Increasing HIV testing among adolescents

Among adolescents living with HIV, 80 percent live in sub-Saharan Africa. And young people ages 15-24 15–24 make up almost 40 percent of new HIV infections among adults. Despite this disproportionate burden of HIV, less than one-third of adolescents in sub-Saharan Africa have ever tested for HIV. Furthermore, HIV testing offers an opportunity to establish HIV prevention behaviors, including routine testing and sexual education, for teens and young adults.

In an effort to increase HIV testing among adolescents, UCSF Bixby researchers conducted a study in East Africa — the SEARCH trial — to examine if a campaign that involved community and home-based outreach increased HIV testing among young people ages 10-24. They found that this hybrid approach combining both community and home-based testing achieved an 88 percent testing coverage rate among adolescents. Among those tested, 82 percent tested through community campaigns, and 18 percent through home-based testing. Overall, 57 percent of HIV-positive adolescents reported being unaware of their status prior to testing.

Not only did this hybrid approach greatly increasing testing rates, but it also reached adolescents before a time of increased HIV risk—a critical window for prevention. Additionally, expanding this approach to include other HIV services, such as pre-exposure prophylaxis, may provide a platform for reducing HIV incidence among adolescents in rural sub-Saharan Africa.