Murphy Debra A, Mitchell Rick, Vermund Sten H, Futterman Donna
Health Risk Reduction Projects, Department of Psychiatry, University of California, Los Angeles, California 90025-3556, USA.
Pediatrics. 2002 Sep;110(3):e36. doi: 10.1542/peds.110.3.e36.
To describe human immunodeficiency virus (HIV) testing patterns among high-risk, uninfected adolescents and HIV-infected adolescents, and factors associated with testing.
HIV-infected adolescents (N = 246) and high-risk, uninfected adolescents (N = 141) at 15 sites nationwide were asked about the number of times they were tested for HIV, the type of agency at which testing occurred, and reasons for testing.
The majority of participants reported being influenced to obtain testing by health care providers (53.1% of the HIV-infected group and 66.1% of the HIV-uninfected group, respectively). Female participants were somewhat more likely to have used a confidential or anonymous site for the most recent test, compared with male participants (73.5% and 67.5%, respectively). Among the HIV-infected group, feeling sick was the only factor associated with number of tests. Among the HIV-uninfected group, having more male partners, marijuana use in the past 3 months, white race, and having had same-gender partners in their lifetime (males only) were associated with number of tests. Multivariate analyses identified 2 significant models. Modeling the probability of having been tested 3 or more times, black participants were less likely to be tested than white participants (odds ratio [OR] = 0.4), and participants who felt sick were more likely to be tested than those who did not (OR = 1.7). Modeling the probability that the last test would be positive, black participants were more likely than white participants to test positive (OR = 2.3); those who were tested because they thought they might have gotten HIV from sex (OR = 3.0) or they felt sick (OR = 3.9) were more likely to test positive; participants who were tested because a health care professional recommended it were actually less likely (OR = 0.5) to test positive.
Overall, these findings highlight the importance of making HIV testing more routinely available to sexually active adolescents. More work needs to be done to normalize HIV testing among adolescents, and more innovative approaches need to be implemented on a wide scale.
描述高危未感染青少年和感染人类免疫缺陷病毒（HIV）的青少年的HIV检测模式，以及与检测相关的因素。
对全国15个地点的感染HIV的青少年（N = 246）和高危未感染青少年（N = 141）进行询问，了解他们接受HIV检测的次数、检测机构类型以及检测原因。
大多数参与者报告称，他们接受检测是受到医疗保健提供者的影响（分别占感染HIV组的53.1%和未感染HIV组的66.1%）。与男性参与者相比，女性参与者在最近一次检测时更有可能选择保密或匿名检测点（分别为73.5%和67.5%）。在感染HIV的组中，感觉身体不适是与检测次数相关的唯一因素。在未感染HIV的组中，拥有更多男性伴侣、在过去3个月内吸食大麻、白人种族以及一生中曾有过同性伴侣（仅男性）与检测次数相关。多变量分析确定了2个显著模型。在对进行过3次或更多次检测的概率进行建模时，黑人参与者接受检测的可能性低于白人参与者（优势比[OR]=0.4），感觉身体不适的参与者接受检测的可能性高于未感觉不适的参与者（OR = 1.7）。在对最后一次检测呈阳性的概率进行建模时，黑人参与者检测呈阳性的可能性高于白人参与者（OR = 2.3）；因认为自己可能通过性行为感染HIV（OR = 3.0）或感觉身体不适（OR = 3.9）而接受检测的参与者更有可能检测呈阳性；因医疗保健专业人员建议而接受检测的参与者实际检测呈阳性的可能性较小（OR = 0.5）。
总体而言，这些发现凸显了使性活跃青少年更常规地进行HIV检测的重要性。需要开展更多工作以使青少年中的HIV检测常态化，并需要大规模实施更多创新方法。
