ArticleThe Journal of adolescent health : official publication of the Society for Adolescent Medicine2018
The Optimal Age for Screening Adolescents and Young Adults Without Identified Risk Factors for HIV.
Article in The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evidence Gaps in Economic Evaluations of HIV Interventions Targeting Young People: A Systematic Review.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Pooled it
- Factors Associated with HIV Testing Uptake in Cameroon: Data from the 2018 Cameroon Demographic and Health Survey.HIV/AIDS (Auckland, N.Z.) · 2025Article
- Profiles of HIV-Related Knowledge and Self-Regulation Factors in At-Risk Pre-Adolescents.Children's health care : journal of the Association for the Care of Children's Health · 2025Article
- Who declines "opt-out" HIV/HCV testing? Experience of an internal medicine resident continuity clinic serving a predominantly Black adult population in South Carolina.Journal of the National Medical Association · 2024Article
- Daily Oral HIV Pre-exposure Prophylaxis Among Young Men Who Have Sex With Men in the United States: Cost-saving at Generic Drug Price.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Analysing Early Diagnosis Strategies for HIV Infection: A Retrospective Study of Missed Diagnostic Opportunities.Healthcare (Basel, Switzerland) · 2024Article
- Assessing secular trends in HIV rapid diagnostic test uptake and positivity in Northeast Iran, a country in MENA region; ingredients for target-specific prevention policies.BMC infectious diseases · 2023Article
- Financing Benefits and Barriers to Routine HIV Screening in Clinical Settings in the United States: A Scoping Review.International journal of environmental research and public health · 2022Article
- Adolescents and Young Adults: The Pediatrician's Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis.Pediatrics · 2022Article
- Cost-effectiveness of Frequent HIV Screening Among High-risk Young Men Who Have Sex With Men in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Modeling Adherence Interventions Among Youth with HIV in the United States: Clinical and Economic Projections.AIDS and behavior · 2021Article
- Article
- The Potential Impact of One-Time Routine HIV Screening on Prevention and Clinical Outcomes in the United States: A Model-Based Analysis.Sexually transmitted diseases · 2020Article
- Higher Acuity Resource Utilization With Older Age and Poorer HIV Control in Adolescents and Young Adults in the HIV Research Network.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Trends in HIV Testing Among US Adults, Aged 18-64 Years, 2011-2017.AIDS and behavior · 2020Article
- HIV screening in men and women in Senegal: coverage and associated factors; analysis of the 2017 demographic and health survey.BMC infectious diseases · 2019Article
- Can the United States achieve 90-90-90?Current opinion in HIV and AIDS · 2019Review
- Model-Based Methods to Translate Adolescent Medicine Trials Network for HIV/AIDS Interventions Findings Into Policy Recommendations: Rationale and Protocol for a Modeling Core (ATN 161).JMIR research protocols · 2019Article
- Missed Opportunities for HIV Screening Among a Cohort of Adolescents With Recently Diagnosed HIV Infection in a Large Pediatric Hospital Care Network.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2018Article
- Screening for HIV and linkage to care in adolescents: insights from a systematic review of recent interventions in high- versus low- and middle-income settings.Adolescent health, medicine and therapeutics · 2018Review
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Authors and funding
13 authors.
Funding
Abstract
purposeTo assess the optimal age at which a one-time HIV screen should begin for adolescents and young adults (AYA) in the U.S. without identified HIV risk factors, incorporating clinical impact, costs, and cost-effectiveness.
methodsWe simulated HIV-uninfected 12-year-olds in the U.S. without identified risk factors who faced age-specific risks of HIV infection (.6-71.3/100,000PY). We modeled a one-time screen ($36) at age 15, 18, 21, 25, or 30, each in addition to current U.S. screening practices (30% screened by age 24). Outcomes included retention in care, virologic suppression, life expectancy, lifetime costs, and incremental cost-effectiveness ratios in $/year-of-life saved (YLS) from the health-care system perspective. In sensitivity analyses, we varied HIV incidence, screening and linkage rates, and costs.
resultsAll one-time screens detected a small proportion of lifetime infections (.1%-10.3%). Compared with current U.S. screening practices, a screen at age 25 led to the most favorable care continuum outcomes at age 25: proportion diagnosed (77% vs. 51%), linked to care (71% vs. 51%), retained in care (68% vs. 44%), and virologically suppressed (49% vs. 32%). Compared with the next most effective screen, a screen at age 25 provided the greatest clinical benefit, and was cost-effective ($96,000/YLS) by U.S. standards (<$100,000/YLS).
conclusionsFor U.S. AYA without identified risk factors, a one-time routine HIV screen at age 25, after the peak of incidence, would optimize clinical outcomes and be cost-effective compared with current U.S. screening practices. Focusing screening on AYA ages 18 or younger is a less efficient use of a one-time screen among AYA than screening at a later age.
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