60 percent of youth with HIV don't know they are infected, CDC says

About 60 percent of young people with HIV don’t know they are infected, leading to higher rates of new infections, the Centers for Disease Control and Prevention said today.


In its Vital Signs report, the CDC said youth ages 13-24 accounted for less than seven percent of all HIV cases in the U.S. in 2009 but made up more than a quarter - 25.7 percent - of new HIV infections in 2010. With 12,200 new infections in that age group, that means “every month 1,000 youth are becoming infected with HIV,” said CDC Director Thomas Frieden. With an estimated lifetime cost of $400,000 to treat each infection, “that means that every month we are accruing about $400 million of health care costs and every year $5 billion from preventable infections in youth,” Frieden said. “Given everything we know about HIV and how to prevent it after more than 30 years of fighting the disease it is just unacceptable that young people are becoming infected at such high rates.”

The rates were highest among males who have sex with males, who accounted for more than 72 percent of cases, and were disproportionately higher among blacks, who accounted for more than 57 percent of new infections. The percentage of those youth who did not know they were infected is significantly higher than the overall population of those who are HIV-positive and don’t know, which is estimated at less than 20 percent, Frieden said.

Part of the reason could be a lack of testing. Only about 13 percent of high school students had been tested for HIV and little more than a third of all youth ages 18-24 had received the test, CDC said. The CDC recommends the test be part of routine medical screening for those ages 13-64.

For many there are societal issues that keep them from testing and care, said Dr. Kevin Fenton, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention at CDC.

“Stigma, discrimination and homophobia also serve as significant barriers to prevention and many lack access to health care so they don’t receive the preventive services they need,” he said.

As a community outreach specialist with the Ryan White Program at Georgia Health Sciences University, David Thompson stakes out music stores, ice cream shops and other places young people flock to so he can offer free rapid HIV testing.

“That’s always been one of the harder groups for us to reach,” he said.

The CDC report found much higher rates of risky behaviors, such as four or more partners lifetime and lower rates of condom use, among those engaging in male-to-male sex as opposed to heterosexual peers. Part of that could just be lack of awareness and lack of education that speaks to them, Thompson said.

“They don’t really get a message that is tailored to them,” he said.

Part of the problem with the youth might be that they were not exposed to the heightened awareness of the AIDS epidemic of the ‘80s and early ‘90s, said Justin Neisler, 24, a second-year student at Medical College of Georgia at GHSU, who is helping to organize World AIDS Day events this week.

“You have a generation that did not experience that so they no longer realize it is an issue,” he said.
Even among his medical school classmates, Neisler said he has been surprised by the mindset of some.

“It is unbelievable how some of them have attitudes that they never need to get tested, that they should never test their patients unless their patients tell them they are gay,” he said.

That will have to change if more people are going to get tested, and treated, Neisler said.

“Even among my generation, the younger generation, even among medical professionals, I think that has to be something that is addressed because if you don’t make people feel like they will be welcomed and supported if they are positive, then you are not going to get people who will want to be tested,” he said.

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