Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
Departments of Medical Social Sciences and.
Pediatrics. 2020 Mar;145(3). doi: 10.1542/peds.2019-2322. Epub 2020 Feb 11.
Adolescent men who have sex with men (AMSM) have a high rate of HIV diagnoses. An estimated 14.5% of HIV infections in the United States are undiagnosed; but among 13- to 24-year-olds, the rate is 51.4%. We describe HIV testing rates and identifies salient individual, family, school, and health care influences among AMSM.
Data were collected as part of SMART, an ongoing pragmatic trial of an online HIV prevention intervention for AMSM ( = 699). Measures included lifetime HIV testing, demographics, sexual behaviors, condom use, HIV education from school and family, sexual health communication with doctors, HIV knowledge, and risk attitudes.
Only 23.2% of participants had ever had an HIV test. Rates of testing increased with age (5.6% in 13- to 14-year-olds; 15.8% in 15- to 16-year-olds; 37.8% in 17- to 18-year-olds), and sexual experience was a strong predictor of testing (odds ratio: 6.54; 95% confidence interval: 3.95-11.49; < .001). Most participants had a regular doctor (67.5%), but few had conversations about same-sex sexual behaviors (21.3%), HIV testing (19.2%), or sexual orientation (29.2%). Speaking to a doctor about HIV testing had a large effect (odds ratio: 25.29; confidence interval: 15.91-41.16; < .001), with 75.4% who had such conversations having been tested, compared to only 10.8% of those who had not had such conversations.
Despite higher risk, few participants reported ever having received an HIV test. Data indicate pediatricians are an important, but largely untapped, source of testing and could be integral to achieving testing rates needed to end the epidemic.
男男性行为青少年（AMSM）的 HIV 感染率很高。据估计，美国约有 14.5%的 HIV 感染者未被诊断；但在 13 至 24 岁的人群中，这一比例为 51.4%。我们描述了 AMSM 中的 HIV 检测率，并确定了个人、家庭、学校和医疗保健方面的显著影响因素。
数据是作为 SMART 的一部分收集的，这是一项针对 AMSM 的在线 HIV 预防干预的持续实用试验（n=699）。测量包括一生中的 HIV 检测次数、人口统计学数据、性行为、避孕套使用、学校和家庭提供的 HIV 教育、与医生的性健康沟通、HIV 知识和风险态度。
只有 23.2%的参与者曾经接受过 HIV 检测。检测率随着年龄的增长而增加（13-14 岁组为 5.6%；15-16 岁组为 15.8%；17-18 岁组为 37.8%），性经验是检测的一个强有力的预测因素（优势比：6.54；95%置信区间：3.95-11.49；<0.001）。大多数参与者都有一个常规医生（67.5%），但很少有人与医生讨论过同性性行为（21.3%）、HIV 检测（19.2%）或性取向（29.2%）。与医生谈论 HIV 检测有很大的影响（优势比：25.29；置信区间：15.91-41.16；<0.001），有 75.4%的人进行了检测，而没有进行过这种对话的人只有 10.8%。
尽管风险较高，但很少有参与者报告曾经接受过 HIV 检测。数据表明，儿科医生是一个重要但尚未充分利用的检测来源，对于实现结束艾滋病流行所需的检测率至关重要。
