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Multicenter Study
. 2024 Nov;28(11):3596-3604.
doi: 10.1007/s10461-024-04444-6. Epub 2024 Jul 24.

A Provider-Focused Intervention to Increase Universal HIV Testing among Adolescents in School-Based Health Centers

Neal D Hoffman  1 , Adam Ciarleglio  2 , Susanna Lesperance-Banks  3 , Tom Corbeil  4 , Harpreet Kaur  5 , Ellen J Silver  5 , Laurie Bauman  5 , Theo G M Sandfort  4
Affiliations
Multicenter Study

A Provider-Focused Intervention to Increase Universal HIV Testing among Adolescents in School-Based Health Centers

Neal D Hoffman et al. AIDS Behav. 2024 Nov.

Abstract

We describe a provider-focused intervention to increase universal HIV testing among adolescent users in a network of School-Based Health Centers (SBHC) and compare the rate of HIV test offer and acceptance for SBHCs with and without the HIV testing intervention. The intervention was implemented at the six largest SBHCs in the 12-site network and included system- and staff-level initiatives, including an implementation coach to support SBHC associates. Rates of HIV test offer and acceptance at six sites in the Intervention Cohort were compared to that at the six sites in a Non-Intervention Cohort which was not randomly selected but had comparable distributions by age, gender and race/ethnicity. The model showed an intervention effect for universal HIV test offer, but no overall effect for test acceptance. Analyzing the intervention effect by whether a patient had a history of sexual activity, the intervention was very effective early in its implementation at increasing test offer to those with no history of sexual activity, and late in its implementation at increasing test acceptance for those with no or unknown sexual activity. Increasing and sustaining universal HIV testing in SBHCs may benefit from using Implementation Science frameworks to guide adaptation of the intervention.

Keywords: Adolescents; HIV testing; School-based health centers.

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Conflict of interest statement

The authors have no financial or non-financial interests that are directly or indirectly related to the work submitted for publication.

Figures

Fig. 1
Fig. 1
Proportion of patients who received an HIV test offer among those with at least one medical visit in a school year stratified by cohort. The Intervention Cohort includes data from both the early and delayed intervention groups combined (where Year 0 corresponds to 2015–2016 for the early group and to 2016–2017 for the delayed group). Year 0 for the Non-Intervention Cohort is taken as 2015–2016
Fig. 2
Fig. 2
Proportion of patients who received an HIV test offer among those with at least one medical visit in a school year stratified by cohort and sexually active ever status. The Intervention Cohort includes data from both the early and delayed intervention groups combined (where Year 0 corresponds to 2015–2016 for the early group and to 2016–2017 for the delayed group). Year 0 for the Non-Intervention Cohort is taken as 2015–2016
Fig. 3
Fig. 3
Proportion of patients accepting an HIV test offer among those with at least one offer in a school year by cohort. The Intervention Cohort includes data from both the early and delayed intervention groups combined (where Year 0 corresponds to 2015–2016 for the early group and to 2016–2017 for the delayed group). Year 0 for the Non-Intervention Cohort is taken as 2015–2016
Fig. 4
Fig. 4
Proportion of patients accepting an HIV test offer among those with at least one offer in a school year stratified by cohort and sexually active ever status. The Intervention Cohort includes data from both the early and delayed intervention groups combined (where Year 0 corresponds to 2015–2016 for the early group and to 2016–2017 for the delayed group). Year 0 for the Non-Intervention Cohort is taken as 2015–2016
See this image and copyright information in PMC

References

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