Children of women with HIV are at risk of infection when they are still in the womb, during birth, and while breastfeeding. Many children and youths now living with HIV were infected at birth. Effective drugs against HIV now allow these children to survive and grow into adulthood.
In the United States, new infections at birth are now very rare because of drugs that pregnant women can take that can block HIV transmission to the child. It is important to start these drugs early in pregnancy. In parts of the world where pregnant women do not have access to these drugs, the rate of infection among infants is much higher. Before such drugs were available, about 25% of infants of HIV-infected women in the United States would become HIV-infected; now, less than 2% of HIV-infected women in the United States will pass infection to their infants.1 Read more about mother-to-child transmission of HIV.
Unprotected sexual activity can lead to new infections. The Centers for Disease Control and Prevention's (CDC) national Youth Risk Behavior Survey and other CDC data have identified risk factors that can increase adolescents' and young adults' risk of HIV infection. These include:2
- Male–male sex. Young men who have sex with men, especially African Americans and Latinos, have high rates of new HIV infections. This may be because this group is less likely to be aware of their infections than other young people who are HIV positive. Another reason may be that these young people have been less likely to receive relevant, effective prevention education and interventions.
- Early sex. By age 16, about one-third of boys and girls have had sex.3,4
- Sex with older partners or with a number of partners. This may increase teens' infection risk.
- Use of alcohol or drugs before sex. This can affect decision making about whether to engage in sex or to use protection during sex.
- Not knowing HIV status. Most of the undiagnosed HIV infections in the United States are among young people aged 13–24.5 Youths who are at the highest risk of infection (males who have sex with males and minority youth) are not only more likely to be infected, but also they are the most likely to not get tested for HIV. This risks their own health and the health of people with whom they have sex.
A study co-funded by the NICHD and the National Institute of Allergy and Infectious Diseases found that American children with HIV are surviving in greater numbers than ever before. Due to anti-HIV drugs, the number of deaths among children with HIV has dropped to one-ninth of its former level. However, children with HIV are still 30 times more likely to die than other children. Organ failure and kidney disease are often responsible. Read more about this study.
The CDC collects detailed data on HIV in the United States. It has more information on HIV and youth in the United States.