High-risk teens not being tested for HIV

Most sexually active US high school students have not been tested for human immunodeficiency virus (HIV), despite recommendations from the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, and other organizations calling for routine testing.

CDC researchers analyzed data from the 2009 Youth Risk Behavior Survey, a nationally representative sample of students in grades 9 to 12. Students completed self-administered questionnaires about sexual activity, use of illegal drugs, and other HIV-related risk behaviors.

Of 16,410 students who returned usable data, 7,591 reported ever having sexual intercourse. Among those who had had sexual intercourse, only 22.6% had been tested for HIV. Overall, students who reported engaging in risky behaviors were more likely to have been tested for HIV.

The odds of being tested were highest among students who had engaged in high-risk behaviors such as injecting illegal drugs (1.70), being forced to have sexual intercourse (1.43), not using a condom (1.28), and having 4 or more sexual partners (2.32). In no case, however, was the proportion tested greater than 42%.

The survey did not ask about same-sex behaviors in young men, which omits a population that is at elevated risk for HIV infection.

Many adolescents underestimate their personal risk for HIV from engaging in risky behaviors, said the researchers. Current testing practices are “falling short” of making HIV testing a routine part of medical care for these sexually active adolescents.

Health care providers must be able to assess adolescents’ risk for HIV and encourage sexually active teens to be tested. Also, access to convenient, confidential testing sites in health care, school, and community settings must be provided to overcome barriers to testing, the researchers suggest.

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