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Vital Signs: HIV Infection, Testing, and Risk Behaviors Among Youths — United States

Vital Signs: HIV Infection, Testing, and Risk Behaviors Among Youths — United States

Early Release

November 27, 2012 / 61(Early Release);1-6

Abstract

Background: In 2009, 6.7% of the estimated 1.1 million persons living with human immunodeficiency virus (HIV) infection in the United States were youths (defined in this report as persons aged 13–24 years); more than half of youths with HIV (59.5%) were unaware of their infection.
Methods: CDC used National HIV Surveillance System data to estimate, among youths, prevalence rates of diagnosed HIV infection in 2009 and the number of new infections (incidence) in 2010. To assess the prevalence of risk factors and HIV testing among youths, CDC used the 2009 and 2011 Youth Risk Behavior Surveillance System for 9th–12th grade students and the 2010 National Health Interview Survey (NHIS) for persons 18–24 years.
Results: Prevalence of diagnosed HIV was 69.5 per 100,000 youths at the end of 2009. Youths accounted for 12,200 (25.7%) new HIV infections in 2010. Of these, 7,000 (57.4%) were among blacks/African Americans, 2,390 (19.6%) among Hispanics/Latinos, and 2,380 (19.5%) among whites; 8,800 (72.1%) were attributed to male-to-male sexual contact. The percentage of youths 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.
Conclusions: A disproportionate number of new HIV infections occurs among youths, especially blacks/African Americans, Hispanics/Latinos, and men who have sex with men (MSM). The percentage of youths tested for HIV, however, was low, particularly among males.
Implications for Public Health: More effort is needed to provide effective school- and community-based interventions to ensure all youths, particularly MSM, have the knowledge, skills, resources, and support necessary to avoid HIV infection. Health-care providers and public health agencies should ensure that youths are tested for HIV and have access to sexual health services, and that HIV-positive youths receive ongoing health-care and prevention services.

Introduction

The risk for acquiring human immunodeficiency virus (HIV) infection during adolescence and early adulthood starts with initiation of sexual behavior or injection drug use, and initiation of contributing behaviors such as use of alcohol and other drugs. The prevalence of HIV in potential sex partners, the percentage of HIV-infected persons unaware of their status, and the frequency of risky sexual behaviors and injection drug use contribute to the level of risk. In 2009, youths (defined in this report as persons aged 13–24 years), who represented 21% of the U.S. population, comprised 6.7% of persons living with HIV. More than half (59.5%) were unaware of their infection, the highest for any age group (1). All persons need to understand the threat of HIV and how to prevent it (2). Youths, particularly those at highest risk, need effective school-based, school-linked, and community-based interventions (3) that make them aware of their risk for HIV and help delay initiation of sexual activity, increase condom use for those who are sexually active, and decrease other behaviors, such as alcohol and drug use, that contribute to HIV risk. This report describes, among youths, 1) rates of those living with a diagnosis of HIV infection at the end of 2009, 2) the estimated number of new HIV infections in 2010, 3) the percentage that have been tested for HIV, and 4) the percentage that engage in selected risk behaviors.