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

Authors

Neal D. Hoffman, Division of Adolescent Medicine, Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY, 10467, USA. nhoffman@montefiore.org.
Adam Ciarleglio, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Susanna Lesperance-Banks, Montefiore School Health Program, Bronx, NY, USA.
Tom Corbeil, New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, Columbia University, New York, NY, USA.
Harpreet Kaur, Preventive Intervention Research Center for Child Health, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
Ellen J. Silver, Preventive Intervention Research Center for Child Health, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
Laurie Bauman, Preventive Intervention Research Center for Child Health, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
Theo G. Sandfort, New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, Columbia University, New York, NY, USA.

Document Type

Journal Article

Publication Date

7-24-2024

Journal

AIDS and behavior

DOI

10.1007/s10461-024-04444-6

Keywords

Adolescents; HIV testing; School-based health centers

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.

APA Citation

Hoffman, Neal D.; Ciarleglio, Adam; Lesperance-Banks, Susanna; Corbeil, Tom; Kaur, Harpreet; Silver, Ellen J.; Bauman, Laurie; and Sandfort, Theo G., "A Provider-Focused Intervention to Increase Universal HIV Testing among Adolescents in School-Based Health Centers" (2024). GW Authored Works. Paper 5234.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5234

Department

Biostatistics and Bioinformatics