HIV testing, behaviors, and knowledge among adolescents at high risk

Purpose: We examined HIV testing behavior and its predictors among adolescents considered at high risk for HIV. Methods: Self-reports of HIV testing, knowledge, attitudes, and high-risk acts were examined among 272 adolescents aged 13-23 years (M = 18.7; SD = 2.3) attending community-based agencies that serve youth at high risk for HIV in Los Angeles, New York City, and San Francisco. Results: Evidence of adolescents' risk for HIV is reflected in a rate of 4.8% seropositivity, 24% injecting drug use, a mean of 4.3 (SD = 11.6) sexual partners during the previous 3 months, and 71% condom use during vaginal/anal sex. HIV testing was common (63%) and often repeated (M = 3.6, SD = 4.0). Knowledge of the meaning and consequences of testing was high (84% correct). Contrary to service providers' expectations, youth were likely to return for their test results (90% returned). Youth who were older, labeled themselves gay or bisexual, lived in Los Angeles or San Francisco, and those who injected drugs were significantly more likely, compared to peers, to get tested for HIV. Conclusions: These results suggest a need for more detailed observational studies of HIV testing behavior that include evaluation of characteristics of the youth, the testing site, and the attitudes and beliefs of providers offering HIV testing.