Kurth, A. E., Lally, M. A., Choko, A. T., et al. Journal of the International AIDS Society (February 2015), Vol. 18, Issue 2, Supplement 1, doi: 10.7448/IAS.18.2.19433.
In both low- and high-income countries, HIV testing is an important entry point for primary and secondary prevention, as well as care and treatment for young people, including young key populations (YKPs). The authors of this paper discussed critical issues for young people, including YKPs, along the HIV testing-prevention-treatment continuum. They noted that existing school-based HIV education does not always encourage youth to seek testing, and there are few youth-friendly facilities available. In most countries, minors require consent from parents or guardians for HIV testing, and providers deny unaccompanied adolescents an HIV test. Youth who discuss testing with their parents are more likely to test for HIV. However, young people often rightfully fear negative reactions from parents and providers, and also from schools, where they fear isolation and missed opportunities and employment prospects, if they are known to be HIV positive. In some communities, women cannot give consent without the consent of family members. The authors suggested making testing venues more youth-friendly, and monitoring promising new approaches, such as self-testing, to assess how well they work for youth. They also recommended that, in general, HIV testing venues encourage empathetic and professional health provider behaviors, including assurance of confidentiality about test results, and social and clinical support for those testing positive for HIV.