HIV Among Youth

In 2014, youth aged 13 to 24 accounted for an estimated 22% of all new HIV diagnoses in the United States. Most of those occurred among young gay and bisexual males. Young black/African American^a and Hispanic/Latino^b gay and bisexual males are especially affected. Youth with HIV are the least likely out of any age group to be linked to care. Addressing HIV in youth requires that we give youth the tools they need to reduce their risk, make healthy decisions, get treatment and care if needed, and communicate effectively with others.

The Numbers

HIV and AIDS Diagnoses^c

• An estimated 9,731 youth aged 13 to 24 were diagnosed with HIV in 2014 in the United States. Eighty-one percent (7,868) of diagnoses among youth occurred in persons aged 20 to 24.
• Among youth aged 13 to 24 diagnosed with HIV in 2014, 80% (7,828) were gay and bisexual males. Of those newly diagnosed young gay and bisexual males, 55% (4,321) were black, 23% (1,786) were Hispanic/Latino, and 16% (1,291) were white.
• From 2005 to 2014, HIV diagnoses among both black and Hispanic/Latino gay and bisexual men aged 13 to 24 increased about 87%. Among young white gay and bisexual men, HIV diagnoses increased 56%. However, the most recent 5 years of data (2010-2014) indicate that the diagnoses among black and white gay and bisexual men aged 13 to 24 have stabilized and the increase has slowed to 16% among Hispanic/Latinos.
• In 2014, an estimated 1,716 youth aged 13 to 24 were diagnosed with AIDS, representing 8% of total AIDS diagnoses that year.

Living With HIV and Deaths

• At the end of 2012, an estimated 57,200 youth aged 18 to 24 were living with HIV in the United States. Of these, 25,300 were living with undiagnosed HIV—the highest rate of undiagnosed HIV in any age group.  
• Among youth aged 13 to 24 who were diagnosed with HIV in 2013, 78% were linked to care within 3 months—the lowest rate of any age group.^d
• Among youth diagnosed with HIV in 2011 or earlier, 52% were retained in HIV care at the end of 2012.
• Among youth aged 18 to 24 who were living with HIV in 2012, 21% were prescribed HIV medicines (antiretroviral therapy or ART), and 16% had a suppressed viral load—the lowest rates of any age group.
• In 2013, 109 youth aged 15 to 24 died of HIV or AIDS.

Prevention Challenges

Inadequate Sex Education. The status of sexual health education varies substantially throughout the United States and is insufficient in many areas according to CDC’s 2014 School Health Profiles. In most states, fewer than half of high schools teach all 16 critical topics that CDC recommends for inclusion in curriculums. Specifically, many curricula do not include prevention information that relates to the needs of young gay and bisexual men. In addition, sex education is not starting early enough: in no state did more than half of middle schools meet goals put forth by CDC. Finally, sex education has been declining over time across the country. The percentage of US schools in which students are required to receive instruction on HIV prevention decreased from 64% in 2000 to 41% in 2014.

2013 data from the Youth Risk Behavior Surveillance System (YRBS), which monitors health risk behaviors that contribute to the leading causes of death and disability among youth reveal:

• Low rates of testing. Only 22% of high school students who had ever had sexual intercourse had been tested for HIV.
• Low rates of condom use. Of the 34% of high school students reporting sexual intercourse during the previous 3 months, 41% did not use a condom the last time they had sexual intercourse.
• Substance use. Among the 34% of currently sexually active students nationwide, 22% had drunk alcohol or used drugs before their most recent sexual intercourse.

High rates of sexually transmitted diseases (STDs). Some of the highest STD rates are among youth aged 20 to 24, especially youth of color. The presence of another STD greatly increases a person’s likelihood of getting or transmitting HIV.

Stigma around HIV. In a 2012 Kaiser Family Foundation survey, 84% of youth aged 15 to 24 said there is stigma around HIV in the United States, which means they may not be comfortable discussing their status with others and agreeing on measures to protect themselves and their partners. For gay and bisexual youth who are just beginning to explore their sexuality, homophobia can pose obstacles to HIV testing and treatment.

Feelings of isolation. Gay and bisexual high school students may engage in risky sexual behaviors and substance abuse because they feel isolated and lack support. They are more likely to experience bullying and other forms of violence, which can lead to mental distress and engagement in risk behaviors that are associated with getting HIV.

What CDC Is Doing

CDC uses a multifaceted approach to meet the goals of the National HIV/AIDS Strategy for the United States: Updated to 2020:

• CDC funds state and local health departments to develop and implement HIV prevention programs in their jurisdictions in communities most affected by HIV.
• CDC awards $43 million annually to community-based organizations (CBOs) to expand HIV prevention services for young gay, bisexual, and transgender youth of color.
• CDC’s Division of Adolescent and School Health collects and reports data on youth health risk behaviors and funds 19 state and 17 local education agencies to help schools deliver sexual health education emphasizing HIV/STD prevention, increase teen access to sexual health services, and establish safe and supportive environments for students. For example:
  • Advocates for Youth assists state and local education agencies with implementing programs and developing strategic collaborations between schools and community-based, mental health, and social services organizations to meet the HIV/STD prevention needs of young gay and bisexual men.
  • The National Coalition of STD Directors works with state education agencies, and Cicatelli Associates Inc. (CAI) works with local education agencies to increase adolescent access to preventive sexual health services.
  • The American Psychological Association works with state education agencies, and the Gay-Straight Alliance Network works with local education agencies to establish safe and supportive learning environments for students and staff.
  • Healthy Teen Network works with local education agencies to deliver sexual health education emphasizing HIV/STD prevention.
• CDC’s Act Against AIDS initiative focuses on raising awareness about HIV, fighting stigma, and reducing the risk of HIV infection among at-risk populations through multiple campaigns such as Doing It, which motivates individuals to get tested for HIV and know their status.

^a Referred to as black in this fact sheet.
^b Hispanics/Latinos can be of any race.
^c HIV and AIDS diagnoses indicate when a person is diagnosed with HIV or AIDS, but do not indicate when the person was infected.
^d In 27 states and the District of Columbia (the areas with complete lab reporting by December 2014).