Opportunity lost for early HIV diagnosis among teens in paediatric hospital

Missed opportunity encounters (MOEs) for HIV diagnosis in adolescents occur frequently and in greater number at a paediatric hospital than in a similar adult setting with universal screening, according to a recent study.

“Universal HIV screening protocols at a paediatric hospital may identify HIV-positive adolescents earlier,” the authors said.

This observational study was conducted at two academic tertiary care hospitals in the US that included all adolescents 13–20 years old with a new diagnosis of behaviourally acquired HIV infection from 2006 to 2017.

MOE was defined as any encounter at a paediatric hospital or a proximate adult hospital after the latter of the individual’s 13th birthday or the date 3 months after the individual’s most recent negative HIV screen, and before the encounter of HIV diagnosis. The authors made the comparisons by site of diagnosis and location of MOE.

A total of 205 individuals (68 percent male; 76 percent black; 81 percent men who have sex with men) were included in the analysis. There were 264 MOEs reported; the proportion of adolescent emergency department (ED) encounters that were MOE at the paediatric hospital ED was 8.3 per 10,000 encounters, while that at an adult hospital was 1.2 (relative risk, 6.7, 95 percent CI, 4.1–11.0; p<0.001).

“Early diagnosis of HIV infection improves patient outcomes and reduces transmission,” the authors said. “Adolescents make up one-fifth of new HIV diagnoses in the US.”