National Youth HIV and AIDS Awareness Day

April 10 is National Youth HIV and AIDS Awareness Day, spotlighting the long struggle to protect some of our most vulnerable Americans from these diseases. We are slowly gaining ground in the fight against HIV and AIDS, but rates of the disease increase and its suppression decreases in populations without stable housing or consistent access to health care. This is especially true for youth and young adult populations, who often bear the heaviest burden of health care inequality.

The Facts About Youth HIV and AIDS

The outlook for America's fight against HIV and AIDS is optimistic, although should still be treated with gravity. The data surrounding the diseases shows declining rates, but ones that disproportionately affect vulnerable populations:

• Youth HIV infections have dropped 6 percent in the past decade; this is a lower rate than the 9 percent decrease among the entire population.
• 21 percent of new HIV diagnoses in the U.S. in that time were among youth and young adults ages 13-24.
• The percentage of high school students who reported sexual activity shrank 8 percent in the past decade, from 48 percent to 40 percent.
• Condom use among sexually active high school students decreased 8 percent in that decade, from 62 percent to 54 percent.
• Only 9 percent of high school students have been tested for HIV.

Although HIV rates are declining for everyone, and the rate of sexual activity among teenagers have been consistently dropping for years, young people are still sometimes at increased risk of the disease compared to older Americans. Increased education and access to health care services is the best way to decrease this risk.

The Ryan White HIV and AIDS Program

One of our best sources of data regarding youth rates of HIV and AIDS is the Ryan White HIV/AIDS Program, which provides services to more than half the Americans diagnosed with these diseases. It's a government program administered by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), and HIV/AIDS Bureau (HAB).

The RWHAP data regarding younger clients shows a vulnerable population in need:

• 4.1 percent of RWHAP clients are youth clients, between 13-24.
• 69.6 percent of RWHAP youth clients are living at or below the federal poverty level, higher than the national average of all clients.
• 5.9 percent have unstable housing, higher than the national average.
• 73.6 percent of youth clients are male
• 87.1 percent of youth clients are from racial or ethnic minority groups.
• 61.4 percent of youth clients identify as black/African American.
• 21.6 percent of youth clients identify as Latino or Hispanic.

Also alarming are the relative numbers of RWHAP youth clients who are not virally suppressed. Viral suppression is when the amount of a virus drops to an undetectable level, which means that a person has effectively no risk of transferring the virus to a partner. RWHAP youth clients who are receiving RWHAP care for HIV have much lower rates of viral suppression than the RWHAP average of 87.1 percent:

• 76.3 percent of RWHAP youth clients are virally suppressed.
• 78.3 percent of young men who have sex with men (MSM) are suppressed.
• 74.8 percent of young black/African-American MSM are suppressed, and 72.1 percent of young black/African-American women.
• 68 percent of transgender youth and young adults are suppressed.
• 68.2 percent of youth with no health care coverage are suppressed.
• 63.7 percent of youth with unstable housing are suppressed.

However, it should be noted that nationwide, only 59.8 HIV and AIDS patients are virally suppressed, showing that programs like RWHAP do work in reducing the spread of these diseases and improving the lives of those who have them. Consistent access to HIV medication can reduce the viral load to the point of suppression, which makes this access crucial.

What Can You Do?

Whether you're a young person, a parent, a medical professional, or a trusted adult in the life of a young person, HIV prevention starts with frank, open discussions about sexual health. Some ideas:

• Educate yourself and others: Know the basic facts about HIV.
• Have conversations: There's a lot of stigma surrounding HIV/AIDS and discrimination towards those who have the disease. Discuss the real facts about the disease with those you love and trust, without judgment or stereotyping.
• Promote access to services: Confidential HIV counseling and testing services, especially through schools, are great ways to increase youth awareness of HIV and access to testing and other care.
• Get tested: The CDC recommends HIV testing at least once for everyone between the ages of 13 and 64 as part of routine health care.
• Support those who have it: The quality of life for HIV/AIDS patients, as well as viral suppression, increases with social and familial support. If you know someone with the disease, help them get access to the care they need.

Awareness of HIV and AIDS has constantly increased since these diseases were first identified, and the public's understanding of them is greater than ever. We now largely treat these diseases as public health issues requiring care, rather than bogeyman that justify discrimination. But access to education, testing, and health care has to be provided equally. Gulfs in support and services between different populations endanger everyone.