The number of black high school students engaging in risky sexual behavior for HIV has declined dramatically in 20 years, significantly reducing the disparities in risk between black youth and youth of other racial or ethnic groups, according to a new analysis by the Centers for Disease Control and Prevention.
Among students overall, however, behavior changes have stalled during the last 10 years studied, the report said.
“We’re encouraged by the progress we see over time in reducing HIV-related risk behaviors, especially among black youth, but we have more to do,” said Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention.
“Risk behavior remains far too high among all students and it’s clear that, to realize our goal of an AIDS-free generation, parents, schools and communities will need to intensify efforts to ensure that every young person in America knows about HIV and how to prevent infection,” Fenton said in a CDC statement announcing the findings.
The data, covering 1991 to 2011, were presented Tuesday by Laura Kann at the XIX International AIDS Conference in Washington, D.C., and published as an early release in CDC’s Morbidity and Mortality Weekly Report.
The data come from CDC’s National Youth Risk Behavior Survey, a nationally representative biennial survey of public and private school students in grades 9-12.
The analysis, which examines trends in several reported behavior related to HIV risk by race and ethnicity, found that between 1991 and 2011:
• Overall, the proportion of U.S. high school students who had ever had sex declined from 54 percent in 1991 to 46 percent in 2001 and has stabilized at 47 percent since then.
By race and ethnicity, the proportion significantly declined among black students, from 82 to 60 percent and from 53 to 49 percent among Hispanic students. After an initial decline, from 50 percent in 1991 to 42 percent in 2003, the percentage has stabilized among white students, standing at 44 percent in 2011.
• Overall, the proportion of students who had sex within the preceding three months declined from 38 percent in 1991 to 34 percent in 2011. The decline among black students was from 59 to 41 percent; for Hispanic students, it dropped from 37 to 34
percent and for white students, from 34 to 32 percent.
• Overall, the proportion of students who had four or more sex partners decreased from 19 percent in 1991 to 14 percent in 2001 and has stabilized since then at 15 percent in 2011.
For black students, the decline was especially dramatic, from 43 to 25 percent; for Hispanic students, the decline was from 17 to 15 percent. For white students, there was an initial decline from 15 percent in 1991 to 11 percent in 2003 but the number has stabilized since then at 13 percent in 2011.
• Overall, the proportion of sexually active students who used a condom the last time they had sex increased from 46 percent in 1991 to 63 percent in 2003 and has stabilized since then at 60 percent in 2011.
Among black youth, again the change has been especially notable. Condom use among black youth increased from 48 percent in 1991 to 70 percent in 1999 but declined since then to 65 percent in 2011.
Condom use among Hispanic youth rose from 37 percent in 1991 to 61 percent in 2007 and then stabilized at 58 percent in 2011. Among white youth, it rose from 46 percent in 1991 to 62 percent in 2003 and stabilized at 60 percent in 2011.
The report said sexual risk behavior declined most dramatically among black youth over the 20-year study period. The gap in risk behavior between these students and their white counterparts has narrowed considerably.
In 1991, black students were nearly two-thirds more likely to have had sexual intercourse and almost three times as likely to report having multiple partners, compared to white students. By 2011, the disparity between black and white students who ever had sex was cut in half and the difference in the likelihood of having multiple sex partners declined even more, to 58 percent.
The report said while declines in risk behavior among black students generally persisted over the two decades analyzed, progress among youth overall was significant only through the early 2000s and has stalled since then.
Since 2001, there has been no significant overall change in the proportion of U.S. high school students who reported ever having sex or who had multiple sex partners, the report said. The percentage of sexually active students who used a condom the last time they had sex has been stable since 2003.
Additionally, while black students made greater progress than youth of other racial or ethnic groups, black students report higher levels of sexual risk behavior than their white or Hispanic peers, with the exception of reporting higher levels of condom use. Of concern, the report said, condom use has been declining in this group since 1999. There has been no significant change in sexual risk behaviors among Hispanic students since 1991.
People under age 30 represent about four of every 10 new HIV infections each year.
“Our challenge is to build on the tremendous strides made by African-American youth, while again jump-starting the progress among youth overall,” said Howell Wechsler, director of the CDC’s Division of Adolescent and School Health. “We must also confront the persistent lack of progress among Hispanic and white students.”
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