The Use of Mystery Shopping for Quality Assurance Evaluations of HIV/STI Testing Sites Offering Services to Young Gay and Bisexual Men

Abstract

Young men who have sex with men (YMSM) are at increased risk for HIV and STI infection. While encouraging HIV and STI testing among YMSM remains a public health priority, we know little about the cultural competency of providers offering HIV/STI tests to YMSM in public clinics. As part of a larger intervention study, we employed a mystery shopper methodology to evaluate the LGBT cultural competency and quality of services offered in HIV and STI testing sites in Southeast Michigan (n = 43).We trained and deployed mystery shoppers (n = 5) to evaluate the HIV and STI testing sites by undergoing routine HIV/STI testing. Two shoppers visited each site, recording their experiences using a checklist that assessed 13 domains, including the clinic’s structural characteristics and interactions with testing providers. We used the site scores to examine the checklist’s psychometric properties and tested whether site evaluations differed between sites only offering HIV testing (n = 14) versus those offering comprehensive HIV/STI testing (n = 29). On average, site scores were positive across domains. In bivariate comparisons by type of testing site, HIV testing sites were more likely than comprehensive HIV/STI testing clinics to ascertain experiences of intimate partner violence, offer action steps to achieve safer sex goals, and provide safer sex education. The developed checklist may be used as a quality assurance indicator to measure HIV/STI testing sites’ performance when working with YMSM. Our findings also underscore the need to bolster providers’ provision of safer sex education and behavioral counseling within comprehensive HIV/STI testing sites.

Community stigma, internalized homonegativity, enacted stigma, and HIV testing among young men who have sex with men

“…YMSM in Detroit who reported higher perceptions of sexuality‐related prejudice in their communities also reported higher odds of HIV testing; however, perceived place‐based sexuality‐related prejudice was not associated with timing since last HIV test. It is possible that YMSM who had previously tested for HIV gain a greater awareness of the sexuality‐related prejudice in their communities during test counseling sessions (Bauermeister et al., ; Sullivan, ), and/or that they react to perceived stigma by participating in pro‐LGBT spaces (e.g., LGBT centers, pride events, bars and clubs) where HIV tests are offered (Bauermeister et al., ; Bowles et al., ). Given the cross‐sectional nature of the data, however, these temporal relationships cannot be tested.…”

Reducing HIV Vulnerability Through a Multilevel Life Skills Intervention for Adolescent Men (The iREACH Project): Protocol for a Randomized Controlled Trial

“…Participants who click on the “Locator” button will access a prepopulated list of national (eg, crisis hotlines) and local resources (eg, gay-straight alliances, HIV testing locations). We identified 1833 eligible resources across our four study regions; each resource was verified through mailers and phone calls using protocols adapted from HIV testing [ 20 ] and pre-exposure prophylaxis (PrEP) [ 21 ] locators. A random subsample (20%) of resources will be selected for review every 6 months and updated as necessary.…”

Building evidence to guide PrEP introduction for adolescent girls and young women

“…The mystery client (or shopper) method involves researchers posing as prospective clients in order to evaluate client experience when seeking services, such as health care. [39][40][41] The method reduces the bias that can be introduced in observations; that is, where individuals change their behaviors because they know they are being observed. Mystery clients are individuals who possess the characteristics of the types of patients who would seek the service.…”