Background: Youth ages 13-24 comprise 25% of incident HIV infections. Approximately 72% of new youth HIV infections are in men who have sex with men (MSM) and transgender youth. This study compares the characteristics of youth tested for HIV in 2011 versus 2012, as well as those who tested positive.
Methods: The Health & Education Alternatives for Teens (HEAT) is a clinical care and community outreach program for HIV-infected and high-risk adolescents in Brooklyn, New York. Youth participants are offered HIV testing. In 2011, youth were reached through 13 venues, including ballroom events, an LGBT youth support agency, college campuses, public libraries, and the HEAT clinic. In 2012, HEAT program expanded to 3 additional venues and more frequent outreaches at existing venues.
Results: In 2011, HEAT performed 575 HIV tests, of whom 5 unique individuals (0.87%) tested positive. In 2012, HEAT performed 1326 HIV tests, of whom 30 unique individuals (2.3%) tested positive: 21 MSM, three bisexual men, four heterosexual men, and two with undisclosed sexual orientation. The median age of HIV-positive was 21 (inter-quartile range: [17.5, 24.5]). Most (70%) positive results were identified through direct HEAT related events. More participants reporting addresses in the Bronx and Manhattan tested positive for HIV than participants reporting addresses in Brooklyn: 2.75% and 3.26% versus 1.88%. A majority (56.7%) of HIV-positive individuals entered HIV treatment.
Conclusions: Expanding an HIV screening program risks diluting the proportion of positives by contacting low-risk youth. HEAT’s expansion increased the proportion of positive tests by six-fold in 2012, compared to 2011, and helped them enter care. Higher HIV seropositive rates from Bronx and Manhattan likely reflect higher volume of young MSMs attending LGBT friendly HEAT events and engagement at an LGBT youth program. The program expansion was effective in reaching more youth at highest risk for HIV.