20th International AIDS Conference - Melbourne, Australia

Abstract

WEPE126 - Poster Exhibition


Unequal progress and cause for concern: differences in HIV-related risk behavior trends among subgroups of US adolescents, 1991-2013

L. Kann1, R. Lowry2, E. Olsen2, S. Zaza2

1Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, United States, 2Centers for Disease Control and Prevention, Atlanta, United States

Background: In 1991, black students were nearly two-thirds more likely to have had sexual intercourse and almost three times more likely to have had multiple (4+) sex partners than white and Hispanic students; rates of condom use were similar. The Youth Risk Behavior Surveillance System, the largest public health surveillance system in the US measuring risk behaviors among youth, monitors how these behaviors have changed during the past 22 years.
Methods: Twelve national school-based surveys were conducted during 1991-2013. Each cross-sectional survey employed a three-stage sample of students in grades 9-12 (ages 14-17). Black and Hispanic students were oversampled. Secular trends were analyzed using logistic regression analyses controlling for sex, grade, and race/ethnicity and assessing both linear and non-linear (quadratic) changes.
Results: Among female, black, and Hispanic students, prevalence of lifetime sexual intercourse decreased during 1991-2013. However, overall and among male and white students, prevalence of lifetime sexual intercourse decreased during 1991 through 2001, 1997, and 2003, respectively, then leveled off. Among female, black, and Hispanic students, prevalence of multiple partners decreased during 1991-2013. However, overall and among male and white students, prevalence of multiple partners decreased during 1991 through 2003 and 1997, respectively, and then leveled off and among white students prevalence of multiple partners decreased during 1991-2009 and then increased during 2009-2013. Overall and among all sex and racial/ethnic subgroups, condom use increased from 1991 at least through 1999. However, condom use prevalence has not changed significantly among male, white, and Hispanic students since at least 2005 and overall and among female and black students, the prevalence has decreased since 1999 or more recently.
Conclusions: While the gap has narrowed between white, black, and Hispanic students and some progress has been made in reducing HIV-related risk behaviors, decreases in condom use and unequal progress across sex and race/ethnicity subgroups is concerning and may help explain disproportionate rates of HIV infection among adolescents.


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