Despite new guidelines from the U.S. Centers for
Disease Control and Prevention saying that all teens should
be routinely tested for HIV, many pediatricians continue to
test only patients with high-risk behaviors, according to a
study from the
Johns Hopkins Children's Center.
A survey of 60 physicians and nurse practitioners
showed that even though 92 percent support routine testing
in theory, in practice two-thirds said they follow the old
guidelines and offer HIV testing only to high-risk teens,
such as those who have a history of sexually transmitted
infections, report sex without a condom or inject drugs.
"Testing based on risk is risky because it may miss
teens who might be already infected or at high risk for HIV
yet don't report their risky behavior to the doctor or are
simply unaware of their risks," said lead author Renata
Arrington-Sanders, a pediatrician at the Children's
In 2006, the CDC issued new, more encompassing
guidelines that call for routine HIV testing of all people
between the ages of 13 and 64 regardless of risk profile.
Under the old guidelines, only people engaging in high-risk
behaviors or those living in areas with high prevalence of
HIV were offered testing. Health officials say routine
testing will lead to earlier diagnoses of asymptomatic
people infected with HIV, decrease transmission to others
and prevent complications of untreated HIV infection by
starting therapy earlier.
In the survey, slightly more than one-third of health
care providers reported that they were familiar with the
new CDC guidelines, and only 10 percent had actually read
the guidelines, a finding that points to the need for
continuing medical education as well as daily reminders to
providers, such as asking them to wear "get tested" buttons
or sending them e-mail alerts.
The findings were presented at the annual meeting of
the Pediatric Academic Societies, held May 5 to 8 in