WP 12 Is Contraceptive Method Associated with HIV Testing Among High School Students? United States, 2013

Wednesday, September 21, 2016
Galleria Exhibit Hall
Zewditu Demissie, PhD, MPH, Division of Adolescent and School Health, School-based Surveillance Branch, Centers for Disease Control and Prevention, Atlanta, GA, Heather Clayton, PhD, MPH, Division of Adolescent and School Health, School-based Surveillance Branch, Centers for Disease Control and Prevention and Richard Dunville, MPH, Division of Adolescent and School Health, Research Application and Evaluation Branch, Centers for Disease Control and Prevention, Atlanta, GA

Background:  Adolescents frequently engage in sexual behaviors that increase their risk for HIV/AIDS and other STIs. These risks differ based on the contraceptive methods used during sexual intercourse. Thus it is important to assess HIV testing prevalence by contraceptive method among adolescents to understand existing testing behaviors and how to increase the prevalence of testing, particularly among those at increased risk for HIV/AIDS.

Methods:  Data from the 2013 national Youth Risk Behavior Survey, conducted among a nationally representative sample of 9th–12th grade students, were used to calculate prevalence estimates of HIV testing among currently sexually active students (n=4,667). Logistic regression models estimated adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs) for associations of condom use, primary contraceptive method, dual use of both a condom and another highly effective method [birth control pills; an IUD or implant; or a shot, patch, or birth control ring], and any contraceptive method at last sexual intercourse with HIV testing.  

Results:  Among currently sexually active students, 24.5% were ever tested for HIV. The lowest prevalence of HIV testing (18.8%) was found among condom users. The highest prevalence of HIV testing (71.0%) was found among IUD or implant users. Students who used a condom were less likely than students who did not use condoms to have had HIV testing (PR:0.75; CI:0.63,0.89). Students using other highly effective contraceptive methods were more likely than students using no method to have been tested (birth control pills PR:1.40, CI:1.11,1.78; IUD or implant PR:3.12, CI:2.53,3.84; shot, patch, or birth control ring PR:1.75, CI:1.34,2.29).

Conclusions:  Study results suggest that HIV testing aligns with risk level; testing is more likely among students using non-barrier contraceptive methods. However, HIV testing prevalence can be improved. These findings can be used by practitioners, schools, and public health professionals to focus HIV testing promotion efforts.