Young People and HIV: A Generation at Risk
amfAR Congressional Briefing Illuminates Need for Youth-Focused Prevention and Research
September 29, 2010— Born after the first HIV/AIDS cases made headlines, teenagers and young adults in the U.S. have never known a world without AIDS. But they also live during a time when many people consider HIV a treatable disease, and relatively few of them have witnessed the complications of the virus or its treatments. Widespread complacency about the epidemic and a dearth of comprehensive sex education have contributed to a growing number of young people living with HIV in the U.S., many of whom have no idea they are infected.
The complex biological and psychosocial factors driving the spread of HIV among young people require a multifaceted approach to prevention and treatment, according to public health experts, researchers, clinicians, and activists who gathered in Washington, D.C., on September 21 for an amfAR-sponsored Congressional briefing on HIV and youth. Heartfelt testimony from two young people infected with HIV in their late teens provided a glimpse into some of these driving forces.
Marvelyn Brown hadn’t heard much about HIV before she was diagnosed at the age of 19. She learned quickly, however, that the impact of the virus extended beyond the difficulties of taking numerous hard-to-swallow pills every day. Her best friend refused to see her after hearing her diagnosis, and her family refused to share dishes and utensils with her.
(L to R) Panelists Donna Futterman, M.D., Cree Gordon, Marvelyn Brown, and Ligia Peralta, M.D,
For Cree Gordon, lack of knowledge about HIV wasn’t the problem. As a young MSM who was open about his sexuality at an early age, he knew the facts about transmission. But during a period when he was often homeless and doing sex work as a means of survival, he felt unable to negotiate condom use. “My basic needs were more important,” he explained. Like Brown, he now speaks publicly about his status in order to raise awareness of the epidemic among young people.
In 2006, more new HIV infections occurred among adolescents and adults aged 13–29 than any other age group. Young MSM, particularly those of color, have the highest risk of HIV among youth, representing 54 percent of all cases from 2004–2007 among people aged 13–24. African Americans are also disproportionately affected, representing 17 percent of the teenage population in the U.S., but 72 percent of HIV/AIDS cases in this age group. Females—who are biologically more susceptible to HIV during heterosexual contact, particularly when their reproductive systems are still developing—made up 31 percent of HIV cases among teenagers in 2007, and 23 percent of cases among people aged 20–24.
Reaching young people with prevention messages will require fresh and innovative approaches, said Donna Futterman, M.D., a physician and researcher who works with young MSM of color in New York City. “We need to remember that every five years it’s a new generation of young people,” she said. “The message you think you gave in high school is meaningless because in three years it’s a completely different group of kids. So we need to continue the same energy and passion in reaching each generation of young people.”
Kevin Fenton, M.D., Ph.D., of the CDC reviewed the scope of the epidemic among young people in the U.S.
Moderated by amfAR’s senior medical and policy advisor, Susan Blumenthal, M.D., M.P.A., former U.S. assistant surgeon general, the panelists included Jeffrey Crowley, M.P.H, director of the White House Office of National AIDS Policy, who discussed how the new national HIV/AIDS strategy will address HIV among youth; and Kevin Fenton, M.D., Ph.D., director of the Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention, who offered an overview of the scope and impact of HIV/AIDS among young people. The briefing also featured presentations by prominent AIDS experts who emphasized the need for increased investment in youth-focused AIDS research, reviewed the challenges of reaching vulnerable groups, and discussed the biological and psychosocial issues that fuel the epidemic among young people.
“Every hour, two young people become infected,” said Dr. Blumenthal. “That’s why we’re here today, to mobilize all sectors of society to make the investments that are needed in research and to involve our communities in addressing the issues surrounding youth and HIV/AIDS. Our goal: an HIV free generation in the future.”
Coinciding with the briefing, amfAR released a new issue brief, Youth and HIV/AIDS in the United States: Challenges and Opportunities for Prevention.