Making New Efforts to Convince Youths They're Not Invulnerable to HIV

The number of new HIV infections among U.S. youths rose slightly in 2002, according to figures released at the 2003 National HIV Prevention Conference. The increase may be attributable in part to the fact that many of the newly infected youths were too young to have experienced the fear that surrounded HIV before the advent of effective drug therapy. Of the roughly 40,000 estimated new infections last year, more than half are thought to be in people younger than 25, with most infections contracted sexually.

"We are concerned about attitudes toward AIDS in younger patients who have been sexually active since AIDS or HIV infection has become a treatable disease," said Dr. Harold Jaffe, director of CDC's National Center for HIV, STD and TB Prevention.

According to figures released at the conference, half the HIV-positive people ages 13 to 24 are female, compared with one-fourth of those 25 and over. And about two-thirds of infected youths are black, compared with slightly less than half of those over 25.

Experts say HIV-positive youths are less likely to be aware of their serostatus, and there is growing evidence that they are less likely to adhere to the demanding regimen of HIV therapy. A study published in the March Archives of Pediatric and Adolescent Medicine (2003;157;(3):249-255) found that only 28 percent of HIV-positive adolescents reported taking all of their prescribed medicine in the previous month.

"Patients skip doses," said Dr. Jeffrey Birnbaum, medical director of the Health and Education Alternatives for Teens program serving teenagers with HIV in New York City. "They forget them. They get the instructions wrong. They'll decide to take all of the medicine in the morning," Birnbaum said.

Tailor-made programs are being created to improve treatment adherence for young people, said Dr. Donna Futterman, director of the adolescent AIDS program at Montefiore Medical Center in the Bronx. Some programs have started assigning visiting nurses or adherence counselors to such patients. They monitor compliance through phone calls or home visits. Other health care workers prescribe HIV drugs only after the adolescent patients have been emotionally prepared to take them, often after a concerted effort to convince them of the seriousness of their condition.

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