Predictors of HIV/AIDS confirmation and differences by guardian status in HIV+ adolescents in Jamaica.
BACKGROUND
Approximately 25% of the cumulative AIDS cases in Jamaica involve adolescents and young adults. However the lives of adolescents living with HIV within Jamaica and the Caribbean have been understudied.


OBJECTIVE
(1) To describe the sociodemographic characteristics of HIV+ Jamaican adolescents who have ever been a part of the Kingston Paediatric/Perinatal HIV Programme (KPAIDS) from September 1, 2002 to August 31, 2006 (2). To identify predictors of HIV/AIDS confirmation as well as factors associated or uniquely present in these adolescents by their guardian status.


METHODS
Seventy-two HIV+ adolescents, ages 10-19 years, were included. Factors studied included demographics as well as time to and time between HIV and AIDS confirmation. Data were analyzed by bivariate and multivariate statistics.


RESULTS
The mean age of the adolescents was 12.6 +/- 2.8 years with slightly more males (52.8%) in the programme. There were equal proportions of adolescents living with HIV as with AIDS (43.1%). There were equal proportions who were lost to follow-up or deceased (8.3%). Twenty-two of them lived with parents, 25 with guardians and 18 in residential institutions. The primary mode of transmission was perinatal infection (68.1%), followed by sexual (20.8%), blood transfusion (2.9%) and unknown (8.3%). The mean time from HIV exposure to HIV confirmation and AIDS confirmation in mother-to-child transmission (MTCT) cases were 8.0 +/- 2.9 years and 9.6 +/- 3.3 years, respectively. In the multivariate analysis model, age and gender were significant in predicting time from HIV exposure to HIV confirmation.


CONCLUSIONS
The majority of HIV-positive adolescents reside with parents and guardians and this might indicate support in spite of stigma and discrimination. However; the mean time to HIV confirmation in MTCT cases is quite long and must be reduced.
Pilgrim
N
N
Yale University School of Public Health, USA.
Kershaw
T
T
Pierre
R B
RB
Moore
J
J
Palmer
P
P
Davis
D
D
Christie
C D C
CD
D000293:Adolescent; D002648:Child; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology / Q000635:transmission; D006801:Humans; D007872:Legal Guardians / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult