Only one in five sexually active high school students has been tested for HIV, and young adults aren’t doing much better at finding out their status, U.S. health officials report.
As a result, an estimated 50 percent of young Americans infected with the virus that causes AIDS don’t know they have it, the researchers found.
“We haven’t made the dent that we would like to have made,” said study author Michelle Van Handel, a health scientist with the division of HIV/AIDS prevention at the U.S. Centers for Disease Control and Prevention. In fact, she said, the HIV testing rate is actually lower among those aged 18 to 24 than for older people in the United States.
Thanks to medical advances, HIV has evolved into a chronic disease instead of a fatal one. But those who are infected must take medications for their entire lives and face higher risk of various health problems as they age.
Young people — especially blacks — are particularly hard hit by HIV. According to the U.S. Centers for Disease Control and Prevention, blacks accounted for about 57 percent (7,000) of all new HIV infections among youth in 2010, which are the latest figures available. Hispanic/Latino youth accounted for 20 percent (2,390) and white youth accounted for 20 percent (2,380).
Overall, young adults made up 17 percent of the U.S. population in 2010 but more than a quarter of all new HIV diagnoses, the CDC noted. Gay and bisexual young men are most likely to get infected, but 27 percent of new infections are in females and heterosexual males.
For the new study, researchers examined the results of two U.S. surveys — one of high school students and one of adults aged 18 to 24.
Among high school students, the researchers found that 22 percent of those who’d had sex reported being tested for HIV. The survey for this age group, which looked at an average of 14,500 students a year from 2005-2013, didn’t find any change in testing rates over that time.
Among high school students, males (17 percent) were less likely to have been tested than females (27 percent).
The rates were a little higher among those aged 18 to 24. To gauge testing in that age group, the study authors looked at surveys from 2011-2013 with an average of 19,600 participants a year. The researchers found that 27 percent of males had been tested and 40 percent of females had been tested. Young adult black females had an especially high testing rate, at 60 percent in 2013.
Why are the testing rates low? Van Handel said potential reasons include lack of access to health care and too few health professionals who know about — and follow — HIV-testing guidelines. Those guidelines recommend testing for those aged 13 to 64.
“Research has shown that adolescents are more likely to get tested if their physician recommends it,” she said.
High school students may also be wary of getting tested because they fear their parents will find out through their health insurer, she said. Another hurdle, Handel said, is that blood tests aren’t necessarily routine for people of high school age.
Lisa Metsch, chair of the department of sociomedical sciences at Columbia University’s Mailman School of Public Health in New York City, said creative strategies are needed to boost testing rates among teens and young adults. Her research group, for example, has explored HIV testing at dental offices. High schools and other places where teens congregate are other potential venues for testing, she said.
Gregory Phillips II, a research assistant professor with the department of medical social sciences at Northwestern University’s Feinberg School of Medicine in Chicago, agreed with Metsch.
“Incorporating HIV testing activities into school activities — like having a mobile unit available for HIV testing outside the school on a regular basis — will normalize the activity and hopefully remove some of the stigma that remains around seeking a test,” Phillips said.
The new study findings were published online Jan. 19 in the journal Pediatrics.
For more about HIV testing, visit the U.S. Centers for Disease Control and Prevention.