HIV-infected pregnant adolescents and youth : results from a European cohort study

Globally the HIV epidemic mainly affects young people, particularly young females who are vulnerable to acquisition of HIV as a result of their biological and social susceptibility. Women represent an increasing proportion of newly diagnosed HIV cases in Western and Eastern Europe, reaching 35% and 40%, respectively, in 2004. In the European Collaborative Study (ECS), HIV-infected pregnant women are enrolled and their infants followed-up prospectively. By the end of 2005, 5956 women had enrolled, of whom 1912 (32%) were aged < 25 years at delivery. Enrolments of youth declined in Western European centres from 59% in 1985 to 18% in 2005. In Ukraine, youth enrolments declined from 52% in 2001 to 43% in 2005. Median ages of the young and older sub-cohorts were 22.3 and 29.9 years, respectively. Injecting drug use (IDU) was more common in the older than younger sub-cohorts [42% (n = 1684) vs. 35% (n = 675), p < 0.001]. However, young IDUs were more likely to be currently using injecting drugs than older IDUs (59% vs. 38%, p < 0.001), to report current sharing of injecting equipment (22% vs. 13%, p = 0.001) and to report an IDU sex partner (59% vs. 48%, p < 0.02). Young HIV-infected pregnant women in Europe are a heterogeneous group, possibly less identifiable as being at risk of HIV infection. They will have diverse needs for services during and after pregnancy, including harm reduction services and psychosocial support, in addition to a universal need for prevention of mother-to-child transmission services.