761    

Background:   HIV rapid testing is becoming increasingly accepted in many settings. Little is known of the acceptability and use of rapid testing focused on urban minority youth. These youth, particularly the youth at highest risk for HIV, do not often have routine medical care where testing can be provided, and if provided do not come back for results. We hypothesize that rapid testing that focuses on outreach to high-risk youth will be effective in identifying new positives and then enroll them in care.

Methods:  In a pilot program for youth rapid testing in Philadelphia, program staff outreached to community sites including community college, emergency shelters, family court, and gay/lesbian/bisexual/transvestite (GLBT) youth centers for on-site testing, advertised at community sites to provide walk-in testing at children’s hospital site, and provided testing in a children’s hospital HIV clinic, walk-in pregnancy clinic, emergency department, and inpatient ward. Although targeted at youth, all clients requesting testing were tested.

Results:  Over 10 months, 450 tests were performed, of which 248 were for youth aged 14 to 24 and 7 of these were new positives, seroprevalence 1.6%. Results of total group:  62% black, 24% Hispanic; testing was 43% community based, 52% in 2 clinics, 2% inpatient, 2% emergency departments; 58% were previously tested. Age ranged from 0 to 72; mean 22, median 19. Demographics of total positives:  100% were black, non-Hispanic, 43% male, 57% female, mean age 22 years, 86% with heterosexual risk factors, 14% MSM; Youth Positives 75% heterosexual, 25% MSM, 50% male/female, mean 22 years. Total youth (combined positive and negative) risk factors:  61% with heterosexual contact only, 33% with at least 1 risk factor, 15% with ≥ 3; 13% with a sexually transmitted disease and 8% sexually assaulted; none of youth with multiple risk factors was positive. One who tested negative thought he was positive but had never returned for results. A 2-year-old child identified as an in-patient, with perinatal transmission. Of 7 positive patients, 6 were linked to care and had at least 1 medical visit.   

Conclusions:  Rapid testing in Philadelphia youth identified 4 new positives (seroprevalence 1.6%), predominantly heterosexual, all black, similar to expected adult rates. Minority youth rapid testing in community settings is a tool to identify newly positive youth and is a useful adjunct for pediatric and adolescent HIV programs to use in the in-patient and out-patient settings. More study for attitudes toward their testing experience more testing to reach statistical significance in trends identified is needed.     

Keywords: Rapid Testing; Youth; Community Outreach