HIV and Youth

Many American adolescents are engaging in behaviors that may put them at risk of acquiring HIV infection and other sexually transmitted diseases. In periodic studies of high school students, the Centers for Disease Control and Prevention (CDC) consistently found the following:

• Young people account for an increasing number of new HIV infections despite a decline in sexual risk behaviors and an increase in condom use among sexually active young people.

• Approximately 50% of high school students have had sexual intercourse.

• Nearly 25% of 12th-graders have had four or more sex partners.

• Only about half of sexually active 12th-graders report using latex condoms all of the time.

Surveys of risk behavior among young people suggest that prevention programs have helped increase condom use among adolescents who are sexually active without increasing the level of sexual activity among young people. The following statistics are taken from the CDC's Youth Risk Behavior Survey:

• Drug injection led to 6% of HIV diagnoses in those aged 13-24 from 1994-1997. 57% of HIV cases were attributed to sexual transmission (26% heterosexual and 31% male-to-male sex).

• The percentage of sexually experienced high school students decreased from 54% in 1991 to 48% percent in 1997.

• Condom use among students who are sexually active increased from 46% to 57% from 1991 to 1997.

• 1 in 50 high school students reports having injected an illegal drug.

Other studies have indicated the following:

• Young men who have sex with men remain at high risk for HIV, particularly young men of color.

• Adolescents who are most vulnerable to HIV infection also include those who are homeless or runaways, juvenile offenders and school dropouts.

• Adolescent females are becoming infected by older sex partners or needle-sharing.

STDs and HIV

Infection with a sexually transmitted disease (STD) increases the risk of HIV infection, especially in women. In other words, a person infected with a sexually transmitted disease has an increased risk of contracting HIV from an infected partner; in addition, an HIV-infected person co-infected with another STD will transmit HIV more easily to his or her partner during unprotected intercourse.

• People infected with an STD are 2-5 times more likely to become infected with HIV.

• The prevalence of STDs can be an important indication of where HIV infection may spread and where efforts to promote safer sexual behaviors should be targeted.

• STDs that cause genital lesions can create a portal of entry for HIV. Even without lesions, STDs increase the number of HIV target cells (CD4 cells) in cervical secretions, thereby increasing HIV susceptibility in women.

• Recent studies suggest that treatments for some STDs, such as gonorrhea and chlamydia, reduce HIV transmission. This new evidence does not mean that people infected with HIV or an STD should not consistently practice safer sex; nor does it imply that STD treatments cure HIV infections.

HIV Among the Incarcerated

HIV is one of the most common diseases among the incarcerated. Despite this, HIV testing, emotional support, prevention education, and proper medical care are often not readily available in prison environments. In some prisons, they are nonexistent. Also, in some prisons HIV-positive prisoners are arbitrarily labeled as high-security prisoners because of their HIV status.

• The incidence of AIDS is 14 times higher in state and federal correctional facilities than in the general population, according to the Health Resources Services Administration.

• AIDS is the second leading cause of death in the nation's prisons.

• A recent survey indicated that in 1997, 4% of all women in state prisons were HIV-positive compared with 2.3% of all men in state prisons.

• Even in prisons where HIV care is present, common challenges include monitoring inmates during their treatment regimens and helping them comply with demanding drug treatment regimens.

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