Teens & HIV Test 2

Approximately 1.1 million Americans are living with HIV/AIDS, and more than 56,000 become infected with HIV every year. One-third of them are between the ages of 13 and 29. That means at least two teenagers and young adults in this country are infected with HIV every hour of every day. But many young people still do not think they are personally at risk for HIV.

When teens in the United States become infected with HIV, it usually happens in one of two ways:

1. By sharing needles used to inject drugs or other substances (including needles used for injecting steroids, tattooing, piercing, and body art). If the person who has used the needle is infected with HIV, his or her blood on the needle can infect anyone else who uses the same needle.

2. Through unprotected sex including anal, vaginal, and oral sex. This can happen when body fluids such as semen, vaginal fluids, or blood from an infected person get into the body of someone who is not infected. Everyone who has unprotected sex with an infected person is at risk of contracting HIV, but people who already have another sexually transmitted disease (STD) are even more at risk.

Children can be infected with HIV if an infected pregnant woman passes the virus to her unborn child. Treating the mother and child around the time the baby is delivered, delivering by cesarean section, and avoiding breastfeeding can reduce the baby's risk of infection.

If people with HIV get treated, they can live long, relatively healthy lives — just as people who have other chronic diseases like diabetes can. But, as with diabetes or asthma, there is still no cure for HIV and AIDS.
Pediatricians should offer routine HIV testing to adolescents at least once before they are 16 to 18 if the local prevalence of the virus is greater than 0.1%, according to a new policy statement from the American Academy of Pediatrics.

If the local community prevalence is lower, pediatricians should offer the test to all sexually active patients as well as to those with other risk factors, such as drug use, according to Patricia J. Emmanuel, MD, of the University of South Florida, and colleagues on the academy's Committee of Pediatric AIDS.

The recent introduction of rapid HIV tests makes screening less invasive, although the gold standard remains detection of HIV antibody in serum, followed by confirmatory tests with Western blot or immunofluorescent assay.

The AAP policy recommends that adolescents being tested for other sexually transmitted infections should be tested for HIV at the same visit.

The statement notes that there are several barriers to routine testing of adolescents, including the fact that young people may forgo reproductive services if parental consent is required. Because laws surrounding consent and confidentiality vary from state to state, doctors need to be familiar with local laws.

"Although parental involvement in adolescent healthcare is always desirable," the policy says, "consent of the adolescent should be sufficient to provide testing and treatment for HIV infection or STIs."

It is also important that pediatricians "provide an environment of tolerance and facilitate open discussions regarding sexual risk and sexual orientation."
(AAP Backs HIV Tests for Teens By Michael Smith, North American Correspondent, MedPage Today; Published: October 31, 2011)

There are several types of HIV tests. The most basic is the HIV antibody test, which takes one to two weeks to generate results and may produce false positives. A positive antibody test is always followed by an antigen test to confirm the first test. If doubts still persist, doctors usually recommend a third very sensitive and expensive test that can detect the presence of the virus itself.

The new recommendation also advocates for the rapid-response HIV test, which provides a diagnosis within 20 minutes, as opposed to other types of tests that can take more than a week to yield results. However, the AAP fears that pediatricians may not recognize the importance of HIV testing. Plus, they fear that at-risk adolescents may be uninsured or not have access to primary care physicians, making testing at emergency facilities a priority.

Testing options include blood, saliva, and urine tests (the rapid, 20-minute test is a blood test). Many doctors provide HIV testing, but testing is also available at many clinics and health departments, as well as with at-home testing kits. The CDC recommends everyone be tested for HIV at some point, and that people who participate in certain risky behaviors be tested annually.

Bear in mind—it normally takes three months after the last possible exposure to HIV before a person will test positive. Since the virus is most infectious in the earliest weeks after HIV infection, and since HIV antibody tests cannot definitely confirm infection earlier than three months, you should take great care to avoid unprotected sex if you think you may have been exposed to HIV recently.

A positive HIV test result indicates that antibodies to HIV were detected. It does not mean that you have AIDS or that you will get sick right away. And although there is no cure for HIV/AIDS, many opportunistic infections can be prevented or treated.

Likewise, negative test results do not necessarily rule out HIV infection, because there is a window period between HIV infection and the appearance of HIV antibodies. If you have engaged in risky activities, it is important to be re-tested every three months.