A generation of children born with HIV are now coming of age and reaching sexual maturity. Girls in this group who are sexually active are experiencing a higher number than expected of cervical abnormalities, a new study finds.
Researchers monitored the rate of first-time pregnancies, genital health and Pap test results of 638 girls, ages13 and over, who became infected with HIV around the time of birth. Nearly 50 percent of the girls had abnormal cervical cells.
"We have already seen this in HIV-infected women," said lead author, Susan Brogly, Ph.D., of the Harvard School of Public Health. However, in the adolescent girls, "we didn't expect to see as high rates as we did."
The study also found that only half of the girls who were sexually active had had Pap tests. "It's hard to get adolescents into the [HIV] clinic and when we do seem them, we need to look at the HIV and what's going on with the HIV disease," Brogly said. "But the clinicians [also] have to be thinking of the sexual health of these girls."
The study appears in the June 2007 issue of American Journal of Public Health. Up to now, small studies have looked at the rate of pregnancy among HIV-positive girls, but there has been little information available on the reproductive health of girls who developed HIV at birth.
Joseph Harwell, M.D., an associate professor of medicine and pediatrics at Brown University, said that the results are troubling. "This is an important reason for trying to protect this population from invasive cervical cancer with the HPV vaccine," Harwell said. "Cervical cancer is an AIDS-defining illness and young girls are at higher risk of progressing to cervical cancer if they are also HIV-infected." Harwell was not involved with the current study.
Brogly says that researchers will be investigating the use of the HPV vaccine in immunocompromised girls in the near future.
Brogly SE, et al. Reproductive health of adolescent girls perinatally infected with HIV. Am J Public Health 97(6), 2007.
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