WASHINGTON — Nearly half of high school students say they've had sex, yet progress has stalled in getting them to use condoms to protect against the AIDS virus, government researchers reported Tuesday.
Today, four of every 10 new HIV infections occur in people younger than 30, according to the Centers for Disease Control and Prevention – and the teen years, just as many youths become sexually active, are key for getting across the safe-sex message.
Using a long-standing survey of high school students' health, the CDC tracked how teen sexual behavior has changed over 20 years. The results are decidedly mixed.
About 60 percent of sexually active high school students say they used condoms the last time they had sex, researchers said at the International AIDS Conference. That's an increase from the 46 percent who were using condoms in 1991.
"This is good news," said Dr. Kevin Fenton, director of CDC's HIV prevention center. But, "we need to do a lot more."
Condom use reached a high of 63 percent back in 2003.
Black students are most likely to heed the safe-sex message, yet their condom use dropped from a high of 70 percent in 1999 to 65 percent last year, the study found.
The proportion of high school students who've had sex is 47 percent today – down a bit from 54 percent in 1991 – and they typically start at age 16, CDC said. Black teens showed a bigger decrease, with 60 percent sexually active today compared with 82 percent two decades ago.
The more partners, the more risk. Fifteen percent of high school students say they've had four or more partners, down from 19 percent in 1991.
Fenton said many school systems don't have strong enough sex education policies that include teaching teens about how to prevent HIV. But he cautioned that the CDC study can't link the abstinence-only policies pushed by Congress through the late 1990s and early 2000s to the stalled condom use.
Focusing on individual risk behaviors is just part of the story. Increasingly, HIV is an infection of the poor, and specialists at the world's largest AIDS meeting are making the point all week that tackling the virus globally will require broader efforts to address problems of poverty. Those include gaining better access to overall health services and fighting stigma.
In hard-hit Africa, where 60 percent of infections are among women, U.S. researchers announced a new step to develop tools women can use to protect themselves when their partners won't use condoms. A new study will test a monthly vaginal ring that oozes an anti-AIDS drug into the surrounding tissue in hopes of blocking HIV. The study, funded by the National Institutes of Health, will enroll nearly 3,500 women in Malawi, South Africa, Uganda, Zambia and Zimbabwe.
Also Tuesday, researchers reported more evidence that male circumcision is an important HIV-prevention tool in Africa, where it helps protect men from becoming infected by female partners. In Orange Farm, South Africa, just over half of the 52,000 men had been circumcised by last year, up from 17 percent in 2008. Circumcised men had half the rate of HIV infection as the uncircumcised, said Bertran Auvert of France's University of Versailles, who estimated that 1,000 new infections were avoided last year as a result.
While scientists were releasing new data at the meeting, AIDS activists marched across Washington to the White House to call for increased funding of HIV programs. Thirteen were arrested after tying dollar bills and pill bottles to the executive mansion's fence.
In the U.S., where new infections have stubbornly held at about 50,000 a year for a decade, complacency is part of the reason that progress in teen condom use has stalled, CDC's Fenton said.
"We have to generate a new sense of urgency," he said.
Overall, though, a characteristic of the young is to think they're invincible, Fenton added.
Lawrence Stallworth II, 20, of Cleveland, can attest that they're not. He learned he was infected with HIV at age 17, when he was a high school senior, after a hospitalization. A black gay man, he's among one of the nation's highest-risk groups.
He's now an Ohio AIDS activist who works to teach young people that they need to protect themselves, and how.
"I want people to have the tools to keep themselves safe," said Stallworth, who is working with the nonprofit Advocates for Youth to declare a National Youth HIV & AIDS Awareness Day in April to increase young people's knowledge about their risk.
Part of that involves society getting "better at being more open about being able to talk about sex," Stallworth said. "It's still a taboo issue."
The CDC recommends that everyone in the U.S. ages 13 to 65 be tested for HIV at least once. Those at increased risk – such as people who have multiple sex partners or men who have sex with men – should be tested more frequently, at least once a year.
In South Carolina, 18-year-old Quinandria Lee offers an example of the safe sex practices that CDC says more young people should adopt.
Lee was frustrated at her school's abstinence-only focus. She learned about both male and female condoms from the South Carolina Contraceptive Campaign, and last year her principal allowed her to teach her classmates about them. Condoms are the only contraceptives that also protect against HIV infection.
But Lee credits her mother's frank talk about sex for this key protective step: Lee persuaded her boyfriend to go with her to a clinic where both got a clean bill of health before they ever had sex. Still, they use a condom every time.
"It's hard," she said of that get-tested conversation. But "you can't be too sure."
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