April 14, 2011
A quarter of new HIV cases in Philadelphia are teens and young adults -- the primary target of the city's new STD prevention campaign. Among local high school students, 64 percent reported being sexually active; 15 percent disclosed sexual debut before age 13; 26 percent had four or more partners; and 47 percent were sexually active in the previous three months, according to the federal Youth Risk Behavior Survey. Thirty-seven percent of the city's sexually active teens reported no condom use at last intercourse.
Philadelphia's comprehensive STD screening program tests all high school students who agree to it, so long as their parents do not object. City health department workers offer screening and treatment services at every high school each year. When matched with HIV data, a positive STD test in high school was associated with a 2.5 times higher risk of HIV a few years later for males and a three-fold increase for females. Three of more positive STD tests translated to a four-fold HIV risk for males and six times the risk for females.
"If all of your sex is in one ZIP code when you are a teenager, and the ZIP code surrounding you has high HIV and you are having lots of sex, then eventually you are going to have sex with someone who has HIV," said epidemiologist Claire Newbern, who performed much of the analysis.
"One of the biggest things is they say, 'Well I looked at him and he was clean,'" said Jill A. Foster, director of the pediatric and adolescent HIV center at St. Christopher's Hospital for Children.
"Kids now, they think that the worst part of HIV is how people are going to react to you," Foster said. "Gonorrhea or chlamydia, [they] sort of laugh over it. Nobody is going to tell anybody that they have HIV."