HIV Infection in Adolescents, NIAID Fact Sheet: NIAID
Article title: HIV Infection in Adolescents, NIAID Fact Sheet: NIAID
Conditions: HIV
Source: NIAID
October 2001
HIV Infection in Adolescents
Overview
Through December 2000, 4,061 cases of AIDS in
people ages 13 through 19 had been reported to the U.S. Centers for
Diseases Control and Prevention (CDC). Many other adolescents are
currently infected with HIV but have not yet developed AIDS. Data
from the 36 states that conduct HIV case surveillance indicate that
among adolescents ages 13 through 19,
- 58 percent were male
- 42 percent were female
- 28 percent were White, not Hispanic
- 50 percent were Black, not Hispanic
- 20 percent were Hispanic
- Asian/Pacific Islander or American Indian/Alaskan Native, less
than 1 percent
Because the average period of time from HIV
infection to the development of AIDS is 10 years, most young adults
with AIDS were likely infected with HIV as adolescents. Almost 18
percent of all reported cases of AIDS in the United States have
occurred in people between the ages of 20 and 29. HIV infection is
the ninth leading cause of death in adults ages 25-44.
Transmission
Most adolescents recently infected with HIV are
exposed to the virus through sexual intercourse, injection drug use,
or less often, oral sex. Through June 2000, HIV surveillance data
suggest that nearly half of all HIV-infected adolescent males are
infected through sex with men. A small percentage of males appear to
be exposed by injection drug use and/or heterosexual contact. The
same data suggest that almost half of all adolescent females who are
infected with HIV were exposed through heterosexual contact and a
very small percentage through injection drug use.
CDC
studies conducted every two years in high schools (grades nine
through 12) consistently indicate that approximately 60 percent of
the students have had sexual intercourse by grade 12; half report
use of a latex condom during last sexual intercourse, and about
one-fifth have had more than four sex partners.
Approximately
two-thirds of the 12 million cases of sexually transmitted diseases
(STDs) reported in the United States each year are among individuals
under the age of 25 and one-quarter are among teenagers. This is
particularly significant because if either partner is infected with
another STD, the risk of HIV transmission increases substantially.
If one of the partners is infected with an STD that causes the
discharge of pus and mucus, such as gonorrhea or chlamydia, the risk
of HIV transmission is three to five times greater. If one of the
partners is infected with an STD that causes ulcers, such as
syphilis or genital herpes, the risk of HIV transmission is nine
times greater.
Treatment
Adolescents tend to think they are invincible, and
therefore, to deny any risk. This belief may cause them to engage in
risky behavior, to delay HIV testing, and if they test positive, to
delay or refuse treatment. Doctors report that many young people,
when they learn they are HIV-positive, take several months to accept
their diagnosis and return for treatment. Health care professionals
may be able to help these adolescents by explaining the information
slowly and carefully, eliciting questions from them, and emphasizing
the success of newly available treatments.
The U.S.
Department of Health and Human Services (DHHS) has developed two
documents that address the standard of care for the treatment of
HIV, including information about how to treat HIV in adolescents.
The documents,
Guidelines for the Use of Antiretroviral Agents
in HIV-Infected Adults and Adolescents and
Guidelines for
the Use of Antiretroviral Agents in Pediatric HIV Infection are
available from the National Prevention Information Network and the
HIV/AIDS Treatment Information Service (telephone numbers are listed
in the resources section). These documents also can be downloaded
from the Internet at
http://www.hivatis.org/.
According
to the
Guidelines for the Use of Antiretroviral Agents in
HIV-Infected Adults and Adolescents, adolescents who were
exposed to HIV sexually or via injection drug use appear to follow a
clinical course that is more similar to HIV disease in adults than
in children. At this time, most adolescents with sexually acquired
HIV are in a relatively early stage of infection and are ideal
candidates for early intervention. Adolescents who were infected at
birth or via blood products as young children follow a unique
clinical course that may differ from other adolescents and long-term
surviving adults. Health care workers should refer to the treatment
guidelines for detailed information about the treatment of
HIV-infected adolescents.
Clinical Trials
The National Institute of Allergy and
Infectious Diseases (NIAID) supports clinical trials at many clinics
and medical centers throughout the United States. These studies help
evaluate promising therapies to fight HIV infections, prevent and
treat the opportunistic infections and cancers associated with AIDS,
and reconstitute HIV-damaged immune systems.
Recruiting
adolescents into clinical trials is important to ensure that
research results will be applicable to therapy for that age group.
Most clinical trials are open to adolescents, but in reality very
few enroll. Of the 53,000 participants in studies conducted in the
NIAID-supported AIDS Clinical Trials Groups, for children and adults
affected with HIV, 812 (1.5 percent) were adolescents. To encourage
participation by more adolescents, NIAID has identified the
development of a robust adolescent health agenda for HIV-infected
youth as an area of emphasis during the ongoing recompetition of the
Pediatric AIDS Clinical Trials Group (also funded by the National
Institute of Child Health and Human Development
[NICHD]).
Another resource for adolescent research is the
Adolescent Medicine Trials Network (ATN), which was recently
established by NICHD. The ATN will work in close collaboration with
many of NIAID's clinical research networks in an effort to increase
adolescent participation in HIV/AIDS research. For more information
about ATN contact:
Audrey Rogers, Ph.D.
National Institute of Child Health
and Human Development
(301) 496-7339
Other Resources
For information about U.S. Food and Drug
Administration-approved HIV-related clinical trials being conducted
throughout the United States, call the AIDS Clinical Trials
Information Service:
1-800-TRIALS-A
(1-800-874-2572)
1-888-480-3739
(TDD/Deaf Access)
http://www.actis.org/For
federally approved treatment guidelines on HIV/AIDS, call the
HIV/AIDS Treatment Information Service:
1-800-HIV-0440
(1-800-448-0440)
1-888-480-3739
(TDD/Deaf Access)
http://www.hivatis.org/Both
services operate from 9 a.m. to 5 p.m. Eastern Time, Monday through
Friday. Spanish-speaking specialists are available.
To obtain
information specifically about clinical trials conducted by the
National Institutes of Health, call 1-800-243-7644 (
http://clinicaltrials.gov/).
For
materials contact the CDC National Prevention Information
Network.
NIAID, a component of the National Institutes of Health,
supports research on AIDS, tuberculosis and other infectious
diseases as well as allergies and immunology.
Prepared by:
Office of Communications and Public Liaison
National
Institute of Allergy and Infectious Diseases
National Institutes
of Health
Bethesda, MD 20892
Public Health
Service
U.S. Department of Health and Human Services
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HIV Infection in Minority Populations, NIAID Fact Sheet: NIAID
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