The topic of sexuality is challenging to discuss in our society and culture, so tackling the subject of sexually transmitted infections (STI’s) is even harder, yet teens and young adults are more likely to get an STI than older adults. One infection that has changed our society forever is human immunodeficiency virus or HIV. It’s the virus that leads to acquired immune deficiency syndrome (AIDS). In the early days of new infection (the 1980’s), the virus was nearly synonymous with a death sentence, an incurable infection that we, in medicine, did not know much about. A recent CDC report shows that of the 50,000 people infected with HIV each year, 1 in 4 is a teen or young adult. In light of those numbers, it’s critical that teens have the facts about HIV and how to prevent it.

I remember watching the movie Philadelphia, with Tom Hanks and being deeply saddened. This was one of my first exposures to how HIV/AIDS could destroy a person’s quality of life and take an emotional toll on loved ones. It portrays a young, successful lawyer in the 1980’s who gets HIV from a partner and chronicles his struggles to find acceptance amongst peers and fight for his rights.

Now, people with HIV can live long, fulfilled lives if they have access to routine health care and medications. Though we don’t yet have a cure, treatment of infections associated with HIV and AIDS (such as certain cancers and pneumonia associated with a poor immune system) have also advanced.

HIV is a virus, but unlike the viruses that cause colds or the flu, it is really picky! It isn’t spread by kissing someone or hugging an infected person. You won’t get HIV if you share food or hold someone’s hand. In fact, the risk of spread is lower for HIV than for hepatitis C if a healthcare worker is poked by an infected needle (we’ll cover hepatitis later). It is spread through blood products (like getting a transfusion from an infected person, though now blood is screened and this route is very very unlikely) and bodily fluids that are shared during sex. AIDS is a syndrome or group of symptoms that occurs because of the HIV virus. It includes a weakened immune syndrome and high amount of virus in a person’s body.

Unfortunately, HIV continues to have the fastest spread amongst young gay males, though anyone who is sexually active is at risk of the infection.  The CDC recently released an update on the spread of HIV. There are approximately 50,000 new infections in the US each year and 1 in 4 is among young people age 13-24.  87% of males got the infection from having sex with an infected male, but having heterosexual contact and using IV drugs are also risk factors. African Americans make up 60% of the youth with new infections. Females are most likely to get HIV from heterosexual contact, but IV drug use is also a risk factor.

Fortunately HIV is preventable. Not having sex at all is the only way to 100% guarantee a person won’t get it thru sex, but safer sex practices, such as using a condom with every sexual encounter (including oral sex, anal sex, and vaginal sex) and not using drugs or alcohol decrease the risk of HIV. For pregnant females, taking medications to prevent the spread from mother to baby and not breastfeeding if the mother is infected, dramatically decreases the risk of spread to the unborn baby.

HIV/AIDS continues to be an infection with a lot of stigma. People have unreasonable fears about getting the infection (no you can’t get it by sharing a toilet seat or going swimming with someone) and many people with the illness may be afraid to talk about it with friends and family. Hopefully, as medicine gains new insights into a cure, our society will continue to look for ways to decrease the stigma and rally around those who are living with the infection.

Talk with your teens about safer sex practices, safety, and your beliefs and expectations regarding sexual activity. Prevention continues to be our strongest tool for fighting HIV and AIDS.

Here are some tips for talking with your teen about HIV prevention:

1. Start the conversation. Talk with your teen about your expectations of their behavior, including family values.

2. Emphasize the importance of condom use if they decide to become sexually active. The only way to 100% guarantee they don’t get an STI or become pregnant is to not have sex, but if they decide to, they should always use a condom and appropriate birth control

3. Talk about substance use. IV drug use is a way HIV is spread, but using drugs and alcohol can decrease inhibitions making it more likely a teen could have sex without being safe (i.e. using a condom)

4. Describe and model healthy romantic relationships. Teens should feel comfortable asking a partner to use a condom. If they aren’t comfortable talking with a partner about safe sex, I’d argue they aren’t ready to start having sex.

5. If you aren’t comfortable, ask your teen’s health care provider to talk with them about safe sex.