Acquired immunodeficiency syndrome transmission: changes in knowledge and behaviors among teenagers, Massachusetts statewide surveys, 1986 to 1988.

Despite substantial progress, adolescents remain at high risk for human immunodeficiency virus (HIV) infection. Two independent random digit dial statewide Massachusetts surveys of 16- to 19-year-old persons conducted August through September 1986 and 1988 revealed that the proportion of teenagers who had discussed acquired immunodeficiency syndrome (AIDS) in schools increased from 52% to 82%. Knowledge about how AIDS is transmitted was also significantly higher in 1988. The proportion of teenagers using drugs other than alcohol and marijuana declined from 13% to 9%, and intravenous drug use declined from 1% to 0.1%. At the same time, among sexually active teenagers, the proportion who reported changes in sexual behavior to avoid AIDS increased from 16% to 34%. The proportion who adopted condom use to avoid AIDS increased from 2% to 19%. However, the overall proportion of teenagers who reported sexual intercourse in the past year increased significantly from 55% to 61%. In 1988, among sexually active teenagers, 37% never used condoms and 33% used them only some of the time. Of all respondents, 18% reported unprotected sex with more than one partner in the previous year, and 3% reported unprotected sex with intravenous drug users. Although mass media and school education may increase knowledge and stimulate some teenagers to change behavior, for others more personal forms of counseling may be needed. The effects of increasing physician counseling warrant special study. Teenagers who had spoken to physicians about AIDS were much more likely to have adopted condom use to avoid HIV exposure. However, although 80% of adolescents saw a physician in the past year, only 13% were counseled about AIDS.