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HIV-positive youth may be unaware of their infection

Tuesday November 27, 2012
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Young people between the ages of 13 and 24 represent 26% of new HIV infections each year, and 60% of these youth living with HIV are unaware they are infected, according to a report from the Centers for Disease Control and Prevention.

Researchers analyzed the latest data on HIV infections, testing and risk behaviors among young people. Overall, an estimated 12,200 new HIV infections occurred in 2010 among young people ages 13 to 24, with young gay and bisexual men and African Americans hit harder by HIV than their peers. In 2010, 72% of estimated new HIV infections in young people occurred in young men who have sex with men. By race/ethnicity, 57% 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," CDC Director Thomas R. Frieden, MD, MPH, said in a news release. "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.

Risk of infection also can increase due to other factors, including higher levels of unrecognized and untreated infection and social and economic factors such as poverty, lack of access to healthcare, stigma and discrimination, according to previous research.

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

Partially as a result of lower testing levels, HIV-infected people under age 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 reduces their risk of transmitting HIV to partners, the researchers noted.

The CDC also examined risk behaviors among high school students in 12 states and nine large urban school districts, and found that young men who have sex with men (MSM) reported engaging in substantially higher levels of risk behavior than their heterosexual male peers.

Specifically, young MSM were more likely to report having had sex with four or more partners or ever injecting illegal drugs. Among students who currently were 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 also were 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, MD, director of the CDCís National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "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."

Such efforts are underway as part of the National HIV/AIDS Strategy: http://aids.gov/federal-resources/national-hiv-aids-strategy/overview/.

The report appears in the November issue of Vital Signs: www.cdc.gov/mmwr/preview/mmwrhtml/mm61e1127a1.htm?s_cid=mm61e1127a1_w.


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