On this page, we provide a brief overview of HIV/AIDS with a focus on youth. For more detail, view Dr. Taylor Starr's 2017 presentation HIV Basics for Health Educators. Find clips from that presentation on the topics of PrEP, PEP, and informed consent below.
HIV Basics for Health Educators
What is HIV/AIDS?
Human Immunodeficiency Virus (HIV) is a virus that attacks and destroys cells that fight infection (CD4 cells). The virus rapidly copies itself, increasing the body's viral load and decreasing CD4 "helper" cells. If HIV treatment is not begun in time and maintained adequately, the immune system becomes so compromised that the body is not able to defend against other infectious diseases and cancers. These "opportunistic infections" signal Acquired Immunodeficiency Syndrome (AIDS), the late stage of HIV infection, which leads to death. High concentrations of HIV are found in blood, semen, vaginal secretions, breast milk, and amniotic fluid, among other internal body fluids. A person can contract HIV in a number of ways:- Anal, vaginal, or oral sex with an infected partner (see Sexual Behaviors and Health in Adolescence)
- Sharing needles
- Maternal-child transmission during pregnancy, birth, or breastfeeding
Prevalence and Risk
According to the CDC, in 2017 the prevalence of diagnosed HIV infection among youth age 13-19 was 18 per 100,0000 people (35.6 in New York State). The prevalence among young adults age 20-24 was 133.1 per 100,000 (208.5 in New York State). Among adolescents and young adults, certain groups are at particularly high risk:- Young men who have sex with men are at higher risk than other groups. Male-to-male sexual contact is the highest transmission category among youth age 13-24, and accounted for 85% of diagnoses among teen boys in 2017.
- Young black adolescents are also disproportionately at risk. Compared to other racial/ethnic groups, most HIV diagnoses in 2017 were among black youth (61% of all infections among youth age 13-19, though black youth make up only 14% of this population).
- Transgender youth are among the groups at highest risk for HIV infection. There are many reasons for this, most of which originate in stigma and discrimination. For example, trans youth may not have family support, leading to homelessness, limited access to health care, and in some cases survival sex work.
- Homeless youth are at increased risk of HIV infection. Gay, bisexual, and transgender teens are more likely to be homeless, compounding their risk. Being homeless may also drive young people to exchange sex for money or shelter, making them especially vulnerable.
Prevention
Adolescents have increased susceptibility to HIV because of factors relating to poverty, lack of access to health care, lower levels of education, high rates of sexually transmitted diseases (STDs), and undeveloped prevention skills. Many youth are unaware of their level of risk: The CDC estimates that half of HIV-positive youth do not know they are infected. Some of these issues can be addressed through coordinated community efforts that attend to risk and protective factors for adolescent sexual health.Individuals can lower their risk of acquiring or transmitting HIV by:
- Using condoms
- Using condoms and dental dams for oral sex
- Obtaining the HPV vaccination
- Practicing mutual monogamy
- Reducing the number of sex partners
- Avoiding drugs and alcohol, which can impair sexual decision making
- Using a water-based lubricant with condoms (to decrease the chance that the condom will break)
- Avoiding sex with anyone who has symptoms of an STD
- Avoiding sex with anyone who uses IV drugs
- Regular STD screening for all partners
- Pre-exposure prophylaxis for HIV (PrEP)
- Post-exposure prophylaxis (PEP)
- If HIV-positive, taking antiretroviral drugs during pregnancy, labor, and delivery
PrEP and PEP
The preventive drug protocols PrEP and PEP may be appropriate in certain cases. For more information, view the video clips from Dr. Starr's presentation below, or visit CDC: HIV/AIDS - PrEP and CDC: HIV/AIDS - PEP.PrEP and PEP Provider Directories
New York State PrEP/PEP Provider Voluntary Directory
PrEP Locator (US)
Please PrEP Me (global)
Screening
An HIV test is recommended for anyone who has:- Had sex with someone who is HIV-positive or whose status is unknown since their last HIV test
- Injected drugs (including steroids, hormones, silicone) and shared needles and syringes with others
- Exchanged sex for drugs, shelter, money
- Been diagnosed with or sought treatment for a sexually transmitted disease
- Been diagnosed with or sought treatment for hepatitis or tuberculosis
- Had sex with someone who could answer "yes" to any of the above questions or someone whose history they don't know
Treatment
There is no cure for HIV. When started in time, medications extend the lives of people who are HIV-positive and may also decrease the chance that they will infect partners. HIV is treated using a combination of drugs that must be taken following a strict protocol. For more information, visit AIDS.gov: Overview of HIV Treatments.Informed Consent in New York State
| In New York State, minors can consent to HIV screening, prevention (PrEP and PEP), and treatment; no other person's consent is necessary. |
Resources
Centers for Disease Control and Prevention: Get Tested (enter zip code to locate testing site)
New York State Department of Health: AIDS Institute
It's Your (Sex) Life: STDs & Testing - HIV/AIDS FAQs
STD Clinics in New York State by County
HIV.gov: HIV Basics
References
Centers for Disease Control and Prevention. (2018, April 20). HIV Among Youth.Centers for Disease Control and Prevention. (2018, November 15). Slide Sets: HIV Surveillance in Adolescents and Young Adults.
Starr, T. (2017). HIV Basics for Health Educators.