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 account for 4% of those living with HIV/AIDS in Minnesota in 2013. This percent has stayed stable over the past 5 years, however youth and adolescents are accounting for an increased 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 2013 this percentage was 17%. 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 83% compared to 2008, to 79 cases, the highest seen since 1986.
In 2013, the number of cases decreased from 55 in 2012 to 41. Of these 41 new cases among adolescent and young adult men, 16 (39%) were known MSM of color. Since 2004, the number of cases among young males has increased by about 78%.
Unlike young men, the annual number of new HIV infections diagnosed among young women has remained relatively consistent over time; however an increase was seen in 2013. In 2013 there were 11 cases diagnosed among young women, this accounts for a 175% increase from the four cases diagnosed in 2012. However the number of cases diagnosed in 2013 is still below the ten year average of 14 cases. Females accounted for 21% (11/52) of new HIV infections diagnosed among adolescents and young adults in 2013.
Overall, young women accounted for 15% (11/74) of new infections among females and young males accounted for 18% (41/227) of new infections among males in 2013.
Similar to the adult HIV/AIDS epidemic, persons of color account for a disproportionate number of new HIV infections among adolescents and young adults. Among young men, Whites accounted for 43% of new HIV infections diagnosed between 2011 and 2013, African Americans accounted for 40%, and Hispanics 11%. American Indians, Asians and other racial groups made up 3%, 1% and 2% of the remaining cases, respectively. Among young women, Whites accounted for 41%, African-born 23%, African Americans 27%, American Indians 4%, Asian/Pacific Islanders 5% of the new infections diagnosed during the same time period. There were no young Hispanic women diagnosed with HIV during this time frame.
By Mode of Exposure
Men who have sex with men was the predominant mode of HIV exposure among adolescent and young adult males, accounting for an estimated 94% of the new HIV infections diagnosed between 2011 and 2013, 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 and IDU accounted for an estimated 6% of HIV infections diagnosed among adolescent and young adult females between 2011 and 2013.
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 602 HIV positive persons aged 13-29 included in the treatment cascade analyses and 83 cases in this age group reported in 2012 that were included in the linkage to care calculation. People age 13-29 have slightly higher linkage to care rate, but lower viral suppression rate compared to the overall Minnesota cascade.