AIDS SPREADING THROUGH MIDDLE EAST/HIV in youth on the rise

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AIDS SPREADING THROUGH MIDDLE EAST

 

MENL

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July 21, 2003

 

LONDON [MENL] -- The Middle East has experienced a wave of Acquired Immuno

Deficiency Syndrome cases.

 

A new report warned that the spread of AIDS has been most prominent in the

eastern Mediterranean. The report by the World Health Organization said

750,000 people in the region have been infected.

 

The report also said that nearly every state in the Persian Gulf region has

been struck by AIDS. The WHO said at least 1,000 HIV positive cases were

reported in virtually every Gulf state.

 

" Almost every country in the Gulf region has a minimum of 1,000 cases of

people who are HIV positive, " Dr Hussain Gezairy, WHO regional director for

the Eastern Mediterranean, told a seminar in Abu Dhabi. " The government and

the community should both cooperate to prevent the spread of AIDS and reduce

the social stigma associated with the infection. "

 

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HIV in youth on the rise

 

Bay Windows

 

 

July 24, 2003

 

July 24, 2003 Current Issue: July 24, 2003

 

 

HIV in youth on the rise

Diagnoses rise as prevention money is cut

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By Ethan Jacobs

The face of AIDS is changing in Massachusetts. It´s getting younger.

 

According to the HIV/AIDS Bureau of the Department of Public Health (DPH),

the past four years have seen a rise in the percentage of HIV infections

among young people. Although youth aged 13 to 24 accounted for just 6.1

percent of new HIV diagnoses in 1999, the number rose to 8.7 percent by

2002. Since the DPH began conducting surveillance reports of HIV infection

in 1999, young people have made up an increasingly larger segment of the

population diagnosed with HIV.

 

The youth population infected with HIV differs greatly from its adult

counterpart. While the vast majority of Massachusetts residents diagnosed

with HIV who are over age 25 are male, the situation is quite different for

HIV-infected youth. The HIV/AIDS Bureau reported in a June 24 presentation

to the DPH Public Health Council that among 13 to 24-year-olds, there was

nearly the same number of females as males diagnosed with HIV.

 

" We were surprised that there was such [gender] parity among the youth, "

said Dr. Jean Flatley McGuire, director of the DPH HIV/AIDS Bureau.

 

McGuire said the DPH is trying to determine why the pattern of HIV infection

among young people is so different from that of the adult population. While

young men and women are being diagnosed with HIV in nearly equal numbers,

there is a gender difference in terms of cause of infection. Most young men

pick up the virus through same-sex contact, while young women usually

contract the virus through heterosexual partners.

 

" You can certainly see that in terms of young men their risk is

differentially their sex with men, and in terms of young women their risk is

differentially their sex with men also, " said McGuire.

 

Kevin Cranston, deputy director of the HIV/AIDS Bureau, said that young gay

men are at particular risk for contracting HIV when they seek out partners

in the adult gay community. The higher rate of HIV infection among older gay

men in Massachusetts, many of whom Cranston says are experiencing

" prevention fatigue " and are less careful about practicing safer sex, puts

youth at great risk for contracting the virus when they choose adult

partners.

 

" We´re talking about young men engaging in risky behavior in a population

with a high seroprevalence, " said Cranston.

 

Cranston said that young HIV positive women, like their male counterparts,

are contracting the virus primarily from older partners. According to

Cranston, the relatively low incidence of HIV infection among heterosexual

male youth suggests that young women are being exposed to the virus from

partners outside their own age group.

 

In addition to HIV, youth in Massachusetts are making up a growing

percentage of new cases of chlamydia and gonorrhea, suggesting that there

has been an increase in the number of youth having unprotected sex. McGuire

told Bay Windows that in the past few years there has been an increased

percentage of cases of gonorrhea among youth as young as 10 to 14 years old.

In some of the cities with the largest percentages of youth HIV infection,

such as Chelsea, Lawrence, and Holyoke, the DPH has also seen higher rates

of other STDs and teen pregnancy, suggesting that many young people in these

cities are not practicing safer sex.

 

Differing risk factors

 

Yet studies have not shown a decrease in safer sex among youth across the

state. McGuire explained that condom use among young people in Massachusetts

has actually increased over the past few years. According to a 2001

Department of Education (DOE) survey, the number of sexually active youth

who report using condoms has been on the rise since at least 1993. By 2001

about half of Massachusetts high school students reported that they had been

taught how to use condoms at school, an increase from 1999.

 

Cranston said that the increased percentage of youth HIV infections is due

less to increases in infection rates across the board and more to increased

infections in communities where kids are either at higher risk for poverty

or where they live in areas with high adult HIV infection. He explained that

a number of factors associated with poor neighborhoods, including

homelessness, drug use, and exposure to violence all greatly increase risk

of contracting HIV.

 

Brookline has the fifth highest percentage of youth HIV infection, but the

city is much more affluent than Chelsea. Cranston said that Brookline´s

proximity to Boston, which has a higher number of people infected with HIV,

has led to an increase in youth HIV infection.

 

McGuire pointed out that the increased availability of cheap heroin in

Massachusetts has made young drug addicts particularly susceptible to HIV.

While needle exchange programs help reduce the risk of infection among adult

drug addicts, youth under 18 cannot access these programs.

 

" Young intravenous drug users are not particularly visible to [our

communities], " said McGuire.

 

Lack of Information

 

Yet none of these factors easily explain why in 2003, two decades after the

AIDS epidemic began, young people are still putting themselves at risk for

contracting HIV. According to the DOE about 94 percent of Massachusetts high

school students reported that they had learned about HIV prevention in

schools. So why are the numbers of at-risk youth getting infected with HIV

increasing?

 

According to Donna Saunders-Wallace, program coordinator for the Urban Youth

Institute at the Wayne Wright Resource Center, a program of Justice Resource

Institute (JRI), the answer is that the safer-sex education curriculum in

public schools is not meeting the needs of youth, particularly youth of

color. The Institute, which works with youth of color to address their

health and social needs, has noticed that many kids come to them lacking

basic knowledge about HIV transmission.

 

" We get questions like, ´Can you get HIV from a spoon that someone used five

days ago?´ " said Saunders-Wallace.

 

Saunders-Wallace explained that among the youth that she works with, many

come from school districts that provide insufficient sex education.

Massachusetts allows individual communities to determine the structure and

content of their sex education programs, and many of the youth that

Saunders-Wallace serves come from schools that stress abstinence and

downplay the importance of condoms.

 

Saunders-Wallace also said that many of the youth who utilize the Urban

Youth Center programs begin having sex at a young age, often as young as 13,

and the lack of safer sex resources in public schools disproportionately

increases their risk for contracting HIV. Without condom distribution in

schools, she said, poor youth, and especially poor young women, often cannot

afford condoms and do not want to endure the stigma of buying them at the

local drugstore.

 

Funding in crisis

 

The recently adopted state budget, which slashed funds for both sex

education curricula in schools and for HIV/AIDS service providers, means

that in the wake of a rise in the young HIV-positive population,

organizations like the Urban Youth Center must make due with dramatically

reduced resources.

 

" We´ve had a whole department cut. Our ability to conduct [HIV] counseling

and testing has been eliminated, " said Saunders-Wallace. To continue

providing these services to youth, Wayne Wright staff members working in

other departments are also taking on the responsibilities of counselors and

testers who were let go.

 

Emilia Ortega, who runs the Shades of Color peer education program for

Boston Gay and Lesbian Adolescent Social Services (GLASS), also said that

organizations providing HIV/AIDS services to youth will have to take drastic

steps to continue providing services.

 

GLASS, a drop-in center that primarily serves GLBT youth of color, providing

information about HIV prevention and treatment, has so far managed to retain

its full staff despite the budget cuts. Ortega said that GLASS has become

much more aggressive about pursuing grants, doing fundraising, and relying

on volunteers to provide services.

 

" Considering how much was cut from our budget, we´ve still been able to keep

95 percent of our programming up and running, " said Ortega.

 

Yet both Ortega and Saunders-Wallace say that organizations providing HIV

services to youth will have to get creative in the coming months. Ortega

expects that service organizations will have to form coalitions and pool

their resources to keep essential services up and running.

 

Ortega also said that particularly for young GLBT people, many of whom are

poor, homeless, or transient, there is a need for the adult gay community to

take an active role in teaching youth about HIV and AIDS.

 

" A lot of [GLBT] youth aren´t in school. They aren´t getting [the

information] from their parents, they aren´t getting it from adult gay and

lesbian community members, " said Ortega. " I don´t see a lot of education

coming from adult GLBT people. "

 

Saunders-Wallace warned that the state budget cuts, which also greatly

reduced funding for programs like substance abuse treatment programs and

rehabilitation centers, would only exacerbate the problem of youth HIV

infection.

 

" It´s a chain reaction, " said Saunders-Wallace. " We know that jobless youth,

homeless youth, are at greater risk for HIV and AIDS. "

 

She said that if budget cuts in social programs serving young people lead to

an increase in drug abuse, homelessness, violence, and poverty among at-risk

youth, the HIV infection rates among youth could conceivably worsen.

 

" When one system is cut, it´s a trickle-down effect, " said Saunders-Wallace.

 

Ethan Jacobs is a staff writer at Bay Windows. His e-mail address is

ejacobs.