HIV Testing, Linkage to HIV Medical Care, and Interviews for Partner Services Among Youths — 61 Health Department Jurisdictions, United States, Puerto Rico, and the U.S. Virgin Islands, 2015

Stein, Roger B.; Song, Wei; Marano, Mariette; Patel, Heta; Rao, Shubha; Morris, Elana

doi:10.15585/mmwr.mm6624a2

Cited by 17 publications

(9 citation statements)

References 6 publications

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“…The United States Centers for Disease Control and Prevention (CDC) has recommended targeted HIV testing for persons at high-risk for HIV infection including MSM [4]. However, a study from the US revealed that only 28% of young MSM received HIV tests despite that they accounted for 83% of new diagnoses of HIV infection among all youths in non-health care facilities [5]. In addition, another study demonstrated that the rate of HIV-infected young MSM who were unaware of their infection was 52% compared to the rate of 15% among other HIV-infected persons [6].…”

Section: Introductionmentioning

confidence: 99%

HIV risk, risk perception and uptake of HIV testing and counseling among youth men who have sex with men attending a gay sauna

et al. 2019

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Background Men who have sex with men (MSM) are amongst populations at-risk for HIV acquisition in Thailand. In youth MSM (aged 15–24 years), the incidence of HIV infection has substantially increased. However, data on HIV risk, risk perception and HIV testing and counseling (HTC) uptake among youth MSM in hotspots are limited. Methods A subanalysis of a prospective study among Thai MSM attending a gay sauna was conducted. HIV risk and risk perception were assessed by an anonymous survey. The MSM were categorized as having actual “low-risk”, “moderate-risk” and “high-risk” for HIV acquisition based on the validated study risk categorization tool. HTC was provided on-site with result notification within 1 h. HIV care establishment appointment was arranged by the counselors for HIV-infected participants. Care engagement within 1 year of diagnosis was subsequently assessed. Results There were 358 MSM participants; 87 (24%) were youth MSM. Comparing to other MSM, youth MSM had significantly higher median number of lifetime sexual partners [2 (IQR 1–9) vs. 1 (IQR 0–1); P < 0.001), were more-likely to ever exchange sex for money (44% vs. 9%; P < 0.001) and have sexual partner who exchanged sex for money (8% vs. 1%; P < 0.001). Rates of consistent condom use in the past 3 months for anal, oral and vaginal sexes were low and not significantly different between youth and other MSM (51% vs. 61%, 26% vs. 35% and 72% vs. 61%, respectively). By using the study risk categorization tool, there were 68 youth MSM with moderate or high-risk for HIV acquisition, of which 43 (63%) had false perception of low HIV risk. Youth MSM were more likely than other MSM to accept HTC [68% vs. 33%, P < 0.001)] and to be first-time testers (42% vs. 28%, P = 0.07). By HTC, the rates of HIV infection tended to be higher among youth MSM comparing to other MSM [14/59 (24%) vs. 11/89 (12%); P = 0.07]. Among the 14 youth MSM newly-diagnosed with HIV infection, only 6 (43%) showed-up for continuity care after 1-year follow-up. Conclusions Youth MSM had substantial high HIV risk, false perception of low HIV risk and low rate of care engagement but demonstrated considerable rate of HTC uptake. Strategies to improve access to HTC, risk perception and linkage to care are needed for HIV prevention and management among the youth MSM.

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Section: Introductionmentioning

confidence: 99%

HIV risk, risk perception and uptake of HIV testing and counseling among youth men who have sex with men attending a gay sauna

et al. 2019

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“…8 Initial linkage to and engagement in care are particularly important in the southern US. The south has 52% of all new diagnoses of HIV infection in the US, but significantly lower rates of linkage to care when compared with the northeast or west 9,10 and 47% of all US HIV deaths. 11,12 Health disparities in care engagement also exist for African Americans and Hispanics, where stigma, lack of access to care, and other barriers may impact effective engagement in HIV care and treatment.…”

Section: Introductionmentioning

confidence: 99%

Improving HIV Care Engagement in the South from the Patient and Provider Perspective: The Role of Stigma, Social Support, and Shared Decision-Making

Taylor

Fornos

Tarbutton

et al. 2018

AIDS Patient Care and STDs

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Initial linkage to medical care is a critical step in the HIV care continuum leading to improved health outcomes, reduced morbidity and mortality, and decreased HIV transmission risk. We explored differences in perspectives on engagement in HIV care between people living with HIV who attended (Arrived) their initial medical provider visit (IMV) and those who did not (Missed), and between patients and providers. The study was conducted in two large majority/minority HIV treatment centers in the United States (US) south, a geographical region disproportionately impacted by HIV. The Theory of Planned Behavior informed semistructured interviews eliciting facilitators and barriers to engagement in care from 53 participants: 40 patients in a structured sample of 20 Missed and 20 Arrived, and 13 care providers. Using Grounded Theory to frame analysis, we found similar perspectives for all groups, including beliefs in the following: patients' control over care engagement, a lack of knowledge regarding HIV within the community, and the impact of structural barriers to HIV care such as paperwork, transportation, housing, and substance use treatment. Differences were noted by care engagement status. Missed described HIV-related discrimination, depression, and lack of social support. Arrived worried what others think about their HIV status. Providers focused on structural barriers and process, while patients focused on relational aspects of HIV care and personal connection with clinics. Participants proposed peer navigation and increased contact from clinics as interventions to reduce missed IMV. Context-appropriate interventions informed by these perspectives are needed to address the expanding southern HIV epidemic.

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“…The majority of sexually active high school students have never tested for HIV [ 7 , 8 ], large proportions of adolescent sexual minority males who engaged in condomless sex at last intercourse report never testing for HIV [ 9 ], and half of young HIV positive men who have sex with men remain undiagnosed [ 10 ]. When youth do test for HIV, current ED standards of care do not include education about prevention and retesting for adolescents who test negative yet engage in high-risk behaviors [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Mobile Augmented Screening to Increase HIV Testing Among Emergency Department Patients as Young as 13 Years

Aronson¹,

Zhang

Rajan

et al. 2021

Cureus

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Because adolescents and emerging adults are frequently not offered HIV testing, and often decline tests when offered, we developed and tested a tablet-based intervention to increase HIV test rates among emergency department (ED) patients aged 13-24 years. Pediatric and adult ED patients in a high volume New York City hospital (N = 295) were randomized to receive a face-to-face HIV test offer, or to complete a tablet-based intervention that contained an HIV test offer delivered via computer. Test rates in both conditions were then compared to historic test rates in the same ED during the previous six months. Among participants aged 19 years and younger who were offered HIV testing and declined before enrollment in the study, participants in the tablet-based condition were 1.7 times more likely to test for HIV compared to participants in the face-to-face condition. Participants aged 19 years and younger were three times as likely to test for HIV compared to patients the same age who were treated in the previous six months (26.39%, n = 71 study participants vs. 10.29%, n = 189 prior patients, OR = 3.13, 2 = 54.76, p < 0.001). Protocols designed to offer HIV testing to all eligible patients can significantly increase adolescent test rates compared to standard practice. Because tablets are equally effective compared to face-to-face offers, and in some cases more so, EDs may consider tablet-based interventions that require fewer staff resources and may integrate more easily into high-volume workflows.

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HIV Testing, Linkage to HIV Medical Care, and Interviews for Partner Services Among Youths — 61 Health Department Jurisdictions, United States, Puerto Rico, and the U.S. Virgin Islands, 2015

Cited by 17 publications

References 6 publications

HIV risk, risk perception and uptake of HIV testing and counseling among youth men who have sex with men attending a gay sauna

HIV risk, risk perception and uptake of HIV testing and counseling among youth men who have sex with men attending a gay sauna

Improving HIV Care Engagement in the South from the Patient and Provider Perspective: The Role of Stigma, Social Support, and Shared Decision-Making

Mobile Augmented Screening to Increase HIV Testing Among Emergency Department Patients as Young as 13 Years

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