(Reuters Health) - Nearly one in four youth living with HIV in the U.S. don’t notify sex or drug-use partners about potential HIV exposure - despite medical professionals and others urging them to do so, a study of teens and young adults suggests.
This high-risk population continues to contract HIV at alarming rates, so identifying individuals unaware of their infection is imperative to prevent further transmission, as well as to link and retain patients into medical care, the study team writes online October 4 in the Journal of Acquired Immune Deficiency Syndrome.
A surprising finding from this survey-based study was that 81.7% of participants reported not having been contacted by a partner about their own potential exposure to HIV, said lead author Jacob J. van den Berg of the Brown University School of Public Health in Providence, Rhode Island.
It’s possible that their partners had no contact information for them, or that attempts to contact them were unsuccessful. It is also conceivable that they were tested before their partners became aware of their own infection, the study authors point out.
Still, “this number is incredibly high considering that at least one person should have contacted them regarding their own potential exposure according to current Centers for Disease Control and Prevention guidelines,” van den Berg told Reuters Health in an email.
Over a fifth of all new HIV diagnoses in the U.S. occur in individuals age 13 to 24, according to CDC estimates. This age group is particularly vulnerable to exposure, the study authors write, because it has the highest proportion of undiagnosed HIV of any age category.
For the study, the researchers recruited 924 mostly male participants between 13 and 24 from fourteen adolescent medicine clinics in U.S. cities with established HIV epidemics. All the participants had been “behaviorally infected,” for example, through sex or drug use.
All of the youth answered an online survey that asked about their past sexual partners and practices, drug-use partners with whom they had shared needles and interactions with healthcare professionals, among other things.
Overall, more than three quarters of the participants reported that once they learned they were HIV positive, they contacted all or at least some of their past sex or drug-use partners to notify them they may have been exposed to HIV. Another 22.4% of participants did not succeed or didn’t try to contact former partners.
Nearly all study participants reported that someone, such as their HIV tester, doctor, community clinic representative or a friend/family member, had talked to them about notifying their sexual partners about potential exposure. Just over half of participants, however, said only one person had discussed partner notification with them.
The study team found that youth who had themselves been contacted about potentially being exposed to HIV were more likely to engage in partner notification.
They also found that survey participants were more likely to notify past partners if more than one person had talked to them about notification. That result is the “biggest takeaway” from the study, said Adam Cohen, director of advocacy and policy research at the AIDS Healthcare Foundation in Los Angeles.
Cohen, who wasn’t involved in the study, also highlighted the finding that more than 80% of survey participants were not themselves notified of potential HIV exposure. “There is a serious discrepancy between discussing partner notification and engaging in partner notification,” he said by email.
The authors acknowledge that limitations of the study include the fact that participants were already in care, so they might be more likely than youth outside the medical system to notify their partners. Because the data on notification was self-reported, though, it’s also possible that participants exaggerated how often they notified partners.
“Although we do not know if our findings with youth living with HIV will translate to young people living in other countries or to older persons living in the United States,” van den Berg said, “we speculate that the more healthcare professionals or family members/friends who talk to people living with HIV about notifying their sexual partners, the more likely it will be that they will notify their sexual partners regarding potential exposure to HIV.”
J Acquir Immune Defic Syndr 2017.