Increasing HIV Testing Rates Among Teenagers and Young Adults: Agency and Social Responsibility As Points for Intervention

Background and purpose: In the U.S. each year, about 1 in 4 new HIV-infections are among youth ages 13-24. In 2012, the CDC reported 20% of youth get HIV-tested and 60% of HIV-positive youth are unaware of their HIV-status. The discrepancy between testing and awareness contributes to the spread of HIV. Increasing HIV-testing rates is part of the national HIV prevention strategy; yet testing rates remain low and rates of new infections are high among youth. Little empirical literature focuses on how perceptions of personal agency and social responsibility influence HIV-testing rates among teenagers and young adults. This study addresses this gap in the literature and may inform efforts to improve HIV testing rates among adolescents and young adults.

Methods: Using multivariate logistic regression, we analyze data from 1,437 adolescent and young adults (males: 689; females: 748) participating in the National Survey of Teens and Young Adults on HIV/AIDS. Analyses explore associations among personal agency/interest in helping to decrease HIV-rates, perceived stigma around HIV, age, gender differences, and HIV testing.

Results: The HIV testing rate in the entire sample is 24%, with significant differences between males (17%) and females (33%). Teenagers age 15-17 were 13 times more likely to get tested for HIV in comparison to young adults ages 18-24 (females OR: 10.11, CI: 5.16-19.79; males OR: 3.59; CI: 1.69-7.63). Perceptions around HIV stigma increased the likelihood of having been tested for males by 2.78 times (OR: 2.78; CI: 1.23-6.33), conversely it decreased the likelihood of having been tested for females by 8.43 times (OR: .15; CI: .061-.395). When asked “How much of a role, if any, do you think you personally can play in achieving the goal of an AIDS free generation?” males answering they can play a small role (OR:0.39; CI: .163-.951), no role (OR:0.17; CI: 0.68-.453), or do not want to play a role (OR:0.13; CI:.026-.653) were significantly less likely to get tested compared to those who believe they can play a big role; was not significant for females.  Males who believed HIV was “somewhat serious” problem (OR: 0.36; CI .164-794) or “not too serious” problem (OR: 0.20; CI: .082-.517) were significantly less likely to be tested. Female youth reporting HIV is not at all serious were 10 times more likely to get tested than those who think HIV is a serious problem (OR:10.32; CI: 2.44- 43.63)

Conclusion and Implications: These results demonstrate that agency and social responsibility may be important intervention points for increasing HIV-testing, but that needs around these issues differ based on gender. The significant impact of HIV stigma on testing also suggests research must continue to find methods to decrease stigma among all teenagers and young adults. Overall, these findings promote the importance of gender-specific HIV prevention/intervention programs that include an emphasis on HIV-testing as a significant component of broader HIV-prevention strategies.