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APHA Scientific Session and Event Listing

Karen G. O'Connor, Division of Health Services Research, American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove Village, IL 60007-1098, Peter L. Havens, MD, Department of Pediatrics/Infectious Diseases, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226-3548, Lisa Henry-Reid, MD, Stroger Hospital of Cook County, 1900 W. Polk St, Adm Bldg, Rm 1111, Chicago, IL 60612-3723, Jeanne Lindros, Division of Safety and Health Promotion, American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove Village, IL 60007, Jonathan D. Klein, MD, MPH, Division of Adolescent Medicine, University of Rochester, 601 Elmwood Ave, Rm 4-6234, Rochester, NY 14642-8690, 585-275-7760, jonathan_klein@urmc.rochester.edu, and Donna Futterman, MD, Adolescent AIDS Program, Montefiore Medical Center, 111 E 210th St., Bronx, NY 10467-2401.

Background: Studies show half of new HIV infections in the US occur in 13-24 year olds. This survey assessed pediatricians' HIV/STD screening and counseling practices and identified barriers to providing these services. Methods: Random sample, mailed survey of 1,614 US members of the AAP in 2005; response=48%. Participants include providers of health supervision to children ≥11y. Bivariate analysis assessed provision of HIV/STD prevention services by pediatrician characteristics. Nonrespondents were compared to respondents for age and gender. Results: Most pediatricians (>70%) discuss sexual activity at preventive care visits; about half discuss abstinence (52%), use of condoms (50%), STDs (52%) and HIV (46%); only 15% discuss homosexuality. Younger (<45y) pediatricians, female and group practitioners are more likely to counsel about risky behaviors. Most (69%) identify teens with high-risk behaviors by clinical interviews only; 22% use standardized assessment tools. About 30% prescribe and 22% distribute condoms; 19% provide condom demonstrations. While 46% of pediatricians recommend STD tests for all sexually active teens, only 28% recommend they be tested for HIV. Clinic and inner-city practitioners are more likely to prescribe, provide and demonstrate condoms (p<.001) and recommend HIV/STD tests for sexually active teens (p<.01). Lack of time, cultural/language differences, physician discomfort talking about sexual issues and belief that teens are not truthful about risky behaviors are most frequently named as barriers to prevention counseling. Conclusions: Most pediatricians routinely address adolescent sexual activity, however, fewer than half use screening tools, discuss HIV or recommend appropriate testing. Counseling and testing practices vary by physician characteristics.

Learning Objectives:

• 1)Describe the frequency with which pediatricians address sexual and other sensitive topics during office visits, identify adolescents with high risk behaviors and recommend HIV/STD testing. 2)Identify barriers to providing HIV/STD prevention counseling and on-site testing during pediatric visits.

Keywords: HIV/AIDS, Adolescent Health

Presenting author's disclosure statement:

Not Answered