1. AIDS in Adolescents and Youngsters Prof. Jorge Peláez Mendoza M.D. Prof. Jorge Peláez Mendoza M.D. Obstetrics and Gynecology Department Obstetrics and Gynecology Department Havana University School of Medicine Havana University School of Medicine

2. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 WHO Reports: The higher rates of Sexually Transmitted Diseases (STDs) including AIDS and HIV infection, have been reported in young people 20 to 24 years old, followed by Adolescents from 15 to 19 years old. Population Reference Bureau,1996.

3. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 More than 34 millions have been infected by the HIV virus all over the World. Conservative estimates report that 50% or more are younger than 25 years. WHO Reports:

4. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 ¡16 000 AIDS new cases are daily reported in the World ! 8 000 are youngsterss between 10 and 24 years “EVERY MINUTE FIVE NEW CASES ARE DIAGNOSED “ UN / AIDS / 1999.

5. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Reported cases do not include :   Adolescents who are infected by the HIV and are asymptomatic.   Adolescents whose symptoms do not meet the specific criteria for AIDS.   Young adults who were infected as teenagers but became symptomatic in their 20s.

6. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Given the long period of latency between infection and the onset of symptoms (mean:11 years), many individuals 25 to 30 years of age with AIDS must have acquired the disease as teenagers. Reported cases do not include :

7. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Associated Risk Factors   Physiologic Development   Sexual Activity   Sexually Transmitted Diseases   Alcohol and Drug Use Behavior   Gender and Sociocultural Factors

8. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 AIDS in the United States of America   Rapidly becoming one of the leading causes of death among adolescents.   The number of adolescents diagnosed with AIDS is doubling every 14 months.   Heterosexual contact was the most frequent route of transmission among females.

9. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Adolescents and Youngters: 1120 - 39,8 % Females 350 31,2 % of the adolescents 52,8 % of the females 12,4 % of all seropositives and AIDS patients..Epidemiologíc Dep. SSV/ 04-2000 Cuba Reported cases : 2810 - 100%

10. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Epidemiologic Dep. SSVApril 2000 AIDS in Cuba. Patients per years AIDS in Cuba. Patients per years

11. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Route of Expossure (10 - 24 years) Route of Expossure Female % Male % Route of Expossure Female % Male % Homo / Bisexual 4 1,14 640 83,1 Homo / Bisexual 4 1,14 640 83,1 Heterosexual 343 98,0 128 16,6 Heterosexual 343 98,0 128 16,6 Others 3 0,85 2 0,2 Others 3 0,85 2 0,2 N=1120 N=1120.Epidemiologíc Department SSV/ 04-2000

12. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Epidemiologic Dep. SSV /April 2000 AIDS in Cuba, Sex Ratio N=1120

13. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Age at First Intercourse and AIDS Age at First Intercourse and AIDS  Males  Females Epidemiologic Dep. SSV/April 2000 N=1120

14. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Number of Sexual Partners and AIDS Number of Sexual Partners and AIDS Epidemiologic Dep. SSV/April 2000  Males  Females N=1120

15. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Epidemiologic Dep. SSV/April 2000 Socials and Sexual Risky Factors(Females) N=350

16. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Socials and Sexual Risky Factors (Males) Socials and Sexual Risky Factors (Males) Fathers Others S.T.D. Penal Records Use drugs/alcohol 138 17,9 % 483 62,7 % 487 63,2 % 343 44,5 % N=770 Epidemiologic Dep. SSV/April 2000

17. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Epidemiologic Dep. SSV/April 2000 AIDS in Cuba. Ocupation. N=1120

18. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Epidemiologic Dep. SSV/April 2000 Adults Male Female Total of Dead Total of Dead Adolesc and Young N=724

19. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 The sex ratio tends to be evened while the age at diagnosis descends. Prevailed the heterosexual route of expossure in adolescents and young females, and the homo / bisexual in males. The precedent of precocious sexual initiation and multiple sexual partners presented a high incidence. Conclusions:

20. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Conclusions: The majority of the adolescents and youngsters with HIV / AIDS were not studying neither working at the time of the diagnostic. More than half of the adolescents and young females had antecedent of Abortions.

21. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Conclusions: More than half of the adolescents and youngsters had antecedents of risky “Penal and social behavior and even “Penal Records”. Records”.

22. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001

23. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 We can help reduce the risks by providing!!!   Information about HIV infection, transmission and prevention.   Education on purchasing and the proper use of condoms.   Information to help adolescents identify their own risk-related behaviors.   Training and role playing exercises to help adolescents develop communication and assertiveness skills needed for negotiations.

24. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Adolescents will be benefited with:   Accurate, age-appropriate, culturally-relevant information.   Identification of high-risk adolescents and   Preventive intervention and risk reduction.   Training of different levels of care in risk-reduction counseling.   Medical and psychosocial treatments.

25. ? ? All primary health care service providers ? ? who works with youngsters should become knowledgeable about HIV in order to incorporate methods of assessment, referral and treatment into their practice. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Recommendations:

26. ? This is particularly critical given that ? the number of adolescent affected by ? the AIDS epidemic will continue to ? increase in the New Millenium.. AIDS in Adolescents and Youngsters JPM/SIJ SCOG/2001 Recommendations:

27. AIDS in Adolescents and Youngsters THANKS YOU VERY MUCH FOR YOUR ATTENTION JPM/SIJ SCOG/2001