Adolescent Sexually Transmitted Infections and Risk for Subsequent HIV

• Published in: American journal of public health (1971) 2013-10, Vol.103 (10), p.1874-1881
• Main Authors: CLAIRE NEWBERN, E, ANSCHUETZ, Greta L, EBERHART, Michael G, SALMON, Melinda E, BRADY, Kathleen A, DE LOS REYES, Andrew, BAKER, Jane M, ASBEL, Lenore E, JOHNSON, Caroline C, SCHWARZ, Donald F
• Format: Article
• Language: English
• Subjects: Adolescent; Age groups; Biological and medical sciences; Child; Child development; Chlamydia; Death Certificates; Epidemiology; Epidemiology. Vaccinations; Ethnicity; Female; General aspects; Gonorrhea; Health surveillance; HIV; HIV Infections - epidemiology; HIV Infections - etiology; HIV/AIDS; Human immunodeficiency virus; Human viral diseases; Humans; Infections; Infectious diseases; Male; Medical sciences; Miscellaneous; Philadelphia - epidemiology; Poisson Distribution; Population Surveillance; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Research and Practice; Retrospective Studies; Risk Assessment; Secondary schools; Sex Distribution; Sexual Health; Sexually transmitted diseases; Sexually Transmitted Diseases, Bacterial - epidemiology; Sexually Transmitted Diseases, Bacterial - urine; STD; Students; Surveillance; Syphilis; Teenagers; Trends; Unsafe Sex; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2013.301463

We estimated the risk of HIV associated with sexually transmitted infection (STI) history during adolescence. We retrospectively studied a cohort of adolescents (n = 75 273, born in 1985-1993) who participated in the Philadelphia High School STD Screening Program between 2003 and 2010. We matched the cohort to STI and HIV surveillance data sets and death certificates and performed Poisson regression to estimate the association between adolescent STI exposures and subsequent HIV diagnosis. Compared with individuals reporting no STIs during adolescence, adolescents with STIs had an increased risk for subsequent HIV infection (incidence rate ratio [IRR] for adolescent girls = 2.6; 95% confidence interval [CI] = 1.5, 4.7; IRR for adolescent boys = 2.3; 95% CI = 1.7, 3.1). Risk increased with number of STIs. The risk of subsequent HIV infection was more than 3 times as high among those with multiple gonococcal infections during adolescence as among those with none. Effective interventions that reduce adolescent STIs are needed to avert future STI and HIV acquisition. Focusing on adolescents with gonococcal infections or multiple STIs might have the greatest impact on future HIV risk.