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Adolescents & HIV/AIDS
The number of acquired immunodeficiency syndrome (AIDS) cases reported each
year among U.S. adolescents (13-19 years Of age) has increased from one
case in 1981 to 417 cases in1994. Through June 1995, a total of 2,184 AIDS
cases among adolescents has been reported. Human immunodeficiency virus
(HIV)/AIDS is still the sixth Ieading cause of death among 15- to 24-year-olds
in the United States.
Although the number of adolescents with AIDS is relatively small, we know
many more young people are infected with HIV. Since1 in 5 reported AIDS
cases is diagnosed in the 20-29 year age group, and the incubation period
between HIV infection and AIDS diagnosis is many years, it is clear that
large numbers of people who were reported with AIDS in their 20s became
infected with HIV as teenagers. (Through June 1995, almost 18,000 persons
aged 20-24 and more than 69,000 persons aged 25-29 have been reported
with AIDS to the Centers for Disease Control and Prevention [CDC].)
Among adolescents reported with AIDS, older teens, males, and racial and
ethnic minorities are disproportionately affected. However, the proportion
of females among U.S. adolescent AIDS cases has almost tripled-- from
14 percent in 1987 to 43 percent of the reported cases in 1994.
Many American teenagers are engaging in behaviors that may put them at risk
of acquiring HIV infection, other sexually transmitted infections, or
infections associated with drug injection. CDC studies conducted every
2 years in high schools (grades 9-12) consistently indicate that by the
twelfth grade, approximately three-fourths of high school students have
had sexual intercourse; less than half report consistent use of latex condoms,
and about one-fifth have had more than four lifetime sex partners. Many
students report using alcohol or drugs when they have sex and, in the most
recent survey, one in 61 high school students reported having injected
an illegal drug.
Surveys conducted in 1992 show that reported condom use actually declines
with age, often because other forms of contraception, such as birth control
pills, are used more frequently in the older age groups, and/or many older
youth are married or in long-term monagomous relationships.
To reach youth with HIV prevention messages and services, CDC provides numerous
HIV prevention programs through three primary avenues:
-School settings
-Community-based, regional, and national organizations, including minority
organizations
-Programs for the general public
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School-Based Programs
Ninety-one percent of all persons between the ages of 5 and 19 in the United
States are enrolled in schooIs, providing an effective way to reach young
people. School-based health education programs in the United States have
had consistently positive effects in preventing students from engaging
in health-risk behaviors.
Since 1987, CDC has provided direct assistance to schools to develop, implement,
and evaluate HIV/AIDS education programs. In 1988, only 17 states required
such education. By 1992, the number of states requiring HIV education has
increased to 34. CDC also helps train teachers, school administrators,
and representatives from youth-serving community organizations from every
state on the best ways to conduct HIV prevention education programs. CDC's
combined Health Information Database, which is accessible to any educator
through the CDC National AIDS Clearinghouse, provides information on more
than 1,000 curriculum guides, audiovisuals, and other relevant information
for use in teaching young people about HIV infection and AIDS.
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Community-Based, Regional & National Prevention Programs
Not all Youth can be reached through the schools. To reach teenagers and
others not in school who may be at high risk for HIV infection, CDC funds
(directly or through state and local health departments) HIV prevention
activities by more than 500 community-based organizations. These efforts
include street outreach; clinic-based education; counseling, testing, and
referral programs; and programs that address the specific needs of runaway,
incarcerated, migrant, homeless, and other youth in high-risk situations.
Recent data indicate that street outreach activities are useful in providing
HIV prevention messages and interventions to populations at high risk of
infection, including youth. CDC also provides financial and technical assistance
to 21 national organizations for educational programs and materials directed
to youth in high-risk situations, particularly, inner-city and minority
youth.
All CDC-funded state, local, and territorial health departments have instituted
an HIV prevention community planning process. The community planning process
aims to address unique community needs and at the same time to improve
the cultural competence and scientific basis of prevention programs. Together,
representatives of affected populations, epidemiologists, behavioral scientists,
HIV/AIDS prevention service providers, health department staff, and others
analyze the course of the epidemic in their jurisdiction, determine their
priority, prevention needs,and identify HIV prevention interventions to
meet those needs. The health department then incorporates these priority
interventions into its prevention objectives for funding by CDC. In this
manner, HIV prevention planning is shifted from a federally mandated to
a locally directed program.
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Public Information/Education Programs
CDC also targets prevention efforts for young people through its public
information education campaigns. These programs include a number of activities
designed to educate all members of the public, including adolescents, about
how HIV is transmitted, who is at risk for acquiring the infection, and
how the infection can be prevented. The programs include a national public
information campaign, the CDC National AIDS Hotline, and the AIDS Clearinghouse.
Research has shown that most Americans, including teenagers, understand
how HIV is transmitted and how they can be avoid being infected. Therefore,
confronting the belief that "it can't happen to me" was a primary
goal in one series of CDC-sponsored public service announcements. Previous
phases of the Public Information campaign have included many youth-oriented
materials. In 1989, CDC launched a special education effort called "Parents
and Youth" designed to help parents, teachers, and other concerned
adults talk to children about HIV and AIDS. The educational materials from
that campaign, including a brochure called "The AIDS Prevention Guide,"
are still available to anyone who requests them from the CDC National AIDS
Hotline.
Another activity targeting youth is CDC's Prevention Marketing Initiative
(PMI), a large-scale social marketing program to influence behaviors that
contribute to the sexual transmission of HIV and other diseases. It represents
a shift from previous mass health communications programs, aimed at increasing
general awareness of HIV/AIDS, to influence behavioral changes among people
at high risk for HIV infection or transmission. PMI is an application of
marketing techniques and consumer-oriented communication technologies based
on science and directed , in its first phase, to the prevention of sexual
transmission of HIV and other STDs among young adults 18-23 years of age.
To achieve the PMI behavioral objectives, CDC will work simultaneously at
the national, state, and local levels through four components: (1) National
Communications, (2) Prevention Collaborative Partners, (3) Local Demonstration
Sites, and (4) Application in HIV Prevention Community Planning.
For more information:
CDC National AIDS Hotline: 1-800-342-AIDS (2437)
Spanish: 1-800-344-SIDA (7432)
Deaf: 1-800-243-7889
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