November 1, 2011
The American Academy of Pediatrics on Monday issued a new policy statement on routine testing for HIV, urging providers to screen all youths who are sexually active and those with other risk factors, and all teens ages 16-18 in high-prevalence settings.
Persons ages 13-24 make up 55,000 of the 1.1 million Americans living with HIV. "Forty-eight percent of the youth who are infected don't know they are infected," said Dr. Jaime Martinez of the University of Illinois-Chicago, a co-author of the statement. "It's important to realize that those who don't know they are infected drive the epidemic," he said.
Martinez said some pediatricians may be uncomfortable offering HIV
testing to younger teenagers. But more than 60 percent of 12th-graders say they are sexually active, often while under the influence of drugs or alcohol, he noted.
Since 2006, CDC has recommended routine HIV testing for everyone ages 13-64. An HIV test costs about $14, and is 99 percent accurate, said Martinez.
"I think the policy statement is a reasonable statement, but I say that recognizing that they don't take it far enough in terms of how this should be done," said Denver Health Medical Center's Dr. Jason Haukoos. He said questions remain as to cost-effectiveness and who would pay for the screening, as well issues pertaining to minors' consent and disclosure.
The statement, "Adolescents and HIV Infection: The Pediatrician's Role in Promoting Routine Testing," was posted online in the journal Pediatrics (2011;doi:10.1542/peds.2011-1761).