Promoting Early Detection of Human Immunodeficiency Virus Infection Among Adolescents

Abstract

While a significant and increasing number of adolescents are infected with the human immununodeficiency virus (HIV), few youth are identified as seropositive and even fewer are linked to medical care and social services. If more youth were identified, transmission to sexual partners and offspring would be reduced and individuals could benefit from treatment. Prior to initiating wide-scale early detection for HIV, we must (1) examine alternative strategies of conducting pretest and posttest counseling; (2) address barriers to prevention and testing within the HIV system of care; and (3) mount community-level intervention campaigns that address youth at high risk of infection.

HIV testing and counselling in Colombia: evidence from a national health survey and recommendations for health-care services

“…Other studies have found that approximately 80% of those infected are young MSM, and have not been informed of their diagnosis. 10,11 These data cause concern because people who have not received their diagnosis of HIV are responsible for transmission of about 50% of new cases. 12 In Colombia, the Pan American Health Organization 13 has called for broadening the scope of, and guaranteeing access to HIV testing.…”

Effective Detection of HIV

“…Even among individuals who suspect they may have been exposed to HIV, testing is often delayed, sometimes for longer than a year (59,60 (74). Data from adolescent medicine clinics (75) suggests that only about 11% of identified youth living with HIV are linked to care (76). Although linking seropositive persons to care is an important goal in itself, increasing the proportion of infected individuals who are referred to and followup in care will also help to decrease rates of HIV transmission.…”

“…Mainstreaming of HIV testing refers to offering HIV testing as a routine procedure in primary health care with an informed right of refusal (i.e., voluntary opt-out), rather than relying on client requests for testing (i.e., voluntary opt-in) (76,125). In routine testing, the burden is shifted from those who would want to take an HIV test to those who want to refuse testing.…”

“…Methods for increasing the numbers of high-risk individuals tested include community outreach efforts (97,135,136); increased testing accessibility (97,103,129,130,136); partner notification (137); postexposure prophylaxis for sexual transmission (138,139); and tailored social marketing of HIV testing (28,76,128). Several types of outreach have been demonstrated to increase testing rates.…”

“…Overall, increased funding and research to implement culturally appropriate, tailored social marketing of HIV testing to individuals and populations at high risk for HIV, and least likely to be tested (e.g., inner city adolescents), may be vital to promoting early detection (28,76). In particular, messages must be tailored for high-risk and untested populations, so as not to increase testing predominantly among the worried well (28).…”