DURBAN, South Africa, July 10 (AP)--U.S. teenagers are clearly getting the message about AIDS, new data show. Compared with a decade ago, they wait longer to have sex, use condoms, and have fewer partners. The data, released Monday, are part of a generally encouraging view of the AIDS epidemic in the United States that contrasts with the gloomy picture from much of the rest of the world, especially Africa. The U.S. Centers for Disease Control and Prevention reported some upbeat trends, especially falling HIV infection rates among U.S. women. But at the same time, officials caution that infection rates are unacceptably high among blacks in some northeastern and southern cities, and there are worrisome hints that young gay men may be turning away from condom use. "This is an increasingly complex picture of HIV/AIDS," said the CDC's Dr. Ronald Valdiserri. "Balancing our successes is a need to sustain our efforts." A letup in teenage sexual activity was first noticed by the CDC two years ago. But officials say the latest data, which cover the entire decade, prove that is a clear trend and not merely a statistical blip.

Based on five school-based surveys, the CDC found:

  • 50% of teenagers reported ever having had sex in 1999, down from 54% in 1991.
  • 16% said they'd had four or more partners, down from 19%.
  • 8% had sex before age 13, down from 10%.
  • 58% said they used a condom the last time they had sex, up from 46%.

"This means fewer U.S. high school students are engaging in sexual activity that puts them at risk for HIV infection," said the CDC's Dr. Laura Kann. The researchers attributed the change to the widely repeated dual message of sexual abstinence and condom use.

Overall, the CDC estimates that 40,000 new HIV infections occur in the United States each year, and this rate has stayed constant through the '90s. At the epidemic's height in the 1980s, there were 100,000 new infections annually. Early in the last decade, health officials worried about a possible epidemic of heterosexually spread AIDS among U.S. women, but the latest data show this did not happen. Figures from 25 states show that the number of HIV infections in women actually declined by 9% from 1994 to 1998. But officials caution that even though infections dropped steeply among older women, they actually doubled among those in their early 20s. Nevertheless, the number of reported new infections in young women is small, just 498 in 1998. Just over half of all new U.S. HIV infections are in blacks, while 15% are in Hispanics. The CDC surveyed cities with large black and Hispanic populations and found a wide range of infection rates. Among blacks, the highest infection rate is in Jersey City, N.J., where 2% have the virus. This rate is 13 times higher than in Flint, Mich., the city with the lowest. Among Hispanics, infections are highest in Newark, N.J., and lowest in Albuquerque, N.M. The data do not include HIV rates in New York and Florida, which are not available.
"This study is especially important because it shows that each community faces unique prevention needs, but in many areas, primarily in the Northeast and the South, communities of color are dramatically affected," said Dr. Robert Janssen of the CDC. Earlier, Dr. Helene Gayle, the CDC's AIDS chief, said gonorrhea rates are increasing in several cities among HIV-infected gay men, a sign of a possible return to the risky sexual behavior that caused an explosive spread of the virus among homosexuals in the 1980s. Overall, the CDC estimates that between 2% and 4% of the U.S. adult population--4 million to 5 million people--still put themselves at high risk. This includes having six or more sexual partners annually, having sex with an HIV-infected person, prostitution, having male homosexual contact, using crack cocaine, or injecting drugs.
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