Abstract
In 2014, persons aged 13-29 years represented 23% of the U.S. population, yet accounted for 40% of diagnoses of human immunodeficiency virus (HIV) infection during the same year (1). During 2010-2014, the rates of diagnosis of HIV infection decreased among persons aged 15-19 years, were stable among persons aged 20-24 years, and increased among persons aged 25-29 years (1). However, these 5-year age groups encompass multiple developmental stages and potentially mask trends associated with the rapid psychosocial changes during adolescence through young adulthood. To better understand HIV infection among adolescents aged 13-17 years and young adults aged 18-29 years in the United States and identify ideal ages to target primary HIV prevention efforts, CDC analyzed data from the National HIV Surveillance System (NHSS)* using narrow age groups. During 2010-2014, rates of diagnosis of HIV infection per 100,000 population varied substantially among persons aged 13-15 years (0.7), 16-17 years (4.5), 18-19 years (16.5), and 20-21 years (28.6), and were higher, but less variable, among persons aged 22-23 years (34.0), 24-25 years (33.8), 26-27 years (31.3), and 28-29 years (28.7). In light of the remarkable increase in rates between ages 16-17, 18-19, and 20-21 years, and a recent study revealing that infection precedes diagnosis for young persons by an average of 2.7 years (2), these findings demonstrate the importance of targeting primary prevention efforts to persons aged <18 years and continuing through the period of elevated risk in their mid-twenties.
Highlights
To help address the impact of human immunodeficiency virus (HIV) infection among adolescents and young adults, especially sexual and racial/ethnic minority populations, two national goals focus on persons aged 13–24 years as a priority population at risk to monitor the percentage of young gay and bisexual men who have engaged in HIV acquisition risk behaviors and the percentage of adolescents and young adults with diagnosed HIV infection who are virally suppressed (
Among persons aged 13–24 years with infection diagnosed in 2014, 68% were linked to HIV medical care within 1 month of diagnosis, and among those living with diagnosed HIV infection at the end of 2013, 55% were retained in care, and 44% were virally suppressed [8]
HIV diagnoses analyzed by age groups revealed striking differences in rates of diagnosis of HIV infection between ages 13–21 years
Summary
§§ Includes persons with diagnosed infection attributed to hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified. Morbidity and Mortality Weekly Report had infections attributable to male-to-male sexual contact, and among these, males aged 22–23 years accounted for the highest number of diagnoses (12,275 [20.6%]). Among 11,866 females with diagnosed HIV infection, 10,462 (88.2%) had infections attributable to heterosexual contact, and among these, females aged 26–27 and 28–29 years accounted for the highest numbers of diagnoses (1,891 [18.1%] and 1,904 [18.2%], respectively). The South accounted for the highest number and rate of HIV diagnoses among persons aged 13–29 years (40,667 [51.9%]; 148.2 per 100,000 population). Rates remained stable among persons aged 13–15, 22–23, and 28–29 years
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