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Fact Sheet: HIV/AIDS and Young People

December 1998

In the United States, teenagers and young adults account for an increasing number of HIV infections every year and are now infected with and affected by HIV more than any other population group. The relationship between young people and the HIV/AIDS pandemic is fortified by a number of often interrelated factors.

Adolescence is the stage of development when young people become intrigued with sexual relations and experience sexual feelings. Most adolescents and young adults also develop a sense of invincibility which often results in risky behavioral experimentation, particularly when it comes to sexual contact.

Today, more information about effective HIV prevention is known than in years past. However, the high incidence of HIV infection among teenagers and young adults suggests that the inconsistency between what is known about prevention and what is actually done for protection needs to be addressed. The increasing rate of HIV infection among young people also indicates that more emphasis needs to be placed on HIV prevention.

  • Last year, roughly 50% of reported new HIV infections worldwide occurred in people between 15 and 24 years of age.

  • In the United States last year, one out of every four reported new HIV infections occurred in a person under 22 years of age.

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  • AIDS-related illnesses are the sixth leading cause of death among people between the ages of 15 and 24 in the United States.

  • By the end of 1997, 22,953 cases of AIDS had been reported in people between the ages of 20 and 24 in the United States.

  • Most people with AIDS before the age of 30 were infected with HIV in their teens or twenties. This illustrates the importance of advocating prevention to young people so that they have the information and resources they need to protect themselves and each other from HIV when they make decisions about experimentation with drugs and sex.

While abstinence is the most effective method of prevention of sexual transmission of HIV, consistent and correct use of condoms significantly lowers the risk and rates of HIV transmission. A mutually monogamous sexual relationship with someone who is not infected with HIV also decreases the chances of HIV transmission. However, most young people with HIV were infected through sex, and many young people have had multiple sexual partners.

  • Almost 7 out of 10 high school 12th graders have had sexual intercourse.

  • About 23% of 12th graders have had four or more sexual partners.

  • Less than half of sexually active 12th graders report consistently using a latex condom.


Who is especially at risk for HIV?

The HIV/AIDS pandemic disproportionately affects specific populations of teenagers and young adults. Young men who have sex with men (MSM), young people who live on the streets, African-American and Latino teenagers and young adults, and women between the ages of 15 and 24 are especially at risk of becoming infected with HIV.

There are a number of social factors that contribute to the high incidence of HIV infection in high-risk population groups in the United States. When a young person is the victim of homophobia, poverty, sexism or racism, his or her self-esteem and confidence often are deeply affected. As a result, that young person's inclination to openly discuss sex and sexuality, and his/her sense of self-respect, which would encourage self-protection, are significantly lessened.

  • Roughly three out of four HIV infections among young men occur in young MSM.

  • African-American and Latina women over the age of 13 comprise 80% of reported AIDS cases among women in the United States last year.

  • HIV/AIDS is the leading cause of death among African Americans between 25 and 44 years of age.

  • Young people who live on the street often exchange sex for shelter, security or food, and are thus at an increased risk for HIV infection.

  • The Centers for Disease Control and Prevention (CDC) reports that roughly one out of every 50 high school students has injected an illegal drug.

  • Some young people who are addicted to drugs suffer from an increased risk of becoming infected with HIV by exchanging sex for drugs.


Effective Prevention Methods for Young People -- What Works?

HIV/AIDS awareness efforts, particularly those aimed at young people, need to focus on HIV prevention and all of the risks with which young people today are faced. The current state of the HIV/AIDS epidemic in the United States illustrates that addressing risk factors in isolation is not effective in reducing the prevalence of HIV infection among teenagers and young adults. The time has come for educators, community and faith leaders, and public health officials to design and implement comprehensive HIV prevention programs that address the synergy of risks that threaten the health of young people.


Young Injection Drug Users (IDUs)

HIV prevention initiatives geared to young IDUs require a number of concerted efforts.

  • When HIV prevention programs incorporate effective methods of changing sexual behavior and reducing drug-related behavioral risks, sexual transmission of HIV is decreased among IDUs and their partners.

  • Young IDUs who continue to inject drugs must be educated about the extreme dangers of sharing needles and syringes, even those that have been cleaned in bleach or another disinfectant.

  • Increasing the availability of new syringes to young IDUs who continue to inject drugs significantly would reduce the rate and prevalence of new HIV infections.

  • Needle exchange programs have been found to reduce HIV transmission among IDUs without encouraging or increasing illegal drug use, according to CDC.


Young Men Who Have Sex With Men (MSM)

Despite the increase in HIV prevention messages targeted toward MSM, a shocking number of young MSM continue to engage in unsafe anal sex. This partly is due to their perceived notion that 1) HIV infections are typically among older MSMs and 2) their peers are practicing unsafe anal and oral sex as well.

Prevention efforts geared toward young MSM need to be based on the idea that young MSM often sit at the intersection of HIV and drug/alcohol use. According to a recent study by CDC, many MSM rely on alcohol and drug use to enhance sexual relations and to accomplish a sense of identity and intimacy in the community. Therefore, substance abuse counseling and treatment services need to be incorporated as integral components of HIV prevention efforts aimed at young MSM.

  • Of the total number of AIDS cases among adolescents and adults in the United States reported to CDC by the end of 1997 (633,000), 40,534 men were reported to have been exposed to HIV through both male-male sex and injection drug use.


Young People of Color

The HIV/AIDS epidemic is especially apparent in young population groups of color.

  • AIDS-related illnesses are the leading killer in African Americans 25 to 44 years old. Many of these adults likely were infected during their teenage years.

The disproportionate number of communities of color (especially African-American and Latino) that are affected by the HIV/AIDS epidemic strongly suggests that many of the HIV prevention efforts thus far have not been successful.

A number of factors -- including exposure to sexually transmitted diseases, injection drug use and unsafe sexual practices -- increase the risk of HIV infection for these population subgroups. These risk factors need to be addressed in HIV prevention efforts aimed at young people of color because only advocating abstinence simply is not enough.

  • An STD infection facilitates transmission of HIV. Gonorrhea rates in African-American teenagers are four times higher than the average rate. Prevention efforts need to incorporate the importance and effectiveness of condom use in STD and HIV prevention.

  • HIV prevention programs need to include information and resources on safer practices for MSM. Young MSM of color suffer from a number of social vulnerabilities (e.g., homophobia and cultural/ethnic traditions) that often are ignored in HIV prevention efforts aimed at young people of color.

HIV prevention programs aimed at young people of color are more effective when they are comprehensive, addressing all of the risk factors and situations with which young people of color are confronted. Programs that address a risk factor in isolation or offer only one solution are not effective in educating young people or changing their sexual behaviors.

Community and faith leaders as well as educators need to abandon the tendency to only offer abstinence as an HIV prevention method. Instead, young people, particularly those of color, need to be given the education, means and support to protect themselves and each other from HIV.


Young Women

Prevention programs aimed at young women need to realistically address the topic of sexual relations, condoms and protection. AIDS-related illnesses are the third leading cause of death for women between the ages of 25 and 44. Women of color, particularly African-American and Latina women, are especially at risk of becoming infected with HIV and together are represented in more than three fourths of all reported AIDS cases among women.

  • Women who developed AIDS by the age of 30 were probably infected with HIV during their teenage years or in their early twenties.

  • More than half of all young women have had sexual intercourse by the age of 18, so early education about the importance and effectiveness of condom use is necessary.

  • HIV prevention programs aimed at adolescent and young adult females need to stress the biological predisposition that all women to HIV infections. Effective prevention programs need to encourage women to take responsibility for their safety if they decide to have sexual relations.

  • Young women often are affected by a number of social factors -- sexism, sexual assault and abuse, and rape -- that diminish their level of self-respect and confidence in asking their partner to wear a condom. Young women need to be encouraged to value and protect themselves.

Prevention programs need to address these issues and equip adolescent and adult young women with the confidence and knowledge to make healthy decisions about themselves and HIV.


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This article was provided by American Association for World Health. It is a part of the publication Be a Force for Change.
 
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