More than half of HIV-infected young Americans are not aware of their status, according to a new Vital Signs report from the US Centers for Disease Control and Prevention (CDC) released this week that suggests too many young people in the US continue to become infected with the AIDS virus and few are tested for it.

The report is published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) for 27 November, in advance of World AIDS Day on 1 December.

CDC experts suggest several factors are responsible for high levels of HIV in young people, and these vary by population. For instance, HIV is more prevalent in some communities, and this increases the chance of exposure with each sexual contact.

Studies also show that higher levels of unrecognized and untreated infection, plus social and economic factors, such as poverty, inaccessible health care, discrimination and stigma, all increase the risk for HIV infection.

This new report analyzes the latest figures on HIV infections, testing and risk behaviors among young people.

The CDC authors used National HIV Surveillance System data to estimate rates of diagnosed HIV infection among youths in 2009, and the number of new infections in 2010.

They estimate 12,200 new HIV infections occurred in 2010 among young people between the ages of 13 and 24. This age group represents 26% of new HIV infections every year in the US, and most of them are not aware they are infected, say the authors.

A breakdown of the figures shows that in 2010, 72% of the estimated new HIV infections in young people in the US was in young men who have sex with men (MSM). A breakdown by race/ethnicity shows 57% of new infections among young Americans was in African-Americans.

CDC Director Thomas R. Frieden says in a statement:

“That so many young people become infected with HIV each year is a preventable tragedy.”

“All young people can protect their health, avoid contracting and transmitting the virus, and learn their HIV status,” he adds.

Despite the CDC and the American Academy of Pediatrics calling for routine testing for HIV among young people in medical settings, the report shows 35% of 18 to 24 year-olds have been tested for the virus, while only 13% of high school students (and only 22% of sexually experienced ones) have ever had an HIV test.

The CDC authors suggests that partially because testing levels are so low, under-25s infected with HIV are significantly less likely to receive and continue in HIV care, with the consequence that their virus is not sufficiently controlled so they get sick and run the risk of passing it on.

To assess risk behaviors and HIV testing among youths, the CDC authors used 2009 and 2011 Youth Risk Behavior Surveillance System data for 9th to 12th grade students, and the 2010 National Health Interview Survey (NHIS) for young persons aged between 18 and 24 years.

They found young men who have sex with men (young MSM), reported having much higher levels of risk behavior than their heterosexual counterparts, for instance:

  • Young MSM were more likely to report having ever injected illegal drugs.
  • They were more likely to report having had sex with four or more partners.
  • Among those reporting as being currently sexually active, young MSM were more likely to have drunk alcohol or taken drugs before their last sexual encounter, and less likely to have used a condom.

Young MSM were also less likely to report having received education about HIV or AIDS at school.

Kevin Fenton, director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, says:

“We can and must achieve a generation that is free from HIV and AIDS.”

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,” he urges.

The CDC is in partnership with a number of organizations across and around the US to promote more HIV education and testing among young people. They are also funding the delivery of targeted testing and prevention for those at higher risk, and addressing the social and environmental issues that can put them at higher risk.

In addition to this the CDC provides data and support to help communities and schools develop HIV and STD prevention programs.

Written by Catharine Paddock PhD