Youths with HIV taking more sex risks

Teens infected with HIV are having more risky sex with more partners than did similar teens in the years before new anti-HIV medications became prevalent, researchers report in a new study.

A group of HIV-positive youths studied in 1999-2000 reported having more sex partners, more unprotected sex and more drug abuse than HIV-positive youths studied between 1994 and 1996, researchers at the UCLA School of Medicine said.

The first drugs in the class of highly active, anti-retroviral therapies (HAART), the so-called AIDS cocktail drugs, were introduced in 1996. The new drugs dramatically lower virus levels so that progression to AIDS is put off indefinitely in many patients, lengthening the lives of tens of thousands in this country.

While the new study, which was published today in the American Journal of Health Behavior, does not prove that teens have increased risky behavior since the new drugs became widely available, "these findings indicate the need for continued attention to the issue of sexual risk and the impact" of the new drugs, said Marguerita Lightfoot, the lead author of the study.

Although the therapies have significantly improved the care of HIV patients, the longer lives of those patients potentially mean more opportunities to transmit the virus to others, Lightfoot said.

"Simultaneously, evidence suggests that many people living with HIV believe that sexual behaviors that could lead to transmission of HIV, like unprotected sex, are less risky" if viral levels are low, the researcher said.

According to the federal Centers for Disease Control and Prevention, a quarter of the estimated 40,000 new HIV infections in the United States each year occur in people under age 21.

The study compared behaviors of 349 teens with HIV in Los Angeles, San Francisco, New York and Miami studied in 1994-96 with 175 teens with HIV in the same cities in 1999-2000. Although the two groups did not include the same people, they were similar in gender, age, race and socioeconomic characteristics.

Teens in the more recent study group were almost twice as likely as those in the older group to have engaged in unprotected sex in the past three months. On average, youths in the recent study group had nearly double the number of sexual partners as the other group, and they were more likely to have had a sexual partner who injected drugs.

Lightfoot and colleagues also found that despite having been diagnosed earlier, the recent study group was in worse health and only 53 percent were taking the cocktail drugs.

Lightfoot said it is surprising, given the availability of the anti-HIV drugs, that that later group experienced more symptoms. "This suggests that although they are being identified as HIV-positive at a younger age, these youth are being identified later in the progression of disease. Therefore, it is also likely that they were infected at a younger age."