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Exposure to gunfire, assaults and other violence may negatively impact the health of children born with HIV, according to a new Harvard University study.

Researchers analyzed the medical records of 268 youths ages 8 to 15 and then asked them about their exposure to violence within the previous year. Fifty-three said they had heard gunshots on their block, for example, and 23 said they lived in a neighborhood where there had been a murder. Twenty reported that a neighbor had been hit by a police officer.

Overall, of the 34 percent of youths who answered affirmatively, 1 in 3 had detectable levels of HIV, the researchers found. By comparison, only 18 percent of those without the same background had detectable viral loads. Virtually all participants in the study were on an antiretroviral drug regimen.

The study, published recently in the Journal of Adolescent Health, didn't establish a causal relationship between the children's HIV status and their environment.

"I don’t think it necessarily means that living in a violent neighborhood predisposes you, because there were many people who were experiencing violence who did not have bad health outcomes," said Deborah Kacanek, a scientist at Harvard’s Center for Biostatistics in AIDS Research.

Yet the health of those with higher viral loads was inherently more at risk, with an increased chance of physical complications from HIV later in life. “It could also increase your risk of transmitting HIV to others,” Kacanek added.

The sample was part of a larger, ongoing Pediatric HIV/AIDS Cohort Study conducted at 15 clinical sites throughout the United States and Puerto Rico.

In the United States, as well as worldwide, the number of children with HIV has declined dramatically in the past 20 years. Worldwide in 2014, about 2 million adolescents ages 10 to 19 were living with the virus, according to UNICEF.

Of the youths in the Harvard study, 71 percent were black and 21 percent white (which included those identifying themselves as Latino). More than 4 in 10 lived in households that earned less than $20,000 annually.

“These results highlight the need for strategies both to reduce violence exposure and address violence-exposure experiences” among infected youth, according to the study. Doing so “may reduce risks of HIV-associated complications and transmission of HIV and promote youth well-being."

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