14 - Prevention of infection with human immunodeficiency virus in adolescent substance abusers  pp. 284-310

Prevention of infection with human immunodeficiency virus in adolescent substance abusers

By Robert M. Malow, Rhonda Rosenberg and Jessy Dévieux

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Despite considerable progress in the design, implementation and refinement of interventions, infection with the human immunodeficiency virus (HIV) and subsequent acquired immunodeficiency syndrome (AIDS) has only become a more entrenched pandemic, reaching into populations originally not deemed to be at risk. Adolescents are one such population. While the overall incidence of HIV has been declining in the USA, the opposite pattern has been true for adolescents, particularly those who abuse alcohol and other drugs (AOD).

Individuals between the ages of 10 and 24 years make up approximately one third of the world's population and 80% of these young people reside in developing countries where the burden from sexually transmitted diseases (STDs), including HIV, is greatest (Aggleton, 2000). Globally, it has been estimated that approximately half those who acquired HIV do so before age 25 (UNICEF, 2002). Similar estimates are provided by the Strategic Plan of the Center for Disease Control & Prevention (CDC, 2003), in which at least half of all new HIV seroconversions in the USA occur among adolescents or young adults under the age of 25. Between 1993 and 1999, the number of adolescents with HIV dramatically increased by 34% (Jemmott & Jemmott, 2000; Kirby, 2000; Rotheram-Borus, 2000; Rotheram-Borus et al., 2000). Moreover, the CDC reported in 2002 that the prevalence of AOD use “before last intercourse” among adolescents had increased 18% in the previous decade (CDC, 2002).

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