Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- 7 Diagnosis of HIV-1 infection in children
- 8 Prevention of mother-to-child transmission of HIV
- 9 Routine pediatric care
- 10 Immunizations
- 11 Prevention of opportunistic infections and other infectious complications of HIV in children
- 12 Emergency evaluation and care
- 13 Adherence to antiretroviral therapy in children and youth
- 14 Adolescents and HIV
- 15 Adolescent reproductive health and HIV
- 16 Growth, nutrition, and metabolism
- 17 Neurobehavioral function and assessment of children and adolescents with HIV-1 infection
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
15 - Adolescent reproductive health and HIV
from Part II - General issues in the care of pediatric HIV patients
Published online by Cambridge University Press: 03 February 2010
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- 7 Diagnosis of HIV-1 infection in children
- 8 Prevention of mother-to-child transmission of HIV
- 9 Routine pediatric care
- 10 Immunizations
- 11 Prevention of opportunistic infections and other infectious complications of HIV in children
- 12 Emergency evaluation and care
- 13 Adherence to antiretroviral therapy in children and youth
- 14 Adolescents and HIV
- 15 Adolescent reproductive health and HIV
- 16 Growth, nutrition, and metabolism
- 17 Neurobehavioral function and assessment of children and adolescents with HIV-1 infection
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
Summary
Introduction
Reproductive and gynecological conditions common among adolescent girls, in general and among HIV-infected girls specifically, include delayed puberty; menstrual disorders, such as abnormal uterine bleeding (amenorrhea, hyperandrogenism, oligomenorrhea, and dysfunctional uterine bleeding [DUB]); dysmenorrhea; premenstrual syndrome; and pregnancy. Infectious gynecological conditions include vulvovaginal candidiasis, bacterial vaginosis (BV), trichomoniasis, atypical infections of the female genital tract, cervicitis, pelvic inflammatory disease (PID), human papillomavirus infection (HPV), and herpes simplex virus (HSV) infection. This chapter addresses common reproductive health disorders among HIV-infected adolescents, and also includes a description of risk factors unique to adolescents that contribute to the acquisition of sexually transmitted infections as well as age-appropriate recommendations for secondary prevention. Most reproductive health disorders among HIV-infected adolescent girls are best managed by an adolescent medicine physician. Certain patients, such as those with delayed puberty, amenorrhea, and hyperandrogenism should be managed in collaboration with an endocrinologist.
Common non-infectious reproductive and gynecological conditions
HIV-infected adolescents, similar to their uninfected counterparts, may experience delayed puberty and menstrual disorders. In addition to these conditions, we will discuss particular considerations related to contraception and pregnancy.
Delayed puberty
Diagnosing delayed puberty may be difficult due to wide ethnic and regional variations in normal development [1–5]. Pubertal maturation in girls begins with the acceleration of growth followed by onset of breast development (thelarche) between the ages of 8 and 13 years.
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- Textbook of Pediatric HIV Care , pp. 205 - 243Publisher: Cambridge University PressPrint publication year: 2005