Advances in antiretroviral therapy for the treatment of the human immunodeficiency virus (HIV) have changed the epidemiology of the disease. Once considered an acute disease with a high mortality rate, HIV infection is now viewed as a chronic illness. Children infected perinatally are now entering adolescence and sexual maturity, while adolescents and young adults are becoming infected with HIV in increasing numbers. Of the 40,000 to 80,000 new HIV infections each year in the US, one-third to one-half are in patients under 25 years. The emergency department (ED) plays a valuable role in the medical management of the HIV-infected adolescent. This article reviews the epidemiology of HIV in the adolescent population and the challenges of providing HIV-specific health care in the ED setting. It provides the emergency physician with an HIV-oriented approach to the adolescent history and physical exam. This article also discusses special circumstances that may be encountered in the ED, such as post-exposure prophylaxis, the pregnant HIV-positive adolescent, and the acute retroviral syndrome.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Emergency Medicine