Factors affecting acceptance of routine human immunodeficiency virus screening by adolescents in pediatric emergency departments

Natella Rakhmanina*, Nicole Messenger, Gregory Phillips, Stephen Teach, Sephora Morrison, Jaclyn Hern, Jun Payne, Kavitha Ganesan, Amanda D. Castel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Purpose Human immunodeficiency virus (HIV) screening in health care settings including emergency departments (EDs) is recommended for adolescents in the United States. This study aimed to evaluate the acceptance of and the factors affecting the HIV screening in pediatric EDs. Methods A prospective, cross-sectional study of rapid opt-out oral HIV screening among adolescents ≥13 years of age was conducted in two pediatric EDs during 2009-2011. Descriptive statistics and logistic regression models were used to identify factors associated with the acceptance of HIV screening. Results During 24 months, 8,519 adolescents were approached for HIV screening; 6,184 (72.6%) did not opt out, and of those 5,764 (93.2%) were tested for HIV. Most adolescents who accepted testing were black (80.5%), female (57.6%), aged 15-17 years (50.1%), and District of Columbia residents (67.7%), and were accompanied by a guardian (69.1%). Acceptance of HIV screening varied by age, race/ethnicity, and state of residence, with younger (<15 years) (adjusted odds ratio [aOR], 1.67; 95% confidence interval [CI], 1.33-2.09), non-black adolescents (aOR,.88; 95% CI,.77-.99) and non-District of Columbia residents (aOR,.86; 95% CI,.77-.96) being more likely to opt out of testing. Lower odds of opt-out of HIV testing were seen among adolescents with a guardian present (aOR,.42; 95% CI,.34-.53). The reasons for opt-out varied significantly by age and the presence of a guardian. Conclusions The patient's age and the presence of a guardian were significantly associated with adolescents' decision and reasons to opt out of HIV screening in pediatric EDs. Further studies are necessary to evaluate the interventions needed to increase routine ED HIV screening in adolescents.

Original languageEnglish (US)
Pages (from-to)176-182
Number of pages7
JournalJournal of Adolescent Health
Volume54
Issue number2
DOIs
StatePublished - Feb 1 2014

Keywords

  • Adolescents
  • Emergency department
  • HIV
  • Routine screening

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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