Adolescents and HIV Risk Behaviors: A national concern

Many teens engage in behaviors that increase their risk for sexually transmitted infections. It is not surprising that adolescents/ young adults ages 13-24 constitute 15% of HIV cases in Puerto Rico. This study aims to estimate the prevalence of several risk behaviors for HIV infection among adolescents in PR and to determine their degree of HIV risk. This is a secondary analysis of a survey designed to monitor drug use among adolescents. A nationally representative sample of 13,672 students from 7th-12th grade was selected using a multi-stage stratified cluster sampling design. Data was collected over two academic years (2005-07) using a self-administered questionnaire. An HIV risk index was constructed using seven behaviors: alcohol or drug use, sexual debut, inconsistent condom use, multiple sexual partners, and sex during the influence of alcohol or drugs. Proportions were compared using Chi-square tests. Results were weighted to represent 309,878 students. Approximately 27.5% of the students reported sexual debut (mean onset=14 years), 56.2% reported alcohol use, and 10.7% drug use. Significantly more males reported all behaviors, except for alcohol use (similar by gender). About a third (38.8%) had none of the behaviors, 32.4% were at low HIV risk (1 behavior), 16.6% were at moderate risk (2-3 behaviors), 9.8% were at high risk (4-5), and 2.5% were at extremely high risk (6-7). Males and teens >15 had significantly (p<0.001) more risk behaviors than females and younger students. About 22.6% reported both sexual debut and alcohol use. Gender-specific prevention programs need to be developed to better address HIV risk profiles.