December 1st, 2003 is World AIDS Day. Twenty-two years into the HIV/AIDS epidemic, we are given the chance to reflect on our progress in the HIV/AIDS epidemic and on our remaining challenges. And the fact of the matter is: HIV/AIDS still threatens the lives of young people around the world. According to the United Nations Population Fund (UNFPA), HIV/AIDS is a "disease of young people."

Right now, half of all new HIV infections occur in youths aged 15 to 24, according to the UNFPA's State of World Population 2003 report. In fact, every 14 seconds, an estimated 6,000 young people are infected with HIV/AIDS. But only a small percentage know they're infected, and many more may not understand how HIV is transmitted.


Worldwide View
HIV/AIDS is spreading fastest among youth in sub-Saharan Africa, where approximately 8.6 million young people are HIV-positive (67% of them female). In South Asia, an estimated 1.1 million youth are affected (62% female), reports UNFPA. Factors influencing these incredibly high rates are poverty, varying gender and cultural norms, and a remarkable lack of education and preventative services.

HIV/AIDS is also an issue for young people in America. At least one half of all new HIV infections in the United States occur among young men and women under age 25. Most of them are infected through sex, according to the U.S. Centers for Disease Control and Prevention.

Despite the increasing effect of HIV on young people, Robert Johnson, M.D., director of the Division of Adolescent and Young Adult Medicine at the University of Medicine and Dentistry of New Jersey, believes we've made considerable advances in the past 22 years. These gains include "the identification of the [HIV] virus, development of the HIV test to identify infection in asymptomatic individuals, development of effective treatments, and effective methods to monitor treatment response and disease progression," he says. This means that today, HIV is not a death sentence in the U.S., but that doesn't mean young people can be complacent. HIV is preventable, and learning how the virus is (and isn't) transmitted is important to keeping yourself safe.


Ending the Stigma
The theme of World AIDS Day 2003 is "Stigma and Discrimination." Despite advances in knowledge about HIV/AIDS, HIV-positive people still face prejudice. In all parts of the world, people who have HIV are often treated as if they're inferior to others.

One HIV-positive youth, 24-year-old Michael M. from Fort Lee, NJ, who acquired HIV in his teens, remembers facing discrimination after he disclosed his HIV status. His friends started calling him less; his boss didn't want to talk with him; and even his little brother stopped playing ball with him.

"It was Tom Hanks in Philadelphia all over again," he remembers.

One or two of Michael's teachers were really helpful, he says, but others, like his soccer coach, were appalled.

"She asked me to quit! I get really angry when people who don't know what they're talking about open their mouth and talk about HIV like they're some professional," he says.

Michael acquired HIV through sharing intravenous drug needles.

"One day I was at New York City with some friends and their friends. There were a couple of people we didn't know. I forgot whose needle I used, but it wasn't mine or anyone else's that I knew," he says.

Later on, he started to get flu-like symptoms and swollen glands. His girlfriend wouldn't have sex with him until he got tested.

"Not everyone finds out about having HIV in time. [It] sounds funny, but I'm glad she wouldn't have sex with me-or else I would've thought it was just the flu."

Michael's friend, who also shared needles, didn't want to get tested.

"He dragged it on for months," says Michael. "He's in a worse condition than me. He even had to drop out of school. Good thing he used condoms every single time he had sex, or his girlfriend would've gotten it. Always use a condom-even if it means doing something embarrassing like going to the clinic every night."

Michael says it's important to educate young people about the risk factors for HIV, including sharing intravenous drug needles. Knowing the risks could slow the growth of HIV and help end discrimination against people living with the virus.

Dr. Johnson urges everyone who engages in sexual activity or shares needles to be tested for HIV.

"Early identification and treatment of infection is the best way for an HIV-infected individual to prevent the development of AIDS," he says.

There are several types of HIV tests:

- Standard blood test - Blood is drawn and sent to a lab for screening. Results are usually returned in a few days to two weeks. This is the most commonly used test.

- Oral HIV test - A tissue sample is collected from inside the mouth and tested. The only Food and Drug Administration (FDA)-approved oral test is OraSure.

- Rapid test - Requires only a drop of blood and detects infection in minutes instead of days. Two rapid HIV tests have been approved by the FDA: the OraQuick Rapid HIV-1 Antibody Test and the Single Use Diagnostic System for HIV-1 (SUDS).

- Home test - Taken at home, a person pricks his or her finger to draw blood and sends the blood sample to a lab for screening. A personal identification number may be used instead of a real name, and a counselor gives results over the phone within a few days. HomeAccess is the only home HIV test approved by the FDA.

- Urine test - A urine sample is sent to a lab for screening. The test must be ordered by a doctor or health care provider.


Staying Healthy
Clearly, abstaining from sex is your best bet at staying free from STDs, including HIV. But if you're going to have oral, vaginal, or anal sex, use a latex condom correctly each and every time. (The best way to stop the growth of HIV/AIDS is to first protect yourself!)

If you think you're at risk for HIV, get tested immediately. For more information, see the Protect Yourself testing section. And if you have questions about HIV/AIDS call the Fight For Your Rights hotline at 1-888-BE SAFE 1 to get more information or be connected to local testing centers in your area.


- Chelsea Jia, 17, of Rutherford, NJ, is an editor for SEX, ETC., the national newsletter and Web site written by teens, for teens, on sexual health issues, published by the Network for Family Life Education at Rutgers, The State University of New Jersey.

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