American teenagers have a relatively clear view of which unhealthy behaviors will put them at greatest long-term risk.
That was my conclusion reading the results of a new survey put out by the MAC AIDS Fund (PDF). The online survey of about 1,000 teenagers was conducted this year by the communications firm Kelton, and does reveal some worrisome data about their attitudes and level of information about HIV and AIDS. Given its funding source, it makes sense that those facts would be the focus of the report. But taken as a whole, the results indicate that adolescents have a pretty good understanding of what choices are most likely to worsen their health over time.
The most startling and worrisome finding (helpfully highlighted by Vox) is that roughly a third of the respondents did not identify HIV as a sexually transmitted infection (STI). If a true reflection of teenagers’ knowledge of how HIV is spread, that number is troubling indeed. A 2002 study of youth at an urban clinic found that, despite spotty knowledge about STIs as a whole, HIV was identified as such by 91 percent, a larger number than identified any of the others. While a difference in study populations may account for some of that discrepancy between the two surveys, a drop to 67 percent in the span of a dozen years would be a precipitous decline in informedness.
Unfortunately, it’s difficult to know how much credence to give those findings. Unlike studies that typically appear in peer-reviewed journals, there is little information provided by Kelton in the report regarding the survey methods. (More detailed methodology information was not provided to The Daily Beast by press time.) While it’s certainly possible that American teenagers have become drastically less informed about HIV than they should be, it’s hard to put aside my skepticism about how solid those numbers are without seeing how the survey was worded.
The survey reports that less than a third of respondents rated having unprotected sex as the most risky health behavior they could be engaging in. However, that’s still more than those who rated smoking or drinking (28 percent) or eating unhealthy foods (20 percent) as the riskiest. Without seeing the study’s methods, it’s impossible to know what those numbers really mean. Were respondents only given one choice or asked to rank several? Just because a teenager thinks drinking is the most risky thing she could be doing (which, given the effects of drinking on mortality, isn’t a crazy answer) doesn’t mean she perceives unprotected sex as being risk-free.Taking the numbers at face value, the survey finds that 88 percent American teenagers don’t perceive themselves to be at risk for lifetime HIV infection. In contrast, they are concerned about the risks of developing cancer (38 percent), diabetes (33 percent), heart disease (28 percent) and obesity (22 percent). Comparing the prevalence of HIV infection to mortality and obesity rates in the United States, those attitudes are actually pretty sensible. While 50,000 new HIV infections a year are far too many, on balance American adolescents are at far more risk of developing those other health problems.
For an organization like the MAC AIDS Fund, it makes sense to look at the survey results and respond with alarm. Its focus is on HIV and AIDS, and the report certainly indicates that there is work to be done in communicating to youth about preventing infection. But when viewed as part of a bigger picture, it shows that teenagers have a good idea of what their long-term health risks truly are. Coupled with data showing decreased risk behavior among adolescents as compared to older generations, it’s actually rather encouraging.
Though my reading of the report is that most teens have a good idea about the health risks they actually face, it remains important to inform adolescents about their risk of infection with HIV. The survey report contains no information about the respondents’ demographics beyond their ages, so it’s impossible to know how many fall into higher-risk groups. For those who do, giving them the information they need to lower that risk remains just as important as ever.What is truly discouraging are the numbers regarding new HIV infections among men who have sex with men (MSM), the group comprising the largest number of new diagnoses by far. Among MSM aged 13-24 years rates of new infections have actually risen over the past decade, while the overall rate of new diagnoses has dropped by 30 percent. As a gay man standing on the cusp of middle age, I fear that the lessons learned by my generation and the ones that came before are being lost. While medications like Truvada can be used to lower the risk of infection for those engaged in high-risk behaviors, about which I have put my reservations aside, that doesn’t mean attention to lowering those risks isn’t important.
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