title: Sexual health, HIV risk, and retention in an adolescent HIV-prevention trial preparatory cohort.
abstract: OBJECTIVE
  Although adolescents are at high risk for human immunodeficiency virus (HIV) infection, they have not been, included in HIV vaccine trials.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa. hbjaspan@gmail.com
authors.forename: Heather B
authors.initials: HB
authors.lastname: Jaspan
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Flisher
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.forename: Catherine
authors.initials: C
authors.lastname: Mathews
authors.forename: Keren
authors.initials: K
authors.lastname: Middelkoop
authors.forename: Daniella
authors.initials: D
authors.lastname: Mark
authors.forename: Linda-Gail
authors.initials: LG
authors.lastname: Bekker
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006293:Health Promotion; D006801:Humans; D008297:Male; D010352:Patient Dropouts; D011446:Prospective Studies; D018570:Risk Assessment; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires