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June 2017

Finding Youths at Risk for HIV Infection: Targeted Testing, Universal Testing, or Both?

Author Affiliations
  • 1Division of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Division of Adult Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
JAMA Pediatr. 2017;171(6):517-518. doi:10.1001/jamapediatrics.2017.0329

The disparate proportion of new human immunodeficiency virus (HIV) infections occurring annually among young sexual minority men of color in the United States constitutes a public health emergency. Young men of color who have sex with men between the ages of 13 and 24 years make up a group with high HIV incidence, representing approximately 20% of new diagnoses in the United States; they are one of the only groups with rising incidence rates.1 To improve HIV diagnosis, the Centers for Disease Control and Prevention first recommended in 2006 universal testing of all individuals between 13 and 64 years.2 Despite these recommendations, an estimated 40% to 60% of youths living with HIV are unaware of their diagnosis, increasing their risk of immune deterioration and transmission.3,4 Furthermore, youths have the lowest rates of progression through the HIV care cascade from diagnosis to viral suppression.4 While the United Nations Joint Programme on HIV/AIDS 90-90-90 goal should be attainable, youths are the hardest to reach for the first 90 (testing) and the second 90 (linkage to care).5

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