Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
J Adolesc Health. 2011 Jul;49(1):42-6. doi: 10.1016/j.jadohealth.2010.10.009. Epub 2011 Mar 12.
Although adolescents are at high risk for human immunodeficiency virus (HIV) infection, they have not been, included in HIV vaccine trials.
In preparation for enrollment in HIV vaccine trials, 100 HIV-negative adolescents aged 14-17 years from Cape Town were recruited into a cohort. HIV, syphilis, pregnancy testing, and sexual risk questionnaires were conducted at varying intervals for a year.
The mean age of the participants was 15 years, and 70% of them were female. Recruitment was completed within 3 months. Retention was found to be 82% at 1-year follow-up. The main reasons for dropout were as follows: relocation to other communities, phlebotomy, and visit frequency. In a Cox proportional hazards model, only female gender was significantly associated with retention. No change in reported sexual risk occurred, but the proportion of individuals who were aware of their partner's HIV status was significantly higher (17% at baseline, 83% at 1-year follow-up; p < .001). Five pregnancies were reported during follow-up.
To our knowledge, this is the first prospective adolescent HIV-prevention cohort in Southern Africa. Despite reports of risky sexual behaviors and high pregnancy rates, HIV seroconversions did not occur in the retained cohort. HIV-prevention trials with high-risk adolescents will require rigorous efforts to prevent future pregnancies, and may require risk eligibility criteria. Retention may improve with transport provision, visits with incentives, and efforts to retain males.
尽管青少年感染人类免疫缺陷病毒（HIV）的风险很高，但他们并未被纳入 HIV 疫苗试验。
为准备招募参加 HIV 疫苗试验，我们从开普敦招募了 100 名年龄在 14-17 岁的 HIV 阴性青少年，将他们纳入一个队列。在一年的时间里，以不同的间隔进行 HIV、梅毒、妊娠检测和性风险问卷调查。
参与者的平均年龄为 15 岁，其中 70%为女性。在 3 个月内完成了招募。在 1 年的随访中，保留率为 82%。辍学的主要原因如下：搬迁到其他社区、采血和就诊频率。在 Cox 比例风险模型中，只有女性性别与保留显著相关。报告的性风险没有变化，但知晓伴侣 HIV 状况的个体比例显著更高（基线时为 17%，随访 1 年时为 83%；p<0.001）。随访期间报告了 5 例怀孕。
据我们所知，这是南非首例前瞻性青少年 HIV 预防队列研究。尽管报告了危险的性行为和高怀孕率，但保留队列中并未发生 HIV 血清转化。针对高危青少年的 HIV 预防试验需要付出巨大努力来预防未来的怀孕，并可能需要风险资格标准。提供交通、激励性探访以及努力留住男性可能会提高保留率。
