Why Young People At Risk For HIV Aren't Getting Tested

(Reuters Health) - Young people may be at risk for HIV infection, but very few get tested, partly because it can be difficult to access testing, researchers say.

Community organizations may be important settings for youth to get tested, according to the authors of a new report. Their study in Baltimore, Maryland, however, showed that most organizations serving youth there do not test for HIV and few can connect youth to places to get tested.

“These settings are often located close to where young people live and thus may be alternate testing locations that are easier to access than traditional clinical settings,” lead author Dr. Arik Marcell told Reuters Health by email.

Marcell added that young men in racial/ethnic minorities, or who have sex with men, may be at great risk for HIV infection.

“However, HIV testing rates are low among this population, in part because of inadequate access to testing, and this results in many young people not knowing their HIV status,” said Marcell, a professor of pediatrics at Johns Hopkins University School of Medicine in Baltimore.

In 2014, more than one in five diagnoses of HIV were among youth ages 13 to 24, according to the Centers for Disease Control and Prevention.

To determine whether youth organizations in Baltimore provide HIV testing, the study team conducted phone surveys in 2013 and 2014 with 51 heads of youth community organizations.

As reported in Public Health Reports, the organizations were located in areas identified as high risk for HIV and included afterschool programs, community centers, LGBTQ centers, recreation centers, and religious organizations.

In the survey, the researchers asked whether the organizations provided HIV testing and whether a staff member conducted the tests. Organizations that did not offer testing were asked if they referred youth to other programs for testing.

The results showed that a minority - 40 percent - of organizations serving youth offered HIV testing. Most offered testing through an external agency.

Among the 60 percent of organizations not offering testing, the majority - 73 percent - did not offer to connect youth to other settings that could provide testing.

Most of the organizations offered services not related to health, though they perceived their staff to be knowledgeable about health resources and comfortable discussing sexual health.

Organizations offering general health services were more likely to provide HIV testing. Settings where staff were more comfortable talking with youth about sexual health were also more likely to offer testing.

In addition, settings that provided referrals for STI screening and HIV care were more likely to offer HIV screening.

“Knowing one’s HIV /status is powerful, and is the portal to life-saving antiretroviral therapy,” said Ann Kurth, the dean of the Yale School of Nursing in New Haven, Connecticut, who studies youth access to HIV testing.

“Agencies that work with youth have an opportunity to help them navigate the seasons of risk around sexually transmitted infections including HIV, and should make HIV testing available and youth-friendly.”

Kurth said all young people should get tested for HIV at least once, and those at higher risk should get re-tested regularly.

“Young people need access to HIV testing, treatment, and prevention. Agencies that work with youth should provide those services or work closely with agencies that do offer them,” Kurth said.

“Agencies that wish to improve their HIV-related care can use CDC resources available at hivtest.org and gettested.cdc.gov to help review their organization’s HIV testing readiness and identify local HIV testing sites with which to partner/collaborate and/or link to,” Marcell advised.

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