6 of 10 young people with HIV don't know they have it, study says
The U.S. Centers for Disease Control and Prevention used data collected from several metro areas to unveil a detailed picture of HIV among young people in the U.S. on Tuesday.
HIV infections are increasing in young people ages 13 to 24 - particularly among African Americans - while decreasing among older people, the CDC said.
"This is our future generation and the bottom line is that every month, 1,000 youth are becoming infected with HIV," CDC Director Thomas Frieden told reporters during a national telebriefing. "Given 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."
HIV hits black youths at a far higher rate than whites. Nearly 60 percent of new infections in youths occur in African Americans, about 20 percent in Hispanics/Latinos and about 20 percent in whites, according to the CDC.
Over half (54 percent) of new infections among young gay and bisexual males are in African Americans.
Of all new cases, 82 percent are in men, and blacks are 10 times more likely to be infected than whites.
By risk group, nearly three-quarters (72 percent) of new HIV infections among youths occur through male-to-male sexual contact, while 20 percent are infected through heterosexual contact. Relatively few are infected through injection drug use.
Gay and bisexual men reported much higher levels of risky behavior than their heterosexual peers, according to the CDC's large analysis of high school students in 12 states and nine large urban school districts who responded to Youth Risk Behavior Surveys.
Gay and bisexual males are much more likely to have multiple sex partners, to inject illegal drugs, to use alcohol or drugs before sex, and also are much less likely to use condoms, according to the survey results.
While it is preventable and treatable, HIV remains an incurable and costly infection. The estimated cost of medical care for a single HIV patient is $400,000 over a lifetime. HIV patients are living a lot longer with the infection than they used to, Frieden said.
With 12,000 new HIV infections among American youths each year, that's an additional $400 million in HIV-related health care costs per month, or about $5 billion per year.
Testing is critical to stemming the tide, public health officials said.
The CDC says the percentage of young people tested for HIV is far lower than other age groups. Just 13 percent of high school students overall have been tested for HIV, and only 22 percent of sexually active high school students nationwide have been tested, according to the CDC's study.
That means infected youths are unknowingly transmitting HIV to others.
HIV testing should be done routinely, just like cholesterol testing among adults, Frieden said.
The largest risk factor for not getting tested for HIV is doctors not recommending it, said Frieden, who does not support mandatory HIV testing.
Many young people don't regularly see health care providers, so schools and community organizations play key roles in health education, outreach and services, Frieden said.
"It's critical that we reach young people, especially young African American gay and bisexual men, with HIV prevention and testing," Frieden said. "We have to do so to see a generation free of AIDS."
The CDC has partnered with state and local health departments to look for innovative ways to scale up access to HIV testing, either within schools or through referral programs, Frieden said.
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"Testing has improved considerably in the last year in Milwaukee," said Gary Hollander, president and CEO of Diverse & Resilient Inc., a nonprofit organization whose mission is the healthy development of lesbian, gay, bisexual, and transgender (LGBT) people in Wisconsin.
"We're working very aggressively to turn this epidemic around," Hollander said, referring to HIV infections among young people, and African Americans and Latinos in particular.
Hollander attributed the rise in HIV among young blacks to lack of exposure to HIV prevention information, limited social networks, and racism and homophobia that contribute to feelings of lack of acceptance.
What you should know about HIV
• About 87 percent of young males who have HIV got it from male-to-male sex, 6 percent from heterosexual sex, 2 percent from injection drug use and about 5 percent from a combination of male-to-male sex and injection drug use.
• Youths who are sexually active can reduce their risk of HIV infection by choosing to stop having sex. They can also limit their number of sex partners, not have sex with an older partner who may be more likely to already have HIV, and use a condom every time.
• Most new HIV infections in youths (about 70 percent) occur in gay and bisexual males; more than half (54 percent) are African Americans.
• Sexually active young gay and bisexual males have a higher risk for getting HIV if they are having sex with older or multiple partners, using drugs or alcohol, or not using condoms during every sexual encounter.
• Sexually active young gay and bisexual males should get an HIV test at least every year. Those at greater risk may benefit from testing every 3 to 6 months.
Source: U.S. Centers for Disease Control and Prevention
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