Significant health disparities among racial and ethnic groups persist. Adolescents and young adults who are African American, American Indian, or Latino—especially those living in poverty—experience greater health disparities when compared to their White peers.^[1] Most often, the leading causes of illness and death for young people are preventable: adolescent and young adult health outcomes, grounded in their environments (i.e., how and where they live, learn, and play) can be impacted by an individual’s behaviors.^[2] Increasing HIV testing among adolescents and young adults is one such behavior that has the potential to improve health outcomes.

Compared with the overall population, HIV disproportionately affects teens and young adults. Although they made up just 17% of the population in 2010, teens and young adults accounted for 26% of the new HIV infections that year. Still, HIV testing among these populations remains low—and in some cases, even lower than in previous years.

A recent study published in the journal Pediatrics includes analyses of the National Youth Risk Behavior Survey (YRBS) and found that among high school students, no change was detected in HIV testing prevalence between 2005 and 2013. Among young adult women, however, there was a significant decrease in testing prevalence between 2011 and 2013—from 42.4% to 39.5%. Rates for young adult men during this time period—already lower than their counterparts—decreased as well, from 27.2% in 2011 to 26.3% in 2013.

In 2006, the Centers for Disease Control and Prevention (CDC) released recommendations that called for routine HIV testing for Americans starting at age 13, yet the majority of adolescents and young adults are not getting tested. What does that mean for these young people? Without testing and diagnosis, they won’t benefit from treatment and care that can not only improve their health, but can also reduce the risk of transmission to others, study authors noted.

What are some barriers that stand in the way of adolescents and young adults getting tested for HIV? Among them are “lack of access to health care, low provider awareness of recommendations, and insufficient sexual health knowledge.” According to previous research, provider recommendation has been shown to be the most important predictor of adolescents getting tested for HIV, and authors of this study say their results support this, noting that “80% of young adults who were ever tested for HIV [were] last tested in a clinical setting.”

Schools can also play a “critical role” in increasing students’ access to HIV testing services, authors of the study said, recommending access to confidential services in school and increased sexual health education.

Among the youth with whom you work, what do you see as the top barrier to getting tested for HIV? How do you support navigating around these barriers?