AIDS and Other STDs in Youth

What’s the Problem?

Young people face tough decisions about sex. Sometimes they do not understand the direct relationship between their decisions and the possible consequences of acquiring a sexually transmitted disease (STD) such as chlamydia, gonorrhea, herpes, the human papillomavirus, or HIV (human immunodeficiency virus). All of these STDs can potentially have very serious consequences, but HIV is one of the most devastating because it is nearly always fatal.

Roughly half of all new HIV infections in the United States occur in people under the age of 25. (Most young people are infected sexually, but sharing injection drug needles can also lead to HIV exposure.) HIV infection in a teen can lead to death as a young adult. HIV is a leading cause of death for Americans ages 25 to 44, particularly racial and ethnic minorities. It is the leading cause of death for African-American men ages 35 to 44 and African-American women ages 25 to 34.

In about half the people who acquire HIV, the virus can be present in the body for 10 or more years without causing outward signs of illness. Today’s medications, in addition to the health status of a person who becomes infected, mean the time between HIV infection and the development of AIDS has become highly variable. However, infection, once acquired, is lifelong and leads in the great majority of cases to death.

HIV breaks down the immune system so that the body cannot fight illnesses. People with HIV infection eventually develop symptoms of other conditions that often would be less severe in a person who didn’t have HIV. Symptoms include enlarged lymph glands, depression, fatigue, fever, yeast infections of the mouth and vagina, night sweats, diarrhea, and loss of appetite, memory, and weight.

The HIV-infected person also is more susceptible to illnesses that normally do not affect healthy people, opportunistic illnesses that take advantage of the weakened immune system. A person with one or more opportunistic infections is said to have AIDS. The most common opportunistic infections are PCP (Pneumocystis carinii pneumonia), yeast infections of the esophagus, tuberculosis, Kaposi’s sarcoma, and CMV (cytomegalovirus). Even if no such infections are present, an HIV-infected person with a CD4 cell count (also referred to as T-cell count) below 200 is considered to have AIDS.

Other STDs can cause symptoms and conditions that range from blisters and itching to long-term disability. Some may lead to infertility. The human papillomavirus, which can cause both external and internal warts on the genitals of both men and women, may lead to cancer of the cervix in women.

Who’s at Risk?

Anyone who has unprotected sex, especially with more than one partner, is at risk for contracting and/or spreading an STD. While heterosexual transmission occurs in men, the most common mode of HIV transmission for young men between the ages of 13 to 24, is unprotected sex with other men. For young women of the same age, the most common mode is unprotected heterosexual sex. Young people between the ages of 13 to 24 make up more than 15% of all HIV cases ever reported. This suggests there will be a growing number of young and middle-aged adults with AIDS in years to come, especially among young African-American men and women.

In some cases, STDs may not cause symptoms, which may give young people a false sense of security. The fact is, however, that rates of STD infections (excluding HIV) are alarmingly high.

Can It Be Prevented?

Yes. A person can prevent HIV and transmission of other STDs by using a condom every time he or she has sex and by not sharing injection drug equipment. Reducing the number of sex partners also lowers risk, but only if condoms are always used. Centers for Disease Control (CDC) research shows that adolescents look to their parents, particularly mothers, as their most helpful source of information on sexuality issues, including HIV and AIDS. When mothers discuss a broad range of sex-related topics with their adolescents, those children are less likely to take sexual risks. When adolescents talk with their mothers before their first sexual encounter, they are three times more likely to use a condom than are those who do not.

The Bottom Line

No matter how healthy or attractive a person looks, he or she can still be infected with HIV or another STD. Having sex (vaginal, anal, or oral) without a condom or sharing injection drug equipment (e.g., needles) may result in transmission of HIV, the virus that causes AIDS or other STDs. Discussions among young people and adults, especially mothers, about sexuality, HIV, AIDS, and other STDs are a powerful deterrent against teens having unprotected sex. If someone is infected with HIV or another STD, they should not be stigmatized. It can happen to anyone.

Case Example

Anthony, an 11-year-old African-American junior high school student, has always had a close relationship with his mother, Angela. Recently, girls have started to notice Anthony and call him at home. Although Angela has explained to Anthony “where babies come from” and talked about behaving respectfully toward girls, she has never explicitly addressed unprotected sex, unintended pregnancy, HIV and AIDS. Not knowing how to best have this discussion, she seeks advice from a friend with an older son. Denise reminds Angela it’s not a matter of just one discussion: mothers must always look for “teachable moments” and keep the discussion going. When Angela first wants to talk with Anthony in greater depth and detail about sexual issues, he’s embarrassed and withdraws. However, she persists, introducing the topic when she senses the time is right. Angela doesn’t know if she’s made her point, but when she hears him talking with friends about his mom’s persistence, she’s relieved these issues are on his mind. She hopes her efforts pay off when Anthony becomes sexually active.