Every year, on April 10th, National Youth HIV & AIDS Awareness Day (NYHAAD) provides an important opportunity to both reflect on accomplishments and chart the way forward. Taking stock of what our nation’s young people need this year is especially important as we’ve come to realize the true toll that the past two years have taken on their physical and mental health.
The data on HIV prevalence among young people tells us that about 20% or 1 in 5 new diagnoses occur in those aged 13 to 24 years and those rates tend to be higher among young men who have sex with men (MSM) and transgender women.1 HIV-related data also tell us that approximately 44% of young people with HIV do not know they have the virus1 and so are not receiving care for themselves or reducing their viral load to prevent further transmission. Among high school students, in 2019, only 9% had ever been tested for HIV.2
Data on health behaviors and experiences that put youth at risk for HIV present a more nuanced picture. Over the ten years prior to the COVID-19 pandemic, sexual risk behaviors and high-risk substance use declined significantly, but condom use decreased significantly. More than 10% of female high school students reported that they had been sexually assaulted, a trend that has been unchanged for at least 10 years, and more students reported not going to school because of safety concerns. Finally, mental health, which had been moving in the wrong direction for a number of years, became even more concerning during the pandemic, particularly for LGBTQ youth.3
Acknowledging that there is more work to be done to support young people experiencing risk for or living with HIV, the National HIV/AIDS Strategydesignates youth ages 13-24 as one of its priority populations.4 The Strategy calls for an enhanced focus on primary prevention for youth, increasing HIV testing, status awareness, and linkage to prevention or care services for youth, and improving viral suppression among youth with HIV. There are additional strategies that affect youth, including increasing the number of schools that have implemented LGBTQ-supportive policies and practices and increasing the number of schools providing on-site sexual health services. CDC will continue to do all it can to collaborate with federal and nonfederal partners to implement actions that improve HIV outcomes for youth and help the nation achieve the NHAS goals.
One of the primary ways we can support youth to prevent HIV is through their schools. Schools play a critical role in the primary prevention of HIV by providing young people with knowledge and skills through health education. They can also be an important bridge to needed HIV prevention services like condoms, HIV and STI testing, and PrEP. But one of the most important things that schools can provide is a sense of connectedness and belonging, and a safe space for all youth, including LGBTQ youth.
CDC’s What Works In Schools approach harnesses the power of schools to be places where youth can thrive. Our approach promotes quality health education, helps schools set up systems to connect youth to health services, and makes schools safer and more supportive by promoting activities to increase school connectedness and support for LGBTQ youth.
We have seen that schools that implement the What Works In Schools approach demonstrate improvements among their students in reduced sexual risk, decreases in substance use, and are less likely to experience sexual assault or avoid going to school because of concerns about violence.5 In schools that implement policies and practices to support LGBTQ students, like creating or strengthening Gender and Sexuality Alliances (GSAs), identifying safe spaces, and having anti-harassment policies, we see not only better mental health and lower rates of suicide attempts among sexual minority students, but also fewer suicide attempts among heterosexual students.6, 7 Reducing behaviors and experiences that increase risk for HIV and STIs while also supporting our youth who need it most is a goal that is within our reach today.
On NYHAAD and every day, CDC joins with our partners to ensure that young people have every opportunity to stay safe, stay healthy, and stay well. Help us promote NYHAAD by accessing our digital toolkit and downloading and sharing materials on social media using the #NYHAAD hashtag. Together we can help to ensure a healthy future for our young people.
1 CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021;32.
2 CDC. Youth Risk Behavior Surveillance—United States, 2019. MMWR Suppl 2020;69(1):1-83.
3 CDC. Youth Risk Behavior Survey: Data Summary & Trends Report: 2009-2019. Atlanta: Centers for Disease Control and Prevention; 2020.
4 The White House. 2021. National HIV/AIDS Strategy for the United States 2022–2025. Washington, DC.
5 Robin L, Timpe Z, Suarez NA, Li J, Barrios L, Ethier KA. Local Education Agency Impact on School Environments to Reduce Health Risk Behaviors and Experiences Among High School Students. J Adolesc Health. 2022 Feb;70(2):313-321. doi: 10.1016/j.jadohealth.2021.08.004. Epub 2021 Sep 14. PMID: 34531096; PMCID: PMC8792165.
6 Kaczkowski W, Li J, Cooper AC, Robin L. Examining the Relationship Between LGBTQ-Supportive School Health Policies and Practices and Psychosocial Health Outcomes of Lesbian, Gay, Bisexual, and Heterosexual Students. LGBT Health. 2022 Jan;9(1):43-53. doi: 10.1089/lgbt.2021.0133. Epub 2021 Dec 17. PMID: 34935516.
7 Harper CR, Johns MM, Orenstein D, Pampati S, Jones TM, Leonard S, Taylor KR, Robin L. Association Between LGBTQ Student Nondiscrimination Laws in Selected States and School District Support for Gay-Straight Alliances. J Adolesc Health. 2022 Feb 11:S1054-139X(21)00678-9. doi: 10.1016/j.jadohealth.2021.11.032. Epub ahead of print. PMID: 35165028.