Information on 861 adolescents shows that in 1991 36 per cent reported having been sexually active in the previous 12 months, but only 6.2 per cent had ever used a condom (11% males, 2.4% females). The HIV infection rate was 5.9 per cent overall, 0.8 per cent in males and 9.9 per cent in females. The proportion sexually active and the rate of HIV infection rise with age. The annual incidence of HIV infection was 2.0 per 100 person-years of follow-up among all adolescents, 0.8 in males and 3.0 in females. The annual mortality rate among HIV-negative adolescents was 0.37 per cent versus 3.92 per cent among the HIV-positive adolescents, a rate ratio of 10.6. Sexual network data were collected on 389 adolescents aged 15-19 years of whom 55 per cent were sexually active. The median age of first sexual intercourse was 15 years in either sex. The 214 adolescents reported 339 sexual relationships of which 38.5 per cent were with spouses, 36 per cent with boy or girl friends and 21 per cent with 'friends'. There were 52 concurrent sexual relationships reported by 35 adolescents. Males report higher rates of concurrent sexual relationships than females. The sexual partners of boys were mainly younger students and housemaids while the girls' partners were mainly older traders and salaried workers. Adolescents in this community report high rates of sexual activity and have complex sexual networks. They probably are important in the dynamics of HIV infection.
PIP: Interview and HIV serostatus data were obtained for 861 adolescents aged 13-19 years in 1991 living in Rakai district, Uganda. Although 36% reported having been sexually active during the previous 12 months, only 11% of males and 2.4% of females had ever used a condom. 0.8% of males and 9.9% of females were infected with HIV. The proportion of adolescents who are sexually active and the rate of HIV infection both increase with age. The annual incidence of HIV infection was 2.0 per 100 person-years of follow-up among all adolescents, 0.8 in males and 3.0 in females. The annual mortality rate among HIV-negative adolescents was 0.37% compared to 3.92% among the HIV-positive adolescents. Sexual networking data were collected from 389 adolescents aged 15-19 years of whom 55% were sexually active. The median age at first sexual intercourse was 15 years for both boys and girls. The 214 sexually active adolescents reported 339 sexual relationships of which 38.5% were with spouses, 36% with boyfriends or girlfriends, and 21% with friends. 52 concurrent sexual relationships were reported by 35 adolescents, with males reporting higher rates of concurrent sexual relationships than females. Boys' sex partners were mainly younger students and housemaids while the girls' partners were mainly older traders and salaried workers.