HIV Among Youth: Protecting a Generation

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Photo: Four students on campusIn commemoration of World AIDS Day (Dec. 1), Vital Signs looks at the alarming impact of HIV on youth, ages 13-24, and underscores the importance of HIV prevention, testing, and treatment for youth.

World AIDS Day Serves as a Call to Action

World AIDS Day is a time to reflect on the impact of HIV around the globe and the efforts to educate everyone on the facts about HIV, to prevent the spread of the virus, and to ensure that everyone with HIV gets proper care and treatment. As part of CDC's U.S. HIV prevention efforts, the November 27 edition of Vital Signs reports on the alarming impact of HIV on our nation's youth, ages 13-24.

HIV Among Youth

An estimated 1.1 million people are living with HIV in the United States and about 50,000 people get HIV each year. Recent data indicate that 1 in 4 (26%) of new HIV infections occur in youth, between the ages of 13-24. In 2010, about 12,000 young people, or about 1,000 per month, were infected with HIV.

Photo: Students sitting around talkingAlso disturbing is that about 60% of youth with HIV do not know that they are infected and can unknowingly pass the virus to others.

HIV Testing

Since most young people with HIV do not know they are infected, it is vital that youth at risk for HIV be tested and know where to get a confidential HIV test. Gay and bisexual males should get tested at least annually; those who are at greater risk (e.g., illicit drug use, multiple sex partners) may benefit from testing more often.

HIV testing helps to save lives and prevent the spread of HIV. For those infected, HIV testing is the critical first step to getting the medical care and treatment needed to help them live longer, healthier lives. Testing is also critical for those without HIV, so they can take steps to stay uninfected.

HIV Risk Education

A coordinated effort by parents, families, schools, community-based organizations, web-based prevention programs, and the government is needed to ensure that all youth understand what puts them at risk for HIV and how to prevent it.

The main risk factors for HIV among youth are

  • not knowing how HIV is transmitted and their own personal risk.
  • having sex.
  • using alcohol or drugs with sex.
  • injecting drugs.
  • having sex with older partners who may be more likely to already have HIV.
  • having multiple sex partners.
  • not using condoms consistently and correctly (having unprotected sex).
  • not getting HIV tested, and, if infected, not getting treated.

Having sex under the influence of drugs or alcohol can increase risky behaviors such as unprotected sex. Belonging to a group or living in a community with high rates of HIV automatically puts young people at higher risk because their potential sex partners are more likely to have HIV. Research has shown that young gay and bisexual males who have sex with older partners are at a greater risk for HIV infection. This is because an older partner is more likely to have had more sexual partners or other risks, and is more likely to be infected with HIV.

Reducing Risk

Youth, particularly those at highest risk, should be reached early with age-appropriate HIV prevention education that includes information about risks and teaches skills to help delay sex and prevent HIV. CDC supports effective interventions for communities that can help.

The best way for youth to avoid getting infected with HIV is to not have sex or inject drugs. Youth who are sexually active can reduce their risk if they stop having sex or limit their number of sex partners, do not have sex with an older person who may be more likely to already have HIV , and use a condom consistently and correctly every time.

Greater Risk for HIV for Some Youth

Among all Americans, more African Americans have HIV than other races or ethnic groups, and gay and bisexual men are 40 times more likely to have HIV than other men. These trends put young, black gay and bisexual males at increased risk-especially if they have sex with older partners who may be more likely to already have HIV.

About 87% of young males got HIV from 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. In 2010, more new infections occurred among young African American males than among young people of any other race/ethnicity and sex.

Social and economic realities prevalent in some African American communities-such as higher levels of poverty, racial discrimination, limited access to health care and housing, and higher rates of incarceration-are associated with increased HIV risk.

Consistent and correct condom use is essential for HIV prevention. Unfortunately, only 44% of gay and bisexual males in high school reported using condoms the last time they had sex.

Action Steps

Photo: Two male teenagersThis issue of Vital Signs on HIV among youth promotes the following action steps:

  • Youth can get the facts about HIV and resist pressure to have sex or use drugs that can lead them to take more chances with sex. If sexually active, youth could stop having sex, or limit their number of sex partners and use a condom correctly every time. CDC recommends that youth at risk between the ages of 13 and 24 get tested for HIV at least once as part of routine health care.
  • Parents and families can talk with their children early and often about HIV and sexual health facts, and involve their child's doctor in the conversation. They can also support HIV education and safe environments in schools for all youth.
  • Health care providers can follow current HIV testing and treatment guidelines and test young patients at risk for HIV-sexually active young gay and bisexual men should be tested at least once a year and those at highest risk may benefit from more frequent testing. Health care providers can also educate parents and youth about sexual development and HIV prevention.
  • Schools, community-based organizations and the web can all be sources for HIV prevention information for youth.
  • Everyone can get the facts, get tested and get involved, and we can all support programs to prevent HIV among youth.

CDC and its partners remain committed to HIV prevention education, routine testing, knowing one's HIV status and reducing risky behavior. But these efforts must be intensified, especially among young people. On this World AIDS Day, let us refocus on how we can work together to protect the lives of this generation of youth to impact both the overall HIV epidemic and to protect generations to come.

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