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The newspaper of The Johns Hopkins University May 7, 2007 | Vol. 36 No. 33
HIV and Teens: Many Pediatricians Still Following Old Testing Guidelines

By Katerina Pesheva
Johns Hopkins Medicine

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 Center.

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 Toronto.


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