Only 1 in 5 Sexually Active Students Tested for HIV, Says CDC

A new comprehensive analysis by the Centers for Disease Control and Prevention reveals that only 1 in 5 sexually experienced U.S. students has ever been tested for HIV. It shows that efforts to reduce sexual risk behaviors among youth differs in race and gender, and has stalled overall in recent years.

"This analysis offers a mixed progress report on sexual risk among U.S. high school students -- we've seen substantial progress in some areas, but risk persists in others," said Jonathan Mermin, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention. "It is clear that HIV testing is not reaching everyone who needs it."

Only 22 percent of sexually experienced U.S. high school students have ever been tested for HIV, even though young people account for a disproportionate share of new infections, researchers for the CDC reported July 23 at the 20th International AIDS Conference in Melbourne, Australia.

The CDC analysis found that female and black students were more likely to be tested than male students and other racial/ethnic groups, but that HIV testing among all groups of adolescents remains low. This is troubling because young people aged 13-24 account for approximately one out of every four new HIV infections and half of new sexually transmitted infections in the United States each year. It is critical to reduce sexual risk in this age group and ensure that HIV testing reaches those who need it.

The new analysis provides an in-depth look at trends in sexual risk behaviors among students by race and gender from 1991 to 2013, building upon data released last month on trends in sexual risk behaviors among all U.S. students. Data indicate that areas of progress in reducing sexual risk differ among various groups.

The proportion of black, Hispanic and female students who have ever had sexual intercourse has declined throughout the 22-year time period, but progress has stalled in this area for white and male students.

Similarly, the analysis noted consistent declines in the proportion of black and Hispanic students who had multiple sexual partners, but found increases among white students since 2009. And following years of increases, condom use has now declined among sexually active female and black students, and stabilized among male, white and Hispanic students, the researchers found.

"Protecting the health of America's youth will require action not just from CDC, but also from parents, schools, health care providers and communities," Dr. Mermin said.

The new analysis was presented on July 23 by Laura Kann, Ph.D, and is based on data from CDC's National Youth Risk Behavior Survey (YRBS), a nationally representative survey, done every other year, of public and private school students in grades 9-12.

Key findings reveal that since 2005, the proportion of students who had ever had sexual intercourse and who had been tested for HIV has remained stable (22 percent in 2013). The CDC recommends that adolescents and adults ages 13-64 years in the United States get tested for HIV at least once as part of routine medical care.

It reveals overall declining numbers in the proportion of U.S. high school students who ever had sexual intercourse, as well as an overall decline in the proportion of students who had sexual intercourse with four or more partners during their lifetime.

The findings also show a troubling decline in condom use. While the proportion of sexually active students who reported using a condom the last time they had sexual intercourse increased from 1991 (46 percent) to 2003 (63 percent), it has declined since then (to 59 percent in 2013).

And despite substantial progress in reducing sexual risk behaviors among black students, including decreases in the proportion of black students who have ever had sex, risk remains higher among these students than among their white and Hispanic counterparts.

"African-American youth have made tremendous strides in protecting themselves. However, they continue to shoulder a disproportionate burden of HIV and STD infections," said Stephanie Zaza, M.D., M.P.H., director of CDC's Division of Adolescent and School Health. "It's important that we build on progress in reducing sexual risk behaviors among African-American students, while working to provide all young people with essential information, skills, and services to protect themselves from HIV and STDs."

The YRBS does not measure some of the known social and economic determinants of risk behaviors, such as family income and education, so researchers cannot assess the degree to which these factors may account for the higher levels of risk behaviors among African-American youth in this study.

More information is available at www.cdc.gov/nchhstp/newsroom.