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Fewer Teens Engage in Risky Sexual Behavior

THURSDAY, Aug. 10 (HealthDay News) -- Risky sexual behavior by U.S. high school students that can spread the AIDS virus has declined over the past 15 years, a new federal report finds.

But certain subgroups of teens, including Hispanic and black students, have shown less progress or no progress at all.

"We're clearly making progress over time," said Howell Wechsler, a co-author of the report and director of the division of adolescent and school health at the U.S. Centers for Disease Control and Prevention. "The overall trend is positive. It's not nearly enough, but at least it's going in the right direction," he said in a prepared statement.

But the report, which is in the Aug. 11 issue of the Morbidity and Mortality Weekly Report (MMWR), a publication of the CDC, may not be telling the whole story.

"At first glance, it's very reassuring," said Dr. Michael Horberg, director of HIV/AIDS policy, quality improvement and research at Kaiser Permanente Health Plan in Santa Clara, Calif. "But sexual intercourse is just one aspect of sexual expression. We have no idea if, instead of vaginal intercourse, that they're engaging more in anal intercourse or oral sex, both of which carry a risk of HIV. That's unclear from the article."

This week's MMWR has a number of reports on HIV/AIDS and appears on the eve of the International AIDS Conference, to be held in Toronto, Aug. 13-18. According to another report in the same issue, there was a more than 200 percent increase in the number of people worldwide receiving antiretroviral therapy. But only 20 percent of people needing the therapy are currently getting it. More than 4 million people were newly infected with HIV, and 38.6 million were living with HIV and AIDS, in 2005 alone.

To examine changes in U.S. teen behavior in recent years, CDC researchers analyzed data from eight national Youth Risk Behavior Surveys conducted between 1991 and 2005. The surveys were completed anonymously by the students.

During that time, the number of teens ever having had sexual intercourse decreased from 54.1 to 46.8 percent; the prevalence of multiple (four or more) sex partners decreased from 18.7 to 14.3 percent; the prevalence of current sexual activity (within the past three months) decreased from 37.4 percent to 33.9 percent; and the prevalence of condom use increased from 46.2 percent to 62.8 percent.

The most reassuring statistic, Horberg said, was the increase in condom use. "That was very encouraging," he said. "Safer-sex messages are being heard, not just preached."

An editorial note in the report pointed out that gains in behavior coincide with a simultaneous decrease in gonorrhea, pregnancy and teen birth rates.

From 1995-2005, the percentage of students who ever injected drugs -- another transmission route for HIV, the virus that causes AIDS -- remained below 4 percent.

Still of concern is the fact that Hispanic students have not experienced decreases in the prevalence of sexual experience or multiple partners. "That's very troubling," Wechsler said.

And while black students made dramatic changes up to 2001, that progress has now flattened out, especially in the areas of ever having had sexual intercourse and condom use. "They are no longer making progress," Wechsler said. "Clearly, we need to address those populations where there either has been no progress or where progress is slowing down."

It's unclear what is causing these behavioral changes, but Horberg speculated that it's due to safe-sex educations in the schools. The editorial note added that parents, youth-serving community organizations, health-care providers, the media, government agencies and teens themselves may also be making a positive impact.

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