Evaluating Testing Strategies for Identifying Youths With HIV Infection and Linking Youths to Biomedical and Other Prevention Services
| Autor: | Bendu Cooper-Walker, Kate Chutuape, Robin Lin Miller, Bill G. Kapogiannis, Craig M. Wilson, J. Dennis Fortenberry, Cherrie B. Boyer, Peter Lindeman, Danielle Chiaramonte |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatric AIDS and promotion of well-being Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Pediatrics Sexual and Gender Minorities Adolescent medicine 0302 clinical medicine Mass Screening 030212 general & internal medicine African Americans Pediatric Continuity of Patient Care Test (assessment) Infectious Diseases Community health HIV/AIDS Infection Adolescent Sexual Activity medicine.medical_specialty Adolescent Hiv testing Article Paediatrics and Reproductive Medicine Young Adult 03 medical and health sciences Clinical Research 030225 pediatrics Behavioral and Social Science medicine Humans Psychiatry business.industry Prevention Community Health Centers Patient Acceptance of Health Care Prevention of disease and conditions United States Black or African American Sexual minority Good Health and Well Being Adolescent Health Services Family medicine Pediatrics Perinatology and Child Health 3.1 Primary prevention interventions to modify behaviours or promote wellbeing Observational study business Serostatus Program Evaluation |
| Zdroj: | JAMA pediatrics, vol 171, iss 6 |
| ISSN: | 2168-6203 |
| DOI: | 10.1001/jamapediatrics.2017.0105 |
| Popis: | Importance Most human immunodeficiency virus (HIV)–infected youths are unaware of their serostatus (approximately 60%) and therefore not linked to HIV medical or prevention services. The need to identify promising and scalable approaches to promote uptake of HIV testing among youths at risk is critical. Objective To evaluate a multisite HIV testing program designed to encourage localized HIV testing programs focused on self-identified sexual minority males and to link youths to appropriate prevention services after receipt of their test results. Design, Setting, and Participants Testing strategies were evaluated using an observational design during a 9-month period (June 1, 2015, through February 28, 2016). Testing strategies were implemented by 12 adolescent medicine HIV primary care programs and included targeted testing, universal testing, or a combination. Data were collected from local youth at high risk of HIV infection and, specifically, sexual minority males of color. Main Outcomes and Measures Proportion of sexual minority males and sexual minority males of color tested, proportion of previously undiagnosed HIV-positive youths identified, and rates of linkage to prevention services. Results A total of 3301 youths underwent HIV testing. Overall, 35 (3.6%) of those who underwent universal testing in primary care clinical settings, such as emergency departments and community health centers, were sexual minority males (35 [3.6%] were males of color) compared with 236 (46.7%) (201 [39.8%] were males of color) who were tested through targeted testing and 693 (37.8%) (503 [27.4%] were males of color) through combination efforts. Identification of new HIV-positive cases varied by strategy: 1 (0.1%) via universal testing, 39 (2.1%) through combination testing, and 16 (3.2%) through targeted testing. However, when targeted tests were separated from universal testing results for sites using a combined strategy, the rate of newly identified HIV-positive cases identified through universal testing decreased to 1 (0.1%). Rates of new HIV-positive cases identified through targeted testing increased to 49 (6.3%). Youths who tested through targeted testing (416 [85.1%]) were more likely to link successfully to local HIV prevention services, including preexposure prophylaxis, compared with those who underwent universal testing (328 [34.1%]). Conclusions and Relevance The findings suggest that community-based targeted approaches to HIV testing are more effective than universal screening for reaching young sexual minority males (especially males of color), identifying previously undiagnosed HIV-positive youths, and linking HIV-negative youths to relevant prevention services. Targeted, community-based HIV testing strategies hold promise as a scalable and effective means to identify high-risk youths who are unaware of their HIV status. |
| Databáze: | OpenAIRE |
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