One in Four Is Too Many

Evelyn Kappeler

Evelyn Kappeler

One in four new HIV infections in the United States occurs among young people ages 13-24. One in four! I don’t know about you, but this recently reported CDC finding gave me pause. That same report illuminated some other startling facts:

  • About 1,000 youth per month were infected with HIV in 2010
  • Most new HIV infections in youth (about 70%) occurred in gay and bisexual males, most of whom were African Americans
  • Of the new HIV infections among youth, 2,100 were among young women; two-thirds of these were among young African American women
  • Youth are 7% of the estimated 1 million Americans living with HIV
  • Most youth are not getting tested for HIV
  • About 60% of youth with HIV do not know they are infected and so don’t receive treatment, putting them at risk for sickness and early death. These youth can also unknowingly pass HIV to others.

The CDC Vital Signs on HIV among youth is a vivid and compelling reminder of facts too often overlooked in our conversations about both adolescent health and HIV: Too many young people become infected and too few are tested for HIV.

This has prompted concern here at the Office of Adolescent Health (OAH) and across HHS. We are looking for opportunities to strengthen our HIV activities that reach our nation’s youth so we can help prevent new infections and support those living with HIV to learn their status and get connected to care. We also know that similar efforts are underway in many national, state, and local agencies and community-based organizations working to improve the health and well being of adolescents and young people.  There are actions everyone can take—young people, parents and families, and health care and social service providers—get informed about HIV, know the risks of HIV infection and how to prevent it, share this information with others, help link young people to HIV testing and, when necessary, treatment, and encourage and support people living with HIV to stay in care. Read more about what you can do.

Among the recommendations contained in the CDC Vital Signs report is that “all youth should know how HIV is transmitted and prevented, understand what puts them at risk for HIV, and be tested if they are at risk.” This echoes the National HIV/AIDS Strategy’s call for age-appropriate HIV and sexually transmitted infection prevention education for all Americans and its affirmation that “educating young people about HIV before they begin engaging in behaviors that place them at risk for HIV infection should be a priority”.

With that in mind, I want to share a few things we are doing and highlight an important resource that may be helpful to you or others in your community.

First, OAH has shared the CDC report with our grantees across the country—which include many social service, public health, and education agencies—and is encouraging them to think about how they might address this issue in their work with youth. In addition, the report was shared and discussed with the HHS-wide Adolescent Health Working Group (AHWG), which I chair. The representatives of the over 40 agencies and offices represented on the AHWG were encouraged to forward it to their home offices and stakeholder networks to increase awareness of the issue and ensure that we are all addressing these challenges in our efforts to fight HIV and improve the health of young people.

Finally, we continue to make resources available through the National Resource Center for HIV/AIDS Prevention among Adolescents Exit Disclaimer. The Resource Center, supported by the Secretary’s Minority AIDS Initiative Fund, provides information on evidence-based programs for preventing HIV in young people, particularly adolescents from minority and other at-risk populations. The goal of the Center is to build national capacity in youth HIV prevention by providing a central, online location for resources, professional literature, evidence-based programs and practices, and technical assistance.  If your agency or organization is among the many across the country assessing what you can do new or differently to address the impact of HIV among youth, I hope you will visit the Resource Center online! (Read more about the Resource Center in our prior blog post.)


  1. Does it really come as a complete surprise that HIV has a fundamental relationship to poverty. You are talking about POOR kids. The minute the idea of poverty gets interjected into this dialogue, the suits run. And hide. What will it take to get the suits to realize the answer to this might mean thinking outside the box. I teach adolescent boys who have HIV who do sex work. Survival sex. Do you really think they are worried about HIV. They are worried about not having to sleep in a dumpster tonight. You are not reaching them. That they are utterly marginalized by mainstream culture is a reality mainstream culture cannot even imagine let alone articulate. What’s in it for THEM to listen to you. It might be obvious to you, and to me, but we are not THEM, and to reach them you will need to deal with this obstacle. I have given up on you. I have washed my hands of you. You are not capable to reaching them. You are the ones who do not LISTEN. You preach with rhetoric, posters, slogans, and hand-wringing. You actually think that adolescent boys tune into CDC websites. Please. You push testing and you do not — NOT — take on treatment. You ignore things like waiting lists. Anyone can get tested. Not anyone can get treated. This conflict is a moral issue. It has not gone unnoticed. Poverty and stupidity are NOT synonymous. I have given up on drawing pictures outside the box you could exploit. The reality is that the suits do not really want to reach these kids. It would change your perspective as to what reality actually is.

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