Want Youth Testing for HIV? Tackle Confidentiality Concerns, Offer Full Services

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One of the big challenges in getting young people tested for HIV is their fear that their parents might find out, say experts associated with What Works in Youth HIV, a U.S. government-funded project that provides capacity-building and technical assistance on HIV services to young people and using digital tools to reach youth.

In a recent webinar sponsored by the group, they added that another issue is adolescents' belief that they are not at risk for HIV, driven both by a belief that "this doesn't happen to me" and a lack of sexual health knowledge. Confidentiality can also be a problem even in states where minors do not need parental consent for HIV or pregnancy testing, panelists explained. Health insurance companies are now required to send an explanation of benefits, which may show that an HIV test was performed. Parents have the right to review any information that a school has on their child, including health records, which may disclose referrals to HIV testing centers. The need for a parent's signature may also be an issue for street youth who need such consent to get an ID, which is often required for accessing services.

To counter these and other challenges, HIV service providers have had to become creative, they reported. Use of social media and other online venues is an important tactic for reaching young people, participants said. Some promising approaches are a social marketing campaign in Virginia that provides free at-home HIV testing kits to teens, a community mobilization initiative (Connect to Protect, C2P) that includes youth on its advisory boards, and a cooperative venture between a local clinic and the county health department (SMILE Memphis) that places a dedicated teen outreach specialist at the clinic.

The webinar profiled one project, the Jacksonville Teen Health Center, in more depth. This is a partnership among a number of organizations and bodies in Jacksonville, Florida, that provides HIV, sexually transmitted infection (STI) and pregnancy testing, STI treatment, comprehensive sexual education, counseling and referrals at local "full service" school locations operated by United Way. The teen health drop-in centers operate on specific afternoons in dedicated spaces within the schools and provide snacks and other incentives. Each school has a dedicated person who will help contact students who, for example, do not return for their test results. Schools also feature posters with the health center's hours and announce the center's visit over the public address system on the day when it is open at that school.