Background:  We identified the prevalence of HIV infection and of predictors and risk factors for its acquisition among adolescents and youth seeking voluntary counseling and testing (VCT) in Port-au-Prince, Haiti.

Methods: We conducted a cross-sectional analysis of data obtained from 3481 participants aged 13 to 25 years who came to the Groupe Haïtien d'Étude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Center for coluntary counseling and testing between October 2005 and August 2006. Prior to VCT, face-to-face interviews were conducted with all participants. Data from intake interviews and HIV test results were linked confidentially. Adolescents and youth who reported being sexually active and who had HIV serology results (2603 females and 878 males) were included in an analysis of sexual risk factors for HIV acquisition. Multivariable logistic regression models assessed the association of demographic and HIV-related risk factors with HIV infection.

Results:  HIV prevalence among sexually active adolescents and youth was 6.4%. The prevalence of HIV was slightly higher among females, 6.7%, than males, 5.6% (p = 0.3). Young women represented 78% of all youth receiving VCT who tested HIV positive (n = 222). Prevalence increased with age:  3.3% in 13 to 15 years, 5.1% in 16 to 19 years and 7.1% in 20 to 25 years (p = 0.02). HIV infection among females correlated with poor knowledge about HIV, early sexual debut, perceived unfaithfulness of partners, considering themselves at risk of HIV, and a history of syphilis or sexually transmitted infection symptoms. Demographic risk factors for HIV infection included:  low education, not-residing with parents, low-status or no occupation, and low income. Being married or divorced/widowed, having had a child, and being currently pregnant also predicted HIV infection in females. HIV risk among males was significantly correlated with use of illicit drugs and a history of practicing risky sexual behavior.

Conclusions:  A high prevalence of HIV infection among adolescents and young adults seeking HIV testing in urban Haiti correlated with familiar risk factors. The findings led to the establishment of a counselling and care center for adolescents and young adults at GHESKIO. Youth are aided with HIV/AIDS education, esteem-building, and sexually negotiating skills (for females), as well as care and ART as indicated.