Under the program, adolescents who visit the hospital’s emergency department will receive written information about HIV testing and be asked privately whether they want to receive an HIV test regardless of the reason for their ED visit. Patients who agree to be tested will be administered an oral HIV test. Results will be available within 20 minutes. If the result is positive, patients will receive a blood test to confirm the result, which also takes about 20 minutes.
Patients who test positive for HIV will then schedule a no-cost visit to the hospital’s pediatric HIV clinic to receive counseling, education and information on how to share the diagnosis with relatives. Adolescents who test positive for HIV will not be required to share the diagnosis with their parents, but hospital staff will encourage them to do so. Ericka Hayes, a pediatrician at the hospital, said that although adolescents will not be required to share positive diagnoses, parents or guardians eventually will need to be informed because they likely will be responsible for treatment costs.
Hayes conducted a 10-year analysis that found an increase in new HIV cases among people ages 13 to 24. In 1997, 21 new HIV cases were diagnosed among young people in St. Louis, compared with 54 in 2006, the analysis found. Hayes added that it is likely many teens and young adults in the city are unaware they are living with HIV/AIDS.
CDC in 2006 recommended routine HIV testing for people ages 13 to 64, and some hospitals have begun offering HIV tests to all patients. However, the St. Louis program will be the first such program at a pediatric hospital, Hayes said, adding that it also will be the first program that allows adolescents, rather than parents, to make testing decisions. Under a Missouri statute, minors are permitted to make testing and treatment decisions for HIV and other sexually transmitted infections. At least 25 other states have similar laws, the AP/Globe reports.
Hayes said that many teens “involved in high-risk behaviors” would not consent to an HIV test if the results were not kept confidential. “We really want to remove that from the equation and let the adolescent decide on testing for HIV,” Hayes said, adding, “Otherwise, teenagers engaging in high-risk behaviors often will not get tested.” Hayes added that the new program is a “good thing” for adolescents, even though she said she “accept[s]” that some people “are not going to like” the program.
Peter Sprigg, vice president for policy at the Family Research Council, criticized the program, saying that parents or guardians should consent to HIV testing and receive the results. “When it comes to medical care, the parent should have absolute authority over whether a child is tested and should be the first notified of the results.” He added that it is “outrageous” that teenagers could receive an HIV test without parental involvement. “I don’t think it’s ever for the community’s good for an institution like a hospital to come between a parent and a child” (Salter, AP/Joplin Globe, 6/26).