Association Between HIV-Related Risk Behaviors and HIV Testing Among High School Students in the United States, 2009

Objective: To identify the human immunodeficiency virus (HIV)-related risk behaviors associated with HIV testing among US high school students who reported ever having sexual intercourse. Design: Secondary analysis of a cross-sectional study. Setting: The 2009 national Youth Risk Behavior Survey. Participants: A total of 7591 US high school students who reported ever having sexual intercourse. Main Exposures: Risk behaviors related to HIV. Main Outcome Measure: Having ever been tested for HIV. Results: Among the 7591 students who reported ever having sexual intercourse, 22.6% had been tested for HIV. Testing for HIV was most likely to be done among students who had ever injected any illegal drug (41.3%; adjusted odds ratio, 1.70; 95% CI, 1.14-2.56), had ever been physically forced to have sexual intercourse (36.2%; adjusted odds ratio, 1.43; 95% CI, 1.19-1.72), did not use a condom the last time they had sexual intercourse (28.7%; adjusted odds ratio, 1.28; 95% CI, 1.08-1.51), and had sexual intercourse with 4 or more persons during their life (34.7%; adjusted odds ratio, 2.32; 95% CI, 1.98-2.73). Conclusions: Most sexually active students, even among those who reported high-risk behaviors for HIV, have not been tested for HIV. New strategies for increasing HIV testing among the adolescent population, including encouraging routine voluntary HIV testing among those who are sexually active, are needed.