Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
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Newsday - June 17, 1999
By Laurie Garrett - Staff Writer
Researchers from the National Cancer Institute report in today's Journal of the American Medical Association that heterosexual HIV transmission among the young is rising fast, and females aged 18-27 are far more likely to be infected with the virus than are their older counterparts. This is particularly true for black women.
HIV transmitted homosexually or through IV drug use has dropped dramatically in all age groups. And HIV incidence in white males - from all forms of exposure - dropped a dramatic 45-50 percent between 1988-93.
"I think what we did find was striking," epidemiologist Philip Rosenberg of the National Cancer Institute said of his study - "that young adults who got infected were much more likely to have gotten HIV heterosexually."
Among women aged 27-45 the chances of being HIV-positive are quite low, and infected men outnumber women in that age group by more than 4 to 1. Only one out of seven HIV cases in that age group is acquired heterosexually.
The younger population, however, is far more likely to be catching the dangerous virus heterosexually. One out of three HIV cases in 18- to 27-year-olds are female, and overall one-third of all HIV in that age group is heterosexually transmitted.
Rosenberg, with his co-author Dr. Robert Biggar, used a technique called back calculation to reach these numbers. Using now standardized formulae, the pair calculated how many people of each age group were infected. All their back calculations are for the years 1988-93.
The study found the biggest shift is in black American women. Among 23-to 27-year-olds, for example, one out of every 1,000 white women is infected. But a staggering one out of every 80 black American women in that age group is HIV-positive.
"So there is an `orders of magnitude' difference in minority women," Rosenberg said in an interview.
The numbers observed in 18- to 20-year-olds generally reflect exposures those individuals had as teenagers. That means, Rosenberg said, that HIV prevention and education efforts targeting the high schools currently are inadequate.
"There are some encouraging findings, though," Rosenberg concluded. "Look at this 50 percent decrease in only five years time in HIV in young white men. It's a profound reduction. Remember, it took some 40 years to get smoking in Americans reduced by that much. So I think prevention can work. But obviously the rates in young adults, particularly minorities, are unacceptable."
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