The American Academy of Pediatrics (APA) is calling for pediatricians to play a more active role in routine screening for the human immunodeficiency virus (HIV) and for alcohol, tobacco, and other drug use among adolescents. Policy statements for the 2 measures appear online today in Pediatrics.
The academy’s policy statement on HIV screening said it should be routinely offered to all adolescents at least once by age 16 to 18 years in health care settings where the prevalence of HIV in the patient population is more than 1 in 1000 individuals. In communities in which the prevalence of HIV is less than this, routine HIV testing is encouraged for all sexually active adolescents and those with other risk factors for HIV, such as substance use.
The APA statement also said that youth at high risk of HIV infection (which includes those who use intravenous drugs, exchange sex for money, or have multiple sexual partners and male teens who have sex with other males) should be tested annually for HIV; those tested for other sexually transmitted infections (STIs) should be tested for HIV at the same visit. The academy noted that in 2006, about 1.1 million HIV-infected people were living in the United States, including 55 320, or 5%, who were adolescents and young adults aged 13 to 24 years.
The APA policy statement on substance use recommends that pediatricians provide substance use education and screening to adolescents during routine clinical care, using the universal substance abuse screening guidelines developed by the US Substance Abuse and Mental Health Services Administration.
The policy statements also discuss confidentiality concerns related to screening for HIV infection or substance use. For HIV screening, the policy statement said that while parental involvement in adolescent health care is always desirable, consent of the adolescent should be sufficient to provide testing and treatment for HIV infection or STIs. For substance use screening, the policy statement said pediatricians should ensure appropriate confidentiality by learning about and complying with state and federal regulations governing health information privacy, including the confidential exchange of information about substance use and treatment.