ITASCA, Ill. — The American Academy of Pediatrics, in an updated clinical report, recommends that universal and routine screening for human immunodeficiency virus (HIV) be offered to youth ages 15 and older at least once in a healthcare setting.
The report, “Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Post-exposure HIV Prophylaxis,” published in the January 2022 Pediatrics (published online Dec. 20), notes that the HIV epidemic persists in the U.S., despite great progress in treatment and continued efforts to identify people living with HIV/AIDS. In 2018, an estimated 45% of 13- to 24-year-olds living with HIV were undiagnosed, according to research, and youth were also the least likely of any age group to be linked to HIV care in a timely manner.
The report updates a 2011 policy statement that called for routine screening to be offered to all adolescents at least once by 16 to 18 years of age in healthcare settings when the prevalence of HIV in the patient population is more than 0.1%. The clinical report also reflects changes in epidemiology and advances in diagnostic testing, and provides updated recommendations for HIV testing, post-exposure prophylaxis, and new guidance for pre-exposure prophylaxis in youth at risk of acquiring HIV infection.
The report also recommends that pediatricians create an environment of confidentiality and tolerance and facilitate open discussion of gender, sexual orientation and behavior, and sexual- and reproductive-health issues.