Epidemiological Profile of HIV/AIDS in Minnesota
Risk Populations: Adolescents and Young Adults
HIV/AIDS Prevalence among Adolescents and Young Adults
Adolescents and young adults between the ages of 13 and 24 years accounted for 4% of people living with HIV/AIDS in Minnesota in 2014. This percent has stayed stable over the past 5 years, however youth and adolescents are accounting for an increasing percent of new HIV/AIDS diagnoses in recent years.
Many people are infected with HIV for years before they actually seek testing and become aware of their HIV status. This phenomenon especially affects the observed case counts for younger age groups. And as a result, the reported number of HIV infections among youth (with few or no reports of AIDS at first diagnosis) is more likely to underestimate the true number of new infections occurring in this age group compared to older age groups.
HIV Diagnoses among Adolescents and Young Adults
In 1990, 10% of new HIV infections reported to MDH were among youth. In 2014 this percentage was 19%.
Since 2001, the number of new cases among young males has been increasing steadily, a few cases per year. However, in 2009 the number of cases increased dramatically by 82% compared to 2008, to 80 cases, the highest seen since 1986.
In 2014, the number of increased from 41 in 2013 to 49. Of these 49 new cases among adolescent and young adult men, 21 (43%) were known MSM of color. Since 2005, the number of cases among young males has increased by about 63%.
Unlike young men, the annual number of new HIV infections diagnosed among young women has remained relatively consistent over time. In 2014 there were 8 cases diagnosed among young women, this accounts for a 20% decrease from the ten cases diagnosed in 2013. Females accounted for 14% (8/57) of new HIV infections diagnosed among adolescents and young adults in 2014.
Overall, young women accounted for 11% (8/73) of new infections among females and young males accounted for 21% (49/237) of new infections among males in 2014.
Similar to the overall HIV/AIDS epidemic, people of color account for a disproportionate number of new HIV infections among adolescents and young adults. Among young men, white men accounted for 39% of new HIV infections diagnosed between 2012 and 2014, African American men accounted for 39%, and Hispanic men 15%. American Indian, African-born, and Asian/Pacific Islander men made up 2%, 2%, and 1% of the remaining cases, respectively. Among young women, white women accounted for 32%, African American women 27%, African-born women 32%, Hispanic women 4%, and women with multiple or unknown race accounted 5% of the new infections diagnosed during the same time period.
By Mode of Exposure
Men having sex with men (MSM) was the predominant mode of HIV exposure among adolescent and young adult males, accounting for an estimated 93% of the new HIV infections diagnosed between 2012 and 2014, while the joint risk of MSM and injecting drug use (IDU) accounted for an estimated 4% of the cases in the same time period. Heterosexual sex accounted for an estimated 2% of cases. Heterosexual contact accounted for an estimated 94% of new HIV infections diagnosed among adolescent and young adult females between 2012 and 2014 while IDU accounted for an estimated 6%.
HIV Treatment Cascade among Adolescents and Young Adults
Although the HIV Treatment Cascade for young people includes people living with HIV/AIDS up to age 29, the general trend can be seen for adolescents and young adults. There were 666 HIV positive persons aged 13-29 included in the treatment cascade analyses and 101 cases in this age group reported in 2013 that were included in the linkage to care calculation. Young people living with HIV/AIDS (aged 13-29) have lower rates of linkage to care and retention in care compared to other age groups and they also have the lowest rate of viral suppression (59%).