Reasons for Testing and Clinical and Demographic Profile of Adolescents With Non–Perinatally Acquired HIV Infection

Abstract

OBJECTIVES. We sought to examine the demographic, clinical, and behavioral characteristics; reasons for HIV testing; and factors that contribute to delays in entry into specialized HIV care after diagnosis of HIV infection among adolescents in an urban clinic in Georgia.METHODS. All of the data for this study were obtained solely by medical chart review. Demographic, clinical, behavioral, and HIV testing data were abstracted from medical charts of 59 non-perinatally HIV-infected adolescents who were aged 13 to 18 years and entered care at the pediatric and adolescent HIV clinic of a Georgia hospital during 1999 -2002. HIV-infected adolescents were compared by demographic, clinical, and behavioral characteristics as well as by circumstances surrounding HIV testing. Recent seroconversion was defined as having a documented negative or indeterminate HIV antibody test (confirmed) or a self-reported negative HIV test (probable) Յ6 months before HIV diagnosis.RESULTS. Of 59 HIV-infected adolescents, 35 (59%) were female and 56 (95%) were black/African American. Fifteen (25%) had Ն1 sexually transmitted infection when they entered care. All female (vs 38% male) adolescents were infected through heterosexual sexual intercourse; 9 (26%) were pregnant at the time of HIV diagnosis. Adolescents whose HIV was diagnosed at non-health care facilities entered HIV care much later than adolescents whose HIV was diagnosed at health care facilities (median: 108 vs 25 days). Approximately one half of adolescents had CD4 ϩ T-cell counts Ͻ350 cells per L and/or HIV-1 viral loads Ͼ55 000 copies per mL at entry into care. Twenty-seven (46%) adolescents had a previous negative HIV test; 7 had confirmed recent seroconversion, and 3 had probable recent seroconversion. Among adolescents with a documented reason for testing, routine medical screening was the most frequent reason for HIV testing; few adolescents were documented as having self-initiated HIV testing.

Adolescents and HIV Infection: The Pediatrician's Role in Promoting Routine Testing

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HIV testing experiences of Aboriginal youth in Canada: service implications

“…The most common reasons youth, including Aboriginal youth, seek an HIV test are because they have been advised by a health care worker; have engaged in a high risk behavior (i.e., injection drug use, unprotected sex); for prenatal screening; or because they are feeling sick (Bucharski et al, 2006;Grant et al, 2006;Mackellar et al, 2006;RotheramBorus, Gillis, Reid, Fernandez, & Gwadz, 1997;Samet & Winter, 1997). Very little information is available about youth perceptions on test counseling; however, one study of HIV testing sites in the USA reported that only 28% of youth said the counselor did a ''good'' job helping them identify their HIV risk behaviors (Schneir, Belzer, & Adivi, 1998).…”

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