The New ABCs of HIV
There are so many things to worry about when you start dating someone: Does your boyfriend or girlfriend like you as much as you like them? What level of sexual activity are you comfortable with? How secure do you feel with this person?
Should HIV testing be added to that list?
It should be, according to new guidelines from the U.S. Centers for Disease Control and Prevention (CDC). Released just in time for World AIDS Day on Dec. 1, the new recommendations suggest that sexually active teens get tested starting at 13. The new guidelines, along with nationwide studies on the effect of HIV on teens, represent a shift in the medical establishment's approach to HIV diagnosis and treatment — away from concentrating on specific groups and toward treating HIV like any other long-term illness.
"With teens, we're treating HIV as more of a chronic illness instead of a terminal illness," says Dr. Linda Levin-Carmine, director of the Adolescent HIV Program at Mount Sinai Hospital in New York City. "So it's important to figure out how teens integrate the diagnosis into their lives, including disclosing their HIV status to sexual partners, taking their medication, and risk reduction."
Just for Teens
The new CDC guidelines say if you have been sexually active, you should get tested at 13. You should be tested again after you've had unprotected sex with more than one person since your last HIV test or if your partner has had unprotected sex with other partners since your last HIV test. (In the past, the CDC only recommended teens get tested if they engaged in very high risk behaviors, like sharing needles or having unprotected sex for money.)
HIV is transmitted in blood, semen, breast milk, and vaginal fluids. HIV is most commonly spread from one person to another through
having unprotected sexual intercourse with someone who has the virus
sharing needles or syringes with someone who has the virus
being deeply punctured with a needle or surgical instrument contaminated with the virus
getting HIV-infected blood, semen, or vaginal secretions into open wounds or sores
Some HIV-positive teens were infected with the virus that can cause AIDS by being born to HIV-positive mothers. HIV can be transmitted from mother to infant during pregnancy, labor, delivery, or breastfeeding. The peak in the number of infected infants — about 1,650 — came in 1991. Today, those babies would be 15 years old. Many of these teens know they're HIV-positive. Others, Dr. Levin-Carmine says, have been so healthy that doctors didn't test them for the virus until they became teenagers. And some parents have hidden their children's HIV status from them.
Are Teens Different?
Studies have shown that when people know they have HIV, they're more likely to use condoms to prevent spreading it. But Dr. Levin-Carmine and many other doctors around the country are trying to figure out if that fact applies to teens.
Dr. Levin-Carmine is studying how to help teens deal with HIV-positive status. Early studies show that HIV transmission, disease progression, and treatment in teens may be significantly different than for children or adults.
"The healthcare needs of adolescents are very different — they aren't just big kids or little adults," Dr. Levin-Carmine says. "Teens' needs are more complex because of their emotional and physical development. The younger adolescents are in the process of identity development, including sexual identity. They don't always project into the future when they engage in risky behaviors."
Teens may also be physically different than children and adults — for instance, reacting to medications differently — so some studies are examining how HIV medications effect teens. "Our teenagers are going to be on HIV meds for many years," Dr. Levin-Carmine says. "We want to minimize the toxicity (of the drugs). We are evaluating new ways of doing that."
It All Comes Down to You
In general, teens are among the most at-risk for HIV. The CDC reports young women between 13 and 24 account for 40 percent of new HIV cases. And young people of color are even more at risk: More than half of all new HIV cases are among people of color between 13 and 24.
The statistics can be scary, but prevention can keep scary things from happening. It's simple. Either don't have penetrative sex, or use a condom every time you do.