HIV testing among adolescents attending alternative and therapeutic schools

Background: Teens with mental health problems engage in more HIV risk behaviors than peers, yet little is documented regarding their rates of HIV testing. This study aimed to examine factors associated with HIV testing in a sample of students attending alternative and therapeutic schools, where high rates of mental health problems are observed.

Methods: Adolescents ages 13-19 attending alternative schools were recruited for an HIV-prevention intervention study. Participants (n=162) completed baseline measures on laptop computers regarding demographics, sexual behavior, sexual attitudes, sources of HIV information, and DSM-IV psychiatric diagnostic criteria (DISC). Participants self-reported history of HIV testing.

Results: Fifty-nine percent were sexually active; 27% had ever received HIV testing. Adolescents who met criteria for a psychiatric disorder were significantly more likely to have been tested than those who did not. Testing was associated with being sexually active, being female, being older, having riskier attitudes toward condoms, and having received HIV information from a doctor or therapist. Race, number of sexual partners, and receiving information from family, friends, school, or media were not related to testing.

Conclusions: HIV testing was associated with known risk factors such as active psychiatric disorder, sexual activity, and risky attitudes. Public health initiatives should target this high-risk population, which is accessible while still in school, perhaps by offering testing in therapeutic schools. Also, teens who received information from doctors or therapists were more likely to have been tested, highlighting the importance of efforts in the health care system to promote HIV testing among adolescents.