STD Quarterly
Boost efforts to test teens for HIV — 13% of high school students have been tested
Results of a new report from the Centers for Disease Control and Prevention (CDC) show about 13% of high school students have been tested for HIV, despite the fact that this age group harbors a disproportionate number of undiagnosed cases.1
HIV testing is an essential step in reducing new HIV infections in the United States, says Andrew Voetsch, PhD, an epidemiologist in the CDC's Division of HIV/AIDS Prevention and lead author of the current research. Although young people ages 13-24 represent a relatively small proportion of all people living with HIV in the United States, research suggests that nearly half of all young people living with HIV do not know they are infected.2,3 In contrast, 61% of those ages 30-49 say they have never been tested for HIV.4
To assess the extent to which teens are being tested for HIV, CDC researchers looked at data from the 2007 Youth Risk Behavior Survey, a national survey that monitors priority health-risk behaviors in young adults. After quality control measures, data from 14,041 students were available for analysis; 12,120 (86.3%) students answered the HIV testing question.1
Results indicate that the prevalence of HIV testing increased with higher grade and diminished with increasing age at first sexual intercourse. Prevalence of HIV testing was higher among female students (14.8%) than male students (11.1%), and higher among non-Hispanic black students (22.4%) than Hispanic (12.7%) and non-Hispanic white students (10.7%), researchers report. Prevalence of HIV testing also was higher among students who had ever had sexual intercourse (22.3%) than those who had never had sexual intercourse (4%).1
"While HIV testing was highest among black high school students (39% of female; 21% of male sexually active students had been tested), increases in HIV testing among this population are critical, especially given the significant impact that HIV has on African Americans across the nation," says Voetsch.
Why is it so important that American adolescents be tested for HIV? Consider these statistics from the 2007 Youth Risk Behavior Survey of U.S. high school students:
- 48% have had sexual intercourse at least once (including 33% of ninth-grade students and 65% of 12th-grade students);
- 7% had sexual intercourse for the first time before age 13;
- 15% have had four or more sex partners (including 9% of ninth-grade students and 22% of 12th-grade students);
- 38% of sexually active students did not use a condom the last time they had sex (including 31% of ninth-grade students and 46% of 12th-grade students);
- 2% have injected illegal drugs at least once.5
National guidelines are in place to support routine HIV testing of adolescents. The CDC in 2006 recommended that voluntary HIV screening become a routine part of medical care for all patients ages 13 to 64.6 Recommendations for routine screening without regard to risk also have been adopted by several professional organizations, including the American College of Obstetricians and Gynecologists and the American College of Physicians.7,8
The American Academy of Pediatrics recommends that clinicians obtain information from adolescent patients regarding their sexual activity and inform them how to prevent HIV infection.9 The Society for Adolescent Medicine advises offering testing and effective risk-reduction counseling and assistance as part of routine care of sexually active adolescents, especially those who live in high HIV prevalence areas.10
Because many adolescents access health care, routine testing in these settings as recommended by CDC can play an important role in increasing testing and knowledge of HIV status among high school students, says Voetsch.
Many schools are getting out the message about testing through HIV education, counseling, and testing. Findings from the 2006 School Health Policies and Programs Study indicate that among U.S. high schools, 85% teach how HIV is transmitted as part of required courses. Just more than three-quarters (77%) teach how HIV is diagnosed and treated, while 76% teach how to find valid information or services regarding HIV or HIV counseling or testing.11
On the public health front, providers are finding creative ways to get HIV prevention information out to youth. The Houston Department of Health and Human Services (HDHHS) teamed up with several organizations to host the Third Annual Hip Hop for HIV Awareness Intervention, an early summer screening event that rewarded some 15,000 teens and young adults tested for HIV and syphilis with free entrance to a July 2009 hip hop concert.
The need for HIV awareness is high in Houston. In 2008, African-American youths accounted for 65% of the new HIV cases among county residents ages 13 to 24.12 To conduct the multiday screening, the health department collaborated with more than 30 community-based organizations for testing and education, says Marlene McNeese Ward, the department's bureau chief of HIV, STD, and viral hepatitis prevention.
Using electronic forms of communication such as the Internet is vital to getting out the testing message, says McNeese Ward. To promote the testing sites, the health department listed locations on its web site, with co-sponsor radio station KBXX-FM posting similar information. Affiliated organizations also listed testing times on their web sites, she notes.
Artists performing at the concert included Plies, Pleasure P, Day 26, Melanie Fiona, Bobby Valentino, LeToya Luckett, Yung Problemz, Yung L.A., G.T., Gorilla Zoe, Bun B, Fat Pimp, and Ginuwine. "We're really excited that we have actual hip hop artists who are willing to spread the word and speak very frankly about the importance of getting an HIV test and knowing your status," notes McNeese Ward. "Hopefully, it makes it very unscary and safe for adolescents to get an HIV test."
References
- Centers for Disease Control and Prevention. HIV testing among high school students — United States, 2007. MMWR 2009; 58:665-668.
- Rotheram-Borus MJ, Futterman D. Promoting early detection of human immunodeficiency virus infection among adolescents. Arch Pediatr Adolesc Med 2000; 154:435-439.
- National Institutes of Health, Office of AIDS Research. Report of The Working Group to Review The NIH Perinatal, Pediatric, and Adolescent HIV Research Priorities. Bethesda, MD: National Institutes of Health; 1999.
- Kaiser Family Foundation. 2009 Survey of Americans on HIV/AIDS. Summary of Findings. April 2009. Accessed at www.kff.org/kaiserpolls/7889.cfm.
- Centers for Disease Control and Prevention (CDC). Youth risk behavior surveillance — United States, 2007. MMWR 2008; 57(SS-4).
- Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep 2006; 55(RR-14):1-17.
- American College of Obstetricians and Gynecologists. ACOG committee opinion. Routine human immunodeficiency virus screening. Obstet Gynecol 2008; 112(2 Pt 1):401-403.
- Qaseem A, Snow V, Shekelle P, et al. Screening for HIV in health care settings: A guidance statement from the American College of Physicians and HIV Medicine Association. Ann Intern Med 2009; 150:I-44.
- American Academy of Pediatrics. Adolescents and human immunodeficiency virus infection: The role of the pediatrician in prevention and intervention. Pediatrics 2001; 107:188-190.
- D'Angelo LJ, Samples C, Rogers AS, et al. HIV infection and AIDS in adolescents: An update of the position of the Society for Adolescent Medicine. J Adolesc Health 2006; 38:88-91.
- CDC. The HIV Epidemic and United States Students. Atlanta: U.S. Department of Health and Human Services, CDC; 2008.
- George C. Hip-hop concert serves as lure for HIV screenings. Houston Chronicle, June 21, 2009. Accessed at www.chron.com/disp/story.mpl/front/6491088.html.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content