ERIC Identifier: ED319742
Publication Date: 1990-06-00
Author: Summerfield, Liane
Source: ERIC Clearinghouse on
Teacher Education Washington DC.
Adolescents and AIDS. ERIC Digest.
Acquired immunodeficiency syndrome (AIDS) is a condition that prevents the
body's immune system from effectively fighting disease. Persons with AIDS are
more susceptible to opportunistic illnesses, such as severe infectious diseases
and certain cancers, that can be fatal. Less severe AIDS-related illnesses
include fever, swollen glands, tiredness, weight loss, and diarrhea.
AIDS is caused by human immunodeficiency virus (HIV), initially identified in
1984. It has been found in blood, semen, saliva, tears, urine, vaginal
secretions, mucous membranes, cerebrospinal fluid, breast milk, and amniotic
HIV-infected individuals usually develop HIV antibodies within 6-12 weeks
following infection. Beginning about 12 weeks after infection, HIV is detectable
by blood test: enzyme-linked immunosorbent assay (ELISA or EIA). A positive EIA
means that the individual has been infected and can transmit the virus. The
HIV-infected individual will not necessarily develop AIDS or AIDS-related
There are three principle mechanisms of HIV transmission:
* heterosexual and homosexual activity;
* direct contact with infectious blood or blood products, including
needle sharing and blood transfusion; and
* transmission from infected mothers to their infants, in utero, at
birth, or through breast-feeding.
INCIDENCE OF AIDS IN THE UNITED STATES
The first cases of
AIDS were reported in the U.S. in 1981. Today, approximately one million persons
may be HIV-infected (CDC, February 1990). As of March 1990, 125,000 individuals
were known to have AIDS, 2,000 of them children under age 13 years (CDC, April
1990). Through 1989, 339 males and 82 females ages 13-19 were diagnosed as
having AIDS (Office, 1989).
WHY ADOLESCENTS ARE AT RISK FOR HIV INFECTION
than 1 percent of persons known to have AIDS are teenagers, this segment of the
population presents characteristics that increase the risk of becoming HIV
1. PERCEIVED INVULNERABILITY
Adolescents characteristically believe that they are impervious to disease,
accidents, and death (Hochhauser, 1988). Ninety-one percent of 16-19 year olds
surveyed by telephone did not think they would get AIDS (Strunin & Hingson,
1987), 73 percent of adolescents in another study were not worried about
becoming HIV-infected (Price et al., 1985). Even when 79 percent of San
Francisco teenagers reported being afraid of getting AIDS, more than half
believed they were not the kind of person who gets AIDS (DiClemente et al.,
2. DEVELOPING PERSONAL IDENTITY
Sexual orientation becomes clarified during adolescence. One study found 1-2
percent of 16-19 year old boys had had homosexual relationships (Hingson et al.,
1990); 0.5 percent reported bisexual relationships (Strunin & Hingson,
1987). These boys could serve as agents of transmission to subsequent female or
3. UNPROTECTED SEXUAL INTERCOURSE
Adolescents are already at high risk for sexually transmitted diseases (STD).
Recent data suggest that 70 percent of teenagers are sexually active by age 20,
over half have had sexual intercourse by age 17, and fewer than half use condoms
It is not surprising that slightly under half of all patients treated for STD
are under age 25 years (Yarber, 1987). The Centers for Disease Control (CDC)
reports that 15-19 year olds have the highest rate of gonorrhea of any age group
and that the number of reported cases of STD, an indicator of unprotected sexual
intercourse, is increasing among 15-19 year olds.
4. DRUG EXPERIMENTATION
An individual's first experience with drugs typically occurs during the first
three years of high school (Thorne & DiBlassie, 1985). Over half of
adolescents have experimented with psychoactive drugs by high school graduation
(Guidelines, 1988). Most drug use among 12-17 year olds involves alcohol,
although a small proportion--0.1 percent in a recent study (Hingson et al.,
1990)--uses heroin and other injectable drugs. Experimentation with
noninjectable drugs may impair judgment and lead to behaviors that increase the
risk of HIV infection.
Particularly vulnerable to becoming
HIV-infected are certain subgroups within the adolescent population. These
include: regular intravenous drug users; those from homes in which family
members are substance abusers; those in detention and residential facilities;
dropouts; the homeless; migrant children; adolescents who have had STD;
hemophiliacs; and those who adopt high-risk behaviors, such as unprotected
sexual intercourse and drug and alcohol use. In testimony before Congress, Dr.
Karen Hein called these subgroups "bridges" between HIV-infected adults and
large groups of uninfected adolescents (AIDS and Teenagers, 1988). The extent of
HIV infection within the high-risk population, excluding hemophiliacs, is
largely unknown. Twenty-four states have one or more HIV education programs
addressing youths at highest risk of infection (CCSSO, 1989).
EDUCATIONAL INTERVENTIONS FOR ADOLESCENTS
As of May 1989,
28 states and the District of Columbia required HIV/AIDS education, although
most states did not stipulate content, and virtually all states permitted
parents to exempt their children from instruction (CCSSO, 1989). Only 7 states
provided funding for HIV/AIDS education.
Content of HIV/AIDS education should include: (a) the nature of HIV/AIDS; (b)
how HIV can be transmitted; (c) who is at risk; and (d) behaviors that minimize
the risk of HIV infection (Yarber, 1987).
The following sequence of instruction has been recommended:
a. early elementary school--basic information on HIV to reduce
unnecessary fears of infection;
b. late elementary/middle school--more specific information on how HIV
can and cannot be transmitted; and
c. junior high/high school--modification of behaviors that increase
risk of HIV transmission.
The challenge of preventing HIV infection among adolescents is the same
challenge faced by educators trying to prevent STD and develop healthy
life-style behaviors in this population. Some data suggest that AIDS education,
while improving positive attitudes toward HIV-infected people, has not altered
adolescents' attitudes toward adopting preventive behaviors (Huszti et al.,
Attempts at promoting behavior change through the media may also have mixed
results. When a population does not perceive the consequence of its actions as a
likely event, the population is unlikely to alter its behaviors to avoid the
consequence (Job, 1988). In the case of AIDS, adolescents seem unable to regard
illness and death as likely consequences of unprotected sexual intercourse or
drug use and therefore may be unresponsive to traditional health messages. In
addition, messages aimed at "gay men" may go unheard by adolescent boys who have
occasional homosexual experiences. Messages aimed at "addicts" may be neglected
by adolecents who occasionally experiment with drugs.
Based upon research in STD prevention, Haffner (1989) recommends that both
adolescents and parents be involved in HIV/AIDS education program design; that
programs address the invulnerability issue; and that programs be behaviorally
based, rather than simply offer information. Successful programs would help
adolescents develop and practice skills for communication, refusal, and
assertiveness, as well as show them how to obtain information and resources.
References identified with an EJ or ED number
have been abstracted and are in the ERIC database. Journal articles (EJ) should
be available at most research libraries; documents (ED) are available in ERIC
microfiche collections at more than 700 locations. Documents can also be ordered
through the ERIC Document Reproduction Service; (800) 227-3472. For more
information contact the ERIC Clearinghouse on Teacher Education, One Dupont
Circle, NW, Suite 610, Washington, DC 20036; (202) 293-2450.
AIDS and Teenagers: Emerging Issues. (1988). Hearing before the House Select
Committee on Children, Youth, and Families, U.S. Congress, Washington, D.C.
Washington, D.C.: Superintendent of Documents, U.S. Government Printing Office.
ED 293 070.
Centers for Disease Control (CDC). (February 23, 1990). Estimates of HIV
prevalence and projected AIDS cases: Summary of a workshop, October 31-November
1, 1989. Morbidity and Mortality Weekly Reports, 39 (7).
Centers for Disease Control (CDC). (April 1990). HIV/AIDS Surveillance
Report. Rockville, MD: National AIDS Information Clearinghouse.
Council of Chief State School Officers (CCSSO). Resource Center on Education
Equity. (1989). Profile of State HIV/AIDS Education Survey Results. 1988-89.
Washington, D.C.: CCSSO, 379 Hall of the States, 400 North Capitol Street, N.W.,
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Haffner, D.W. (1989). AIDS education: What can be learned from teenage
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Hochhauser, M. (1988). AIDS: It's Not What You Know, It's What You Do. Paper
presented at the annual meeting of the American Psychological Association,
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Office of Maternal & Child Health. (1989). Child Health USA '89.
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Yarber, W.L. (1987). AIDS: What Young Adults Should Know. Instructors Guide
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