Samet J H, Winter M R, Grant L, Hingson R
Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
Pediatrics. 1997 Sep;100(3 Pt 1):371-7. doi: 10.1542/peds.100.3.371.
To assess sexually active adolescents' knowledge, attitudes, and behaviors associated with human immunodeficiency virus (HIV) testing and to determine the factors important in their decision to obtain voluntary HIV testing.
Anonymous, random, digit-dial telephone survey undertaken in 1993.
Massachusetts households.
Adolescents, 16 to 19 years of age.
Of the 567 adolescents surveyed who had sexual intercourse within the past year, 127 (22%) had received HIV testing, with 54 (10%) stating that this testing was for personal reasons. A "great deal" or "some" worry about getting HIV/acquired immunodeficiency syndrome (AIDS) was expressed by 51%, and 56% felt that it was at least a little likely that they will get AIDS. Misconceptions were common about aspects of HIV testing: 35% did not believe or did not know that the HIV test results were kept in confidence, 19% thought that AIDS testers informed partners if the results were positive, and 30% did not think that the HIV test was very accurate. Although 92% (452/490) had seen a physician in the past year, only 30% (136/452) had ever discussed AIDS with a doctor. Multivariable analysis identified five factors as independently associated with voluntary adolescent HIV testing: 1) having had more than one sexual partner within the past year [odds ratio (OR): 2.9; 95% confidence interval (CI): 1.5, 5.5]; 2) believing that condoms are only somewhat effective at preventing the spread of AIDS (OR: 2. 6; 95% CI: 1.4, 4.8); 3) having discussed AIDS with a doctor (OR: 2. 6; 95% CI: 1.4, 4.8); 4) not having had a teacher discuss AIDS (OR: 2.2; 95% CI: 1.2, 4.2); and 5) believing that a positive test result means one has AIDS as opposed to carrying the virus (OR: 2.0; 95% CI: 1.1, 3.7). High-risk behavior of infrequent condom use and a history of a sexually transmitted disease were not significantly associated with voluntary HIV testing.
Among sexually active Massachusetts adolescents, voluntary HIV testing is uncommon. Teens who have had multiple sexual partners and who do not believe condoms are effective in preventing transmission were most likely to have been tested. Issues requiring clearer communication to patients include the testing process, its availability, and confidentiality. Physicians can play an influential role in the promotion of HIV testing by discussing HIV risk behaviors with patients and offering those at risk voluntary HIV counseling and testing.
评估性活跃青少年与人类免疫缺陷病毒（HIV）检测相关的知识、态度和行为，并确定影响他们决定进行自愿HIV检测的重要因素。
1993年进行的匿名、随机、数字拨号电话调查。
马萨诸塞州家庭。
16至19岁的青少年。
在过去一年中有过性行为的567名接受调查的青少年中，127人（22%）进行过HIV检测，其中54人（10%）表示检测是出于个人原因。51%的人“非常”或“有些”担心感染HIV/获得性免疫缺陷综合征（AIDS），56%的人认为他们至少有一点可能会患上AIDS。对HIV检测的各个方面存在常见误解：35%的人不相信或不知道HIV检测结果会保密，19%的人认为AIDS检测人员如果结果呈阳性会告知伴侣，30%的人认为HIV检测不是很准确。尽管92%（452/490）的人在过去一年中看过医生，但只有30%（136/452）的人曾与医生讨论过AIDS。多变量分析确定了五个与青少年自愿进行HIV检测独立相关的因素：1）在过去一年中有多个性伴侣[比值比（OR）：2.9；95%置信区间（CI）：1.5，5.5]；2）认为避孕套在预防AIDS传播方面只是有些效果（OR：2.6；95%CI：1.4，4.8）；3）曾与医生讨论过AIDS（OR：2.6；95%CI：1.4，4.8）；4）没有老师讨论过AIDS（OR：2.2；95%CI：1.2，4.2）；5）认为检测结果呈阳性意味着感染了AIDS而不是携带病毒（OR：2.0；95%CI：1.1，3.7）。不经常使用避孕套的高危行为和性传播疾病史与自愿HIV检测没有显著关联。
在性活跃的马萨诸塞州青少年中，自愿进行HIV检测并不常见。有多个性伴侣且不相信避孕套能有效预防传播的青少年最有可能接受过检测。需要与患者更清楚沟通的问题包括检测过程、可及性和保密性。医生通过与患者讨论HIV风险行为并为有风险的人提供自愿HIV咨询和检测，在促进HIV检测方面可以发挥有影响力的作用。
