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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

HIV: What we have here is a failure to communicate

Three decades into the AIDS epidemic there remains a troubling disconnect about the risk of infection, as the highest-risk groups don't seem to be getting the message. One may be tempted to conclude there is some kind of death wish at work, but for this rather remarkable finding: Young gay males in urban school districts were "less likely to report having been taught about HIV or AIDS in school," according to the Centers for Disease Control and Prevention. That needs to be addressed even if it is only part of a larger problem.

The CDC reports that about 50,000 people get HIV each year and young people between the ages of 13 and 24 represent about a quarter of these new HIV infections (26%). The majority of youth living with HIV are unaware they are infected. Young gay and bisexual men and African Americans are the most affected.

The latest data on HIV infections, testing, and risk behaviors among youth and young adults show:

  • Nearly 60% of new infections among youth occur in African Americans, about 20% in Hispanics/Latinos and about 20% in whites.
  • About 70% of youth were infected with HIV through male-to-male sex, 20% from heterosexual sex, 4% from injection drug use and about 4% from a combination of male-to-male sex and injection drug use.
  • Young gay and bisexual men and African Americans are hit harder by HIV than their peers.
  • About 86% of young females got HIV through heterosexual sex and 13% from injection drug use.
  • The percentage of youth tested for HIV overall was 12.9% among high school students and 34.5% among those aged 18–24 years; it was lower among males than females, and lower among whites and Hispanics/Latinos than blacks/African Americans.
According to CDC experts, a number of factors contribute to the higher levels of HIV in young people and can vary by population. In some communities HIV prevalence is higher, which increases the likelihood that someone will be exposed to infection with each sexual encounter.

CDC scientists also examined risk behaviors among high school students in 12 states and nine large urban school districts, and found that young gay and bisexual males reported engaging in substantially higher levels of risk behavior than their heterosexual male peers. Young gay and bisexual males are

  • More likely to report having had sex with four or more partners or ever injecting illegal drugs.
  • More likely to have used alcohol or drugs before their last sexual experience and less likely to have used a condom.
  • Less likely to report having been taught about HIV or AIDS in school.
The CDC calls for age-appropriate HIV prevention education through parents, schools, and community and web-based programs. Additionally, the CDC calls for implementation of effective interventions and testing for youth at risk. The CDC also underscores the importance of treatment and care for youth who have HIV.