Linking HIV-Negative Youth to Prevention Services in 12 U.S. Cities: Barriers and Facilitators to Implementing the HIV Prevention Continuum.

TitleLinking HIV-Negative Youth to Prevention Services in 12 U.S. Cities: Barriers and Facilitators to Implementing the HIV Prevention Continuum.
Publication TypePublication
Year of Publication2018
AuthorsDoll M, J Fortenberry D, Roseland D, McAuliff K, Wilson CM, Boyer CB
JournalJ Adolesc Health
Volume62
Issue4
Pagination424-433
Date Published2018 04
ISSN1879-1972
KeywordsAdolescent, Health Services Accessibility, HIV Infections, Humans, Interviews as Topic, Male, Mass Screening, Patient Acceptance of Health Care, Pre-Exposure Prophylaxis, Qualitative Research, Sexual and Gender Minorities, Young Adult
Abstract

<p><b>PURPOSE: </b>Linkage of HIV-negative youth to prevention services is increasingly important with the development of effective pre-exposure prophylaxis that complements behavioral and other prevention-focused interventions. However, effective infrastructure for delivery of prevention services does not exist, leaving many programs to address HIV prevention without data to guide program development/implementation. The objective of this study was to provide a qualitative description of barriers and facilitators of linkage to prevention services among high-risk, HIV-negative youth.</p><p><b>DESIGN: </b>Thematic analysis of structured interviews with staff implementing linkage to prevention services programs for youth aged 12-24 years.</p><p><b>METHODS: </b>Twelve adolescent medicine HIV primary care programs as part of larger testing research program focused on young sexual minority men of color. The study included staff implementing linkage to prevention services programs along with community-based HIV testing programs. The main outcomes of the study were key barriers/facilitators to linkage to prevention services.</p><p><b>RESULTS: </b>Eight themes summarized perspectives on linkage to prevention services: (1) relationships with community partners, (2) trust between providers and youth, (3) youth capacity to navigate prevention services, (4) pre-exposure prophylaxis specific issues, (5) privacy issues, (6) gaps in health records preventing tailored services, (7) confidentiality of care for youth accessing services through parents'/caretakers' insurance, and (8) need for health-care institutions to keep pace with models that prioritize HIV prevention among at-risk youth. Themes are discussed in the context of factors that facilitated/challenged linkage to prevention services.</p><p><b>CONCLUSIONS: </b>Several evidence-based HIV prevention tools are available; infrastructures for coordinated service delivery to high-risk youth have not been developed. Implementation of such infrastructures requires attention to community-, provider-, and youth-related issues.</p>

DOI10.1016/j.jadohealth.2017.09.009
Alternate JournalJ Adolesc Health
PubMed ID29224988
Grant ListU01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States