Doctors urge HIV testing starting at 16
October 31st, 2011
12:01 AM ET

Doctors urge HIV testing starting at 16

The American Academy of Pediatrics now recommends that all teens 16 to 18 years old receive regular, routine HIV tests if they live in an area where the prevalence of HIV is greater than 0.1% of the population.

The AAP also advises that adolescents of any age who are tested for other sexually transmitted infections also be tested for HIV.

Previous guidelines recommended HIV testing only for teens who admitted to being sexually active. The new recommendations were outlined in a position paper released Monday that also advocates that the routine screening be done using a rapid response test that gives a diagnosis about 20 minutes after the test is conducted.

"We're finding that when targeted testing is offered to sexually active youth... we're not getting those youth to actually test and we have not decreased the number of new infections in [that] population," says Dr. Jaime Martinez, an adolescent medicine specialist with Stroger Hospital of Cook County in Chicago. He deals with HIV-infected youth daily and is one of the authors of the AAP paper.

In 2006, there were more than 1.1 million HIV-positive people living in the United States. Of that population, the CDC says 5% were adolescents and young adults, ages 13 to 24 years old. That may seem like a small overall percentage but consider this: Upwards of 70% of new HIV infections are caused by people of all ages who are unaware of their HIV-positive status. Roughly one of every two HIV-infected adolescents don't know they're positive.

"I can't think of a downside [to testing]," says Martinez. "We find that youth who test and become aware of whether they're affected... become more conscious about engaging in safer sex practices."

Data also show that adolescents who engage in routine HIV screening are ultimately less likely to transmit the virus. The sooner a teenager is made aware of his or her status, the sooner he or she can begin treatment, prevent future transmissions of the virus, and, doctors hope, delay the development of AIDS. Yet, despite the AAP's arguments, it's questionable whether health care professionals, particularly pediatricians, will adopt this new recommendation.

"Physicians in general are afraid of the issue of HIV," says Martinez. "Many pediatricians have a skewed view of their patients. They also feel they don't have time to test."

"Unless pediatricians approach young people about the importance of getting tested for HIV, it's not going to happen."

But the need for testing goes beyond pediatricians' offices. The AAP also advocates routine testing be adopted in emergency departments and urgent care clinics in areas with an infected population greater than 0.1%. The argument is that many at-risk adolescents may not have access to a primary care provider and instead receive most of their medical care from an emergency room. Plus, the recent economic downturn has caused families to lose their insurance and thus, access to their regular physician.

"It's been on our watch that these young people have continued to become infected," says Martinez.

"By promoting testing and offering counseling, we can probably have some impact on reducing the number of young people becoming infected with HIV in this country."

soundoff (103 Responses)
  1. joe


    October 31, 2011 at 03:13 | Report abuse | Reply
  2. quade

    Great recommendation, but I can already see the conservatives fighting this and advocating "just say no" instead.

    October 31, 2011 at 04:06 | Report abuse | Reply
    • Oh Yeah...

      Because it worked so great for Bristol Palin...Zing!!!

      October 31, 2011 at 08:51 | Report abuse |
    • futurelawyer2005

      I'm a conservative and I'm totally for it. I also got all 3 sets of HPV vaccs for my 11 yr old daughter. I'm also a HS social studies teacher and am NOT ignorant of what teens do, unbeknownst to their parents; even liberal open parents are usually duped! I'm also female and feel that this is an important issue for women since most new cases of HIV are amongst black females.

      October 31, 2011 at 09:08 | Report abuse |
    • bristoltwit palin... America's favorite dancing cow

      @ Oh Yeah... but everyone loved me on DWTS.

      October 31, 2011 at 09:27 | Report abuse |
  3. Mirosal

    yeah, uh-huh ... GOOD LUCK telling a teenager to say "no" to se.x lol ... that's like dangling a steak in front of a wolf, then saying "Down, boy!!" .. He'll take your hand off trying to get at it.

    October 31, 2011 at 04:40 | Report abuse | Reply
    • constant vigilance

      Why not, it worked for me. Anyone with any portion of functional brain who watches "16 and Pregnant" would either remain abstinant or who make sure everything is covered every time. Those who don't are blithering morons who deserve HIV/AIDS. Yes, HIV/AIDS is 100% preventable (as is pregnancy) and anyone who contracts it outside of blood transfusion or during birth or rape is 100% responsible for their predicament. I have no pity for those people.

      October 31, 2011 at 18:23 | Report abuse |
    • Mike

      I'm pretty confident that if Jesus read the message from "constant vigilance", he would be deeply ashamed.
      You may be chaste, but your cold feelings for your fellow man make you more evil than any amount of wh0ring ever could.
      Such callousness of heart will never be permitted in the Kingdom of Heaven, you have much praying to do.
      And I will pray for you.

      November 1, 2011 at 04:48 | Report abuse |
  4. Bill

    How about we stop marginalizing and harassing young gay men and teach them how to protect themselves (e.g. use condoms) so they will not put themselves at risk and get infected with HIV.

    October 31, 2011 at 06:14 | Report abuse | Reply
    • Darren

      Wow Bill, let's sterotype some more, hate to burst your bubble, but gay men are not the only people that are infected with HIV.

      October 31, 2011 at 07:10 | Report abuse |
    • KlausVos

      I think that's what they are advocating, though not specific to gay men.
      The more testing done, the more people know about their infection, the less likely they are to pass it on. It's good for everyone in the end.
      I don't really know what you're mad about.

      October 31, 2011 at 07:14 | Report abuse |
    • futurelawyer2005

      Bill, I say we let anyone do what they want. Natural selection will take care of the idi0ts who failed to evolve and protect themselves and anyone engaged in unnatural s*xual practices like......well, ya know. Testing isn't prevention; just awareness and/or damage control.

      October 31, 2011 at 09:11 | Report abuse |
    • Epidemiologist (@AskanEpi)

      Actually testing is prevention: people are more likely to seek treatment and avoid spreading the disease if they know they are positive. Knowingly spreading HIV is indeed a crime, and it can be traced easily.

      October 31, 2011 at 11:06 | Report abuse |
    • kmcg

      In the African-American population it is women most at risk for contracting HIV... they typically get it from partners who are cheating (with both males and females) or sharing needles.

      November 1, 2011 at 10:59 | Report abuse |
  5. Katie

    As long as doctors are willing to absorb some of the cost of the test, then I don't mind their recommendations. As long as there isn't some database kept with the results that may come back to haunt these kids, fine. Will future employers turn them down for jobs because there was a chance they had a risky lifestyle? (My neighbor's son visited a cardiologist pro-actively for a full work up because severe heart disease runs in his family. He was fine, but when he applied to the FBI they turned him down because he saw a cardiologist at such a young age. ) Will insurance companies be able to turn them away if they find out they are positive? These questions need to be answered before anyone just agrees with this recommendation.

    October 31, 2011 at 06:58 | Report abuse | Reply
    • Pat

      Well then he was only turn down for that position. Must have been some physical standard that he had to meet because they couldn't have turned him down otherwise. He could still apply for other positions with the FBI.

      October 31, 2011 at 07:20 | Report abuse |
    • J

      I agree with Katie. Let's not forget that this is also a privacy of information issue.

      October 31, 2011 at 09:22 | Report abuse |
    • independentlyowned

      Exactly! Plus, can we really test someone's blood for something without their consent? I'd agree to make it a standard question and free option when someone comes in for emergency care, but you can't test their blood without consent. That's just leading to a Big Brother state.

      October 31, 2011 at 11:19 | Report abuse |
    • ser

      now that is a well thought out and insightful reply...this should be an example of the intelligence that needs to be on these message boards to invoke a meaningful discussion....all you wanna be comedians should read this and think about it.

      October 31, 2011 at 12:11 | Report abuse |
  6. Derek

    I agree with this...however I find it weird that even as a 29-year old man, no doctor has even suggested I get an HIV test. Even when I have a physical. I have always had to request it myself.

    October 31, 2011 at 07:18 | Report abuse | Reply
    • KlausVos

      Just playing devil's advocate here. It could be because you get them frequently because you ask for them.

      October 31, 2011 at 07:22 | Report abuse |
    • LDOPE

      Don't ask your normal doctor. Go to a free testing center where you are anonymous.

      October 31, 2011 at 10:08 | Report abuse |
    • Mack

      As a medical student about to start residency, there has been a huge push to start to ask patients regularly. I think with this generation of doctors coming up, it will be much more common to ask. Older docs still do have some view that it is almost offensive to ask but as medicine changes and culture changes, people become more comfortable with newer and scary diseases. I know most of my classmates will be asking and I would imagine you will see a big change over the years.

      October 31, 2011 at 10:44 | Report abuse |
  7. ChrisC from the D

    I 100% agree with the recommendation. Teens, especially teens in at-risk communities, often engage in risky behavior they do not consider to be actual intercourse. Oral and rear entry are though of as safe, so if a doctor asks if they are having $ex, they will say no. Or, if the doc does ask specific questions, the teen may lie. How many kids would admit to activity with a parent in the room, anyways?

    As much as people hate Planned Parenthood, there was one right near my univeristy and every Wednesday they offered free HIV testing. It was the quick test mentioning in the article. The also did mobile clinics for free HIV testing. As the person mentioned in the article, there is no downside to testing.

    October 31, 2011 at 07:59 | Report abuse | Reply
  8. Sandra

    I can just hear the screed from Michelle Bachman that some woman came up to her and told her that her daughter had an HIV test and then suffered from mental retardation. Seriously though, conservatives keep equating ignorance with innocence. A little education can go a long way to preventing the spread of HIV.

    October 31, 2011 at 08:09 | Report abuse | Reply
    • Tex71

      Innocence is just a nicer sounding word for ignorance.

      October 31, 2011 at 10:54 | Report abuse |
  9. Oscar

    So there are 1.1 million infected people in the US, out of a population of 300 +/- million. It is recommended to be tested if the area's infected population is greater than 0.1%. The testing threshold is about one third of the nation's average infection rate. This just strikes me as being pretty low. Maybe it is intentionally this low, given the consequences of infection.

    How evenly are the infected people distributed across the country?

    October 31, 2011 at 08:24 | Report abuse | Reply
    • Benzin

      I believe the concentrations are higher in urban areas and unfortunately black and gay communities still have slightly higher rates.

      October 31, 2011 at 10:30 | Report abuse |
    • Julnor

      Benzin, would it be more fortunate if white and straight communities were more affected?

      October 31, 2011 at 10:41 | Report abuse |
  10. isadore

    Maybe we should start teaching our children to have an ounce of respect for their bodes and quit f#@*g everything that moves.

    October 31, 2011 at 08:27 | Report abuse | Reply
    • Sakit

      There's a typo in the picture cotpian. Tremors is aw'esome' not aw'ful'. easy mistake to make.on less important issues, you know I agree with everything you write here. Owen Barder agrees. I'm relatively sure Bill Easterly would agree. How do we change it? (sweeping generalisation alert) Most people don't like complexity, they avoid it. It's an endemic part of vast swathes of Western popular culture. And the worst thing is, there are only pockets of popular advocates for complexity as a basis for understanding in most disciplines: Ben Goldacre in medicine stands out with Bad Science, for example, and the number of people who know him are far fewer than those who know The Awful Poo Lady (Gillian McKeith).The other big issue is that the global left (in which I count myself, though as a dissenting voice) LOVES BUNDLING ISSUES. It's not just about funding. It happens everywhere. Read the comments in the Guardian's Comment is Free section. It's full of logic like Of course you're against fox hunting if you're pro-secularisation of schooling!'. It happens when they assume because I'm a Republican (note for American readers, this means I'm against the monarchy, not that I'd vote for Palin) that I must also believe that capitalism is on its last legs.These ISSUES are unrelated. the kind of people who care about one might be more inclined to believe in another cause, but that does not mean the issues should be bundled, because analytically all that does is muddy the waters and give me agita.

      March 5, 2012 at 23:25 | Report abuse |
  11. s-hug

    What's the point? There's no cure, never will be, prospects of having a normal life and family are bleak, and you become a slave to the U.S. healthcare system once you begin treatment.

    October 31, 2011 at 09:11 | Report abuse | Reply
    • HIV doc

      Have you been living under a rock for the last 15 years. Can HIV positive patients have a normal life..yes! Can they have a normal family...yes! They are no more a slave to the health care system than a diabetic or other chronically diseased patient. I have livng proof in my 500+ HIV positive patients I daily take caer of. Educate yourself

      October 31, 2011 at 09:27 | Report abuse |
    • Maya

      That's the kind of thinking that is responsible for the spread of HIV. What you don't know can't hurt you, right? WRONG.

      Not only are there now treatments that substantially improve the length and quality of life of HIV-positive people, but knowledge of their diagnosis allows them to take precautions to protect others from infection. There are even treatments now that allow a pregnant HIV-positive woman to carry and give birth without passing the infection onto the infant.

      Ignorance is toxic.

      October 31, 2011 at 11:05 | Report abuse |
  12. J

    Probably a good idea. I am a little concerned about privacy, though. Will the results of these government-mandated tests be automatically shared with our government-mandated insurance companies?

    October 31, 2011 at 09:28 | Report abuse | Reply
    • dz123

      They're not mandating the test. In fact, it's not even the government. It's the American Academy of Pediatrics, and they're recommending the test. Geez. Or, maybe you were reading a different article?

      October 31, 2011 at 10:09 | Report abuse |
  13. Julnor

    Another article about the need for more medical testing. Another article without one mention of cost. All of you in favor of this without the cost info, please do not ever complain about the rising cost of healthcare or health insurance. Tests do not grow on trees, they cost money.

    October 31, 2011 at 09:31 | Report abuse | Reply
    • Benzin

      Somewhere between $0 and $200 (just guessing, I have no idea how much they cost) or we let people die terrible deaths and unwittingly spread the same disease to others? I'm gonna go with spending the extra dough.
      It will save money in the long run because the cost of treatment is much much less than getting tested.

      October 31, 2011 at 10:34 | Report abuse |
    • Julnor

      Benzin, you test thousands to millions of people to find out which people have a disease and then you still have to treat them. I'm guessing your $200 is low as you must consider the doctor's time, the nurse's time, the lab supplies, the lab tech's time, the cost of the machines to do the testing, the cost of the reporting, the cost of the followup visit., etc. You're probably looking at closer to $500 per test. If you're willing to pay, then open up your checkbook.

      October 31, 2011 at 10:38 | Report abuse |
    • Mack

      Cost for the cheek swab (called an oro-quick) is about $10 is a good test to rule people in (as is there may be false positives but almost never misses people who have it). If that is positive, you run an HIV ELISA which costs $52 to confirm. And there are centers everywhere that absorb the cost themselves through donations. Cost for this is so miniscule that it should never be an issue.

      October 31, 2011 at 10:52 | Report abuse |
    • Tex71

      Healthcare cost is only an issue in countries where profit margins for rich investors are more important than life and health for the general population.

      October 31, 2011 at 10:56 | Report abuse |
  14. popcorn

    There is Cure for AIDS. But you can't cross the line. I remember developing new operating system and new aI search engine. I used regular calculator and divided by zero. It would explode like Atomic Bomb and asteroid would blow up Earth and create super mega ton earthquake. It's not in the bible. I even look back sodom and gomorrah from the bible.

    There is no earth material that can cure system over here.

    October 31, 2011 at 09:32 | Report abuse | Reply
    • Amom

      Why does this post that makes no sense get posted and mine, seemingly, gets lost in cyberspace?

      October 31, 2011 at 10:00 | Report abuse |
    • popcorn

      Go ahead.
      Go create it.
      You will be there.
      You will get there.
      You will see it.

      October 31, 2011 at 10:11 | Report abuse |
  15. steve

    hi id just like to say kids need to be watched 24/7 i dont care what age they are no child under age 18 should contract that i swear that is the worst thing anyone could be stuck with and same with cancer

    October 31, 2011 at 09:44 | Report abuse | Reply
  16. bristoltwit palin... America's favorite dancing cow

    I'm afraid I'm going to get HIV from one of those two black guys I'm shacked up.

    October 31, 2011 at 09:50 | Report abuse | Reply
  17. rich

    People should get tested> IT IS 100 percent treatable! One pill a day.... Can make a person undetectable

    October 31, 2011 at 09:54 | Report abuse | Reply
  18. Mike

    Cue condemnation by the religious right in 5. 4. 3. 2. 1...

    October 31, 2011 at 10:05 | Report abuse | Reply
  19. MedStudent

    Why shouldn't teens be tested? It's not like someone will magically revert to HIV negative if they don't get tested. Detecting HIV early on can enable someone to live a full life expectancy. Delaying a diagnosis can have disastrous consequences on the individual's health and increase the spread of HIV by those who do not know they are HIV positive. This should absolutely be the standard of care.

    October 31, 2011 at 10:07 | Report abuse | Reply
  20. Unanimous

    I wish sodomizing was a crime in the US just like the middle east. People love sodomizing and be sodomized in the US and it's held in high prestige. What the hell is wrong with us?

    October 31, 2011 at 10:15 | Report abuse | Reply
    • bristoltwit palin... America's favorite dancing cow

      I really like anal.

      October 31, 2011 at 11:21 | Report abuse |
  21. RM

    what a mess...goes to show you that even someone with the intelligence of a monkey can work their way around the internet..technology is a terrible thing to waste

    October 31, 2011 at 10:19 | Report abuse | Reply
    • Nuraan

      ELIZA and Western Blot tests are admittedly iurccnaate! So why would you submit yourself to an iurccnaate test that could potentially cause you trouble for the rest of your life? Considering an HIV+ result requires a different criteria in Canada, USA, Sweden and South Africa, we are NOT dealing with science. This is politics and money. AIDS testing is detrimental to our society's health.

      July 1, 2012 at 14:33 | Report abuse |
  22. popcorn

    God cannot cure AIDS/HIV. It in the ten commandments. "Thou shalt not commit adultery."

    The government give trillions of dollars for celebrities, idols, everyone. Remember famous tiger woods. Millionaires are spreading AIDS/HIV. They throw virgins and unemployed people down the street. They didn't commit adultery. If they have. They would get their jobs back. Abomination exists.

    October 31, 2011 at 10:27 | Report abuse | Reply
  23. Guest_NC

    I'm shocked that over 1 million people have aids in this country. How many people are living with cancer and heart disease? Because that's pretty much all we hear about and raise money to research. wow.

    October 31, 2011 at 10:27 | Report abuse | Reply
    • Benzin

      More than 1 million are affected by cancer.

      October 31, 2011 at 10:39 | Report abuse |
  24. odedina olanrewaju

    pizz off.

    October 31, 2011 at 10:29 | Report abuse | Reply
  25. Unanimous

    Google son of the beetch blocked the word sodomy! Awesome, there goes our freedom of speech. Now you can't even search what sodomy really is and people will be illeterate. Let's start a facebook uprising against google. Facebook doesn't like google anyways nor does cnn or yahoo. Google is a menace.

    October 31, 2011 at 10:36 | Report abuse | Reply
    • Benzin

      Try turning off safe search dumb@$$.

      October 31, 2011 at 10:43 | Report abuse |
    • bristoltwit palin... America's favorite dancing cow

      Learn English, dipsh!t.

      October 31, 2011 at 11:30 | Report abuse |
  26. angelia

    just because a physician recommends a test as a parent or patient you dont have to have the test done. that is a patients right.

    October 31, 2011 at 10:37 | Report abuse | Reply
  27. Steve Lyons

    Does anyone other then me see a conflict with the the Amendment here? If they test for STD / DNA / Genetic defects where does it stop. The movie Attica should be required material. And what do we do with / to those with AIDS / HIV? Concentration camps? Thin the herd? Exactly what is the medical / political end game in this nonsense?

    How about we find the "Corrupt Gene" in members of Congress and weed them out?

    October 31, 2011 at 10:42 | Report abuse | Reply
    • MedStudent

      What do we do with those with HIV/AIDS? We TREAT THEM. These people can have normal life expectancies if they begin treatment in a timely manner. Treatment can also significantly reduce risk of transmission to others and to offspring (as in the case of a pregnant HIV+ female). HIV will not be cured/treated by not testing. Routine testing of everybody is crucial.

      October 31, 2011 at 11:00 | Report abuse |
    • Tex71

      The movie is "Gattaca" (GTCA, guanine thymine cytosine adenine).
      Attica is a geographic region.

      October 31, 2011 at 11:00 | Report abuse |
  28. Linus paul

    How can we decrease hiv effection?

    October 31, 2011 at 10:43 | Report abuse | Reply
    • Benzin

      more testing

      October 31, 2011 at 10:46 | Report abuse |
  29. Dawn

    @FutureLawyer2005 i totally agree with your first statement, you see what's going on with teens first hand because you're a teacher. I'm a black female in my late 30's and grew up in Newark, NJ 40% of the women i went to school with either have died or living with HIV/AIDS. Mostly all of them contracted it through unprotected s!x, by thier boyfriends/husband. HIV is the second leading cause of the death amongst black women, the first is homicide. Yes, teens should get tested early!!!

    October 31, 2011 at 10:46 | Report abuse | Reply
  30. Nomalanga

    I don't like where this is going..."routine HIV tests if they live in an area where the prevalence of HIV is greater than 0.1% of the population." Undoubtedly, these "areas" are going to be predominantly minorities. Why not invest these resources in preventative education? Why 16? Nowadays, 16 is too late!

    October 31, 2011 at 12:07 | Report abuse | Reply
    • cmh

      Why not invest in preventive education AND testing?

      October 31, 2011 at 14:50 | Report abuse |
  31. Peter

    I think every single human should be tested no matter their age. And I also think these people that call themselves scientist and researcher has fail the world and also themselves, how come no one can find the cure? Total rubbish

    October 31, 2011 at 12:50 | Report abuse | Reply
    • MedStudent

      Hey genius, get back to me when you discover a cure. thanks.

      October 31, 2011 at 13:28 | Report abuse |
  32. Kent in Dallas TX


    It just not that easy to "cure" HIV/AIDS. The acronym "HIV" stands for Human Immunodeficiency VIRUS. AIDS is caused by virus, not by bacteria.

    Doctors can cure bacterial diseases by killing all the bacteria with antibiotics. That can't work with a virus because a virus is not ALIVE.

    Medical researchers work to invent new antiviral medication that can make it harder for a virus to reproduce and maybe invent a vaccine.

    Unfortunately the people who need a vaccine will refuse to take it.

    Right now, it is not that hard to keep from getting HIV/AIDS. It is very simple:

    One, keep your pants zipped up (unless you need to use a urinal or toilet)! Also keep your mouth shut unless you need to eat/drink something or say something.

    Two, don't use drugs. You can catch HIV by using IV drugs. Also, drugs or booze can make you do stupid things.

    Three, don't believe that condoms always work. They don't.

    If people would follow those three simple rules, they couldn't get AIDS (except by accident).

    October 31, 2011 at 15:59 | Report abuse | Reply
  33. CaptionObvious

    Kill everyone that has AIDS, nobody has AIDS anymore. Problem?

    October 31, 2011 at 17:05 | Report abuse | Reply

    GREAT IDEA !!!

    October 31, 2011 at 19:19 | Report abuse | Reply
  35. Kevin

    I completely agree with this, why not 13 or 14 even?

    Twitter @RiseUpToHIV

    October 31, 2011 at 19:59 | Report abuse | Reply
  36. toddflanders

    Bottom line: there should not be 1 more case of HIV in this country. We know how it's transmitted and we know how to protect ourselves. It's either laziness or stupidity that causes any cases nowadays. Wear a condom, don't share needles. no more HIV

    October 31, 2011 at 20:18 | Report abuse | Reply
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  37. Ruth Bard

    Why assume that kids are going to screw around like rabbits? Most don't. Why not teach them good judgment, self-restraint, and (gasp) morality? It's easy: just model it yourself.

    October 31, 2011 at 21:36 | Report abuse | Reply
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    October 31, 2011 at 23:32 | Report abuse | Reply
  39. Sheeple

    Its amazing how many people continue to be useful idiots in the HIV causes AIDS pseudoscience. Dr. Robert Gallo is a fraud, as is most of the worthless science he has perpetuated as a result. If you don't know what I'm talking about, I suggest you do some googling of your own. Or perhaps, gasp, read a book: "Fear of the Invisible"

    November 1, 2011 at 20:40 | Report abuse | Reply
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