Improving HIV Screening for Adolescents When They Go to Their Primary Care Doctor

Statement of Problem

The incidence of HIV infection is increasing among adolescents and young adults, particularly for those who identify as LGBT and gender-expansive, and now accounts for nearly 40 percent of new HIV infections in the United States. The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend routine HIV screening for all adolescents in order to identify youth living with HIV, link them to appropriate care, and prevent new infections. The reasons for low rates of routine testing in adolescents are unclear, but multiple barriers to testing exist for pediatric primary care providers. If we can better understand these barriers and how they affect adolescents’ unique health care needs, then we can create interventions to ensure all adolescents receive routine HIV screening.

Description

Improving HIV screening for adolescents when they go to their primary care doctor

Almost 78% of youth who reported to be sexually active have not been tested for HIV.

This study aims to evaluate the current HIV screening practices among pediatric primary care providers (PCPs), as well as their knowledge and attitudes towards national HIV screening recommendations and state law. PolicyLab staff administered an anonymous survey to providers in 29 practices in the CHOP pediatric primary care network. The survey sought to identify barriers that exist for testing adolescents for HIV and to develop program and policy change across the institution to reduce these barriers.

Issues related to confidentiality and concerns about having ample time for test counseling and follow-up of results with the patient were the most commonly cited barriers. Providers requested more education on legal and ethical requirements around testing the adolescent and having confidential sexual health discussions without a parent present. Providers also identified that having access to an adolescent health educator would increase screening rates.

Next Steps

Dr. Dowshen and the Adolescent Initiative are now working with several practices throughout the CHOP network to address these barriers and improve screening rates. If you would like to learn more about the Adolescent Initiative and how you can support this work, please click here

Suggested Citation

The Children's Hospital of Philadelphia, Policy Lab. Improving HIV Screening for Adolescents when They Go to Their Primary Care Doctor [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].