In 2020, youth ages 13 to 24 accounted for one out of every five new HIV diagnoses in the United States (CDC, 2023). While this number seemingly represents an overall decrease in HIV diagnoses among youth compared to previous years, youth still face several unique challenges when it comes to staying healthy and preventing the spread of HIV.
- Youth are less likely to get tested. Although 37% of high school students reported being sexually active by the 12th grade, only about one in ten reported every having been tested for HIV (YRBS, 2019). Even among young adults, less than half have ever been tested for HIV (KFF, 2020).
- Youth are less likely to take PrEP. PrEP is a medication that can effectively reduce the risk of HIV transmission when taken as prescribed. However, only about 15% of youth aged 16 to 24 were on PrEP in 2020, compared to about 30% of adults ages 25 to 44 (CDC, 2020).
- Youth living with HIV are less likely to be aware of their status. In 2018, 43% of HIV infections among youth ages 13 to 24 were undiagnosed, the highest percentage among all age groups (CDC, 2018).
- Youth are less likely to be linked to medical care. Once diagnosed with HIV, 2 in 10 youth are not connected to HIV medical care to start antiretroviral therapy (ART) within one month. Even when connected to medical care, 4 in 10 youth struggle to take their medication and achieve viral suppression within 6 months (CDC, 2020).
It’s important for all young people living with HIV to start antiretroviral therapy right away to treat HIV. Taking ART as prescribed can effectively make the amount of HIV, or viral load, in the body undetectable. People who get and keep an undetectable viral load can stay healthy for many years and will not transmit HIV to their sex partners. (CDC). There are also a number of highly effective HIV prevention strategies such as HIV testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). However, youth face several factors that impact access to healthcare and navigating HIV prevention and treatment services. Some of these factors can be addressed through counseling and other available services such as mental health or side effects. However, many factors are related to the world around youth, such as access to HIV services, unstable housing, limited family support, and discrimination (HIV, 2021).
While there are more options in our HIV prevention toolkits such as PrEP, PEP, Undetectable=Untransmittable (U=U), continued research is needed to find more effective ways to prevent and treat HIV among young people, including better medications and interventions to help them live the healthiest lives possible. Driving these disparities are a number of factors that impact how youth are able to navigate sexual health and access HIV prevention and treatment services, such as the mental health, unstable housing, limited family support, and discrimination (HIV, 2021). Our work at the ATN focuses on developing innovative technologies and strategies that address the unique, complex needs and challenges of youth in the United States, especially in communities disproportionately impacted by HIV.
Communities in the South bear a higher burden of HIV compared to other regions of the US. The South accounts for over half of new HIV diagnoses, and eight out of the 10 states with highest rates of new HIV diagnoses are in the South (CDC, 2019). The South’s larger and more geographically dispersed population of people living with HIV creates unique challenges for prevention and treatment.
Black and Latine communities as well as sexual and gender minorities have high rates of new HIV diagnoses. (HIV, 2023; CDC, 2023; CDC,2021). Youth from stigmatized communities often face worse health outcomes throughout the HIV treatment process with only a small percentage achieving viral suppression because of barriers to healthcare access such as stigma, discrimination, income, geographic location, lack of LGBTQ+ culturally sensitive providers, and more (HIV, 2023).
The ATN is committed to its contribution in the Ending the HIV Epidemic (EHE) Initiative launched by the U.S. Department of Health and Human Services (HHS) in 2019. The initiative’s goal is a 75% reduction in new HIV infections in the U.S. by 2025 and at least a 90% reduction by 2030 by scaling up key HIV prevention and treatment strategies focusing initially on priority jurisdictions with the highest numbers of new HIV infections in 2016 and 2017.