AAP Recommends Routine HIV Screening, Prevention for All Teens, At-Risk Youth

By Jonathan Springston, Editor, Relias Media

The American Academy of Pediatrics (AAP) has issued revised guidance to suggest all patients age 15 years and older undergo HIV screening at least once in a healthcare setting. Further, after this first assessment, the AAP recommends screening youth at high risk annually thereafter (perhaps even as often as every three to six months) and offering this group HIV preexposure prophylaxis and HIV postexposure prophylaxis regularly.

A 2011 AAP statement called for routine HIV screening for all patients by the time they reach age 16 to 18 years. However, in the revised guidelines released this week, the authors note that after 40 years, the HIV epidemic lingers; more than 1 million Americans live with an HIV infection, of whom more than 47,000 are age 13 to 24 years. The latest recommendations include an update on epidemiological data and the latest innovations in diagnostics and prophylaxis.

Additionally, the revised guidelines include recommendations that can help clinicians address coverage issues; create assured confidentiality; and build an overall safe space that allows for an open and frank discussion on sexual orientation, gender, and reproductive health.

“Because youth are a population at increased risk of HIV infection, they should be routinely assessed for high-risk behaviors and screened for HIV,” the guideline authors wrote. “Adolescents may be more willing to disclose high-risk behaviors and discuss sensitive topics if pediatricians establish confidential, private discussions; use screening questionnaires; and increase time spent on these discussions.”

The results of a small study released earlier this year indicated women who responded to a recruitment flier that offered a free, rapid HIV test knew little about sexually transmitted infections (STIs). Like the AAP, these investigators noted the importance of discussing STIs at every healthcare visit, but doing so beyond simple yes/no questions. Clinicians who serve as a knowledgeable but nonjudgmental resource can make patients more relaxed and help them discuss these sensitive issues comfortably.