HIV Shelby Mohr Oklahoma State University 27

 

 

 

 

 

 

 

 

 

HIV Among Youth in
the United States

Shelby Mohr

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Oklahoma State
University

27 December 2017

 

 

 

 

 

 

 

 

 

 

            HIV
proves to be an issue that affects individuals from many walks of life, and
despite medical advances, the disease progressively infects new hosts. Youth in
America continue to be at risk for HIV, and at an increasing rate. According to
the Center for Disease Control and Prevention, 50,000 new cases of HIV occur
each year, and out of those people, 1 in 4 of those is between the age of 13 to
24 years old (HIV Among Youth in the US, 2017). In addition, youth infected
with HIV account for 7% of an alarming 1 million people infected in the United
States. Although education regarding HIV has become more available to everyone
with the information programs on the internet, many youths live with HIV and
are not diagnosed. By partaking in risky sexual behaviors, youth become more
vulnerable to infection. Those who are undiagnosed prove to be among the
highest rate of undiagnosed HIV in any age group in the United States, at a
rate of 51% (HIV Among Youth in the US, 2017). Challenges in HIV prevention
among youth vary due to many individual factors to be discussed in further
detail.

            Youth
infected with HIV have many different common host characteristics and
environmental attributes. The amount of youth affected by the disease is many
times due to gender, race, drug usage, and rate of risky behaviors. With
regards to gender, males are much more likely to have HIV than women (HIV Among
Youth in the US, 2017). This characteristic leads to the fact that young men
are also less likely to receive tests for HIV than young women. Males are more
likely to have HIV because of male-to-male sexual contact, and young women acquired
the disease from high-risk heterosexual contact (Corporal, 2008). Due to the
present nature of the HIV gender distribution, connotations surround
individuals with the disease. Youth prove to be extremely vulnerable to
bullying and mistreatment due to the effects HIV and possible interactions of
individuals in school. One adolescent interviewed said, “I usually don’t tell
anyone, I keep it to myself, unless it is a special case, someone going through
this situation then I usually open myself. I like to keep it quiet since I do
not know people’s reaction, because of the prejudice” (Bortolotti et al, 2014). Even at a very young age, the student recognizes
the stigmatization surrounding individuals with HIV and felt feelings of discrimination
and anguish. Other interviewees commented on “biases in romantic relationships,
in their own families and in their social life” (Bortolotti et al, 2014).

            With
regards to race, African Americans are far more likely to be infected, with
nearly 60% of new HIV infections occurring in African American individuals, 20%
in Hispanic youth, and 20% in white individuals (HIV Among Youth in the US,
2017). The disproportionate number of infected African Americans would lead one
to believe that it is due to an increase of risk behavior amongst those
individuals, but in reality, they have similar levels of risk behaviors (HIV Among
Youth in the US, 2017). In 2010, African American and Hispanic young women amount
to 82% of women of ages 13 to 24 infected and living with HIV in the United
States (Corporal, 2008). In the southern part of the United States, young
African American women have a higher risk of HIV infection because of various
socioeconomic factors (Corporal, 2008). These factors include young women’s
dependence on male partners to support them financially, low self-confidence
and self-esteem, as well as feelings of invincibility (Corporal, 2008).

            Individuals
who inject drugs, such as heroin and cocaine, often times share needles.
Sharking needles causes not only an increased risk of acquiring HIV, but also
increases overall possibility of participating in risky behaviors which lead to
the acquisition of HIV (HIV Among Youth in the US, 2017). Youth experience physical
development, and during development, tend to explore their sexual identity by experimenting
with different and diverse partners. Through this exploration period, youth
become more aware of their sexual identity, and, in turn, become more self-absorbed
and feel invulnerable. These feelings of invulnerability, as well as family influences,
causes an increased risk of exposure to HIV and increase of risky behaviors leading
to acquisition of HIV such as injected drug use (Corporal, 2008).

            Risky
behaviors include having multiple sexual partners, not using condoms, drinking
alcohol or using any type of drugs with sex, sex with older partners who are
more likely infected, not being tested for HIV, or not being treated for HIV (HIV
Among Youth in the US, 2017). Individuals who are more likely to participate in
risky behaviors are those who are more vulnerable, such as individuals who are facing
emotional distress, death in the family, verbal or physical abuse, bullying at
school, or those who are insecure or unsure of their sexual identity. Many
young men who experiment sexually with other young men experience disapproval
from others with homophobia, which increases their likelihood of participating
in risky behaviors leading the acquisition of HIV. It has been statistically found
that African Americans, Hispanics, and Whites participate in different risky
behaviors at different rates (Vital Signs: HIV Infection, Testing, and Risk
Behaviors Among Youths-United States, 2013). Hispanic youth, for example, are
more likely to have multiple partners, inject illegal drugs before sexual
contact, or not use a condom. African American youth, in contrast, are less
likely to use drugs before sexual contact. White youth, despite receiving the
most HIV infection education in school, have similar rates of risky behavior to
the above races (Vital Signs: HIV Infection, Testing, and Risk Behaviors Among
Youths-United States, 2013).

            Youth
with HIV, of any background, experience many hardships that are not limited to
the immediate effects of the disease itself. Many times, young men and women
are mistreated in school and at home due to the stigma surrounding those with
HIV. Bullying is an ever-present issue in today’s society, especially due to
the prevalent use of social media, and those with HIV are of no exception. The overall
stigma and discrimination of HIV infected persons has often caused an
overarching homophobic view in the United States (Corporal, 2008). This
negative viewpoint has not only contributed to a prevalence of the LGBTQ
community in the news, but has impacted policies in the United States, such as
those pertaining to marriage equality. The LGBTQ community has worked heavily
in fighting against HIV, and by supporting marriage equality, stigmas have been
addressed and allowed those infected from all socioeconomic backgrounds to feel
affirmed and seek out medical and psychological services (Guiliano, 2017).  While at home, individuals with HIV are
subject to opinions held by their family members, which can be negative or
positive. Many times, speaking about risky behaviors, especially those
pertaining to sex, is a parent-child topic that is many times uncomfortable for
both parties. The uncomfortable nature of the topic, as well as possible
feelings of guilt, often causes the child to not seek testing or treatment for
HIV, and can cause a lack of trust with a parent. One adolescent received
positive support from his mother, while he received negative words from his
aunt and said, “my aunt was more concerned about how I got it; she didn’t care
about my psychological condition” (Bortolotti et al 2014). Adult support, or lack thereof, plays a major
role in a child’s emotional and mental development. Neglect or lack of support,
especially to those youths with HIV, could cause negative effects on the United
States as a whole. These children will grow up to be adults, and make decisions
and formulate opinions based on past experiences, which could impact those
needing treatment for HIV in the future.

            Highlighting
the issue of HIV in youth is not only pertinent in the comparison of the United
States, but also applies to my future academic discipline. After I finish my
undergraduate degree in Chemical Engineering, I hope to pursue a M.D and
specialize in Neurology. Recognizing the medical, as well as the psychological,
effects of HIV is extremely pertinent to my field of study. To successfully and
thoroughly assess an individual’s health, especially those with diseases such
as HIV, an empathetic viewpoint of the effects of the disease on a patients
well-being as well as an understanding of the disease medically. The best
physicians are those who are informed of the medical issues but also recognize other
variables that contribute to each diverse individual’s care. A person with HIV,
many times, will have had a difficult background due to the disease, whether
they faced the disease’s effects, familial disapproval or neglect, feelings of
guilt or hopelessness, or bullying at school or the workplace. The disease requires
special attention that I am now more informed of, allowing me to better
understand those people around me, but also, if I do have the opportunity to
become a physician, better understand HIV in the context of the unique
individual.

            HIV
affects many countries all across the globe, and in different ways. Different
connotations and stigmas surround those with HIV depending on the location of
that individual. In Africa, for example, HIV is a major issue that is not
associated specifically with a certain group, but is a potential threat to
everyone. This is due to not only environmental effects, but also because of
lack of accessible healthcare. Those who have HIV in Africa are often carry the
assumption that they are being punished by a higher power, and this is
heightened in youth who are very vulnerable (Bortolotti et al 2014). Meanwhile, in the United States, the disease
mostly affects young males who have sexual contact with males, which has caused
others to label HIV as one specifically associated with homosexual or bisexuals
in general. This incorrect assumption has been more recently reestablished. HIV
is no longer “The Gay Disease”, but a disease more seriously addressed and
accepted with support from the LGBTQ community, as well one whose effects are
less severe with current medical advances (HIV Stigma and Discrimination, 2017).

            HIV
among youth in the United States is rarely talked about, and studies regarding
individual youth directly infected with HIV in the US are incredibly sparse. With
respect to generalized structures within the United States regarding HIV in
youth, Americans stress early sexual education, as well as information
regarding HIV’s effects and how to avoid contact with the disease. The
stigmatization surround youth with HIV in comparison with adults is somewhat
similar in certain ways, but different in others. With respect to children,
keeping children from acquiring the disease is more a responsibility of the
education system and the individual’s caretakers, but adults are more responsible
for their own livelihood and health. The methods of acquiring the disease are
the same amongst youth and adults, but the disease effects can be different in
youth whose bodies are not yet developed (HIV Among Youth in the US, 2013). A
study preformed in August of 2013 found that “timing and frequency of exposure
to risk reduction programs” prove incredibly important (Dinaj-Koci et al,
2013). The study examined 598 youth in controlled trials, sexual risk
prevention interventions in 6th grade and another in 10th
grade, and others with a controlled curriculum. The results of the study
indicated that, because youth are so vulnerable, prevention programs should be
individually targeted and created for youth. They found that “having been
exposed to two randomized controlled trials of sexual risk prevention
interventions at two different developmental periods during adolescence” lead
to greater understanding of HIV and its effects, as well as had the greatest
increase in condom skills (Dinaj-Koci et al, 2013). More recently, a study done
in Massachusetts in 2014, found that, between the years of 2000-2014, the state
had a 47% decrease (P < .001 for trend) in cases HIV. This proves empirically and historically significant because the decrease was assessed to be due to new healthcare reform as well as medical advances in retroviral therapy (Cranston et al, 2017). The study found that there was a statistically significant decrease in HIV diagnoses among all races (Cranston et al, 2017). Although this data includes all ages, it can be drawn that increased healthcare availability, along with early sexual risk education, can greatly impact a youth's possibility of acquiring HIV.             In order to better asses the current condition of youth infected with HIV, current observational and statistical experimentation should be performed on not only a state scale, but also at a national scale. It would be very fascinating and informative to see the effectiveness or lack thereof of sexual risk prevention programs as well as their impact on those individuals as they become adults with regards to their financial status, political views, and health status. The overall treatment of HIV in youth in the United States involves expanding retroviral treatments available to all infected youth in every socioeconomic background, as well as the possibility of population-level virial suppression (Cranston et al, 2017). HIV infected youth are deserving of special attention, and by implementing treatments and sexual risk education programs in the school system, its minimization can be accomplished.                               References Bortolotti, L. R., Spindola, T., Taquette, S. R., Fonte, V. R., Pinheiro, C. D., & Francisco, M. T. (2014). The meaning of living with HIV/aids in adolescence: a descriptive study. Online-Brazilian Journal of Nursing,13(4). doi:10.5935/1676-4285.20144610 Corporal, E. (2008). Young People and HIV in the United States. Retrieved December 25, 2017, from http://www.advocatesforyouth.org/publications/publications-a-z/2056-young-people-and-hiv-in-the-united-states Cranston, K., John, B., Fukuda, H. D., Randall, L. M., Mermin, J., Mayer, K. H., & Demaria, A. (2017). Sustained Reduction in HIV Diagnoses in Massachusetts, 2000–2014. American Journal of Public Health,107(5), 794-799. doi:10.2105/ajph.2017.303697 Dinaj-Koci, V., Lunn, S., Deveaux, L., Wang, B., Chen, X., Li, X., . . . Stanton, B. (2014). Adolescent Age at Time of Receipt of One or More Sexual Risk Reduction Interventions. Journal of Adolescent Health, 55(2), 228-234. doi: 10.1016/j.jadohealth.2014.01.016 Guiliano, N. (2017, January 12). Marriage Equality and HIV. Retrieved December 27, 2017, from http://sfaf.org/hiv-info/hot-topics/from-the-experts/marriage-equality-and-hiv.html?referrer=https%3A%2F%2Fwww.google.com%2F HIV Stigma and Discrimination. (2017, December 05). Retrieved December 24, 2017, from https://www.avert.org/professionals/hiv-social-issues/stigma-discrimination HIV Among Youth in the US. (2013, January 08). Retrieved December 27, 2017, from https://www.cdc.gov/vitalsigns/hivamongyouth/index.html Vital Signs: HIV Infection, Testing, and Risk Behaviors Among Youths-United States. (2013). American Journal of Transplantation, 13(2), 510-515. doi:10.1111/ajt.12172