Young adults, teens prefer rapid HIV testing

By Becky Ham

Teens and young adults prefer rapid HIV testing that can deliver results in less than an hour, but some still worry about whether their tests will be confidential, according to a new study published online in the Journal of Adolescent Health.

More than 85 percent of youth who came to a Boston clinic for a free chose the rapid tests, “which can help prevent further transmission of HIV,” said Selin Tuysuzoglu, M.D., lead study author.

Although a third of the teens surveyed preferred completely free testing, many said they would be willing to contribute at least $10 toward the cost of a future rapid HIV test. However, 39 percent said they had some concerns that their parents and health insurers would discover the results.

The strong support for was encouraging to Tuysuzoglu and his fellow researchers at Children’s Hospital Boston. Few adolescents know where to undergo testing, he said, and those who get conventional tests rarely return for their results one to two weeks later.

“Even small decreases in turnaround time can improve receipt of results,” he said.

In 2007, the year the study took place, nearly one-third of new HIV infections in the United States occurred among people age 29 and younger. The Centers for Disease Control and Prevention estimates that there would be fewer cases of new sexually transmitted HIV by 30 percent if people knew their HIV status earlier in the course of their infection.

Most of the people who sought free tests at the clinic were women and the average age of the patients was 20 years old. After receiving their choice of a non-rapid or rapid test, 127 of the patients filled out an anonymous survey about what they knew and preferred about HIV testing.

Older youths were more likely to know about the different testing methods and were more willing to pay at least some of the test’s costs. Younger patients were more apt to say they were scared of tests involving needles and they knew less about the different testing options available to them.

Rebecca Swenson, Ph.D., an assistant professor of psychiatry and human behavior at Brown University who has studied other barriers to HIV testing among teens, said that “the context of a relationship” could also influence an adolescent’s willingness to undergo testing.

For instance, teens who use condoms inconsistently with a serious partner “were nearly four times more likely to accept testing than those reporting multiple sex partners,” she said. “Sexually active teens who are not in relationships are less likely to accept testing despite potentially being at greater risk for HIV exposure.”

“Some youth only test if it’s free or if rapid testing is available,” Tuysuzoglu added. The Boston study suggests that health care providers might have to pursue some “creative solutions” to make teen HIV testing more routine, such as using alternate billing codes for the test to provide more confidentiality to the patients.

Study co-author Cathryn Samples, M.D., who heads the adolescent program at Children’s Hospital, said clinicians must be more vigilant about providing post-test counseling and medical follow-up, and alternatives to routine testing, “because younger teenagers in our study were less inclined to discuss test results with medical providers.”

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