Tuesday, June 10, 2014

HIV High Risk Target Group: Adolescent and Young Adult African American Males

HIV High Risk Target Group: Adolescent and Young Adult African American Males

Revised 06.05.2014 1
HIV Infections Among Adolescent and Young Adult African American Males


Similar to other states, Alabama is experiencing a downward shift in the age distribution of newly
diagnosed HIV infections as adolescents and young adults age 15-29 years are now the most affected
age group (Figure 1). Prior to 2007, the majority of newly diagnosed HIV infections were reported
among 30-45 year olds. This downward shift in Alabama’s newly diagnosed HIV population calls for
increased prevention efforts targeting a younger population. Effective HIV prevention efforts require
identification of at risk target groups within Alabama’s adolescent and young adult population.


Figure 1. Trends in Newly Diagnosed HIV Cases by Age Group, Alabama 2004-2013



Adolescents and young adults (15-29 years) are twice as likely to be infected with HIV as the average
Alabama resident (Table 1). During 2012, the rate of HIV infection was 30.3 per 100,000 Alabama
residents age 15-29 years compared to 13.9 per 100,000 residents of any age. Adolescents and young
adults age 15-29 years represented nearly one-half of all newly diagnosed cases during 2012 (45%) and
2013 (47%), compared to only 13 percent of the total population of persons living with HIV infection as
of December 31, 2013. Without proper intervention, the alarming rate of new infections among
adolescents and young adults can be expected to significantly increase the total number of persons
living with HIV infection in Alabama as HIV positive individuals are becoming infected at a younger age
and living longer due to antiretroviral therapy.

4 2
Table 1. HIV Infection Rates by Age Group, Alabama 2012-2013
 Newly Diagnosed, 2012 Newly Diagnosed, 2013† Persons Living with HIV, 2013‡
Age Group (Years) Number (%) Rate Number (%) Rate Number (%) Rate
0-14 5 (0.8) 0.5 - - 76 (0.6) 8.1
15-29 299 (44.7) 30.3 273 (47.2) 27.7 1657 (13.4) 167.9
30-44 213 (31.8) 23.3 168 (29.2) 18.4 3973 (32.2) 434.6
45-59 128 (19.1) 12.8 108 (18.7) 10.8 5335 (43.2) 533.0
≥60 25 (3.7) 2.5 30 (5.2) 3.0 1313 (10.6) 133.0
 Statewide Total 670 (100) 13.9 579 (100) 12.0 12354 (100) 256.2
Source: Alabama Department of Public Health, Division of HIV/AIDS Prevention and Control.
Note: Rates per 100,000 Alabama residents in each age group reported in United States Census Bureau, 2012 Population Estimates. †2013 data
remain incomplete due to delayed reporting; data will be finalized December 31, 2014. ‡Age groups among persons living with HIV as of
December 31, 2013 represent current age.


African American males represent the majority of infections among adolescents and young adults age
15-29 years, with 10 times the risk of becoming infected with HIV as the average Alabama resident in
2012 (137.7 compared to 13.9, Tables 1 and 2). African American males 15-29 years old were 11 times
more likely to become infected with HIV than white males the same age (Table 2). The risk was even
more pronounced among African American females, who were nearly 15 times as likely to become
infected with HIV as white females 15-29 years old during 2012. The infection rate among all African
American males age 15-29 years living with HIV infection as of December 31, 2013 was 3 times the rate
of all persons living with HIV infection diagnosed in Alabama (723.1 compared to 256.2, Tables 1 and 2).


Table 2. HIV Infection Rates Among Adolescents and Young Adults (15-29 Years) by Race, Alabama 2012-2013
 Newly Diagnosed, 2012 Newly Diagnosed, 2013† Persons Living with HIV, 2013‡
Characteristics Number (%) Rate Number (%) Rate Number (%) Rate
African Americans 240 (80.6) 78.7 218 (79.9) 71.5 1317 (79.5) 431.9
 Males 203 (67.9) 137.7 189 (69.2) 128.2 1066 (64.3) 723.1
 Females 37 (12.4) 23.5 29 (10.6) 18.4 251 (15.2) 159.4
Whites 46 (15.4) 7.2 47 (17.2) 7.4 249 (15.0) 38.9
 Males 41 (13.7) 12.6 40 (14.7) 12.3 203 (12.3) 62.3
 Females 5 (1.7) 1.6 7 (2.6) 2.2 46 (2.8) 14.7
All Races 299 (100) 30.3 273 (100) 27.7 1657 (100) 167.9
Source: Alabama Department of Public Health, Division of HIV/AIDS Prevention and Control.
Note: Rates per 100,000 Alabama residents age 15-29 years by race reported in United States Census Bureau, 2012 Population Estimates.
†2013 data remain incomplete due to delayed reporting; data will be finalized December 31, 2014. ‡Persons living with HIV as of December 31,
2013 are currently aged 15-29 years.


Among adolescent and young adult African American males 15-29 years old, sex with another male is
the predominant risk factor reported among newly diagnosed HIV infections (Figure 2). Recent trends
over the previous decade show an alarming increase in the number of HIV infections among African
American males 15-29 years old reporting sex with another male. Identification of African American
men who have sex with men (MSM) age 15-29 years as a high risk target group should guide prevention
efforts. Effective HIV treatment and prevention programs must focus on these individuals to prevent
future HIV infections.

HIV High Risk Target Group: Adolescent and Young Adult African American Males

Revised 06.05.2014 3
Figure 2. Trends in Newly Diagnosed HIV Cases Among African American Males (Age 15-29 Years) by Mode of
Exposure, Alabama 2004-2013


As a largely rural state, some Alabama counties have less than 100 African American males age 15-29
years. To protect the privacy of HIV-positive individuals within this group, statistics are limited to Public
Health Areas (Table 3). It should be noted that HIV-positive African American males 15-29 years old are
represented throughout the state, with many individuals frequently traveling between jurisdictions.
Statewide HIV treatment and prevention efforts should be launched to prevent future HIV infections.


Table 3. HIV Infection Rates Among African American Adolescents and Young Adult Males (15-29 Years) by Public
Health Area (PHA), Alabama 2012-2013
 Newly Diagnosed, 2012 Newly Diagnosed, 2013† Persons Living with HIV, 2013‡
Public Health Area Number (%) Rate Number (%) Rate Number (%) Rate
PHA 1 2 (1.0) 71.4 - - 4 (0.4) 142.9
PHA 2 23 (11.3) 150.0 12 (6.4) 78.2 98 (9.2) 638.7
PHA 3 26 (12.8) 237.1 21 (11.1) 191.5 77 (7.2) 702.2
PHA 4 54 (26.6) 181.9 50 (26.5) 168.4 297 (27.9) 1000.5
PHA 5 2 (1.0) 35.6 2 (1.1) 35.6 14 (1.3) 249.1
PHA 6 6 (3.0) 67.4 10 (5.3) 112.4 47 (4.4) 528.1
PHA 7 1 (0.5) 11.0 11 (5.8) 120.6 33 (3.1) 361.8
PHA 8 49 (24.1) 159.2 41 (21.7) 133.2 267 (25.1) 867.2
PHA 9 6 (3.0) 72.9 4 (2.2) 48.6 31 (2.9) 376.9
PHA 10 12 (5.9) 124.9 8 (4.2) 83.3 55 (5.2) 572.4
PHA 11 22 (10.8) 138.3 30 (15.9) 188.5 143 (13.4) 898.6
Statewide 203 (100) 137.7 189 (100) 128.2 1066 (100) 723.1
Source: Alabama Department of Public Health, Division of HIV/AIDS Prevention and Control.
Note: Rates per 100,000 African American males age 15-29 years residing in Alabama by public health area reported in United States Census
Bureau, 2012 Population Estimates. †2013 data remain incomplete due to delayed reporting; data will be finalized December 31, 2014.
‡Persons living with HIV as of December 31, 2013 are currently age 15-29 years.

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