More than 30 years after the beginning of the AIDS epidemic, young people are again taking dangerous risks with their lives, according to a new report from the Centers for the Disease Control and Prevention.
About 1,000 Americans ages 13 to 24 are newly infected each month with HIV, the virus that causes AIDS, according to CDC data released for the first time. About 60% of HIV-positive young people have no idea that they're infected, according to the report released Tuesday. That rate is far higher than in the general population, in which 20% of HIV-positive patients are unaware of their status.
Young people ages 13 to 24 account for more than a quarter of the 50,000 new HIV infections each year, the CDC says. About 1.2 million Americans have HIV or AIDS.
"This is our future generation," says CDC director Thomas Frieden. "That so many young people become infected with HIV each year is a preventable tragedy."
And while new HIV infections have leveled off among most groups, they are rising among young people, says Kevin Fenton, who leads the CDC's office on AIDS. Most of that increase is being driven by new HIV infections in young black men who have sex with men, he says.
There really are two AIDS epidemics in the USA, says Kenneth Mayer, medical research director of Boston's Fenway Health, a community health organization that provides AIDS services. The first wave of HIV patients is now older and mostly in treatment. A second wave of patients includes newly infected young people who weren't even born when AIDS was first discovered and who often act as if they are unaware of the tremendous risks they're taking.
According to the new CDC report, based on interviews with high school students, young men who have sex with men are less likely than others to use condoms. Yet they're more likely than others to have had four or more sex partners, to have injected drugs, or to get high before having sex. They're less likely, however, to report being taught about AIDS or HIV in school, according to the CDC.
"The AIDS epidemic seems very remote to young people," Mayer says. "There is no equivalent of a young Magic Johnson. If you are young, this seems like a disease of old people."
The lifetime cost of treating someone with HIV is about $400,000. That means these new infections add $4 million in new health care costs each month, Frieden says.
The finding adds to evidence that doctors need to routinely screen all patients for HIV, Frieden says. Last week, the U.S. Preventive Services Task Force endorsed routine HIV testing for everyone ages 15 to 65. The CDC and American Academy of Pediatrics also call for routine screening, beginning in the teen years.
Yet only 13% of high school students have been tested for HIV, the report says. "It is astonishing the level of ignorance of basic physiology that many high school and middle school students have," Frieden says. "There is not going to be an easy, quick, simple solution."
Getting tested is the first step to treatment, which can dramatically improve patients' health and also prevent them from spreading the infection, Mayer says. People who know they're HIV-positive are less likely to engage in risky behaviors, such as sharing needles or having unprotected sex, studies show.
And people whose virus is under control, reduced to undetectable levels, are virtually incapable of spreading the infection to others. Only 30% of those with HIV have their virus under control, however, due partly to a lack of access to health care.
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