Abstract
ObjectivesAlthough youth (12–24 years) in Sub-Saharan Africa have a high HIV risk, many have poor access to HIV testing services and are unaware of their status. Our objective was to evaluate the proportion of adolescents (12–17 years) and young adults (18–24 years) who underwent HIV testing and the prevalence among those tested in an urban adult outpatient clinic with a routine HIV testing program in Durban, South Africa.DesignWe conducted a retrospective cross-sectional analysis of adolescent and young adult outpatient records between February 2008 and December 2009.MethodsWe determined the number of unique outpatient visitors, HIV tests, and positive rapid tests among those tested.ResultsDuring the study period, 956 adolescents registered in the outpatient clinic, of which 527 (55%) were female. Among adolescents, 260/527 (49%, 95% CI 45–54%) females underwent HIV testing compared to 129/429 (30%, 95% CI 26–35%) males (p<0.01). The HIV prevalence among the 389 (41%, 95% CI 38–44%) adolescents who underwent testing was 16% (95% CI 13–20%) and did not vary by gender (p = 0.99). During this period, there were 2,351 young adult registrations, and of these 1,492 (63%) were female. The proportion consenting for HIV testing was similar among females 980/1,492 (66%, 95% CI 63–68%) and males 543/859 (63%, 95% CI 60–66%, p = 0.25). Among the 1,523 (65%, 95% CI 63–67%) young adults who underwent testing, the HIV prevalence was 22% (95% CI 19–24%) in females versus 14% in males (95% CI 11–17%, p<0.01).ConclusionsAlthough the HIV prevalence is high among youth participating in an adult outpatient clinic routine HIV program, the uptake of testing is low, especially among 12–17 year old males. There is an urgent need to offer targeted, age-appropriate routine HIV testing to youth presenting to outpatient clinics in epidemic settings.
Highlights
Conclusions: the HIV prevalence is high among youth participating in an adult outpatient clinic routine HIV program, the uptake of testing is low, especially among 12–17 year old males
In 2007 the World Health Organization (WHO) recommended routine HIV testing among youth in epidemic settings, and South Africa implemented an HIV testing initiative that proposed to mobilize youth and to ensure ‘youth friendly’ HIV testing services –that is services and programs designed for this population. [6,8] little guidance on the operationalization of youth routine testing, which refers to offering HIV testing as a standard component of medical care, irrespective of signs or symptoms, is provided in these recommendations
To better understand testing in an urban adult outpatient clinic with a routine HIV testing program for patients $12 years, we evaluated the number of adolescents (12–17 years) and young adults (18–24 years) who had HIV testing and the prevalence among those tested in Durban, South Africa
Summary
Youth (12–24 years) are disproportionately affected by the HIV epidemic in sub-Saharan Africa. [1,2] In South Africa, the HIV prevalence rapidly rises through adolescence with an HIV prevalence of 3% among 2–14 year olds, 15% among 15–24 year olds, and 24% among those $25 year olds. [3] Despite the highHIV prevalence, youth testing rates are low. [4,5] Compared to 47% of South Africans adults who report ever having an HIV test, [6] only 25% of females and 15% of males 15–24 years old report prior HIV testing [7].In 2007 the World Health Organization (WHO) recommended routine HIV testing among youth in epidemic settings, and South Africa implemented an HIV testing initiative that proposed to mobilize youth and to ensure ‘youth friendly’ HIV testing services –that is services and programs designed for this population. [6,8] little guidance on the operationalization of youth routine testing, which refers to offering HIV testing as a standard component of medical care, irrespective of signs or symptoms, is provided in these recommendations.To better understand testing in an urban adult outpatient clinic with a routine HIV testing program for patients $12 years, we evaluated the number of adolescents (12–17 years) and young adults (18–24 years) who had HIV testing and the prevalence among those tested in Durban, South Africa. Youth (12–24 years) are disproportionately affected by the HIV epidemic in sub-Saharan Africa. [4,5] Compared to 47% of South Africans adults who report ever having an HIV test, [6] only 25% of females and 15% of males 15–24 years old report prior HIV testing [7]. To better understand testing in an urban adult outpatient clinic with a routine HIV testing program for patients $12 years, we evaluated the number of adolescents (12–17 years) and young adults (18–24 years) who had HIV testing and the prevalence among those tested in Durban, South Africa. We hypothesized that adolescent and young adult females would have higher HIV testing uptake and prevalence compared to adolescent and young adult males [3,4]
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