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Do Adolescents With Higher Knowledge of HIV Have Lower Sexual Risk Behaviors?

Hoehn, Erin F. MD; FitzGerald, Michael R. PhD; Bhatt, Seema R. MD; Robinson, Venita M. MHSA; Lippe, Joyce E. MD; Reed, Jennifer L. MD

doi: 10.1097/PEC.0000000000000612
Original Articles

Objectives Human immunodeficiency virus (HIV) remains a leading cause of morbidity and mortality in the United States, and adolescents account for a disproportionate number of new cases. We aimed to assess knowledge of HIV in relation to sexual risk behaviors among adolescents seeking care in our pediatric emergency department and to assess sources of HIV knowledge among this population.

Methods Adolescents aged 14 to 21 years who presented to the pediatric emergency department participated in a questionnaire assessing HIV knowledge, sexual risk behaviors, and sources of HIV knowledge. For purposes of statistical analysis, patients were divided into a high-score (greater than or equal to the median score) or low-score (less than the median score) group based on the HIV-Knowledge Questionnaire 18 portion of the survey.

Results A total of 240 adolescents were enrolled. Of those, 112 patients scored higher than or equal to the median HIV-Knowledge Questionnaire 18 score of 11. High-scoring knowledge was independently associated with patients 18 years or older (P = 0.001), any lifetime sexual activity (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.30–3.67; P = 0.003), previous testing for HIV (OR, 2.40; 95% CI, 1.40–4.11; P = 0.002), and an “expert” source (school-based or medical professionals) as their primary source of knowledge (OR, 1.88; 95% CI, 1.05–3.41; P = 0.034). Age of first sexual encounter, number of partners, and condom use were not significantly associated with knowledge score.

Conclusions Education from “expert” sources is important in providing adolescents with accurate information. However, education alone is unlikely to change sexual practices. A more comprehensive approach to HIV prevention is needed to decrease HIV transmission among this patient population.

From the *Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and †Division of Pediatrics, Kaiser Permanente, Roseville, CA.

This study was supported by the Ohio Department of Health: HIV Testing in Ohio Emergency Departments. Grant #03130012HT0213, Agency Key: 0313001.

Disclosure: The authors declare no conflict of interest.

Reprints: Erin F. Hoehn, MD, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 2008, Cincinnati, OH 45229 (e-mail:

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