November 1, 2011
When should teens get tested for HIV?
In 2006, the Centers for Disease Control and Prevention urged doctors to test all patients between the ages of 13 and 64 in all health care settings. But that universal testing approach has not quite caught on.
Recently, the American Academy of Pediatrics (AAP) changed its HIV testing recommendations. The AAP now wants all teenagers 16 to 18 years old tested for HIV if they live in an area with an HIV prevalence rate higher than .1 percent of the population. In addition, the AAP suggested that rapid HIV tests be used and that STD tests be offered as well.
Older recommendations suggested that all teens who had admitted to being sexually active be tested for HIV.
"We're finding that when targeted testing is offered to sexually active youth ... we're not getting those youth to actually test and we have not decreased the number of new infections in [that] population," says Dr. Jaime Martinez, an adolescent medicine specialist with Stroger Hospital of Cook County in Chicago. He deals with HIV-infected youth daily and is one of the authors of the AAP paper.
In 2006, there were more than 1.1 million HIV-positive people living in the United States. Of that population, the CDC says 5 percent were adolescents and young adults, ages 13 to 24 years old. That may seem like a small overall percentage but consider this: Upwards of 70 percent of new HIV infections are caused by people of all ages who are unaware of their HIV-positive status. Roughly one of every two HIV-infected adolescents don't know they're positive.
"I can't think of a downside [to testing]," says Martinez. "We find that youth who test and become aware of whether they're affected... become more conscious about engaging in safer sex practices."
Data also show that adolescents who engage in routine HIV screening are ultimately less likely to transmit the virus. The sooner a teenager is made aware of his or her status, the sooner he or she can begin treatment, prevent future transmissions of the virus, and, doctors hope, delay the development of AIDS. Yet, despite the AAP's arguments, it's questionable whether health care professionals, particularly pediatricians, will adopt this new recommendation.
In addition, the AAP also wants HIV testing to be done in emergency rooms and urgent care clinics located in those areas with a prevalence rate greater than .1 percent, claiming that many at-risk youths may not have health insurance and thus only use the ER to access medical care.
In other HIV testing related news, last week, a French study found that HIV testing in the ER for HIV was not worth the money or time. Researchers from the Emergency Department HIV-Screening Group found that out of 12,754 patients, only 18 tested positive. The report's authors believe that focusing efforts on only at-risk people is the better way to target new infections.
Kellee Terrell is the former news editor for TheBody.com and TheBodyPRO.com.
Follow Kellee on Twitter: @kelleent.