Testing the Testers: Are Young Men Who Have Sex With Men Receiving Adequate HIV Testing and Counseling Services?

TitleTesting the Testers: Are Young Men Who Have Sex With Men Receiving Adequate HIV Testing and Counseling Services?
Publication TypePublication
Year of Publication2019
AuthorsBauermeister JA, Golinkoff JM, Lin WY, Claude KF, Horvath KJ, Dowshen N, Schlupp A, Vickroy WJ, Desir K, Lopez AV, Castillo M, Tanney M, Wimbly TA, Leung K, Sullivan PS, Santiago DL, Hernandez R, Paul ME, Hightow-Weidman L, Lee S, Stephenson R
JournalJ Acquir Immune Defic Syndr
Volume82 Suppl 2
PaginationS133-S141
Date Published2019 12 01
ISSN1944-7884
KeywordsAdult, Counseling, Culturally Competent Care, Health Care Surveys, Health Services Accessibility, Healthcare Disparities, HIV Infections, Homosexuality, Male, Humans, Male, Mass Screening, Preventive Health Services, Quality Assurance, Health Care, United States
Abstract

<p><b>BACKGROUND: </b>The United States Centers for Disease Control and Prevention promote HIV testing every 6 months among young men who have sex with men (YMSM) to facilitate entry into the HIV prevention and care continuum. Willingness to be tested may be influenced by testing services' quality. Using a novel mystery shopper methodology, we assessed YMSM's testing experiences in 3 cities and recommend service delivery improvements.</p><p><b>METHODS: </b>We assessed YMSM's experiences at HIV testing sites in Philadelphia (n = 30), Atlanta (n = 17), and Houston (n = 19). YMSM (18-24) were trained as mystery shoppers and each site was visited twice. After each visit, shoppers completed a quality assurance survey to evaluate their experience. Data were pooled across sites, normed as percentages, and compared across cities.</p><p><b>RESULTS: </b>Across cites, visits averaged 30 minutes (SD = 25.5) and were perceived as welcoming and friendly (70.9%). YMSM perceived most sites respected their privacy and confidentiality (84.3%). YMSM noted deficiencies in providers' competencies with sexual minorities (63.4%) and comfort during the visit (65.7%). Sites underperformed on Lesbian, Gay, Bisexual, Transgender visibility (49.6%) and medical forms inclusivity (57.95%). Sites on average did not discuss YMSM's relationship context (49.8%) nor provide risk reduction counseling (56.8%) or safer sex education (24.3%). Sites delivered pre-exposure prophylaxis information and counseling inconsistently (58.8%).</p><p><b>CONCLUSIONS: </b>Testing sites' variable performance underscores the importance of improving HIV testing services for YMSM. Strategies are recommended for testing sites to promote cultural sensitivity: funding staff trainings, creating systems to assess adherence to testing guidelines and best practices, and implementing new service delivery models.</p>

DOI10.1097/QAI.0000000000002173
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID31658201
PubMed Central IDPMC6820705
Grant ListP30 AI050409 / AI / NIAID NIH HHS / United States
R13 HD074468 / HD / NICHD NIH HHS / United States
U19 HD089881 / HD / NICHD NIH HHS / United States
P30 AI045008 / AI / NIAID NIH HHS / United States
P30 MH097488 / MH / NIMH NIH HHS / United States
P30 AI050410 / AI / NIAID NIH HHS / United States