Pediatricians can play a key role in preventing and identifying human immunodeficiency virus (HIV) infection by promoting risk-reduction counseling and offering routine testing to adolescent and young adult patients, according to a new AAP policy statement, appearing in the November 2011 Pediatrics (published online Oct. 31).
Despite great progress in treatment and continued efforts to screen targeted populations, more than 1 million Americans were living with HIV in 2006, including 55,320 adolescents and young adults. Approximately 20 percent of Americans with HIV are unaware of their infection (for HIV infected youth, 48 percent are unaware of their infection).
The AAP statement, "Adolescents and HIV Infection: The Pediatrician's Role in Promoting Routine Testing," recommends that pediatricians offer routine HIV screening. In communities where the prevalence of HIV in the patient population is more than 0.1 percent, screening should take place in pediatric offices for all adolescents, beginning at ages 16 to 18. In low-risk areas, screening is recommended for sexually active adolescents and those with other HIV risk factors, such as substance abuse.
Pediatricians should provide an environment of tolerance and facilitate open discussions regarding sexual risk and sexual orientation. In addition, physicians should know and recognize the symptoms of HIV, understand state laws regarding testing of youth, and routinely assess patient sexual and substance use behaviors. Adolescents tested for other STIs should be tested for HIV at the same visit. Testing in emergency rooms and urgent care settings in high-risk areas can reach youth who do not receive regular preventative services. This statement promotes the goal of making discussions of sexual risk and HIV testing a routine part of adolescent health care.