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Most teens still not tested for HIV
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Most teens are not tested for HIV, even those who report risk-taking behavior, so targeted interventions are needed, according to findings published online.
Alexandra Balaji, PhD, and colleagues from the CDC examined data from 16,410 students who participated in the 2009 national Youth Risk Behavior Survey. A total of 7,591 of the survey participants reported ever having had sexual intercourse, but only 22.6% of those students said they had been tested for HIV.
Balaji and colleagues said testing was slightly higher in those who reported riskier behaviors, such as injection drug use or higher numbers of lifetime partners, and in those who reported a sexual assault, but even rates of testing in these groups did not exceed 50%.
In an accompanying editorial, Lawrence D’Angelo, MD, MPH, of the Children’s National Medical Center in Washington, D.C., said the study highlights important gaps in testing. CDC and AAP recommendations differ on routine testing, with the CDC urging HIV testing for those aged 13 to 64 years, and the AAP recommending delayed routine testing until after age 16 years.
D’Angelo and Balaji’s group agreed that “new strategies for increasing HIV testing among the adolescent population, including encouraging routine voluntary HIV testing among those who are sexually active, are needed.”
For more information:
- Balaji AB. Arch Pediatr Adolesc Med. 2012; doi:10.1001/archpediatrics.2011.1131.
- D’Angelo L. Arch Pediatr Adolesc Med. 2012; doi:10.1001/archpediatrics.2011.1555.
Disclosure: The researchers report no relevant financial disclosures.
The article authored by Balaji et al adds further evidence to a growing body of knowledge indicating that too few adolescents who are at risk of acquiring HIV by virtue of their sexual activity are being tested for HIV. Only 22.6% of sexually active high school students have been screened via serological testing. This is despite “new” 2006 guidelines from the CDC urging annual testing for any patient at high risk of acquiring disease. This recommendation is supported by the relatively low cost of screening and concern that more than half of HIV-infected adolescents are unaware of their HIV status, and are thus unable to engage in practices to reduce transmission that are being implemented by those who are aware of their HIV status [MMWR. 2006, 55(RR14);1-17].
It is worrisome that providers are not making this recommendation clear to patients, which may be, as the authors suggest, due in part to provider discomfort with discussing sex and sexuality with patients. It may be helpful to urge providers to “package” annual HIV testing among young people with annual Chlamydia screening, which is estimated to be at about 40% among young females in the United States [MMWR. 2009, 58(22);623]. Thus, HIV screening would be lumped in the category of routine screening and may be easier to accomplish. Finally, the use of strategies found to be successful with other screening and prevention initiatives, such as standing orders and patient recall strategies may prove helpful; more study is warranted.
— Amy Middleman, MD, MPH
Infectious Disease News Editorial Board member
Disclosure: Dr. Middleman reports no relevant financial disclosures.
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