Growing Number of Teen AIDS Victims Linked to Bravado, Sex and Drugs

Lenise Andrade used to think she could catch AIDS from kissing someone. Guvienco Segura thought he might get it from a toilet seat. Now they know better.

Still, Andrade, 16, and Segura, 15, say even after learning how to protect themselves from the deadly virus, they and many of their classmates at Eagle Rock High School are afraid.

“I’ve always been cautious about sex, but now it’s really frightening.” said Jeni Young, 15, another Eagle Rock student. “The idea of sex and the possibility of getting AIDS . . . just overwhelms me. At this point in my life I wouldn’t have sex with anyone.”

But the dozen teen-agers sitting under a row of trees on a sunny day agreed that many of their friends are still being careless, even after taking a required AIDS education unit in their health class. “They take the class but don’t listen,” said Steve Wong, 15. “They were only there because they had to be.”

Although fewer than 1% of those afflicted with acquired immune deficiency syndrome are between the ages of 13 and 19, a host of Southern California doctors, school officials and health professionals are concerned that teen-agers are at substantial risk of contracting the virus because of adolescents’ tendencies to be rebellious, act invulnerable and to experiment with sex and illicit drugs.

Long Period of Latency

Because of AIDS’ long latency period and because teen-agers do not typically engage in as much high-risk behavior as older adults, experts say AIDS may never reach epidemic proportions among 13- to 19-year-olds. They say, however, that teens will continue to become infected and point to the growing numbers of young adults between the ages of 20 and 24 with AIDS or AIDS-related complex, noting that most of these people contracted the HIV virus during their teen-age years.

“We should be very worried,” said Dr. Thomas Mundy, director of the Pediatric AIDS Center at Cedars Sinai Medical Center. “Everyone thinks that adolescents and young teens are going to be the next big risk groups.”

As of last week, 265 teen-agers nationwide had been diagnosed with AIDS. Of those, roughly half are dead. The Centers for Disease Control reports that 4,890 people have been diagnosed with AIDS in the Los Angeles area--12 between the ages of 13 and 19.

Although that number of teen-agers with AIDS is minuscule compared with the 62,740 cases reported nationally, Margaret Oxtoby, medical epidemiologist for the CDC’s AIDS Pediatric and Family Unit, said the number of teen-agers being diagnosed with AIDS each year is almost doubling and that the scale of the problem should not be underestimated.

With no cure or vaccine in sight, changing behavior through education has become the priority. Already 17 states require some kind of AIDS education in the public schools and many others have voluntary programs.

Even though California has more students to educate than any other state, AIDS education is not mandatory. Ruth Rich, coordinator of health education for the Los Angeles Unified School District, said the district has tried to emulate the kind of intensive education put forth in the gay community. But she acknowledged, “Up until now, we haven’t put forth the kind of effort we should have.”

“Students are really scared,” said Sharon Sinclair, head of the health education department at Marshall High School in Los Angeles. “They don’t have the facts, so there is lots of misinformation going around. They want to know, ‘How is this going to affect me personally?’ ”

There is some doubt over how effective education is. A team of UC San Francisco researchers has documented cases in which teen-agers who say they are more aware of the disease and how it’s contracted, are nonetheless less likely to take precautions shown to cut chances of getting AIDS.

“Teen-agers are notorious for thinking they’re invulnerable,” said Mary Kaufman, head of the health education program at Eagle Rock High School. “Unfortunately, it may take a few kids they know to die (of AIDS) before the impact is going to set in.”

Concern for Young Adults

Oxtoby, too, is concerned about the growing numbers of AIDS patients between 20 and 24 years old. She said this group, which is growing faster than the general AIDS population, now represents roughly 8% of all patients.

“There is a worrisome lag between when you test positive and when symptoms start showing up,” said Mundy of Cedars Sinai, citing a recent study by the U.S. Army that showed 2% of new recruits in the New York City area--mostly 18- or 19-years-olds--are healthy, but HIV-positive. There is no way of knowing, he added, just how many of these or similar teen-agers will eventually fall ill with AIDS.

So the push is on to educate. Through education, experts say, teen-agers can be taught that certain activities put them at risk of catching AIDS. And hopefully with knowledge, they say, teen-age behavior will change.

Following an example set by the San Francisco Board of Education, the cities hardest hit by the spread of the disease have developed intensive AIDS education programs.

Although it got a late start, the Los Angeles district has developed one of the country’s leading programs. The recent recipient of a five-year, $225,000 grant from the Centers for Disease Control, the district has been performing in-depth monthly training sessions for principals and health education teachers, those primarily charged with AIDS education.

Up-to-Date Information

Using materials prepared by the CDC and other health agencies, teachers are given up-to-date information from doctors, epidemiologists and other health professionals.

The current curricula, developed late last year, introduces children to AIDS in seventh- and 10th-grade health classes where they are taught about sexually transmitted diseases. High-risk behavior associated with intravenous drugs are discussed, as is heterosexual sexual activity. But discussion of high-risk homosexual behavior is limited to references to “male-to-male” intercourse.

After 10th grade, AIDS education moves outside the classroom to school-sponsored “awareness months” featuring speakers, poster contests and other special programs to make teen-agers aware of the disease, its symptoms and how it is contracted in an attempt to “saturate” the students with information, Rich said.

Until teens are mature enough to handle the implications of intercourse, abstinence is the only method of prevention discussed, Rich said. But when adolescents reach an age where they might be sexually active--usually in ninth or 10th grade--they are given “all the information they need to protect themselves,” including facts about contraception.

Some critics, nonetheless, consider the program puritanical.

‘Learn to Talk Frankly’

“We as a country have to learn to talk about AIDS very frankly,” said Mundy. “That means we have to talk about sex very frankly, including talking about being straight, gay and using condoms.”

Sinclair at Marshall High, who recently completed the two-day training program, said she has noticed a marked change in how her students react to information about sexually transmitted diseases since the onslaught of AIDS.

At Eagle Rock High, Kaufman said where there used to be snickering there is now rapt attention and where there were jokes there are now questions. “One student asked me if you could get it from (saliva on) the dummies they use to teach CPR,” she said.

At Palisades High School, Larry Marshall, head of the health education department, said he is pleased with the reaction to the AIDS unit. He said one boy came to him privately to tell him that because of the class, he had started using condoms.

Begins in Kindergarten

Yet Los Angeles’ AIDS education program is still not as sweeping as others around the country. In San Francisco, for example, basic health education begins in kindergarten with discussions of human anatomy and continues until the reproductive system and the AIDS virus are discussed in fifth grade.

In sixth grade, more intensive instruction takes place. The 14 activity units are repeated and built upon every year until high school.

In high school, the curricula, developed by medical doctors, medical health educators and the San Francisco Department of Public Health, goes beyond the facts of the disease to help students understand the moral, social and even financial problems associated with it.

According to Joan Haskin, curriculum consultant for the San Francisco Unifed School District, the latest program, developed only last December, has not been implemented long enough to gauge its effectiveness.

The New York City schools begin teaching about AIDS in the fourth grade.

Scope Expands

In 1986, the board there introduced a six-phase lesson plan for the seventh through 12th grades, and started smaller programs for children in grades 4 through 6 this month. The junior and senior high school program goes further to not only clarify myths and provide facts, but delves into societal impact, peer pressure and civil liberties issues, such as mandatory HIV testing.

Although the scope of these programs is a giant step above the scare tactics first used to alter behavior, Geri Abelson, AIDS Education Project director for the New York City school board, said education will only go so far.

In New York City, which leads the nation in the number of reported AIDS cases with 14,209, Abelson said children in some parts of the city see their parents “shooting up and sharing needles every day.” For them, she said, education begins too late.

Researchers at UC San Francisco found that while girls said they were more aware of how AIDS is transmitted, the number of 14- to 19-year-olds who said their partners used condoms actually declined from 1984 to 1985. AIDS CASES BY AGE The following statistics are from the Centers for Disease Control’s weekly surveillance report as of May 23.

AGE NUMBER OF CASES Under 5 833 5-12 157 13-19 265 20-29 12,977 30-39 29,077 40-49 13,025 Over 49 6,406