Adolescent HIV Prevalence, Sexual Risk, and Willingness to Participate in HIV Vaccine Trials

PurposeTo determine human immunodeficiency virus (HIV) prevalence, sexual risk behaviors, and attitudes toward HIV vaccine trials among 11–19 year-olds in a peri-urban community near Cape Town, South Africa.MethodsWe performed HIV antibody testing on oral transudate, and assessed sexual risk behaviors and willingness to participate in HIV vaccine trials using self-administered questionnaires.ResultsOf the 510 adolescents selected, 356 (73%) participated. The HIV prevalence of the group was 10.6% (95% confidence interval [CI] 7.5–14.4). One-third of adolescents had experienced sexual debut, with a mean age of 14.6 years. Number of lifetime sexual partners was independently associated with HIV infection (odds ratio [OR] = 1.62; 95% CI 1.1–2.3). In a multivariate analysis, increasing age, female gender, and attending school were independently associated with having had sex. The majority of adolescents (79%) were willing to participate in an HIV vaccine trial. Increasing age and length of residence in the community were significantly associated with willingness to participate (OR = 1.19; 95% CI 1.01–1.4 and OR = 1.14; 95% CI 1.03–1.26, respectively).ConclusionsThe prevalence of HIV and risk behavior among adolescents in this community is high. HIV vaccines are required that target preadolescents. HIV vaccine trials in adolescents in this setting will be facilitated by their willingness to participate.