Bustamante Hospital for Children, Kingston, Jamaica.
Department of Child and Adolescent Health (Infectious Diseases), Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica.
J Infect Dev Ctries. 2021 Jul 31;15(7):989-996. doi: 10.3855/jidc.12156.
Risk factors and outcomes of sexually-acquired human immunodeficiency virus infection were characterized in Jamaican children and adolescents.
Management was carried out by multidisciplinary teams in Infectious Diseases clinics during August 2003 through February 2019 using modified World Health Organization HIV criteria.
There were 78 clients, aged 6 to 19 years, with females:males = 4:1 (p < 0.05). Sexual-initiation occurred in 60%, 47 before < 16 years (median 13 years, with four < 10 years; females:males = 7:1). Sexual-initiation preceded HIV diagnosis in all cases (median 2 years). Secondary education 93% (69/77) and living with non-parental relatives 17% (13/78) were associated with early sexual-initiation (p < 0.042); as was later imprisonment in 6% (3/52). Other sexually transmitted infections 36% (19/53) were associated with sexual-initiation ≥ 16 years (p < 0.01). Risks for ongoing HIV-transmission included infrequent condom use 74% (39/53), body-piercings 50% (24/48), illicit drug use 37% (28/76), tattoos 36% (19/52), transactional sex 14% (7/53) and pregnancy 56% of girls. 77% (59/77) had Centres for Diseases Control's Category A HIV infection; 82% (61/75) initiated anti-retroviral therapy; 75% (56/75) had first-line drugs, with helper T lymphocyte counts ≥ 500 cells/μL in 61% (48/78) and HIV viral load of < 1,000 copies/μL in 63% (40/64). Complications included dermatological 39% (20/52), respiratory 25% (13/52) and neurological 15% (8/52). Early sexual initiation was associated with depression 43% (33/76; p < 0.004) and suicidal attempt or ideation 23% (18/77; p < 0.096). Four (5%) died.
Sexually transmitted HIV/AIDS in children and adolescents should preempt prompt medical, legal and psychosocial interventions.
在牙买加儿童和青少年中，对性传播的人类免疫缺陷病毒感染的风险因素和结果进行了描述。
2003 年 8 月至 2019 年 2 月，通过传染病诊所的多学科团队，按照世界卫生组织修改后的艾滋病毒标准进行管理。
共有 78 名年龄在 6 至 19 岁之间的客户，女性：男性= 4：1（p<0.05）。性初潮发生在 60%的患者中，47 例在<16 岁（中位数 13 岁，其中 4 例<10 岁；女性：男性= 7：1）。在所有情况下，性初潮均先于艾滋病毒诊断（中位数为 2 年）。93%（69/77）的人接受过中等教育，17%（13/78）的人与非父母亲属同住，与性初潮较早有关（p<0.042）；6%（3/52）的人后来入狱。其他性传播感染 36%（19/53）与性初潮≥16 岁有关（p<0.01）。持续艾滋病毒传播的风险包括经常不使用安全套 74%（39/53）、身体穿刺 50%（24/48）、非法药物使用 37%（28/76）、纹身 36%（19/52）、交易性行为 14%（7/53）和 56%的女孩怀孕。77%（59/77）的患者患有疾病控制中心 A 类艾滋病毒感染；82%（61/75）开始接受抗逆转录病毒治疗；75%（56/75）使用一线药物，61%（48/78）辅助 T 淋巴细胞计数≥500 个/μL，63%（40/64）的 HIV 病毒载量<1000 个/μL。并发症包括皮肤病学 39%（20/52）、呼吸系统 25%（13/52）和神经系统 15%（8/52）。早期性初潮与抑郁 43%（33/76；p<0.004）和自杀企图或意念 23%（18/77；p<0.096）有关。有 4 人（5%）死亡。
儿童和青少年的性传播艾滋病毒/艾滋病应预先采取及时的医疗、法律和社会心理干预措施。
