I don’t remember when I first heard about HIV, it was just sort of always present in my world view. When I was very young, I remember overhearing a woman explain that she had left off training to be a lab technician because she was “scared of catching AIDS.” I remember Ryan White. I remember on the show “Life Goes On“, Chad Lowe’s character wouldn’t kiss Kellie Martin’s character, because he was HIV-positive and worried she would catch it. I remember dark murmurings about people catching HIV from becoming blood brothers. I remember the AIDS quilt getting started. I remember meeting my first HIV-positive person and being surprised at how healthy he looked. I remember virgins going to get tested for HIV before becoming sexually active, just in case. I remember Pedro. (If you haven’t, check out the book this blog title comes from.)
Of course, now we know a lot more about HIV- including how it’s transmitted, and if not how to cure it, at least how to- in many cases- keep AIDS at bay for decades. There is no longer the sense of looming danger we grew up with, tied in with the fascination of sex and the message that only condoms can prevent HIV. HIV has gone from being a death sentence to a chronic disease, and the life expectancy of an HIV-positive person in the U.S. has drastically increased.
Obviously, this is good news. We’re no longer in the fight against HIV and AIDS without weapons. People diagnosed with HIV are no longer faced with certain, imminent death. However, HIV is not perceived as the threat it once was. My generation heard about HIV with a gasp of terror; teens nowadays may respond with a shrug.
There is increasing concern about the rates of HIV transmission in adolescents and young adults. In 2011, 26% of people with new HIV diagnoses were aged 13-24. A recent WHO report found that, from 2005-2012, adolescents had a 50% increase in AIDS-related deaths.
Of course, the WHO is looking at a global picture, and we certainly have lower HIV infection rates than other, often developing nations (in Swaziland, for example, over 25% of the entire population aged 15-49 is HIV-positive.) But we’re not as divorced from high HIV rates as we think. In D.C., 3% of the population is HIV-positive. This rate passes the benchmark of over 1% of the population affected, qualifying it as an epidemic.
Statistically, African-American adolescents and adults are carrying the burden of HIV in the U.S., as are adolescent and young adult men who have sex with men (the term men who have sex with men, or MSM, is used because some young men who do not identify as homosexual do have sexual contact with men.)
The reasons HIV rates are higher in African-Americans are complicated, although increased disease rates in minority populations is a constant trend in our country. A main reason that HIV rates are higher in MSM is because anal sex is a riskier act in terms of disease transmission, than oral or vaginal sex.The New Yorker just ran a particularly moving piece, written by an older gay man who lived through the AIDS epidemic in the 1980s, about why unprotected anal sex is on the rise in MSM. (Please note: teens and young adults having heterosexual intercourse have anal sex, too.)
Here is what you and your teen/ young adult need to know:
- Anyone can have HIV, and nearly a fifth of people with HIV don’t know they have it (that number is likely higher, and has been cited at 60%, in adolescents and young adults.)
- HIV is not a “gay disease”. While HIV rates are highest in MSM, men having sexual encounters exclusively with women can and do contract HIV. For young women in the U.S., the number one way of contracting HIV is heterosexual intercourse.
- HIV may no longer mean certain death, but it can still be an awful disease to have. HIV medications are costly, with side effects that can affect quality of life. Medications regimens can be complex and difficult to keep up with- and to complicate things, HIV strains that are resistant to certain HIV medications are cropping up. Medication adherence- traditionally difficult for teens and young adults- is key to prevent opportunistic infections and the development of AIDS.
- Sexually active teens need to use a condom, every time. (This not only prevents HIV, but a bunch of other nasty STIs.) Adolescents and young adults are not great at using condoms, but talks with parents and families are effective at increasing rates of condom use. If you haven’t talked with your teen about safer sex, do it now.
- Make sure your teen has an accurate knowledge of how HIV is transmitted, and how it’s not.
- Don’t be surprised if your adolescent or young adult is offered an HIV test at a primary care visit- this is the standard of care.
- Help your teen understand what HIV and AIDS were like in the 80s & 90s, and what HIV and AIDS are doing to developing nations, and our nation, today.
Does anyone have any thoughts on the current state of HIV/ AIDS, in the U.S., or abroad? How did you talk with your teen/ young adult about this? What do you think is the best way to get teens and young adults to listen to these important messages?