HIV and Youth

Youth still at risk for HIV infection in US

/ Author:  / Reviewed by: Joseph V. Madia, MD

The epidemic of AIDS isn't over yet, and youth are among the most vulnerable. In the United States, thousands of young people are infected with HIV each year.

“HIV continues to be a significant public health problem in the US,” said Dr. Rich Wolitski, Deputy Director for Behavioral and Social Science in Centers for Disease Control's Division of HIV/AIDS Prevention.

“Approximately 50,000 people still become infected in the US each year.” About 39 percent of those infections are among young people between the ages of 13 and 29.

HIV is transmitted mainly through unprotected sex. A diagnosis of HIV used to mean a life cut short. Now, people are living longer with the disease, thanks to advancements in medical care.

Dr. Wolitski told dailyRx that the prognosis for a young person diagnosed with HIV is good, as long as they have ongoing treatment.

Still, Dr. Wolitski and other public health experts are concerned about sharp increases in infections in certain groups of youth.

“Too many people have now started to think of HIV as a problem that really doesn't affect this country anymore,” he said. Prevention is key, he said, to reducing the number of infections in this vulnerable population.

Who is at risk for HIV?

According to the Centers for Disease Control (CDC), in 2009 over one-third of new HIV infections occurred in people under thirty. It's estimated that 58.9 percent of these cases are undiagnosed.

HIV impacts African American youth, disproportionately to other ethnicities. African American males are at highest risk. The CDC reports that the rate of new infections among young African American males aged 13 – 29 is nine times higher than young white males, and greater than three times higher than young Hispanic males.

The story is similar for African American females, compared with white and Hispanic girls.

But the biggest driver for new infections is young black men who have sex with men (MSM). This is Dr. Wolitski's big concern: The number of new infections among young African American MSM increased from 4,400 new infections in 2006 to 6,500 new infections three years later.

“There are a number of factors that people have considered as contributing, potentially, to this increase,” said Dr. Wolitski. “But I think one thing that's incredibly important to keep in mind is that differences in individual risk behavior don't account for this trend.”

Dr. Wolitski explained that it's not as simple as some groups having more unprotected sex than others. People with low income and little education may have barriers to getting information about how to stay safe or get tested.

“We know that young black HIV positive men who have sex with men are less likely to be aware of their HIV status,” Dr. Wolitski said. “We know that undiagnosed HIV infection are not only at risk for progressing in the disease because they're not getting the treatment that would slow it down, but they're also at increased risk for transmission.” That means that these men are getting sicker, and they're also the people who are most likely to be responsible for new infections.

“Getting tested is a critically important step to take,” Dr. Wolitski told dailyRx.

HIV Testing

Significant advances in medical care and treatment have helped create longer lives for people with HIV. But leading a healthy life with HIV requires knowing that you have HIV.

“The keys really are finding the virus early, getting diagnosed early, getting into care, and getting the right treatment and staying in medical care over time. If people can do that, they can expect to have a really long and healthy life,” said Dr. Wolitski.

According to the CDC, between 16 and 22 million Americans get tested for HIV every year. But still, it's estimated that 1 in 5 do not know that they have HIV.

Studies have shown that people who are infected with HIV decrease their risky behaviors, such as having unprotected sex, once they know that they are infected. And medical treatment reduces the risk that they'll transmit the virus to others.

It's easy to find out where you can get tested, call the CDC information line at 1-800-CDC-INFO.

“I really want to emphasize that getting tested is a critical first step to protecting yourself and others from HIV infection,” said Dr. Wolitski. “I'd encourage all adolescents and adults to get tested.”

Review Date: 
December 14, 2011
Citation: 
HIV Testing