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.

Credit: Beth Novey
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.