The average teenager feels as if she or he could not possibly get HIV. Most believe that HIV only happens to other people. However, many teens are getting infected and are now living with HIV (HIV+). All teens need to take HIV seriously, get educated, and be tested if they have sex or use drugs.

Teens and young adults make up the largest number of HIV cases reported in recent years. In fact, the Centers for Disease Control (CDC) estimates that there are at least 56,500 HIV+ young people between the ages of 13 to 24 years old living in the U.S. Yet, most HIV+ teens remain unaware of their infection or even their risk for HIV.

Let’s face it – teens are having sex. In high schools across the U.S., nearly one-half (49 percent) of students say they have had sexual intercourse, yet only 13 percent of them have ever been tested for HIV. One of the most common ways HIV is passed among teens is through unprotected sex. Teens are less likely to use a condom during vaginal or anal intercourse than sexually-active adults. Among sexually-active high school students, over one third (34 percent) did not use a condom the last time they had sex.

• One of the groups most at risk for HIV is young men who have sex with men (MSM). In 2007, 70 percent of HIV in young men ages 13 to 24 was the result of male-to-male sexual contact. MSM who become infected may transmit the virus to women as well as to men. MSM are particularly at risk for several reasons:

There are high numbers of HIV+ MSM; therefore, they face a greater risk of being exposed to HIV each time they have sex

• Many MSM do not know their HIV status
• Many MSM have unprotected sex, especially unprotected anal intercourse
• Many MSM use alcohol and street drugs, which increases their likelihood of risky sexual behaviors
• Young MSM may incorrectly believe that HIV is no longer a serious health problem because of advances in treatment
• Stigma and homophobia have deep and direct negative effects on the health of MSM. Negative cultural messages about MSM can lead MSM to think poorly about themselves and make unhealthy decisions, including those about sex and substance use. Stigma and discrimination may also make MSM less willing to access HIV prevention and care, or isolate them from family, friends, and other community support networks.

Not using condoms also puts teens at risk for other sexually-transmitted diseases (STDs). In fact, one-fourth of all STDs each year occur among teens. This is especially alarming because the presence of an STD greatly increases a person's chances of getting or passing on HIV.

People who have an STD such as syphilis, genital herpes, Chlamydia, or gonorrhea are at greater risk for getting HIV during sex with HIV+ partners. Regularly using condoms significantly reduces the chances of getting STDs.

HIV+ teens come from all different backgrounds; however recent studies show that 75 percent of HIV+ teens (13 to 19 years old) were African-American, even though only 17 percent of all teens are African-American.

Unlike young men, the vast majority of young women get HIV through heterosexual sex (sex between a male and female). Young black women are especially vulnerable. According to the CDC, the rate of new HIV infections last year among young black women aged 13 to 29 was 11 times higher than the rate among young white women and four times higher than the rate among young Hispanic women.

Certain factors may put young women at higher risk for sexually transmitted HIV:

• Not being aware of their partners’ risk factors
• Lack of power in relationships
• Having sex with older men who are more likely to be HIV+
• HIV is transmitted from men to women much more easily than from women to men

Young people in the U.S. use alcohol and drugs at high rates. Many teens are curious about drugs and feel pressure from peers to try them. Teens are more likely to engage in high-risk behaviors, such as unprotected sex, when they are under the influence of drugs or alcohol.

In 2009, 22 percent of sexually-active high school students drank alcohol or used drugs before the last time they had sex. Runaways and other homeless young people are at high risk for HIV infection if they trade sex for drugs or money.

Drug use can also increase the risk of HIV infection if needles are shared. This includes using needles for injecting drugs, injecting steroids, piercing the ears and body, and tattooing.

Teens hear about HIV at school, from friends, and on the TV, radio, and internet. They generally know some basic information. However, what they know may be incorrect and many teens would like to know more. Teens need accurate, age-appropriate information that includes the following:

• What HIV is and how it is spread
• How to protect themselves
• Where to get tested for HIV
• How AIDS differs from HIV
• How to talk with their parents and partners about HIV/AIDS
• How to correctly use a condom
• How to make healthy choices about abstinence or sexual activity

Parents can make a difference. CDC research has shown that it is important for parents to talk early and clearly to their children about sex and values. Ongoing conversations about sex, HIV, STDs, and pregnancy prevention can help teens wait until they are older to have sex and make responsible decisions about sexual behaviors when they do start having sex. Awareness, education, and communication can reduce the risk of teens becoming HIV+.

So let’s start talking! ( See The Well Project’s info sheet: Talking with Your Children about HIV)