Adolescents and HIV/AIDS
The behaviors of young people, particularly adolescents, can make them vulnerable to HIV infection and AIDS. The number of AIDS cases reported annually among U.S. adolescents (13-19 years of age) has increased, from 1 in 1981 to 159 cases in 1992. Through September 1993, a total of 1,412 cases of AIDS among adolescents has been reported. In 1991, HIV infection/AIDS became the sixth leading cause of death among 15- to 24-year olds in the United States.
Although the number of adolescents with AIDS is relatively small, we know many more young people are infected with HIV. Since 1 in 5 reported AIDS cases is diagnosed in the 20-29 year age group, and the median incubation period between HIV infection and AIDS diagnosis is about 10 years, it is clear that many people who were diagnosed with AIDS in their 20s became infected as teenagers.
Among adolescents reported with AIDS, older teens, males, and racial and ethnic minorities are disproportionately affected. However, the proportion of females among U.S. adolescent AIDS cases has more than doubled, from 14 percent in 1987 to 38 percent in 1992.
Many American teenagers are engaging in behaviors that put them at risk of acquiring HIV infection. Studies indicate that the average age of first sexual experience among U.S. adolescents is 16, and more than half (54 percent) of students in grades 9-12 participating in a 1991 CDC survey reported having sexual intercourse at least once in their lifetime; 19 percent of the students said they had already engaged in sex with four or more partners. Among the students surveyed who had ever had sex, 69 percent had had sex within the 3 preceding months; of those, 46 percent used a condom at last sexual intercourse. Of the students with four or more partners, even fewer--41 percent--used condoms. In addition 1 in 70 high school students reports having injected an illegal drug. These are the behaviors that put young people at high risk of HIV infection; the sexual behaviors also put them at high risk for other sexually transmitted diseases and unintended pregnancies.
What then are we doing to reach youth with HIV prevention messages and services? CDC has numerous HIV prevention programs targeted to youth through three primary avenues: school settings; community-based, regional, and national organizations, including minority organizations; and programs for the general public.
About one-fifth of the total U.S. population is in schools or colleges, providing an effective way to reach young people. School-based health education programs in the United States have had consistently positive effects in preventing high school students from using tobacco and from engaging in other health risk behaviors.
Since 1987, CDC has provided direct assistance to schools to develop, implement, and evaluate HIV/AIDS education programs. In 1988, only 17 states required such education--by 1992, the number of states requiring HIV education had increased to 34. CDC also helps train teachers, school administrators, and representatives from youth-serving community organizations from every state on the best ways to conduct HIV prevention education programs. CDC's Combined Health Information Database, which is accessible to any educator through the CDC National AIDS Clearinghouse, provides information on nearly 1,000 curriculum guides, audiovisuals, and other relevant information for use in teaching young people about HIV infection and AIDS.
Community-Based, Regional, and National Prevention Programs
Of course, not all youth can be reached through the schools. To reach teenagers and others not in school who may be at high risk for HIV infection, CDC funds (directly or through state and local health departments) HIV prevention activities by more than 500 community-based organizations. These efforts include street outreach; clinic-based education; counseling, testing, and referral programs; and programs that address the specific needs of runaway, incarcerated, migrant, homeless, and other youth in high-risk situations. Recent data indicate that street outreach activities are useful in providing HIV prevention messages and interventions to populations at high risk of infection, including youth. CDC also provides financial and technical assistance to 21 national organizations for educational programs and materials directed to youth in high-risk situations, particularly inner-city and minority youth.
Public Information/Education Programs
CDC also targets prevention efforts for young people through its public information and education campaign. CDC's National AIDS Information and Education Program includes a number of activities designed to educate all members of the public, including adolescents, about how HIV is transmitted, who is at risk of acquiring the infection, and how the infection can be prevented. This program includes a national public information campaign, the CDC National AIDS Hotline, and the CDC National AIDS Clearinghouse.
Research has shown that most Americans, including teenagers, are well educated about how HIV is transmitted and how they can avoid being infected. Therefore, confronting the belief that "it can't happen to me" was a primary goal of one series of CDC-sponsored public service announcements. Previous phases of the public information campaign have included many youth-oriented materials. In 1989, CDC launched a special education effort called "Parents and Youth" designed to help parents, teachers, and other concerned adults talk to children about HIV and AIDS. The educational materials from that campaign, including a brochure called "The AIDS Prevention Guide," are still available to anyone who requests them from the CDC National AIDS Hotline.
U.S. Department of Health and Human Services
This article was provided by U.S. Centers for Disease Control and Prevention. Visit the CDC's website to find out more about their activities, publications and services.