[HIV seroprevalence and exposure categories among adolescents tested at a sexually transmitted clinic diseases. Madrid, 1986-2000]

[Sexual behaviour and use of condoms by adolescents in our environment]

OBJECTIVE

To identify sexual behaviour in adolescents.

DESIGN

Transversal, descriptive study, by means of an anonymous structured questionnaire.

SETTING

Urban secondary school.

PARTICIPANTS

Simple random sample of 84 students (4th year of ESO--c. 15/16 years old).

MAIN MEASUREMENTS

Personal details, sexual practices, use of condoms.

RESULTS

61.9% were girls. Average age was 16.4 (95% CI, 16.2-16.6). They had a girl/boy-friend or casual partner (33.7%) and stable partner (60.7%). 82.2% had total or sufficient trust. Boys' first masturbation was between 14 and 16 (46.8%). 100% had done so by the age of 16. 72.3% of girls had never masturbated at this age (P<.001).Boys' first kiss on the lips occurred between 14 and 16 (46.8%); 100% had done so by 16. 60.7% of girls had done so between 14 and 16, and 92.2% by 16.30.1% of boys had had their first experience of coitus by the age of the questionnaire, whereas 22.5% of girls had. Both sexes used a condom on 71.4% of occasions.38.1% had sex with penetration, 46.2% masturbated. 22.2% had had 2 sexual partners, 8.9% had had 3, and 40.0% had had 4 or more. Condoms were used in 83.3% of relationships with penetration.

CONCLUSIONS

This is a sexually active population, susceptible to sexually transmitted diseases (STD) and unwanted pregnancies, as it does not use condoms in every relationship involving penetration. Health education activities need to be encouraged.

[Prevalence of the HIV infection in patients seen at specialized diagnosis centers in 9 cities in Spain from 1992 to 2001]

OBJECTIVE

To describe the prevalence of HIV infection in persons tested between 1992 and 2001.

DESIGN

Descriptive, cross-sectional epidemiological study.

SETTING

10 ambulatory centers specialized in diagnosing HIV, located in 9 cities in Spain.

PARTICIPANTS

53,183 persons older than 12 years, tested for the first time for HIV.

MAIN MEASURES

Number of persons tested per year, number of persons diagnosed as seropositive for HIV according to sex, age group and category of exposure.

RESULTS

The number of persons tested increased from 4401 in 1992 to 6407 in 2001. Approximately half reported heterosexual risk exposure/exposure through high-risk heterosexual behaviors, excluding prostitution. Intravenous drug users (IVDU) increased from 15.3% in 1992-1993 to 1.4% in 2000-2001, and women prostitutes/female sex workers increased from 6.7% to 25.1%. A total of 2898 persons were diagnosed as having HIV infection; 78% of them were men. The number of diagnoses decreased from a high of 1058 in 1992-1993 to 304 in 2000-2001, and this trend was seen for all categories of exposure except female prostitutes and men with heterosexual risk factors. The prevalence decreased from 14% in 1992 to 2% in 2001. There were decreases in all categories of exposure, especially during the first years of the study, with a tendency to level off. In 2001 the prevalence figures were 23.8% for IVDU, 7.9% for homosexual men and women, 0.8% for female sex workers and 1% for other heterosexual men and women.

CONCLUSIONS

The specialized diagnostic centers play an important role in diagnosing HIV, and this service complements primary care services. Greater efforts are needed in the prevention of HIV infection.

Epidemiología de la infección por virus de la inmunodeficiencia humana (VIH) en la provincia de Salamanca (1985-2002)

INTRODUCTION

Since effective treatment against HIV has become available, HIV infection surveillance is focussed not only on AIDS cases, but also on new cases of HIV infection. One of the methods used for this task is compilation of case records. We report the results of 18 years of recording information on new diagnoses of HIV (1985-2002) in the area of Salamanca (Spain).

METHODS

Our report system is based on active monitoring of results from the microbiology laboratory of the Salamanca Health Area. All patients testing positive in HIV analytical studies and who had not been previously diagnosed as HIV-infected are included in the report system.

RESULTS

A total of 188 579 analytical results were studied. We found 16,772 (9.23%) HIV-positive results, 1984 of which were new HIV infection diagnoses. The incidence for the entire period was 556 cases/100,000 inhabitants. The highest incidence was found in 1992 (62.2 cases/100,000), with a progressive decrease thereafter to 2002 (5.18/100,000). Among the total, 75.3% of patients were men between 20 and 39 years old and more than half (62.2%) were intravenous drug users. Over the period studied, there has been an increase in the age of patients at the time of diagnosis, a trend to increases in the number of cases acquired through heterosexual transmission and a reduction in the number of drug users. During the study period, 312 AIDS cases were declared.

CONCLUSIONS

Epidemiological information systems for HIV surveillance are essential to know the features, magnitude and evolution of the epidemic. Creation of a national HIV infection surveillance system to compile the information from smaller regional or local organisms would contribute substantially to our understanding of the epidemiology and evolution of HIV infection.