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    Federal Plan Focuses on 'Realistic' Youth AIDS-Prevention Programs


    "We have to change the behavior of young people -- and politicians," Thurman says. "It is important to educate the decision-makers. There is still the fear that if you give youth the information they need about how to protect themselves during sex, they will then start having sex. But science shows that if you provide condoms, young people are more likely to use them during sex -- and that they are not more likely to have sex.

    "We do need to encourage abstinence," she says. "Having said that, we have to give them the facts. Giving condoms to young people is not enough -- we have to teach them how to use them. ... We must insist that young people have the tools to prevent HIV."

    David Harvey, executive director of the AIDS Alliance for Children, Youth, and Families, shared the podium with Thurman. "Abstinence-only programs are not enough," says Harvey, who calls for schools to provide condoms to students.

    The new recommendations do not go quite that far, but they go farther than the first White House AIDS plan, which in 1996 called for better youth health care, comprehensive HIV/AIDS education, routine HIV testing and counseling, and increased study of how best to evaluate AIDS-prevention programs. Despite some impressive increases in federal funding of health programs for young people, there has been no decrease in the annual number of new HIV infections. In the four years since the last set of recommendations, an estimated 80,000 teens have become infected with the AIDS virus. Most of these young people don't know it yet, because seven out of 10 teens don't know where to get an HIV test.

    A key component of the new plan is its acknowledgement that schools can go only so far in providing AIDS services. Community resources are called on to close the gap -- and these include health care providers, whom the plan says should be recruited and trained specifically to treat young people with HIV.

    In a point-by-point analysis, the White House plan sketches the extent of the youth HIV/AIDS problem. Some of the findings:

    • 65% of American youth are sexually active by the time they are in 12th grade.
    • Each year, one in four sexually experienced teens gets a sexually transmitted disease (STD). These diseases are transmitted by the same behaviors that transmit HIV -- and an STD makes a person much more likely to give or get the AIDS virus.
    • Among 13- to 19-year-olds, more females than males are now being diagnosed with HIV. Young women from the South and Northeast have higher HIV infection rates than any other group.
    • Among gay youth, 41% report having unprotected anal sex -- thought to be the highest-risk sexual behavior for contracting HIV.
    • African-Americans make up 15% of U.S. teen-agers, but account for 67% of AIDS cases reported among teens.
    • Very high-risk youth -- those who drop out of school, are sexually abused, who run away from home, who are incarcerated, who live in foster homes, or who are homeless -- are at especially high risk of acquiring HIV. There are between 730,000 and 1.3 million homeless/runaway youths in the U.S.
    • 87% of young Americans think they are not at risk of HIV infection.
    • Only 11% of U.S. young people with HIV receive adequate medical care. One out of three 18- to 24-year-olds has no health insurance -- and this number is increasing.

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