FACTORS ASSOCIATED WITH HIV TESTING AMONG SEXUALLY ACTIVE ADOLESCENTS- A MASSACHUSETTS SURVEY

Objective. To assess sexually active adolescents' knowledge, attitudes , and behaviors associated with human immunodeficiency virus (HIV) tes ting and to determine the factors important in their decision to obtai n voluntary HIV testing.Design. Anonymous, random, digit-dial telephon e survey undertaken in 1993. Setting. Massachusetts households. Partic ipants. Adolescents, 16 to 19 years of age. Results. Of the 567 adoles cents surveyed who had sexual intercourse within the past year, 127 (2 2%) had received HIV testing, with 54 (10%) stating that this testing was for personal reasons. A ''great deal'' or ''some'' worry about get ting HIV/acquired immunodeficiency syndrome (AIDS) was expressed by 51 %, and 56% felt that it was at least a little likely that they will ge t AIDS. Misconceptions were common about aspects of HIV testing: 35% d id not believe or did not know that the HIV test results were kept in confidence, 19% thought that AIDS testers informed partners if the res ults were positive, and 30% did not think that the HIV test was very a ccurate. Although 92% (452/490) had seen a physician in the past year, only 30% (136/452) had ever discussed AIDS with a doctor. Multivariab le analysis identified five factors as independently associated with v oluntary adolescent HN testing: 1) having had more than one sexual par tner within the past year [odds ratio (OR): 2.9; 95% confidence interv al (CI): 1.5, 5.5]; 2) believing that condoms are only somewhat effect ive at preventing the spread of AIDS (OR: 2.6; 95% CI: 1.4, 4.8); 3) h aving discussed AIDS with a doctor (OR: 2.6; 95% CI: 1.4, 4.8); 4) not having had a teacher discuss AIDS (OR: 2.2; 95% CI: 1.2, 4.2); and 5) believing that a positive test result means one has AIDS as opposed t o carrying the virus (OR: 2.0; 95% CI: 1.1, 3.7). High-risk behavior o f infrequent condom use and a history of a sexually transmitted diseas e were not significantly associated with voluntary HIV testing. Conclu sion. Among sexually active Massachusetts adolescents, voluntary HIV t esting is uncommon. Teens who have had multiple sexual partners and wh o do not believe condoms are effective in preventing transmission were most likely to have been tested. Issues requiring clearer communicati on to patients include the testing process, its availability, and conf identiality. Physicians can play an influential role in the promotion of HIV testing by discussing HIV risk behaviors with patients and offe ring those at risk voluntary HIV counseling and testing.