Teens and adults younger than 30 continue to be at increased risk for HIV infection, according to statistics from The Henry J. Kaiser Family Foundation. Research indicated that young people between the ages of 13 and 29 accounted for 34 percent of new HIV infections in 2006, the largest share of any age group. What do young people have to say about this crisis in America? And how informed are they about the basics of HIV? We spoke with three young men—Sean, William and Cheick—ages 19 to 23, who consider themselves informed and aware about HIV/AIDS. Here, they candidly shared their experiences and personal insights (right and wrong) about the virus. Evelyn Harvey, RN, a head nurse at New York City’s Harlem Hospital’s Division of Infectious Diseases and a former patient advocate, also commented on the issue.

Why do you think so many African Americans are disproportionately affected by HIV?
Sean: I’d say it’s because we live in urban neighborhoods where people take risks to “be down” and fit in. People don’t really have all the information they need to know or take precautions the way they should. The one time you slip up, you might not be as blessed.

William: I think it’s because African Americans aren’t guided in the right way. Nobody is teaching them to use protection, or maybe they’re just being knuckleheads and not caring. A lot of people don’t care about themselves, or they don’t think they’re going to get HIV.

Cheick: I think it has a lot to do with a lack of sexual awareness and knowledge. People have to know how they can get HIV/AIDS. I also think it’s because we lack medical resources.

Evelyn Harvey: I think a lot of African Americans are affected by HIV primarily because of stigma, particularly adolescents. If they are sexually active, they’re not going to talk about it unless they have someone they trust with whom to share this information. There are young men and women who experience rape, but they don’t tend to share that information. If they had a strong support system, then stigma wouldn’t affect them as much because they could talk about it and get into treatment early. Also, for women, culturally, men hold control in the bedroom. Many of them feel they don’t have a say in whether or not they can use a condom to protect themselves. Poverty and poor education also contribute, but more important [particularly for women] is their inability to protect themselves during sexual activity.

How did you learn about sex and using condoms for HIV protection?
Cheick: Sex education classes in junior high school.

Sean: My parents had a basic talk with me when I was about 8 or 9 years old. But when I got to middle school, I started going to health classes and learned more about it.

William: I was already sexually active, but my parents talked to me about this when I was growing up. My dad told me to keep the “glove” [condom] on at all times. They both told me to use condoms to prevent pregnancy and avoid catching sexually transmitted diseases and AIDS.

What do you know about how HIV is transmitted?
William: They say you can become infected if you use [dirty] needles [to inject drugs] or to get a tattoo and if you have unprotected sex. Those are the three things I know about, but there are probably more ways [HIV is transmitted].

Cheick: I believe there are four ways you can get the virus: through breast milk, blood and vaginal secretions. I can’t really remember the fourth way, but I know there are four ways you can get it.

Sean: Well, I know that HIV is a virus and AIDS is the disease. I know it starts with the virus and if you don’t get treatment it eventually becomes the disease. I know that the virus can be transmitted through breast milk, conceiving a child and through anal, oral and vaginal sex.

Just for the record, how is HIV transmitted?
EH: HIV is transmitted through transfusions of infected blood (or blood clotting factors) or an exchange of any bodily secretions during sexual contact and sharing needles or syringes. Also, babies born to HIV-infected women may become infected before or during birth or through breast-feeding after birth.

[Editor’s Note: Positive mothers who take HIV medications can give birth to healthy, HIV-negative babies, so it’s important to know your status.]

You’re all sexually active. Do you engage in risky behavior?
William: Yeah, I do, a lil’ bit. I don’t like to use condoms, but I know I can’t go in raw in every girl.

Sean: Yeah, there’s times when I’ve slipped up. But I’ve learned from those times. It’s made me become smarter. Why take risks and be nervous and worried about whether you’ve got something?

Cheick: Right now, I have one sexual partner; that’s my girlfriend. I don’t cheat on her so that’s a good precaution I’m taking on my part. But even if I wasn’t in a relationship, I still would use a condom anyway. I don’t play with that.

How often should people get tested for the virus?
EH: It depends on your risk factors. If you are very sexually active and have multiple partners, you should be tested every three months. If you’ve had a sexual encounter the day or week before the test, you should get tested again within three months. The test doesn’t register what you did the day before or the week before. If you know you’ve had unprotected sex, you have to be tested every three months. If you’re an intravenous (IV) drug user, it’s also every three months. If you’re someone who uses protection all the time, getting tested annually is fine.

What would you do if you found out you were HIV positive?
Cheick: I’d try to find as much help as possible and find out where to go get treatment. I’d also probably get counseling. [Pause.] I don’t know what I would probably do. That’s just crazy.

William: I think my first move would be to isolate myself from everyone. I’d try and get cured, even knowing there is no cure. Well, there is a cure, but it costs millions of dollars and I don’t have that kind of money. When you get HIV, you can’t have kids; you can’t do a lot of things. You can’t live the same; you can’t do the things you want to do.

Sean: The first thing I would do is seek counseling. And that’s because I don’t know how I would react to that. That’s just not something that you plan for. It’s like asking what would you do if someone shoots you in the head? I don’t know. It [contracting HIV] just seems like something crazy to me.

How often have you been tested for HIV?
Cheick: I can’t lie. The last time I was tested was about a year ago. I was doing a class and to be a good sport to encourage more people to do it, I got tested.

Sean: I was tested about three weeks ago. I usually get tested about every six months.

William: Both me and my girlfriend have been tested. I go every month.

What do you think is the best way to educate young people about preventing the spread of HIV?
EH: I believe the best way to get the message across is to use—and it’s unfortunate to say this—someone who is famous. For example, when Magic Johnson participated in World AIDS Day, we got all of the young people to come out. Everyone came to all our functions. If it weren’t for celebrity involvement, we wouldn’t get anybody. Audience [interest] is always slow. I think if you have, maybe, a sports figure or entertainer, people will support your event. I think that’s the best way to get your message across.