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CDC: US AIDS epidemic fresh in risk-taking youth

AIDS is alive and well in a new generation of teenagers and young adults, most of them young men, who are having risky sex, often fueled by drugs or alcohol, U.S. officials said Tuesday.

The Centers for Disease Control and Prevention issued a new report showing that more than a quarter of new U.S. infections are in youths aged 13 to 24, and 60 percent of them don’t even know it. That means they can spread the virus and, worse, aren’t getting treated for it.

The human immunodeficiency virus (HIV) that causes AIDS cannot be cured, and it will kill people who are not treated for it. But a cocktail of drugs can keep patients healthy and if they take their medication consistently, they are far less likely to infect someone else.

The CDC estimates that 12,200 young men and women aged 13 to 24 became infected with HIV in 2010. And by far most of them were boys and men. Nearly three-quarters were boys and men having sex with other men. And more than half of the newly infected youths were African American.

The report “really provides shocking data on the higher rate of risky behavior and the lower rate of condom use” among young men, CDC Director Dr. Thomas Frieden told reporters on a conference call.

The report finds that just 13 percent of high school students have been tested for the virus and just 35 percent of 18 to 24 year olds have been.

“Young gay and bisexual men report much higher levels of risky sexual behavior than their heterosexual peers,” Frieden said. They are more likely to have multiple sex partners, use drugs and alcohol before sex – which makes them in turn more likely to skip using condoms and tsake on other risks, too.

A separate CDC survey of high school kids and young adults found that young gay and bisexual men were more likely to report having had sex with four or more partners. They were also more likely to have injected drugs – another risk factor for AIDS, although most are infected sexually.

The answer, the CDC says, is a combination of testing, treatment and good sex education in schools.

“I don’t think there is a simple answer for this but we are not in support of mandatory testing,” Frieden said.

"The key here is to make it routine screening, just like we have cholesterol screening," Frieden added. "If someone refuses, that is their right, but we should say, ‘This is what we do’."

People who are tested can get treated. “If we double the number of people treated effectively, we we cut in half, roughly, the number of new infections that will occur,” Frieden added.

But kids are not getting this information now, said the CDC’s Dr. Kevin Fenton, who leads the AIDS branch. “I have to tell you, it is astonishing, the level of ignorance about basic physiology among middle school and high school students,” Fenton said.

“Kids who are gay or bisexual were less likely to say they had received sex education in schools,” Fenton added. It’s crucial they get medically accurate sex education, and multi-faceted programs that help young men and women learn about sex, sexually transmitted disease, and how to say no not only to sex but to drugs and alcohol, too.

“Youth who are sexually active can reduce their risk of HIV infection by choosing to stop having sex. They can also limit their number of sex partners, not have sex with an older partner who may be more likely to already have HIV, and use a condom every time,” CDC says.

The CDC estimates that 50,000 people are infected with HIV in the United States each year, and that about 1 million Americans are currently infected with the virus.

“Nearly 60 percent of new infections in youth occur in African Americans, about 20 percent in Hispanics/Latinos, and about 20 percent in whites," Tuesday’s report says.

“About 87 percent  of young males got HIV from male-to-male sex, 6 percent from heterosexual sex, 2 percent from injection drug use and about 5 percent from a combination of male-to-male sex and injection drug use," the report adds. 

Saturday is World AIDS Day and the HIV research and advocacy organization AVAC released its own report Tuesday questioning last week’s UNAIDS report that raised the hope that HIV might be eliminated.

“Recent scientific breakthroughs give us reason to be optimistic like never before, but our chances of success are already imperiled,” said AVAC executive director Mitchell Warren.  “Right now, the world isn’t moving as fast as it should be to begin ending the epidemic.”

 AVAC’s report notes that far too few people are getting HIV drugs.

“A range of studies is looking at ways to narrow this gap, but these efforts are uncoordinated and incomplete. In 2013, researchers and funders need to convene and establish a clear research and implementation agenda to close the gaps in the treatment cascade,” the group said.

There's no vaccine for HIV, although researcher feel they may be getting close. Researchers have also shown that circumcision can protect men from being infected by sex with women -- although it's not effective among gay or bisexual men. And work is also progressing on a microbicide -- a gel or cream that might protect people from sexual transmission of HIV and other diseases.

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