Linking HIV-Negative Youth to Prevention Services in 12 US Cities: Barriers and Facilitators to Implementing the HIV Prevention Continuum
Linking HIV-Negative Youth to Prevention Services in 12 US Cities: Barriers and Facilitators to Implementing the HIV Prevention Continuum
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DOI：
10.1016/j.jadohealth.2017.09.009
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发表时间：
2018-04-01
影响因子：
7.6
通讯作者：
Boyer, Cherrie B.
中科院分区：
文献类型：
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作者：
Doll, Mimi;Fortenberry, J. Dennis;Boyer, Cherrie B.
目的：随着有效的暴露前预防措施的发展，将艾滋病毒阴性青年与预防服务联系起来越来越重要，这是对行为和其他以预防为重点的干预措施的补充。然而，提供预防服务的有效基础设施并不存在，这使得许多解决艾滋病毒预防问题的方案没有数据来指导方案的制定/实施。这项研究的目的是为高危、HIV阴性的青少年提供预防服务联动的障碍和促进者的定性描述。设计：对实施与12-24岁青年预防服务项目联动的工作人员的结构化访谈进行主题分析。方法：12个青春期医学艾滋病毒初级保健项目，作为更大的测试研究项目的一部分，重点放在年轻的性少数族裔男性。这项研究包括实施与预防服务计划相联系的工作人员以及基于社区的艾滋病毒检测计划。结果：八个主题总结了与预防服务联系的观点：(1)与社区伙伴的关系，(2)提供者与青年之间的信任，(3)青年驾驭预防服务的能力，(4)暴露前预防的具体问题，(5)隐私问题，(6)健康记录上的差距，(7)通过父母/照顾者保险获得服务的照顾的保密性，以及(8)卫生保健机构需要跟上在高危青年中优先预防艾滋病毒的模式。主题是在促进/挑战与预防服务联系的因素的背景下讨论的。结论：现有若干以证据为基础的艾滋病毒预防工具；尚未建立向高危青年提供协调服务的基础设施。实施这类基础设施需要关注与社区、提供者和青年有关的问题。(C)2017年青少年健康与医学学会。版权所有。
Purpose: Linkage of HIV-negative youth to prevention services is increasingly important with the development of effective pre-exposure prophylaxis that complements behavioral and other prevention-focused interventions. However, effective infrastructure for delivery of prevention services does not exist, leaving many programs to address HIV prevention without data to guide program development/implementation. The objective of this study was to provide a qualitative description of barriers and facilitators of linkage to prevention services among high-risk, HIV-negative youth.Design: Thematic analysis of structured interviews with staff implementing linkage to prevention services programs for youth aged 12-24 years.Methods: Twelve adolescent medicine HIV primary care programs as part of larger testing research program focused on young sexual minority men of color. The study included staff implementing linkage to prevention services programs along with community-based HIV testing programs. The main outcomes of the study were key barriers/facilitators to linkage to prevention services.Results: Eight themes summarized perspectives on linkage to prevention services: (1) relationships with community partners, (2) trust between providers and youth, (3) youth capacity to navigate prevention services, (4) pre-exposure prophylaxis specific issues, (5) privacy issues, (6) gaps in health records preventing tailored services, (7) confidentiality of care for youth accessing services through parents'/caretakers' insurance, and (8) need for health-care institutions to keep pace with models that prioritize HIV prevention among at-risk youth. Themes are discussed in the context of factors that facilitated/challenged linkage to prevention services.Conclusions: Several evidence-based HIV prevention tools are available; infrastructures for coordinated service delivery to high-risk youth have not been developed. Implementation of such infrastructures requires attention to community-, provider-, and youth-related issues. (c) 2017 Society for Adolescent Health and Medicine. All rights reserved.