tell their HIV status to their sex partners, although most used condoms anyway.
The American Academy of Pediatrics recommends counseling for parents and caregivers of HIV-positive children so this issue can be fully addressed at the right time. "Adolescents should know their HIV status," the academy added, so they can be fully informed about health issues, "including sexual behavior."
"It's not easy" to talk about one's HIV-status, even as an adult, said Dr. Laura Guay, vice president of research at the Elizabeth Glaser Pediatric AIDS Foundation.
Many times, parents or caregivers will tell children with HIV that they're going to doctors because "you have an illness, or your system is weak and you have to take these pills to make you stronger or fight infection," Dr. Guay said. As a result, children may not hear the actual words, "HIV" and "AIDS," until they are age 10, 12 or later.
As for sex education, programs are aimed at helping teens avoid getting AIDS, not dealing with it all one's life, she noted.
While using condoms and protecting oneself is an important message, HIV-positive teens need additional support and education about how to prevent transmission and still have a normal and healthy life, said Dr. Guay, adding that the Elizabeth Glaser foundation has HIV-positive teen "ambassadors" who speak on these very issues to other teens.
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