HIV/AIDS: The Next Generation

Abstract

Like many others, I was swept up in the excitement about the progress we have made in the fight against HIV/AIDS on display at the recent International AIDS Conference in Washington, DC. However, our progress hasn't been universal. In fact, there are a number of areas in which we may be regressing. One is the course of the epidemic among America's youth. Young people between the ages of 13 and 29 have the steepest rise in new HIV infections, compared to stable incidence in other age groups, and account for 39% of all new infections while comprising only 21% of the U.S. population. ([ 1 ][1], [ 2 ][2]). The CDC estimates that overall, 20% of HIV-positive Americans don't know they are infected, but when youth are isolated from the equation, a staggering 60% have no idea they carry the HIV virus ([ 3 ][3]). Who are these youth? As with much of the domestic epidemic in the last decade, new infections occur disproportionately among youth of color, who represent 80% ([ 2 ][2]) of new infections. The disease has also hit hardest among young gay and bisexual men ([ 2 ][2]), which paradoxically results in putting many young women at risk for infection. In my clinic in the Bronx, New York, 50% of the clients who identify as young men who have sex with men report also having sex with women ([ 4 ][4]). By some definitions, there is a new generation every 5 years. Considering that the youth sitting in high school today will be out in the world in as little as 3 years, it's clear that those of us who are called to educate and care for youth must remain vigilant. We must invest in a continually updated and vigorous prevention, testing, and treatment program that evolves to engage each generation of youth. We must be guided by science and not politics. If we maintain the status quo, we risk losing the next generation of youth to apathy and losing our gains through a false hope in the scope of our progress. 1. [↵][5] CDC, “Diagnoses of HIV infection and AIDS in the U.S., 2009” (HIV Surveillance report, 2011), vol. 21. 2. [↵][6] CDC, “HIV among youth fact sheet” (December 2011). 3. [↵][7] CDC, MMWR HIV Surveillance 1981–2008 60, 689 (2011). [OpenUrl][8] 4. [↵][9] 1. A. Fernandez 2. et al ., “YMSM of Color: Perspectives from NYC,” International AIDS Conference, July 2012, Washington, DC. [1]: #ref-1 [2]: #ref-2 [3]: #ref-3 [4]: #ref-4 [5]: #xref-ref-1-1 View reference 1 in text [6]: #xref-ref-2-1 View reference 2 in text [7]: #xref-ref-3-1 View reference 3 in text [8]: {openurl}?query=rft.jtitle%253DMMWR%2BHIV%2BSurveillance%2B1981%253F2008%26rft.volume%253D60%26rft.spage%253D689%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [9]: #xref-ref-4-1 View reference 4 in text