Evaluation of Adolescent HIV Surveillance and Testing Program in Uptown Chicago, 2013-2017

Abstract

Introduction: Adolescent Men who have sex with men (MSM) and transgender women (TW) are currently overrepresented among new HIV cases in the United States. To address this concern, the Adolescent Medicine division of Lurie Children's Hospital has operated an HIV testing program in Uptown Chicago geared towards these individuals. The purpose of this manuscript is to report on the evaluation of the HIV outcome, demographic, and risk behavior information resulting from longitudinal data collection performed as part of this program. The results of this paper will be used to drive future program direction and improve primary and secondary HIV prevention among LGBTQ youth in Chicago.Methods: From May 2013 to June 2017, 1058 individuals presented for HIV testing in the Adolescent Medicine division and filled out questionnaires detailing demographics, sex behavior and known HIV risk factors. This data was aggregated in R and subsetted by gender and sexual orientation. Bivariate analysis was conducted to compare risk factors among HIV positive and negative MSM and TW as well as compare old MSM to adolescent MSM HIV positive individuals. A logistic regression was performed to analyze risk factors for a positive HIV test among young MSM.Results: For MSM and TW, those of African American race were at the highest risk for a positive HIV test. In young MSM, social factors such as homelessness and previous incarceration were more salient risk factors than sexual behavior such as condomless sex. The TW tested showed a significantly higher HIV risk than the young MSM tested, but did not show significant differences between positive and negative HIV results. Older MSM individuals were more likely to report having condomless sex with a male or sex with an HIVpositive male partner. Conversely, individuals in the young group were more likely to report having sex with multiple partners and report having sex for drugs or money.Conclusion: The data presented in this analysis mirrors a trend in the United States; while HIV total infections are decreasing, African American youths show an increasing risk. The results also show the primary difference between those who receive a positive HIV test result and those who receive a negative one are social in nature and not precisely related to sex behavior. The Adolescent Medicine division can use these results to direct their resources towards primary prevention of HIV infection in young MSM and TW.

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