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Yet the epidemic marched on.

  • In the same year that HAART was widely introduced, a report released by the White House Office of National AIDS Policy (ONAP) stated that 25% of all new cases of HIV infection were occurring in young people between 13 and 20 years of age.7

  • Just four years later, ONAP—with support from several organizations, including HRSA—issued a follow-up report, Youth and HIV/AIDS 2000: A New American Agenda.8 That report cited research indicating that half of those being infected each year with HIV were young people between the ages of 13 and 24, and despite this, millions of American youth were still engaging in sexual behaviors that put them at risk for HIV/AIDS. Just as alarming was the fact that most young people who were already HIV-infected didn’t know it.

The Ryan White HIV/AIDS Program in the New Millennium

A broad coalition of organizations and individuals, ranging from federal agencies to activist PLWH across the country, redoubled efforts to bring public attention to the epidemic among young people. Emphasis was placed on improving access to counseling and testing and on increasing the quality and capacity of providers to deliver culturally competent, youth-centered care.

On June 12, 2000, HRSA/HAB conducted a national technical assistance conference call on the topic of reaching HIV-positive adolescents not in care. Presenters on the call included eminent leaders in the field of HIV/AIDS care, representing principal medical centers, AIDS service organizations, and community health centers. Collectively, they represented the nation’s brain trust in how to address HIV/AIDS among youth. Providers from all over America also participated on the call, adding their insights.

HRSA/HAB published a report (PDF – 95.8 KB) Exit Disclaimer based on the national conference call. The report is a must-read for those seeking to understand the Ryan White HIV/AIDS Program response to HIV in youth during the first decade of the program. It provides much more than historical interest, however; it also references best practices and approaches that are still key to reaching HIV-positive youth today.

Best practices that continue today recognize the importance of tailoring services to meet the needs of youth and of normalizing HIV counseling and testing among sexually active youth. It’s important to remember that, at the time, many people were ignorant of the ways that HIV was being transmitted. In fact, 41% of surveyed Americans still thought that HIV could be transmitted by sharing a glass.9

Some ways to tailor services included routinely offering voluntary counseling and testing and expanding the number of settings where testing is offered. For example, Children’s Hospital in Boston created its Boston HIV Adolescent Peer and Provider Network for Services (HAPPENS) project as part of the SPNS Adolescent Initiative. This innovative model tested a citywide network of HIV care for at-risk, HIV-positive and homeless youth. Boston HAPPENS Exit Disclaimer is a program that continues today, providing services to youth who are HIV positive or at risk for the disease and other STDs.

HIV and Youth: Who Is At Risk Today?

Youth represent the only age group in the United States still experiencing increases in HIV diagnoses. From 2007 to 2010, the percentage of new HIV diagnoses occurring among people ages 15–24 increased, while the percentage for all other age groups remained stable or decreased.10 More recent CDC data regarding young people indicate that:

  • Youth ages 13–24 accounted for an estimated 26% of all new HIV infections in 2010, even though they made up just 17% of the population.11

  • Within this age group, 78% of HIV diagnoses in 2011 occurred among young adults ages 20–24, representing the highest rate of HIV diagnoses of any age group (36.3 new HIV diagnoses per 100,000 people).12

  • The rates of AIDS diagnoses among youth 13–24 increased 29% between 2008 and 2011.13

  • The highest concentrations of HIV diagnoses among youth are in the southeastern United States, especially in Florida, Louisiana, and South Carolina.14
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