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More than half of young HIV-infected Americans are not aware of their status - CDC Report: HIV Infection, Testing, and Risk Behaviors Among Youths
 
 
  CDC Press Release Nov 27 2012

Full Article: Vital Signs: HIV Among Youth - United States

Too many young people continue to become infected and few are tested for HIV

Young people between the ages of 13 and 24 represent more than a quarter of new HIV infections each year (26 percent) and most of these youth living with HIV (60 percent) are unaware they are infected, according to a Vital Signs report from the Centers for Disease Control and Prevention. The most-affected young people are young gay and bisexual men and African-Americans, the report says.

The analysis looks at the latest data on HIV infections, testing, and risk behaviors among young people and was published in advance of World AIDS Day, Dec. 1.

Overall, an estimated 12,200 new HIV infections occurred in 2010 among young people aged 13-24, with young gay and bisexual men and African-Americans hit harder by HIV than their peers. In 2010, 72 percent of estimated new HIV infections in young people occurred in young men who have sex with men (MSM). By race/ethnicity, 57 percent of estimated new infections in this age group were in African-Americans.

"That so many young people become infected with HIV each year is a preventable tragedy," said CDC Director Thomas R. Frieden, M.D., M.P.H. "All young people can protect their health, avoid contracting and transmitting the virus, and learn their HIV status."

According to CDC experts, a number of factors contribute to the high levels of HIV in young people and vary by population. HIV prevalence is higher in some communities than in others, which can increase the likelihood that a person will be exposed to infection with each sexual encounter. Previous research has also found that other factors can increase risk of infection, such as higher levels of unrecognized and untreated infection, as well as social and economic factors, such as poverty, lack of access to health care, stigma, and discrimination.

Despite recommendations from CDC and the American Academy of Pediatrics that call for routine HIV testing of youth in medical settings, the analysis shows that 35 percent of 18-24 year olds have been tested for HIV, while only 13 percent of high school students (and 22 percent of sexually experienced students) have ever been tested.

Partially as a result of lower testing levels, HIV-infected people under the age of 25 are significantly less likely than those who are older to get and stay in HIV care, and to have their virus controlled at a level that helps them stay healthy and reduce their risk of transmitting HIV to partners.

CDC also examined risk behaviors among high school students in 12 states and nine large urban school districts, and found that young MSM reported engaging in substantially higher levels of risk behavior than their heterosexual male peers:

· Young MSM were more likely to report having had sex with four or more partners or ever injecting illegal drugs.

· Among students who were currently sexually active, young MSM were more likely to have used alcohol or drugs before their last sexual experience, and were less likely to have used a condom.

· Young MSM were also less likely to report having been taught about HIV or AIDS in school.

"We can and must achieve a generation that is free from HIV and AIDS," said Kevin Fenton, M.D., director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. "It will take a concerted effort at all levels across our nation to empower all young people, especially young gay and bisexual youth, with the tools and resources they need to protect themselves from HIV infection." These efforts are underway as part of the National HIV/AIDS Strategy.

CDC works with partners across the country to help prevent HIV and other STDs among young people. These efforts include encouraging HIV education and testing, funding the delivery of targeted testing and prevention services for youth at greatest risk, and working to address the social and environmental factors that can place some youth at increased risk. CDC also provides data and support to help communities develop effective school- and community-based HIV and STD prevention efforts.

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This is Tom Frieden, CDC Director, thanks very much for joining the call. Today, we are releasing a new Vital Signs report for December that provides a detail look at HIV among young people in the United States. This is our future generation and the bottom line is that every month 1,000 youth are becoming infected with HIV. HIV despite the great treatments that we have remains an incurable infection. And the cost of care of a single patient is approximately $400,000 over their lifetime. That means every month we're accruing about $400 million of health care costs, and every year, $5 billion from preventable infections in youth. Given even everything we know about HIV, and how to prevent it after more than 30 years of fighting the disease, it's just unacceptable that young people are becoming infected at such high rates. Reducing HIV among young people is a top priority for CDC. This is about the health of a new generation and protecting from an entirely preventable disease.

The report includes CDC data showing young people today account for about 1 out of every 4 new HIV infections in U.S. In 2010, people aged 13-24 were 26 percent of all new HIV infections. And African Americans and gay and bisexual men were hardest hit. The report tells us two very important things: first, too few young people are getting tested for HIV. In fact, well over half of youth living with HIV today don't know they're infected. That's a much higher proportion, than the less than 20 percent we estimate overall don't know they are HIV infected. Just 13 percent of high school students overall have been tested for HIV, and only 22 percent of sexually active high school students. Among those aged 18-24, only 35 percent have been tested. Second, young gay and bisexual men report much higher levels of risky behavior than their heterosexual peers. A large analysis of high school students shows that gay and bisexual males much more likely to have multiple sex partners, to inject illegal drugs, to use alcohol or drugs before sex and very unfortunately, also much less likely to use condoms. That was true in general across every race ethnic group. New data included in today's release helps us better understand why HIV is taking such a heavy toll on young men who have sex with men, and it highlights the importance of addressing risk behaviors and improving our education and our efforts to address the epidemic in young people. As we work to drive down new HIV infections in all populations, we have to give particular focus attention on the next generation; especially African Americans and gay and bisexual young men. Every young person should know how to protect themselves from HIV and should be empowered to do so. Protecting our next generation from HIV is key achieving the vision of an AIDS-free generation in the U.S. which a key part in the National HIV/AIDS Strategy. I would now like to ask Dr. Kevin Fenton, Director of the National Center for HIV/AIDS, Viral hepatitis, STD and TB prevention, to discuss the report further.

KEVIN FENTON: This new Vital Signs report shows why driving down new HIV infection rates among young people is so important. I'll start by providing a more detailed look at what CDC's data on new HIV infections also referred to as HIV incidence-tell us about young people and HIV in the United States. As Dr. Frieden noted, in 2010 young people ages 13 to 24 years accounted for 1 in 4, or 26 percent, of all new HIV infections in the United States - but let's take a closer look at which groups of young people are most at risk of HIV infection. The vast majority of newly infected young people - 83 percent of them - are males. More than half of new HIV infections in this age group - or 57 percent - are among African Americans, while Latinos and whites each account for 20 percent of new HIV infections. By risk group, nearly three-quarters or 72 percent of new HIV infections among youth occur through male-to-male sexual contact, while 20 percent are infected through heterosexual sex. Relatively few were infected through injection drug use. Young black gay and bisexual men are particularly affected - accounting for 39 percent of all new infections among youth, and more than half or 54 percent of new infections occurring from male-to-male sexual contact.

In this report we also examined risk behaviors among high school students to better understand why the impact of HIV is so high among young men who have sex with men. In a large study of high school students in 12 states and 9 urban school districts, young men who have sex with men overall reported substantially higher levels of risk behavior than their heterosexual male peers. So, for example: young men who have sex with men were more likely to report having four or more sexual partners, that's approximately 39 percent versus 27 percent. They were far more likely to have ever injected an illegal drug - a startling 20 percent compared to 3 percent. Among the young males who were currently sexually active, those who reported sex with other males were more likely to have used alcohol or drugs before their last sexual encounter, 39 percent versus 24 percent and they were less likely to have used a condom the last time they had sex, 44 percent compared to 70 percent. One finding worth noting is that young men who have sex with men were also less likely to report being taught about HIV or AIDS in school, 75 percent versus 86 percent.

A number of factors increase HIV risk among youth, including inter-related social and economic conditions that can help to fuel HIV infection in this population. So for example: high rates of HIV and other STDs in many African American and gay communities increase the risk of becoming infected with each sexual encounter. Young gay and bisexual men having sex with older partners, who themselves maybe more likely to be infected, also increases risk. Stigma, discrimination, and homophobia also serve as significant barriers to prevention. And many lack access to health care, so they don't receive the preventive services they need.

As Dr. Frieden mentioned at the top of this briefing, the new report also contains data that show too few young people have been tested for HIV. Now, while CDC recommends routine HIV testing in medical settings for Americans age 13 and older, only 13 percent that 13 percent of high school students overall have ever been tested for HIV. Among those who have had sex, the percentage is slightly higher at 22 percent, though still far too low. Looking at a slightly older age group, those aged 18 to 24 years we found that just 35 percent had ever been tested for HIV. CDC estimates that 60 percent of young people currently living with HIV do not even know they are HIV infected. And, HIV-infected people under the age of 25 are significantly less likely than, significantly less likely than those who are older to get and to stay in care, and to have their virus controlled at a level that helps them stay healthy and that reduce the risk of transmitting HIV to partners. Now, I'd like to turn the call back over to Dr. Frieden.

 
 
 
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