Q&A: Make Every Day World AIDS Day by Encouraging HIV Testing Year Round

About 40 percent of all new HIV infections each year occur in 13- to 29-year-olds. And most who have the virus don’t know it: Researchers at the Centers for Disease Control and Prevention estimate that most people who test positive for HIV have had the virus for ten years. We spoke with Michelle Palmer, director of clinical services at Metro Teen AIDS, in Washington, DC, about some of the unique challenges in getting young people to get tested for HIV.

NCFY: What are some reasons youth don’t get tested?  

Palmer: Youth feel invincible. There’s also been a change from HIV being something that was terminal to something that’s chronic, so there’s less fear. Specific to runaway youth, HIV is a long-term issue and requires care and planning for the future. Runaway youth are already just focusing on getting by day to day. Some are working as commercial sex workers doing things they never thought they’d do, and just don’t want to know. Young people who don’t have stability or security in their lives don’t know what they’d do if they were positive, which encourages them to not want to be tested. So lack of support services is a barrier.

NCFY: How can programs encourage youth to get tested?

Palmer: Metro Teen AIDS has been using a social network strategy, where we identify the groups where there’s HIV, encourage members of those groups to get their peers tested, and reward them for each person they’re able to bring in. Because youth think HIV isn’t their problem and aren’t going to necessarily seek out testing, we throw a lot of parties with food, local musicians, games, and have the testing available there.

NCFY: How would encouraging testing be different between short-term, emergency programs and long-term ones?

Palmer: Getting youth to get tested is going to look pretty similar in both kinds of programs. You need to have regular partners who do testing who have an opportunity to develop relationships, but with an emergency program it’s more important that it be regular and fully accessible. It’s also good to have testing for multiple STDs to bring more people in and create opportunities to talk about behaviors and exposure and risk. In longer-term programs, you have more time to develop relationships with the youth and create trust and support networks, so that they know that if you’re providing testing they know when you’ll be there but also that you’re, for example, the one who does collages or has a dog. Responding to young people not knowing what they’d do if they were positive, we try to have other community partners right there with us when we do testing, so they can see who would help them with their medications, with counseling, with school, if they were positive.

NCFY: Why should testing for HIV be important to youth programs?

Palmer: HIV is a social disease and disproportionately impacts people who are already struggling. Youth seeking services are struggling with something. With HIV, you need to get into care, and the earlier you know your status the sooner you can start taking better care of yourself.