Background:
Up to 30 000 to 100 000 adolescents younger than 25 years old are infected with HIV and 25% are unaware of their status. The Centers for Disease Control and Prevention recommends that universal HIV counseling, testing and referral (CTR) be provided by primary care physicians to all clients in settings serving client populations in settings with a >1% HIV prevalence. Few studies have explored the association between patient predictors of HIV testing and HIV testing among health care providers.

Objective:
The objective of this study was to determine factors associated with having HIV testing among adolescents receiving STI services as part of pediatric primary care.

Method:
Retrospective chart review of adolescents and young adults who were screened for an STI in an urban academic primary care practice in a high STI and HIV prevalence community. Data abstracted from chart. The major outcome was lab evidence of HIV testing. Patients who were known to be HIV positive at the time of diagnosis were excluded from analyses. Multivariate logistic regression was used to examine all significant independent relationships.

Result:
The 150 adolescents were predominantly female (81%), African American (93%), and insured (76%). Mean age of males and females was 17 years old. Fifty-four percent of patients were tested for HIV. STI at the visit, provider and current number of partners were associated with HIV testing (AOR 2.7 (1.2-6.7); 2.5 (1.2-5.3); and 3.6 (1.3-10.0) respectively, logistic regression analysis).

Conclusion:
Testing appears to be associated with risk-assessments by providers, diagnosis at the visit, and provider type.

Implications:
Due to the high prevalence of HIV infection in this community and the potential for missed cases due to risk-category misclassification, further quality improvement efforts that increase patient acceptance of HIV testing and provider adherence to the recommendation for universal counseling and testing are indicated.