More Young Americans Are Contracting HIV

More Young Americans Are Contracting HIV
A tulip lays across names on the National AIDS memorial, a circle of engraved names of thousands of victims of AIDS, in Golden Gate Park on Worlds AIDS Day in San Francisco, California, December 1, 2007. (Kimberly White/Reuters)FRIDAY, Nov. 30 (HealthDay News) -- In the 26 years sincescientists first spotted AIDS in America, millions of dollars have beenpoured into outreach efforts aimed at keeping young people clear of HIV,the virus that causes the disease.
But on the eve of World AIDS Day, a disturbing statistical fact hasemerged in this country: The number of newly infected teens and youngadults is suddenly on the rise.
And the question is, why?
According to data from the U.S. Centers for Disease Control andPrevention for 2001 to 2005 (the latest years available), the number ofnew cases of HIV infection diagnosed among 15-to-19-year-olds in theUnited States rose from 1,010 in 2001, held steady for the next threeyears, then jumped 20 percent in 2005, to 1,213 cases.
For young people aged 20 to 24, cases of new infection have climbedsteadily, from 3,184 in 2001 to 3,876 in 2005.
Newer infection numbers set to be released soon by the CDC may be evenhigher, the Washington Post reported Saturday. According to thePost, sources close to scientists preparing the new statistics haveconfirmed that rates of new infection in the United States may be 50percent higher than previously believed -- a jump from 40,000 newinfections per year to up to 60,000. The increase is based on new bloodtesting methods, the Post said, and whether it signifies a growthin actual cases remains to be seen.
Experts say a number of factors may be at play, including the fact thatmany HIV-infected patients are now being kept healthy with powerfuldrugs -- making AIDS seem like less of a threat to young people than itdid in the past.
"Certainly the 'scare factor' isn't there anymore," said RowenaJohnston, vice president of research at the Foundation for AIDS Research(amfAR) in New York City.
In the 1980s and early 1990s, the ravages of AIDS were apparent to mostAmericans -- either on their TV screens as high-profile celebritiessuccumbed to the disease, or as individuals lost friends or family membersto HIV.
"To see people looking gaunt, skinny and skeletal, and to know thatthey were going to be dead soon," Johnston said. "It had a soberingeffect."
The advent of antiretroviral drugs in the mid-1990s changed all that,however. "These days, for the most part, you can look at a person and notknow that they even have AIDS," Johnston said.
That's making HIV seem like less of a threat to young people, saidMartha Chono-Helsley. She's executive director of REACH LA, a LosAngeles-based nonprofit that helps disadvantaged youth understand anddefend against threats like poverty, drug abuse and HIV.
"They're in this age group that feels they are invincible -- that it'snever going to happen to them," she said. "Yes, they're getting all thesemessages from public schools on HIV and AIDS, but they've never actuallyseen what HIV has done, up close and personal."
Chris Blades, one of REACH LA's young, black "peer educators," saidhe's seen a kind of nonchalance towards HIV among the gay or bisexual menof color that he counsels.
"On a daily basis, they don't see their friends suffering from it, soit's not a major threat to them," said Blades, 21. "They're in that wholemindset of 'Oh, it can't happen to me, it will never happen to me.'"
But there has been a recent, troubling spike in new infections amonggay men, young and old alike. According to the CDC, the rate of new casesof HIV infection linked to male-male sex held steady at around 16,000cases between 2001-2004, then suddenly jumped to 18,296 in 2005.
Johnston and Chono-Helsley both point to advertisements forHIV-suppressing medicines as one possible contributing factor.
"In gay magazines, you now see [ads with] buff, handsome men climbingmountains, with some kind of quote about how 'I'm not letting HIV get inmy way,'" Johnston said. "It sends the message that you, too, can be hot,buff and handsome, even with HIV."
Chono-Helsley agreed. "It's always these bright, healthy vibrant youngmen in these ads," she said. That could spur young gay men to relax theirguard and take more risks, thinking that if they do contract HIV, "I onlyhave to take a pill," she said.
The reality of living with HIV in America is much different, however,even when medication is working. According to Johnston, the side effectsof powerful HIV-suppressing drug cocktails include fat redistribution(including unsightly "humps"), insulin resistance, higher cholesterol,increased risks for heart disease, and dangerous liver toxicities.
There's also the fear that, someday, HIV will develop mutations thatrender these drugs useless, triggering the re-emergence of AIDS, shesaid.
HIV continues to cut a wide swath through young men and women in theblack community, too. According to the CDC, the number of new infectionsactually dipped slightly for black Americans between 2001 (20,868 cases)and 2005 (18,121 cases). However, black men are still six times morelikely than white men to contract HIV, and black women are 20 times morelikely to acquire the virus compared to white women.
The answers to that disparity lie mainly in economics, experts say.
"The young men that we work with are predominantly African-American,and HIV is not their No. 1 priority," said Chono-Helsley. "Oftensurvival is their main priority -- where they are going to sleep tonight.They're kicked out of the house; they have substance abuse issues, they'rein recovery."
Young black women can easily get caught up in similar problems, or arecoerced into unsafe sex by their partners, she added.
Another trend -- soaring rates of methamphetamine use over the pastfive years -- may also be fueling HIV infection rates for both blacks andyoung gay men, the experts noted.
Too often, marginalized young people develop "a 'whatever' attitude --whatever happens, happens," Chono-Helsey said.
Outreach aimed at HIV prevention remains important, of course. But oneexpert believes too much state and federal money is being funneled awayfrom community outreach programs and toward "HIV Stops With Me" campaignsthat focus on individuals already living with the virus.
"The message there is that, if I don't have HIV right now, then all Ihave got to do is avoid those people who have got it," said Carrie Davis,director of adult services at the Lesbian, Gay, Bisexual and TransgenderedCommunity Center in New York City.
She believes those types of messages allow uninfected people to shiftthe burden of responsibility from themselves to the HIV-positive, or topeople they deem at high risk, such as gay men or drug abusers.
"I think it affects straight people, too, in that they absorb this'magical thinking' -- that this is someone else's problem," Davissaid.
So what doeswork to change attitudes and behaviors? That's atough question, Chono-Helsley said, and the answer usually depends onparticular contexts and communities.
"You really have to evaluate what methods you're using and think aboutthe person as a whole, not just the infection," she said. "Because they'veall heard 'use a condom, use a condom.'"
The right approach is key, Blades added. "If you deliver the message tothem in a way that's not preachy or looking down on them, I think that'smore effective," he said. "That's what we try to do - deliver HIVinformation in a way that will click in with them, so that they'll takehome something that they didn't know the night before."
"One thing is for sure, we can't just shake our finger at young peopleand say, 'You're bad,'" Chono-Helsley said. "We have to be supportive.They're young, we've all been there, remember. You can save some, but youcan't save them all."
More information
There's more on HIV and AIDS at amfAR.