TEXT 1 HIV INFECTION IN ADOLESCENTS
A
The human immunodeficiency virus (HIV), which causes AIDS, ranks
seventh among the leading causes of death for U.S. children 5 to 14 years of age
and sixth for young people 15 to 24 years of age. Because the average period of
time from HIV infection to the development of AIDS is 10 years, most young
adults with AIDS were likely infected with HIV as adolescents. Almost 18
percent of all reported cases of AIDS in the United States have occurred in
people between the ages of 20 and 29.
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B
In the United States, through June 1999, 3,564 cases of AIDS in people aged
13 through 19 had been reported to the Centers for Diseases Control and
Prevention. Many other adolescents are currently infected with HIV but have not
yet developed AIDS. Data from the 31 states that conduct HIV case surveillance
indicate that among adolescents aged 13 through 19: 46 percent were male; 54
percent were female; 28 percent were non-Hispanic white; 66 percent were non-
Hispanic black; 5 percent were Hispanic; less than 1 percent were Asian/Pacific
Islander or American Indian/Alaskan Native.
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C
Most adolescents recently infected with HIV are exposed to the virus
through sexual intercourse or injection drug use. Through June 1999, HIV
surveillance data suggest that nearly half of all HIV-infected adolescent males
are infected through sex with men. A small percentage of males appear to be
exposed by injection drug use and/or heterosexual contact. The same data
suggest that almost half of all adolescent females who are infected with HIV
were exposed through heterosexual contact and a very small percentage through
injection drug use.
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D
CDC studies conducted every two years in high schools (grades nine through
12) consistently indicate that approximately 60 percent of the students have had
sexual intercourse by grade 12; half report use of a latex condom during last
sexual intercourse, and about one-fifth have had more than four lifetime sex
partners.
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E
Approximately two-thirds of the 12 million cases of sexually transmitted
diseases (STDs) that are reported in the United States each year are in
individuals under the age of 25 and one-quarter are among teenagers. This is
particularly significant because if either partner is infected with another STD,
the risk of HIV transmission increases substantially. If one of the partners is
infected with an STD that causes the discharge of pus and mucus, such as
gonorrhea or chlamydia, the risk of HIV transmission is three to five times
greater. If one of the partners is infected with an STD that causes ulcers, such as
syphilis or genital herpes, the risk of HIV transmission is nine times greater.
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F
Adolescents tend to think they are invincible, and therefore, to deny any risk.
This belief may cause them to engage in risky behavior, to delay HIV-testing,
and if they test positive, to delay or refuse treatment. Doctors report that many
young people, when they learn they are HIV-positive, take several months to
accept their diagnosis and return for treatment. Health care professionals may be
able to help these adolescents by explaining the information slowly and
carefully, eliciting questions from them, and emphasizing the success of newly
available treatments.
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