Vitality

Less Than A Quarter Of Sexually Active Teens And Only A Third Of Young Adults Are Getting Tested For HIV

Teens
A new study shows that HIV testing rates among sexually active teens and young adults are still way too low. Diverbo Idiomas, CC BY 2.0

It seems the young’uns are still reluctant to get tested for HIV, and adults (save Charlie Sheen) aren’t doing much to help encourage them.

A new study published this February in Pediatrics analyzed the trends of HIV screening among sexually active teens and young adults, hoping to update earlier studies that found abysmal low rates among both groups. Despite the growing number of health organizations in recent years recommending that all teens, even those not sexually active, receive regular HIV testing, the authors found that overall rates haven’t significantly changed since 2005. For certain groups, such as young black women, they’ve even gotten worse.

“HIV testing prevalence was low among high school students and young adults,” they wrote. “No increase in testing among young adult males and decreased testing among young adult black females is concerning given their higher risk of HIV infection.”

Specifically, the researchers looked at eight years worth of data from the National Youth Risk Behavior Survey, an extensive poll of high school students taken every two years. From there, they estimated that during 2005 to 2013, an average of 22 percent of teens who ever had sex received HIV testing. For those who had four or more sexual partners in their lifetime, it was slightly higher at 34 percent, and for teens who had sex with one or more people in the last three months, it was 24 percent. Male teens were less likely than their female counterparts to get tested, 17 percent vs 27 percent, while the highest rate was seen among black female teens, at 36 percent.

They then turned to data from the Behavioral Risk Factor Surveillance System (a nationally representative survey performed annually), keying on the years 2011 to 2013, and on young adults from the ages of 18 to 24. These particularly young millennials fared slightly better, with 33 percent on average ever having been tested. As before, there were significant differences when it came to ethnicity and gender, with only 27 percent of young adult men getting tested. Black women again had the highest testing rate, but it decreased from 69 percent of those surveyed in 2011 to 60 percent in 2013. This coincided with a nearly 4 point decrease among all young women, from 42.4 percent in 2011 to 39.5 percent in 2013.

"These results indicate that recommendations to screen all adolescents and young adults for HIV infection, regardless of risk, have not been widely implemented," the authors wrote. "HIV testing programs do not appear to be successfully reaching high school students and young adults."

To bolster their point, they noted earlier research showing that many primary care providers weren’t aware of these recommendations — in one study, even as high as 80 percent. These gaps are particularly concerning because many young adults who do get tested do so in a clinical setting (80 percent in the current study), and other research has shown that people often take their cues about STD testing from their doctors.  

For teens, they note that poor sex education, barriers to health care access, and a lack of confidentiality actively discourage many from getting tested — all factors especially prevalent for minorities.

Despite only being 17 percent of the general population, people from the ages of 13 to 24 represent 26 percent of new HIV infections, though the risk is especially high for young men who have sex with other men and young black women (though this current study couldn’t measure testing rates among the former group, other studies have shown similarly low numbers). Even worse, only around 50 percent of young new HIV sufferers are aware of their status.

To begin lowering these numbers will take an updated public health approach, the researchers concluded.

“Multipronged testing strategies, including provider education, system-level interventions in clinical settings, adolescent-friendly testing services, and sexual health education will likely be needed to increase testing and reduce the percentage of adolescents and young adults living with HIV infection,” they wrote.

Source: van Handel M, Kahn L, O’Malley E, et al.HIV Testing Among US High School Students and Young Adults. Pediatrics . 2016.

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