Most gay and bisexual male adolescents do not get tested for HIV

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NEW YORK (Reuters Health) – Less than one in four teenage men who have sex with men (AMSM) have undergone an HIV test, according to new US research. UU.
"Among HIV-positive adolescents, only half know their status, while among adults it is more than 85%," said Dr. Brian Mustanski, who heads the Northwest Institute for the Health and Welfare of Sexual Minorities and of Gender and is a professor at Northwestern Feinberg University. School of Medicine in Chicago.

"The HIV test is the only way for them to know their status and have access to treatments that not only save lives, but can also prevent transmission to others," he told Reuters Health in an email. "We will not end the HIV epidemic in the United States if we do not expand the tests with this group."
Dr. Mustanski and his colleagues looked at 699 young men aged 13 to 18 who participated in SMART, an ongoing trial of online HIV prevention interventions for AMSM. Overall, 162 (23.2%) reported having ever had an HIV test and 81 had more than one (11.6%).

64.2% reported a history of vaginal or anal sex, and 45.5% reported having had anal sex without a condom (CAS). Participants with sexual experience were more than six times more likely to have been tested for HIV.

While 67.5% of the study participants said they had a regular doctor, only 21.3% had discussed having sex with men with their doctor, 19.2% had talked about HIV testing and 29.2% said they were He asked about his sexual orientation.
"Doctors, particularly pediatricians, need to have frank and open conversations with their male adolescent patients, including a detailed sexual history and a sexual orientation discussion, ideally a private conversation with no parents present," said Dr. Mustanski. "If your patient is sexually active with other men, an HIV test is recommended given its high epidemiological risk."
Doctors who do not wish to discuss sexual orientation with patients can perform HIV tests by default with an informed "voluntary exclusion option," he added. "These conversations can also be facilitated by suppliers who externally show their acceptance of the LGBTQ community through admission forms, asking questions that do not imply a partner's gender, and through visual cues such as posters," he said.

Dr. Mustanski noted that the American Academy of Pediatrics recommends discussing issues related to sexual health such as HIV, same-sex behavior and sexual orientation with patients, "and research shows that most teenagers want their doctors ask them these questions. "
He added: "We must pay special attention to the needs of adolescents as we seek to implement programs that can help end the HIV epidemic. I would like to see ourselves pressuring all homosexual and sexually active children who receive an HIV test and 90% of those who are positive knowing their status. "
In a comment accompanying the study, Dr. Errol L. Fields of the John Hopkins School of Medicine in Baltimore and Dr. Travis A. Gayles of the Montgomery County Department of Health and Human Services in Rockville, Maryland, write: "Pediatricians and doctors in general are often poorly trained in the care of young people from sexual and gender minorities; therefore, more advanced educational interventions may be necessary to support the effective implementation of the changes recommended by the authors."
SOURCE: https://bit.ly/2SAxMNI and https://bit.ly/2OKoaPm Pediatrics, online February 11, 2020.

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