Young People Make Up More Than a Quarter of New HIV Cases in the U.S.

Of the 50,000 new HIV infections in the U.S. each year, more than one in four affect young people ages 13 to 24, more than half of whom don’t know they’re infected. Hari Sreenivasan talks to Science magazine’s Jon Cohen about this continuing epidemic and the cultural hurdles that make talking about sex and protection difficult.

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    Finally tonight: A new government report finds disturbing rates of HIV infections among young Americans.

    Hari Sreenivasan is back with that story.


    Researchers from the Centers for Disease Control and Prevention said they are worried about the latest findings.

    Out of 50,000 new infections in the U.S. each year, more than one out of every four strike young people between the ages of 13 and 24. Moreover, some 60 percent of younger Americans do not know they are infected.

    And 72 percent of new cases in that population were found among young men who have sex with men. The data was released in advance of World AIDS Day this weekend.

    For more on the implications of these findings, we turn to Jon Cohen, an author and writer for "Science" magazine who has long covered the AIDS beat.

    Thanks for being with us.

  • JON COHEN, “Science”:

    Thanks for having me.


    So, you know, just a few weeks ago, we heard from UNAIDS that the rates of infections were actually decreasing, the rates of treatment were up.

    But yet we see this particular population hit so hard. Why is that?


    Well, young people don't have as much experience. And they need more education. And they also traditionally take more risks.


    And then there's a specific focus to younger male African-Americans in specific that are having more unprotected sex perhaps. What is it about this particular community that makes this such a bigger problem?


    We have seen a huge shift in the United States, where the epidemic began in gay men who — upper-middle-class, largely living in the cities or middle-class. And it shifted to the South in poor African-American men, many who have sex with men and don't even identity with gay communities.

    They're often disenfranchised from health care. They don't have access. And their education, their schools might not offer any information or little information about HIV.

    And there's very little encouragement in the community to get tested as well. The role of the church plays a factor.

    And if you're having sex with a community of people who already have a lot of virus, your odds of getting infected are much, much higher.


    So, what about that testing element of it? The AmericanCollege of Pediatrics, the CDC, they have been trying for years to try to increase awareness and increase testing. Why isn't it getting through in these specific communities?


    It comes down to the reactions of local communities, of parents, of schools and there's — people are queasy about kids and sex. And that's the way it is in much of the world. And it is certainly more pronounced in some rural areas.

    I traveled through the South extensively doing an HIV project last spring. And in Mississippi, which has one of the highest HIV new infection rates in the country, there wasn't a single clinic designed for lesbian, gay, bisexual, transgenders, and that's going to reflect with the youth as well.


    So, what can the CDC or anyone do about this when it comes to those sort of larger cultural problems you're talking about tackling?


    Well, the CDC is using World AIDS Day to sound the alarm bells. And they hope there's a trickle-down effect and the communities take it more seriously and that parents sit down and talk with their kids.

    It's going to come down to what communities do. I mean, there are public schools that offer HIV testing even. That's not going to fly in a lot of places.

    But it's going to take a much more aggressive approach in the areas that are hardest hit and more honesty and becoming more up front about the stigma and discrimination that exists, in particular for young gay, bisexual, transgender men.

    Many of them, they wouldn't ever move toward a community of people who said they were part of that community. So you have to understand who the kids are who are taking the risks and are becoming infected at higher rates.


    Is there a level or a factor of invincibility, where the young don't feel like they are threatened by all of the things? I mean, as you sort of slide up that ladder and go out of the teenager and into the 18-to-25-year-olds, you see pretty low rates as well.


    Well, if you look at the risk factors, it's all pretty obvious. It's alcohol.

    So, we all know that, when kids start drinking, they don't control their alcohol use. And when you don't control your alcohol use, you're going to take risks you otherwise wouldn't take.

    It's not using condoms. It's access to condoms. How do you get a condom when you're a 15-year-old gay man living in the South? What do you do? You walk into a pharmacy and actually go up to the pharmacist?

    And, you know, all that stuff is incredibly stigmatized and frightening. So, I think what communities have to do is really address the problem through the lens of, are we doing everything possible to help these kids protect themselves?


    One of the things that people don't necessarily look at very often — it seems very cold and calculated — is the sort of numerical cost. Obviously, the worst cost is someone's life.

    But one of the things that was interesting to me in this report that said that these folks that are infected so young could cost the system $400,000, a cost that all of us are bearing in some ways.



    And one of the things that the report is trying to emphasize and that I think is critical is, if you don't know you're infected, you're not going to start on treatment. The treatment works. And the treatment might be expensive.

    But we know that people who are on treatment and take it every day reduce their own infectiousness. So if we're really going to start curbing the epidemics in communities, using treatment as a prevention tool is critical. And you have to know your status.


    All right, Jon Cohen from "Science" magazine.

    Later this week, Jon, you're going to be ordering — offering a broader status report on the global AIDS fight. That will be on our website.

    Thanks so much.


    Thank you.