HIV Among Youth in the U.S.: Protecting a Generation

Dr. Kevin FentonIn the latest edition of Vital Signs, released by the Centers for Disease Control and Prevention today, we reported that one in four new HIV infections in the United States were among young people between the ages of 13 and 24. That is about 12,000 youth, or about 1,000 per month, were infected with HIV in 2010.

According to the Vital Signs edition of the Morbidity and Mortality Weekly Report, the majority of those youth living with HIV are unaware they are infected. The percentage of youth tested for HIV overall was 12.9% among high school students and 34.5% among those aged 18–24 years; it was lower among males than females, and lower among whites and Hispanics/Latinos than blacks/African Americans. Youth who are not aware of their HIV infection are not getting the treatment they need to live longer, healthier lives, and can unknowingly pass the virus on to others.

Published in conjunction with the annual World AIDS Day observance, Vital Signs looked at many facets of the youth HIV epidemic, finding that:

• Nearly 60% of new infections among youth occur in African Americans, about 20% in Hispanics/Latinos and about 20% in whites.
• About 87% of young males got HIV through male-to-male sex, 6% from heterosexual sex, 2% from injection drug use, and about 5% from a combination of male-to-male sex and injection drug use.
• About 86% of young females got HIV through heterosexual sex and 13% from injection drug use.
• Among youth, more new infections occurred among African American males than among any other group by race/ethnicity and gender.

Risk Among Youth

Vital Signs also looked at the behaviors among youth that may put them at risk for HIV. Youth become at risk for acquiring HIV when they start having sex or injecting drugs. For both males and females, having sex under the influence of drugs or alcohol can increase risky behaviors that could lead to becoming infected with HIV. Young gay and bisexual males who have sex with older partners are at a greater risk for HIV infection because their older partners are more likely to be infected. A number of factors contribute to the higher levels of HIV in youth and can vary by population. In some communities HIV prevalence is higher, which increases the likelihood that someone will be exposed to infection with each sexual encounter. Limited access to sexual health services, stigma, less condom use and more alcohol and drug use also are associated with increased HIV risk.

Mitigating the Risk

Vital Signs calls for age-appropriate HIV prevention education through parents, schools, and community and web-based programs. Additionally, this edition underscores the need for youth to be taught early about HIV prevention with information they can understand and use. This includes education about risks and skills to help delay sex and prevent HIV infection. Youth can reduce their risk of HIV infection by choosing to stop having sex. They can also limit their number of sex partners and use a condom every time they have sex.

Youth need to be tested and know where to get a confidential HIV test. Testing is the first step to getting medical care and treatment that can improve health, save lives, and prevent the spread of HIV.

Our Calling

It will take a concerted effort to provide our nation’s youth with the tools and resources they need to assess their own personal risk, to decrease risky behaviors, to get tested, and to protect themselves from HIV infection. This Vital Signs report on the HIV epidemic among youth serves as the wake up call for public health professionals, sexual health service providers, health care providers, and parents and families to provide those tools and resources. It is time to heed the call. On this World AIDS Day and every day, we should be working together for an AIDS-free generation.