Prevention of Sexually Transmitted Human Immunodeficiency Virus (HIV) Infection in Adolescents

Abstract

Sexual behavior can threaten the physical and social well-being of youngpeople in the United States in a variety of ways. as it can put them atrisk tor infection with the human immunodeficiency virus (HIV), othersexually-transmitted diseases (STDs) and unintended pregnancy. Thisreview describes the current extent of HIV infection in Americanadolescents. identifies and characterizes particular high-risk groupsand risk-bearing and protective behaviors, and identifies barriers toadopting preventive behaviors and using health care services. Our mainfocus is to present findings from intervention research: we summarizethe effects of strategies that operate at the individual level (i.e.biomedical or behavioral, in and outside of the clinic) andenvironmental level (i.e. family, school and community behavioral) toinfluence behavioral change and the prevention of HIV infection.Overall, even though abstinence eliminates the risk altogether and theuse of condoms can effectively reduce the risk of sexual transmission ofHIV, adolescents do not optimally, employ these practices. Variousapproaches to counseling by providers and other behavioral interventionsaimed at reducing high-risk sexual behavior have been effective, buthave met with limited and short-lived success. Among the areas receivinginadequate attention to date have been the link between biomedical andcommunity-based behavior change interventions and the correspondence ofbiologic and behavioral outcomes. These areas are explored anddirections for future research are suggested.