Coeytaux Karen, Kramer Michael R, Sullivan Patrick S
Episight Consulting, 10 Garden Road, Summit, NJ USA.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA.
Springerplus. 2014 Apr 24;3:202. doi: 10.1186/2193-1801-3-202. eCollection 2014.
Human immunodeficiency virus (HIV) remains an important public health issue and CDC recommends routine HIV screening for Americans aged 13-64. Adolescents and young adults are disproportionately affected compared to the overall population. We analyzed self-reported HIV testing and related risk behaviors at the state and national level among youths who had sexual intercourse, with a focus on state level differences.
This study used the state and national Youth Risk Behaviors Surveys 2005-2011. It included a total of 59,793 national-level observations and 39,421 state-level observations of US high school students, of which respectively 28,177 and 13,916 reported ever having sexual intercourse. The outcome of interest was having ever been tested for HIV. The risk behaviors were condom use at last intercourse, number of sexual partners in lifetime, age at first intercourse, ever forced sexual intercourse, and ever illegal injection drug use. Analyses performed included logistic regression and t-test analyses.
HIV testing was positively associated with HIV-related risk behaviors among sexually active high school students. However, HIV testing remained relatively low (22%) between 2005 and 2011, even for those engaging in risk behaviors. Results differed among the only 7 states that monitored HIV testing through YRBS, most commonly with respect to HIV testing and condom use.
Routine HIV testing is critical for early identification of HIV, which was set as a priority in a recent Executive Order. Our data suggest further efforts are needed to achieve widespread uptake of HIV testing among high school students. Furthermore, differences observed across states likely reflect different needs and should be followed up closely by states. Finally, having accurate data that reflects the reality of youths' lives is crucial for efficient prevention planning. Thus, more states should consider collecting HIV testing data to evaluate uptake of HIV testing among youth.
人类免疫缺陷病毒（HIV）仍然是一个重要的公共卫生问题，美国疾病控制与预防中心（CDC）建议对13至64岁的美国人进行常规HIV筛查。与总体人群相比，青少年和青年成年人受影响的比例过高。我们分析了有过性行为的青年在州和国家层面自我报告的HIV检测及相关风险行为，重点关注州层面的差异。
本研究使用了2005 - 2011年的州和国家青少年风险行为调查。该调查共纳入了59,793条国家级观测数据和39,421条州级观测数据的美国高中生，其中分别有28,177条和13,916条报告曾有过性行为。感兴趣的结果是是否曾接受过HIV检测。风险行为包括上次性行为时使用避孕套情况、终身性伴侣数量、首次性行为年龄、曾遭受强迫性行为以及曾使用过非法注射毒品。所进行的分析包括逻辑回归分析和t检验分析。
在性活跃的高中生中，HIV检测与HIV相关风险行为呈正相关。然而，在2005年至2011年期间，即使对于那些有风险行为的人，HIV检测率仍然相对较低（22%）。在仅通过青少年风险行为调查监测HIV检测的7个州中，结果有所不同，最常见的差异体现在HIV检测和避孕套使用方面。
常规HIV检测对于早期发现HIV至关重要，这在最近的一项行政命令中被列为优先事项。我们的数据表明，需要进一步努力以实现高中生中HIV检测的广泛普及。此外，各州之间观察到的差异可能反映了不同的需求，各州应密切跟进。最后，拥有反映青少年生活现实的准确数据对于有效的预防规划至关重要。因此，更多的州应考虑收集HIV检测数据，以评估青少年中HIV检测的普及情况。
