The Best Reasons to Discuss HIV With Your Teen Now

Having "the talk" with your teenager can often be difficult in the best of circumstances. It can evoke a great sense of discomfort in many adults who are otherwise unaccustomed to discussing sexuality with others, much less their own teens. It often challenges moral and religious beliefs and suggests to some a tacit approval (or even encouragement) of teen sex.

Whatever one’s beliefs or concerns, one fact remains: avoiding an open and non-judgmental discussion about sex — or assuming your child’s school will take care of it — is a mistake. The consequences are no longer confined to unplanned pregnancies and treatable sexually transmitted infections (STIs). Despite beliefs among some that HIV is no longer the problem that it once was, teenagers remain at great risk of contracting the disease and spreading it to others.

Here are five reasons why you need to discuss HIV with your teenager today.

Teenage couple kissing on sofa
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Many Infections Occur During the Teen Years

While rates of infection remain highest among young adults, many of these infections occurred when the person is still in his or her teens.

According to the U.S. Centers for Disease Control and Prevention (CDC), nearly one in four new HIV infections occur in youth aged 13 and 24, and that rate has continued to rise year-on-year from 2008 to 2011.

While the data shows that teenagers aged 13 to 19 represent a far lower number of infections than young adults aged 20 to 24 (4.8 percent versus 18 percent), don’t let these figures mislead you. According to researchers at John Hopkins University, as many as 45 percent of persons under the age of 25 only seek treatment when their disease has reached an advanced stage, defined as having a CD4 count that has fallen below 350 cells/mL. In short, persons presenting at this stage of infection will have been infected five or more years earlier while still in their teens.

This is supported by data from the CDC estimating that 60 percent of teens and young adults currently have no idea whether they’ve been infected or not.

Many Teens Don't Know How to Protect Themselves

Here are the facts: according to research published by the CDC, approximately 47 percent of American students reported having had sex before graduating from high school, with 13 percent had four or more sexual partners during those years. Of these, one in four would have acquired an STI before they reached the age of 20, accounting for the nearly 3 million teenage STI diagnoses reported in the U.S. every year.

Underpinning these statistics is the fact that less than 50 percent of students reported using a condom on a consistent basis. While there are many reasons for this, confusion about both condom usage and ​HIV risk appears to play an important role as to why so many young people place themselves at risk.

As an example, in a survey conducted by the Rollins School of Public Health, nearly one in five college-aged men reported never having had received instructions about condoms, while a third did not appear to know how to use condoms correctly. The basic lack of knowledge about condoms and condom use — especially among men who are often expected to be wholly knowledgeable about sex — is exacerbated by the way in which many students tend to prioritize HIV when having or discussing sex.

A survey conducted in 2014 by the M.A.C. AIDS Fund showed that, while 85 percent of teenagers said they had been taught about HIV/AIDS in high school, a full one-third did not know that HIV was an STI. A similar study by the Councils of Ministers of Education in Canada showed that of the numerous reasons not to have sex, only 1 percent of 11th-grade males and 1.9 percent of 11th-grade females ever considered HIV as a factor.

Quite simply, HIV does not figure all that high on a teenager's list of sexual priorities.

Teens Are Unlikely to Discuss HIV With Each Other

Even when teens are concerned about HIV, they generally don't talk about it with each other.

The same study from the Councils of Ministers of Education found that interactions between peers on the subject of HIV were surprisingly low. Of the 3,627 11th grade students surveyed, 49 percent of males and 49 percent of females expressed concerns about getting an STI, while slightly less (47 percent and 43 percent, respectively) had worries about HIV.

Despite this, only 6 percent of the 11th-grade males and 9 percent of 11th-grade females ever discussed HIV with any of their friends.

One of the reasons for this could very well be the negative attitudes many teens have about HIV or what it means to be HIV-infected. In the same cohort of students, 22 percent of 7th-grade males and 17 percent of 7th-grade females stated that they "could not be friends with someone who has HIV/AIDS" while 16 percent and 10 percent believed that "people with HIV/AIDS get what they deserve."

While those numbers tended to wane as the teens grew older, the significant stigma associated with HIV would likely discourage open and ready conversations about the disease, particularly among those who might fear they've been infected.

Parent-Teen Talks Do Work

Frank and open discussions about these condoms, HIV and STIs can mitigate many of the potential risks. One study showed that teens who had discussed condoms with their parents were three times more likely to use condoms and less likely to be infected by STIs than those who didn't while being 20 times more likely to use condoms on a consistent basis.

Similarly, in a national survey of 8,098 U.S. high school students, teens who openly discussed HIV with their parents were seen to be less likely to have multiple sex partners or engage in unprotected sex. The opposite was seen to be true for students who engaged in conversations with their peers, whereby HIV risk was often minimized due to either misinformation, discomfort, or the underestimation of actual risk.

Parental Discomfort Scares Teens Away

Having a frank discussion about HIV can be tough enough given society’s general discomfort with sexuality. Imagine then what it must be like for both parents and teens to discuss all of the so-called "secondary" issues relating to HIV risk—topics which, in some circles, may be considered unacceptable or even taboo.

But consider today that nearly 75 percent of all adolescent HIV infections are a result of male-to-male sexual contact. Consider that as many as 17 percent of teenagers have unprotected sex while on alcohol, while 8 percent who use cocaine and 24 percent who used marijuana also go without a condo. These are just some of the issues one often needs to touch upon when discussing HIV with their teen.

While keeping these subjects on the table may seem difficult-to-impossible for some families, sweeping them under the carpet can do far worse harm — isolating the teen and denying that person the outreach or treatment that he or she may need.

Moreover, ignoring the reality of teen sex by demanding abstinence will likely do little to impact sexual behavior. A comprehensive review of 30 randomized and non-randomized trials published in 2009 concluded that abstinence-based interventions neither decreased nor increased HIV rates among U.S. youth and were, in the authors' words, largely "ineffective."

If faced with issues beyond your expertise or scope of comprehension, seek support from a qualified HIV specialist or healthcare provider. Teens are often more forthcoming about their sexuality and other risky activities when allowed privacy with a third-party professional.

Learn more about how to find a qualified HIV doctor or contact your regional HIV/AIDS hotline to locate youth healthcare resources nearest you.

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