Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Dec 1;82 Suppl 2(2):S133-S141.
doi: 10.1097/QAI.0000000000002173.

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

José A Bauermeister  1 , Jesse M Golinkoff  1 , Willey Y Lin  1 , Kristina F Claude  2 , Keith J Horvath  3 , Nadia Dowshen  4 , Anderson Schlupp  4 , William J Vickroy  4 , Kimberly Desir  4 , Alexander V Lopez  4 , Marné Castillo  4 , Mary Tanney  4 , Taylor A Wimbly  5 , Kingsley Leung  5 , Patrick S Sullivan  5 , Dalisa L Santiago  6 , Rogelio Hernandez  6 , Mary E Paul  6 , Lisa Hightow-Weidman  2 , Sonia Lee  7 , Rob Stephenson  8
Affiliations
Meta-Analysis

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

José A Bauermeister et al. J Acquir Immune Defic Syndr. .

Abstract

Background: 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.

Methods: 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.

Results: 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%).

Conclusions: 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.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1.
FIGURE 1.
HIV testing sites and HIV prevalence per 100,000 people in (A) Philadelphia, (B) Atlanta, and (C) Houston.
See this image and copyright information in PMC

References

    1. Fauci AS, Redfield RR, Sigounas G, et al. Ending the HIV epidemic: a plan for the United States. JAMA. 2019;321:844–845. - PubMed
    1. Goldenberg T, Stephenson R, Bauermeister J. Community stigma, internalized homonegativity, enacted stigma, and HIV testing among young men who have sex with men. J Community Psychol. 2018;46:515–528.
    1. Bauermeister JA, Golinkoff JM, Horvath KJ, et al. A multilevel tailored web app-based intervention for linking young men who have sex with men to quality care (get connected): protocol for a randomized controlled trial. JMIR Res Protoc. 2018;7:e10444. - PMC - PubMed
    1. Merchant RC, Clark MA, Liu T, et al. Comparison of home-based oral fluid rapid HIV self-testing versus mail-in blood sample collection or medical/community HIV testing by young adult black, hispanic, and white MSM: results from a randomized trial. AIDS Behav. 2018;22:337–346. - PMC - PubMed
    1. Liu Y, Silenzio VMB, Nash R, et al. Suboptimal recent and regular HIV testing among black men who have sex with men in the United States: implications from a meta-analysis. J Acquir Immune Defic Syndr. 2019;81:125–133. - PMC - PubMed

Publication types

LinkOut - more resources