STOLEN IN­NO­CENCE

Chil­dren as young as five years old in­fected with HIV through sex­ual preda­tors

Jamaica Gleaner - - NEWS - Na­dine Wil­son-Har­ris Staff Re­porter na­dine.wil­son@glean­erjm.com

AMEDICAL re­view of ado­les­cents with sex­u­ally ac­quired HIV in Ja­maica has found that the ma­jor­ity had their first sex­ual ex­pe­ri­ence be­tween 10 and 14 years old, but in some cases chil­dren as young as five years old have also been in­fected. This re­al­ity is trou­bling for se­nior res­i­dent in pae­di­atric medicine at the Bus­ta­mante Hospi­tal for Chil­dren, Dr Kadene Or­ri­gio, who con­ducted a clin­i­cal epi­demi­ol­ogy of sex­u­ally ac­quired HIV in ado­les­cents in Ja­maica be­tween 2003 and Fe­bru­ary 2017.

“What was sig­nif­i­cant is that most of these pa­tients ini­ti­ated sex­ual ac­tiv­ity be­tween the ages of 10 and 14 years, with the av­er­age age be­ing 12.5,” said Or­ri­gio.

“For those who we were able to doc­u­ment the age of their part­ner, 16 per cent re­ported that their part­ners were older males who were greater than 16 years of age,” added Or­ri­gio dur­ing the Dr Leila Wyn­ter Com­mem­o­ra­tive Con­fer­ence last week at the Bus­ta­mante Hospi­tal for Chil­dren. The

OR­RI­GIO

med­i­cal dock­ets of 53 ado­les­cents who re­ceived treat­ment for sex­u­ally ac­quired HIV at the Univer­sity Hospi­tal of the West Indies and the Com­pre­hen­sive Health Cen­tre’s Pae­di­atric and Ado­les­cent In­fec­tious Dis­ease Clinic were re­viewed. Of this num­ber, 44 were fe­males and nine were males.

“Of the to­tal num­ber of fe­males that were in the study, 60 per cent had been preg­nant once or more, and of note is that sev­eral of these pa­tients were di­ag­nosed with HIV af­ter pre­sent­ing for rou­tine an­te­na­tal care,” she said.

“If we are see­ing this num­ber of fe­males only pre­sent­ing at this point in time, then we can be led to in­fer that there may be sev­eral other ado­les­cents out there with HIV, be­cause we don’t rou­tinely do HIV test­ing in our ado­les­cent pop­u­la­tion,” added Or­ri­gio.

LIV­ING AR­RANGE­MENTS

Only 20 of the ado­les­cents in­fected with HIV were liv­ing with their par­ents, 10 were liv­ing in a chil­dren’s home and 15 were liv­ing with per­sons who were nei­ther con­sid­ered fam­ily nor friends. Some lived with an as­so­ciate of their boyfriend.

“Un­pro­tected sex was seen in ap­prox­i­mately 75 per cent of the pop­u­la­tion, so even though these pa­tients were di­ag­nosed with HIV and they were aware of their sta­tus, 75 per cent were still en­gag­ing in un­pro­tected sex­ual ac­tiv­i­ties,” noted Or­ri­gio.

The study in­di­cated that a few of those who ac­quired HIV had been sent out by their par­ents to have sex with older men for money.

“Of note is that ap­prox­i­mately 50 per cent re­ported that sex­ual ini­ti­a­tion was forced,” added Or­ri­gio.

The health and well-be­ing of the chil­dren un­der re­view was given con­sid­er­a­tion by the se­nior res­i­dent, given that HIV/AIDS is a pri­mary cause of mor­bid­ity and mor­tal­ity in the pae­di­atric pop­u­la­tion.

Ac­cord­ing to Or­ri­gio, “The psy­cho­log­i­cal ef­fects were marked in these pa­tients with ap­prox­i­mately 50 per cent of our pa­tients ex­hibit­ing de­pres­sive symp­toms and a quar­ter of the to­tal co­hort ex­hibit­ing sui­ci­dal ideation.”

IM­MU­NI­SA­TION STA­TUS

A look at the im­mu­ni­sa­tion sta­tus of the pa­tients noted that only six of them had any doc­u­men­ta­tion of re­ceiv­ing the hepati­tis B vac­cine and none had re­ceived the HPV vac­cine.

“In re­view­ing the dock­ets, there were sev­eral per­sons with early cer­vi­cal changes that could pre­dis­pose them to cer­vi­cal cancer in the long term,” she said.

The ad­her­ence of pa­tients to their an­tiretro­vi­ral therapy was also of con­cern since a re­view of the clin­i­cal data showed that the ma­jor­ity had vi­ral loads more than 10,000.

Only 29 per cent of those whose cases were re­viewed are known to be alive while four died based on com­pli­ca­tions from HIV. About 20 pa­tients had de­faulted on their fol­low-ups.

This con­cern is com­pounded by the fact that many of the teens are hav­ing un­pro­tected sex.

“In Ja­maica, ac­qui­si­tion of con­doms by teens are frowned upon as per­sons are seen as promis­cu­ous and this de­ters ado­les­cent from buy­ing con­dom,” said Or­ri­gio, as she noted that, “Be­ing an ado­les­cent, they are not at the point where they can bar­gain con­dom use with older part­ners be­cause it might be seen as a sign of in­fi­delity.”

Based on her find­ings, the doc­tor is call­ing for early and on­go­ing so­cial in­ter­ven­tion for teenagers liv­ing with HIV.

LIONEL ROOKWOOD/PHO­TOG­RA­PHER

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