Updated: June 27, 2016 12:21 PM ET | Originally published: June 23, 2016 1:00 PM EDT

Correction appended, June 27, 2016

Despite the fact that many young men have at least one doctor’s appointment every year, they are rarely tested for HIV, a new federal report shows. The lack of testing may mean missed opportunities for finding people who are infected, the researchers suggest.

The new report, published by researchers at the U.S. Centers for Disease Control and Prevention (CDC), shows that HIV testing was performed during just 1% of doctors’ appointments among men ages 15 to 39 from 2009 to 2012. Those numbers are low despite CDC recommendations since 2006 to routinely test all adults and adolescents for HIV. In practice, actual testing has been “suboptimal,” the CDC says.

That HIV testing didn’t occur 99% of the time in young men, despite regular doctors’ visits, is concerning, the researchers say. The most recent federal data shows that in 2014, 81% of new HIV diagnoses were made among men, with young men aged 20-29 making up about 40% of new diagnoses. “Young males are disproportionately affected by HIV in the United States,” the study authors write. “HIV testing serves as an entry point for HIV prevention and care services.”

In 2014, only 36% of U.S. adult men said they had ever been tested for HIV. An estimated 15% of adult men live with an undiagnosed HIV infection.

Doctors might not test young men for HIV because they don’t know that regular testing is recommended across age groups, or because they believe that the young men they see are not at risk, the study authors speculate. Some providers may also believe that HIV testing is outside of their purview. Encouraging men to get tested in ways that don’t rely solely on providers—by using electronic medical record reminders, for example—could prove beneficial, the researchers add.

Correction: The original version of this story misstated the percent of HIV diagnosis among men ages 20 to 29. It is about 40%.

Contact us at letters@time.com.

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