Changes in human immunodeficiency virus testing rates among urban adolescents after introduction of routine and rapid testing.

OBJECTIVES To examine human immunodeficiency virus (HIV) testing rates among adolescents during a 3-year period to determine (1) if the rate of testing increased after publication of national recommendations for routine HIV testing in 2006, and again after the introduction of rapid testing in the clinic in 2007, and (2) factors associated with HIV testing. DESIGN Retrospective medical record review. SETTING Urban hospital-based adolescent primary care clinic. PARTICIPANTS Thirteen- to 22-year-old sexually experienced patients who had computerized billing data reflecting testing for sexually transmitted infections, including HIV. OUTCOME MEASURES Rates of HIV testing for each of 3 one-year phases-phase 1 (pre-routine testing recommendations), phase 2 (post-routine testing recommendations but pre-rapid testing), and phase 3 (post-rapid testing)-and factors associated with HIV testing. RESULTS In total, 9491 patients were included. The rate of HIV testing in phase 2 was significantly higher than the rate of testing in phase 1 (27.7% vs 12.6%, P < .001). The rate of testing in phase 3 was significantly higher than the rate of testing in phase 2 (44.6% vs 27.7%, P < .001) and phase 1 (P < .001). Factors independently associated with HIV testing included phase, older age, male sex, race, public insurance status, and having a genitourinary-related diagnosis during the same phase. CONCLUSIONS The HIV testing rates increased significantly following publication of recommendations for routine testing and further increased following introduction of rapid testing. Combining routine and rapid testing strategies may increase uptake of HIV testing among adolescents in primary care settings.