The Context of HIV Risk Among Drug Users and Their Sexual Partners

Although these data provide an overview of trends of STDs in
adolescents, they are subject to biases due to differences in the reporting
by public and private-sector clinics. While public health clinics are more
likely to report STDs of poor and minority patients who often utilize
these clinics, reports from private physicians who tend to treat more
affluent patients are affected by the lack of diagnostic validation of their
findings (Cates 1990). Thus, no firm conclusions can be drawn from
STD surveillance data. Nonetheless, specific research on determinants of
STDs in various groups of teens is necessary to control future acquisition
of STDs, especially HIV infection in adolescents.
Pregnancy
The risk of STDs/HIV being vertically transmitted from an infected
mother to her infant is reflected in recent data on teenage pregnancies.
The pregnancy rates among teenagers have remained high over the last
decade and are reflective of the increasingly high level of sexual activity
among adolescents (Rosen et al. 1990). Almost one in four teens
(23 percent) who engage in sexual activity experience pregnancy,
resulting in 1 million pregnancies each year (Dryfoos 1990). Of these
teens, approximately 32 percent are under the age of 15 (Rosen et al.
1990). Eighty-four percent of the pregnancies among adolescents are
unintended, of which 45 percent result in live births, 42 percent end in
abortions, and 10 percent result in either miscarriages or stillbirths
(Coupey and Klerman 1992). It is estimated that among teens who
experience pregnancy, 6 percent are white and 13 percent are African
American between the ages of 15 and 17 years. Fifteen percent are white
and 26 percent are African Americans between the ages of 18 and
19 years. Data regarding other racial/ethnic groups were not reported.
BEHAVIORAL RISK FACTORS ASSOCIATED WITH STDs/HIV
INFECTION
To further place adolescents’ exposure to HIV and other STDs in context,
it is imperative to understand the prevalence and patterns of the primary
risk behaviors that are associated with disease transmission, including a
young age at sexual debut, multiple sexual partners, anal intercourse,
inadequate or no use of barrier-method contraceptives, and use of alcohol
and drugs (including both injectable and noninjectable substances).
These behavioral risk factors are interrelated and are prevalent among
adolescents.
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