Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS

ABSTRACT

The Centers for Disease Control and Prevention has previously recommended that all adolescents undergo HIV testing in the United States (US). Despite these recommendations, national HIV testing among US adolescents has remained low. This study estimated the prevalence of and identified risk factors for not receiving an HIV test among adolescents with a history of sexual intercourse in New York City (NYC), an urban area that has been greatly impacted by the HIV epidemic. Cross-sectional data on 1199 NYC high school students who completed the 2013 NYC Youth Risk Behavior Survey were used. Modified Poisson regression models were used to assess whether demographic factors, alcohol/drug use and sexual behaviors were associated with self-report of lack of HIV testing. In the weighted study population, about 72% were ≥16 years old, approximately 35% were African-American and nearly half were male. Sixty percent reported no history of HIV testing. In adjusted analyses, younger age, male gender, White race/ethnicity, heroin use, as well as reporting one prior sexual partner, were significantly and positively associated with no prior history of HIV testing. Our findings suggest that among NYC adolescents with a history of sexual intercourse, the prevalence of HIV testing is low. HIV testing may have been low in part because of limited experience with current screening guidelines among clinicians. Furthermore, many of the adolescents identified as being more likely to not be tested may have not been screened because of inadequate knowledge about HIV, a low perceived HIV risk or an unstable lifestyle. Therefore, to increase HIV testing among NYC adolescents, interventions that enhance HIV knowledge among adolescents as well as interventions that promote review and application of current screening guidelines among clinicians should be implemented in NYC. Educational interventions should especially be targeted at the adolescents identified in this study.

KEYWORDS:

• Adolescent HIV testing
• youth risk behavior
• sexual intercourse
• risk-taking
• New York City Youth Risk Behavior Survey

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Acknowledgments

The authors thank Dr. Annie Gjelsvik for providing expert advice. Dr. Andrew Zullo was supported by the Agency for Healthcare Research and Quality: [Grant Number 5K12HS022998-02]. Dr. Brandon Marshall was supported by the Henry Merritt Wriston Fellowship from Brown University.

Disclosure statement

No potential conflict of interest was reported by the authors.

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Funding

This work was supported by the Agency for Healthcare Research and Quality: [Grant Number 5K12HS022998-02] and Brown University [Henry Merritt Wriston Fellowship].