Time to up HIV testing in U.S. youth ages 13-24
February 1, 2013 4 minutes read
Time to up HIV testing in U.S. youth ages 13-24
Young people between ages 13-24 represent more than a quarter of new HIV infections each year, and 60% of youth living with HIV are unaware they are infected, according to a new report from the Centers for Disease Control and Prevention (CDC).1
Too few youth are tested for HIV, and many don’t know they are infected, agrees Jonathan Mermin, MD, MPH, director of CDC’s Division of HIV/AIDS Prevention. Just 13% of high school students, and 35% of those ages 18-24, have ever been tested for HIV, the new report reveals.1 These low numbers persist even though recommendations from the CDC and the American Academy of Pediatrics call for routine HIV testing of youth in medical settings.2,3
“A number of factors increase HIV risk among youth and pose challenges to prevention efforts, including making HIV testing easily available,” observes Mermin. “In addition, many young people underestimate their risk of infection, or experience social and economic barriers that impede access to health care.”
One challenge with reaching young people with HIV testing in medical settings is that adolescents and young adults don’t go to the doctor very often, Mermin notes. This fact underlines why it is critical that HIV testing also is available in communities, outside of medical settings, says Mermin.
The CDC issued the report to help increase education and awareness of the problem, Mermin states. Young people need to know the facts about HIV, how they can get tested, and what they can do to protect themselves and their partners from HIV, while healthcare providers should test teen and young adult patients per CDC guidelines, and parents should talk to their children about HIV, he states. “Here at CDC, we are working with partners across the nation to protect young people from HIV and other STDs, including funding targeted HIV testing and prevention efforts to reach those youth at greatest risk,” Mermin reports.
Who is most affected?
Which groups of young people are most at risk for HIV infection? The most-affected young people are young gay and bisexual men and African-Americans, the report says.
In 2010, an estimated 12,200 new HIV infections occurred among young people ages 13-24, with young gay and bisexual men and African-Americans hit harder by HIV than their peers. In that same time period, 72% of estimated new HIV infections in young people occurred in young men who have sex with men (MSM). By race/ethnicity, 57% of estimated new infections in this age group occurred in African-Americans.1
In compiling the current report, the CDC also looked at risk behaviors among high school students in 12 states and nine large urban school districts. They found that young men having sex with men reported engaging in substantially higher levels of risk behavior than their heterosexual male peers. These young men were more likely to report having had sex with four or more partners or ever injecting illegal drugs. Among students who were sexually active, young men having sex with men 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, the report notes.1
New program seeks impact
Young, black men who have sex with men are the only group in the United States among whom new infections are increasing, says Nick DeLuca, MA, branch chief for the Prevention Communications Branch in the CDC’s Division of HIV/AIDS Prevention. Between 2006 and 2009, new HIV infections increased by almost half (48%) among those ages 13 to 29, he notes.4
To address the urgent need to reduce HIV infections in this population, CDC has launched “Testing Makes Us Stronger,” a public awareness and education campaign designed by black gay men for black gay men. Launched in 2011, the campaign encourages HIV testing among black gay and bisexual men ages 18-44 using positive, empowering messages that emphasize HIV testing as a source of strength.
Increasing HIV testing is critical to reducing new infections, because people who know they have HIV can take steps to decrease the risk that they will transmit the virus to others, observes DeLuca Testing also provides the gateway to treatment; research shows that people on antiretroviral treatment are less likely to transmit HIV to others, he states. Those who test negative can take action to protect themselves from infection, says DeLuca.
National online and magazine ads, as well as transit and billboard ads, have been developed to reach out to men at risk, says DeLuca. Facebook, Twitter and blogs targeted to black gay and bisexual men are being employed as social media outreach. A dedicated website, http://hivtest.cdc.gov/stronger, offers freely reproducible materials for use by local communities and health departments, reports DeLuca. The program initially launched in six cities (Atlanta, Baltimore, Houston, New York, Oakland, and Washington, DC) where black gay and bisexual men are heavily affected, he states.
“Together, we must break the cycle of HIV among black gay and bisexual men if we are to stop the HIV epidemic in the U.S.,” says DeLuca. “This campaign is just one part of the solution; we need a nationwide movement to stop HIV in this community and beyond.”
References
- Centers for Disease Control and Prevention (CDC). Vital signs: HIV infection, testing, and risk behaviors among youths -- United States. MMWR 2012; 61:971-976.
- Centers for Disease Control and Prevention (CDC). Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 2006; 55(RR-14).
- Committee on Pediatric AIDS, Emmanuel PJ, Martinez J. Adolescents and HIV infection: the pediatrician’s role in promoting routine testing. Pediatrics 2011;128:1,023–1,029.
- Centers for Disease Control and Prevention (CDC). HIV among African Americans. Accessed at http://1.usa.gov/ueOv24.
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