Division of Adolescent Medicine, Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY, 10467, USA.
Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
AIDS Behav. 2024 Nov;28(11):3596-3604. doi: 10.1007/s10461-024-04444-6. Epub 2024 Jul 24.
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.
我们描述了一种以提供者为中心的干预措施，以增加网络中学校保健中心（SBHC）中青少年使用者的普遍 HIV 检测，并比较了有和没有 HIV 检测干预措施的 SBHC 提供和接受 HIV 检测的比率。该干预措施在该 12 个地点网络中的六个最大的 SBHC 中实施，包括系统和员工层面的举措，包括一名实施教练，以支持 SBHC 员工。在干预组的六个地点与非干预组的六个地点（未随机选择，但在年龄、性别和种族/民族方面分布相似）比较了 HIV 检测提供和接受率。该模型显示了普遍 HIV 检测提供的干预效果，但对检测接受率没有总体影响。通过分析是否有患者有过性行为史，该干预措施在实施早期对于没有性行为史的患者非常有效地增加了检测提供率，而在实施后期对于没有或未知性行为史的患者增加了检测接受率。在 SBHC 中增加和维持普遍 HIV 检测可能受益于使用实施科学框架来指导干预措施的调整。
