Despite the inroads we have made on prevention and treatment of HIV, some cases go undiagnosed. The rate of HIV transmission due to lack of awareness of one partner’s status has been reported to be 14.5% based on data from the Centers for Disease Control and Prevention (CDC), in 13- to 24-year-old males, it has been reported as high as 51.4%. Why is this and what can be done about it? Mustanski et al (10.1542/peds.2019-2322) share with us baseline data from an ongoing trial of interventions to prevent HIV transmission in adolescent men who have sex with men (AMSM). The authors analyze survey data from 699 AMSM participants (ages 13-18) in their study and found that fewer than 25% had ever been tested for HIV, although as these teens get older, the rate of testing does increase. The more sexually experienced subjects also had a greater the chance of getting tested. Most notably is the finding that despite 67.5% of patients having a primary care provider, only 29.2% disclosed their sexual orientation, 21.3% shared with their provider that they were having sex with males, and only 19.2% were HIV tested. If a conversation with their physician did occur, then 75.4% of those teens did get tested compared to only 10.8% of those who did not.
Dr. Errol Fields from Johns Hopkins and Dr. Travis Gayles from the Montgomery County Maryland Department of Health and Human Services (10.1542/peds.2019-3996) helps us better understand what we can do to improve upon this situation. Our ability to better elicit a sexual history and understand how to care for sexual and gender minority youth is one way to make improvements. Another is to educate our AMSM patients about pre-exposure HIV prophylaxis and how to access that medication. There is a lot to absorb and then share with our adolescent patients especially those who identify as being a sexual and gender minority. Link to this article and commentary and learn more.