243727 A Systematic Review of Existing Policies that Affect Adolescent HIV Risk: A Necessary Step for Strategic Development of Future Structural Change Interventions

Monday, October 31, 2011

Christine Powell, MPH, DrPH Candidate , School of Community Health And Policy, Morgan State University, Baltimore, MD
Nancy Willard, MS , Center for Child and Community Health Research, Johns Hopkins University, Baltimore, MD
Anita Hawkins, PHD , School of Community Health and Policy, Morgan State University, Baltimore, MD
Jonathan Ellen, MD , Department of Pediatrics and Neonatology, Johns Hopkins University School of Medicine, Baltimore, MD
Mauri Ziff, PhD , Johns Hopkins University, Center for Child and Community Health Research, Baltimore, MD
Kate Chutuape, MPH , Center for Child and Community Research, Johns Hopkins University, Baltimore, MD
The CDC estimates 56,500 U.S. youth (13 to 24 years) are HIV positive. The majority of high school seniors (65%) reported having sexual intercourse, which remains the leading mode of transmission for HIV. With the epidemic persisting in this generation of Americans, expanded prevention strategies must be considered. Specifically, there needs to be a paradigm shift towards influencing policies and laws that promote HIV prevention. This descriptive study observed four prevention policies across the eight states (including Washington DC) with the highest AIDS prevalence, namely: (1) sex education in public schools, (2) HIV testing consent regulations, (3) HIV testing within the criminal justice system, and (4) needle exchange programs. AIDS prevalence rates from 2000 to 2005 and prevention policies through 2009 were collected using public sources, e.g., CDC HIV/AIDS Surveillance data and National Conference of State Legislators' reports. This study sought to inform the creation and/or tailoring of HIV prevention policies using risk population and policy specific data. Of the eight areas with the highest prevalence, only Washington, DC mandated comprehensive HIV prevention education. Florida, where two of the highest AIDS prevalence cities are located, mandated abstinence only “sex education”. All states allowed minors to consent HIV testing. Only Washington DC mandated testing juveniles in the criminal justice system. Six of the eight states had needle exchange programs. Importantly, during the study period, only Washington DC showed a decrease in youth AIDS rates, which coincides with their mandated policies of comprehensive sex education and testing of juvenile offenders.

Learning Areas:
Program planning
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Discuss existing policies that influence HIV prevention in U.S. adolescents Explain how the adolescent HIV prevention paradigm can be shifted from individual level interventions and towards structural interventions. Identify specific policies to be addressed when seeking to prevent HIV in U.S. adolescents.

Keywords: HIV Interventions, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked on several HIV prevention research projects.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.