HIV incidence is on the rise in adolescents both in the United States and globally. In the US the adolescent epidemic is fueled by new infections in young minority MSM who account for up to a quarter of new infections per year. Globally, there are 3 million new HIV infections a year, 40% of which are in adolescents, predominantly (60%) young girls.
In addition, the CDC estimates that young adults 15-24 account for only a quarter of sexually active population, but account for over half of the 20 million STIs diagnosed each year in the US. Syphilis infections are increasing in young gay and bisexual men, and transgender women who have sex with men, accounting for 75% of all primary and secondary syphilis cases, stages of the disease when the organism is the most infectious.
Infection with sexually transmitted infections (STIs) and contact with HIV increase the likelihood of transmission of and co-infection with HIV. The physiological aspects of STI and HIV acquisition in adolescents are under studied but play a substantial role in the adolescent epidemic globally. Understanding the biological risks for co-infection and interactions between HIV and STIs will contribute knowledge to improve prevention and treatment measures to control the epidemic in adolescents and young adults.
In HIV-uninfected populations, STIs facilitate HIV transmission at the site of infection by breaching the protective mucosal barrier and recruiting immune cells that are susceptible to HIV attachment, entry and subsequent establishment of productive infection. STIs can also cause bleeding further increasing the risk of transmission and acquisition from direct inoculation into the bloodstream during sexual intercourse.
The purpose of this initiative is to understand better the interactions between HIV and STIs and adolescent reproductive development including genital maturation and integrity, hormonal fluctuations, and use of contraception in order to provide an improved knowledge base for treating and preventing STIs and HIV in youth.
Maternal Pediatric Infectious Disease Branch
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