All teens 16 to 18 years old should receive routine HIV testing if they live in areas where the risk of HIV infection is considered prevalent, the American Academy of Pediatrics is recommending.

Previously, the group representing pediatricians only recommended HIV testing for more sexually active teens.

“Pediatricians should provide an environment of tolerance and facilitate open discussions regarding sexual risk and sexual orientation,” the academy said in a statement released Monday. “ In addition, physicians should know and recognize the symptoms of HIV, understand state laws regarding testing of youth, and routinely assess patient sexual and substance use behaviors.”

The academy also stressed that testing should be done routinely by emergency rooms and clinics in areas where the infected population is greater than 0.1 percent because the economic downturn has left many teens and their families unable to afford primary care visits because of job and insurance losses.

The CDC puts the number of HIV-positive people living in the United States at 1.1 million in 2006, with 5 percent of that population ranging in ages from 13 to 24. The CDC estimates that about one of every two HIV-positive teens don’t know they are infected.

“Unless pediatricians approach young people about the importance of getting tested for HIV, it’s not going to happen,” Dr. Jaime Martinez, an adolescent medicine specialist in Chicago, told CNN.

“By promoting testing and offering counseling, we can probably have some impact on reducing the number of young people becoming infected with HIV in this country.”