Correlates of ever had sex among perinatally HIV-infected adolescents in Uganda.   Scovia Nalugo Mbalinda, Noah Kiwanuka, Lars E. Ericksson, Rhoda Wanyenze, Dan Kabonge Kaye     Society of Adolescent Health in Ugand Fourth Clinical and Scientific Meeting Hotel Africana, Kampala,Uganda March 29-30th 2017

Introduction Globally 2.1 million adolescents aged 10-19 years are living with HIV (1) About 260,000 new HIV infections in children and 2.9 million children living with HIV in2012 (2). 2 million of ALHIV are in sub-Saharan Africa and 70% are in ten countries (South Africa, Nigeria, Kenya, Tanzania, Uganda, Zimbabwe, Mozambique, Zambia, Ethiopia and Malawi)(1). In Uganda, 110,000 adolescents were living with HIV in Uganda(3)

Introduction Immune system was not developed results in distinctive chronic clinical complications and challenges include: Chronic illness, psychosocial issues, adherence to drugs, physical and psychological changes and constant fear of death and an uncertain life course (Domek, 2009; Flicker et al., 2005) Negotiate sexual relationship - risk of pregnancy, acquiring STIs and transmitting HIV.

Introduction Emerging population. Adolescents Programs have been focusing of primary HIV prevention. Determinants of being sexually active for HIV perinatally infected adolescents are not well known What are the sexual and reproductive health experiences of HIV perinatally infected adolescents?

Methodology Cross-sectional study Clinic-based recruitment Young people 10 and 19 years. Known HIV status HIV perinatally infected

Results Median age 16 years (IQR:15-18) Variable Number (N=624) Percentage Gender Females 370 59.3 Age groups 10 – 14 years 114 18.3 Education status Out of school 166 26.6 Parenthood status Both parents One parent (one dead) Total orphan 156 196 264 25.0 31.4 42.3

Results 2:Baseline characteristics of HIV perinatally-infected adolescents in Uganda.   Total (N) n (%) Currently on ARVs Yes 624 519 (83.2) Ever had boy/girlfriend? 396 (63.5) Ever had sex 213 (34.1) Used a condom at last sex No 213 93 (43.7) Consistent condom use 48(22.6) Ever been pregnant 144 82(56.9) Ever made someone pregnant 69 23(33.3) Aware of HIV status of partner 396 223(56.3) Partner HIV + 173 86(49.7) Been treated for an STD/STI 101 (16.2)

Adjusted effects for predictors of being sexually active from a multiple logistic regression. Age groups Ever had sex Adjusted (OR (95% CI) P- Value Yes No 10 – 14 years 6 (2.82) 108 (26.41) 1 15 – 19 years 207 (97.18) 301 (73.59) 6.28 (2.63 – 14.99) 0.000 Education status Out of school 111 (52.11) 55 (13.38) In school 102 (47.89) 356 (86.62) 0.20 (0.13 – 0.30) Ever been treated for an STD/STI 73 (34.43) 28 (6.86) 139 (65.57) 380 (93.14) 0.19 (0.11 – 0.32) Ever drunk alcohol 44 (20.66) 37 (9.00) 169 (79.34) 374 (91.00) 0.49 (0.28 –0.87) 0.015

Conclusion, Discussion HIV positive adolescents were in relationships and were sexually active. (Ezeanolue, Wodi et al. 2006; Bakeera-Kitaka, Nabukeera-Barungi et al. 2008; Birungi, Obare et al. 2009; Fernet, Wong et al. 2011; Bauermeister, Elkington et al. 2012) Majority of adolescents did not know the sero status of their partners (Andriamahenina, Ravelojaona et al. 1998; Birungi, Obare et al. 2009; Fair and Albright 2012; Mhalu, Leyna et al. 2013).

The majority of the sexually active were inconsistently using condoms or not using condoms at all. (Beyeza-Kashesya, Kaharuza et al. 2011; Mhalu, Leyna et al. 2013). Being sexually active was associated with adolescents aged 15-19 years, not being in school, staying alone and having ever drunk alcohol (Santelli, Robin et al. 2001; Elkington, Bauermeister et al. 2009).

Recommendation Comprehensive SRH especially Risk reduction programs with focus on underlying risks; out of school adolescents, alcohol use in the routine running of ART care are required.

Limitations Cross sectional study designs, these do not demonstrate causality. Potential of recall bias or under-reporting of sexual behavior. Some participant selection we did not have information available on the mother’s HIV status lead some misclassification bias.

Acknowledgement Supervisors Participants Funders. MEPI MESAU, CARTA. SAHU