SEATTLE – More than half of parents reported they would be willing to have their child screened for HIV, according to a survey conducted in an academic community-based clinic in west Texas.
"Our outcome is very encouraging that a good majority of parents do see the need for [screening]," Stephanie Caples, Ph.D., said in an interview. "I was going into [the study] speculating that nobody would want their child screened because we are such a conservative little part of Texas, even though Medicine is saying very differently – the girls are coming in very young with [sexually transmitted infections] STIs and pregnancies."
Of the 78 parents polled, all of whom had children aged 10-24 years, more than half strongly agreed or agreed that they would be willing to have their child screened, researchers reported at the annual meeting of the North American Primary Care Research Group.
Additionally, when asked what the appropriate age for screening to begin is, 44% thought it should start between ages 11 and 15.
In addition to agreeing that they would be willing to screen their child, the parents "were able to hit the average age right on the money ... as far as what we are seeing in the clinic, children who are coming through and reporting that they are sexually active," she added.
The Centers for Disease Control and Prevention favors routine, voluntary HIV screening for adolescents because the HIV rate is rising among 15- to 24-year-olds, especially among those belonging to minorities, noted Dr. Caples, who is a behavioral health scientist at Texas Tech University Health Sciences Center at the Permian Basin, in Odessa, Tex.
However, pediatric screening rates have been low historically. Both parental attitudes about screening and the knowledge behind those attitudes are potential barriers.
"We wanted to see what parents thought about having their children screened, particularly in our community, for two reasons," she explained. "We have the highest teenage pregnancy rate in the state. But we are also still considered a very conservative community, almost like the Bible Belt."
Dr. Caples and her coinvestigator, Dr. Jamal Islam, gave two questionnaires to adults walking into an academic community-based clinic who had a child between the ages of 10 and 24. One questionnaire asked about sociodemographic factors and attitudes about HIV screening. The other, the 18-item HIV Knowledge Questionnaire (HIV-KQ-18), tested their knowledge.
Initial survey results, reported in a poster session at the meeting, showed that the 78 parents who returned questionnaires were 38 years old, on average, and 93% were female. Most were Hispanic (58%). Two-thirds had three or more children. The majority (57%) had themselves been screened for HIV.
When asked if they would be willing to screen their child for HIV, 23% of parents indicated they would strongly agree, and 34% indicated that they would agree, Dr. Caples reported. Another 23% did not have an opinion one way or another. Only 14% disagreed, and 6% strongly disagreed.
"That 23%, that is kind of in the neutral zone; if their doctor suggested it, they would probably agree to it," she commented. "I think it will be important to identify, for the 20% who do not want their children screened, why not."
The majority of parents believed that pediatric screening should start between ages 11 and 15 years (44%) or at age 16 or older (20%).
As for HIV knowledge, the percentage of parents answering correctly ranged from 43% to 97% for individual statements on the HIV-KQ-18. It was less than 80% for five statements: the female condom prevents HIV (43% answered correctly), deep kissing with an HIV-positive person can transmit HIV (62% answered correctly), all HIV-positive pregnant women will have an HIV-positive baby (71% answered correctly), coughing and sneezing do not spread HIV (73% answered correctly), and sharing a glass can spread HIV (76% answered correctly).
"Age and race of the parent had no effect on their willingness to screen, which is really encouraging," Dr. Caples said. Similarly, HIV knowledge had minimal influence on this outcome. But parents were more likely to be willing to screen if they feared that their child would contract HIV or thought that their child was specifically at risk. The role of level of education is still being assessed.
Most survey participants were mothers, so fathers’ attitudes regarding HIV screening remain unknown, she acknowledged. Also, the findings may not be generalizable to other populations.
"Once we finish [the study] and really get a good grasp on what the parental attitudes are or potential barriers, I think maybe moving a screening into an annual evaluation for children may be the way to go here," Dr. Caples commented.