Mobile Augmented Screening Tool to Increase Adolescent HIV Testing and Linkage to Care

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ABSTRACT Adolescents face increased HIV risk, infrequent testing, inconsistent linkage to care, and a lack of prevention related knowledge. We propose to address this by completing and evaluating the Mobile Augmented Screening (MAS) tool to increase youth HIV testing via a tablet-based intervention in clinical settings, and then use text messages to facilitate linkage to care for those who test positive, and deliver ongoing prevention education via text message to those who test negative. Many adolescents and young adults at greatest risk for HIV are unlikely to have access to primary care, and therefore have limited access to HIV testing and prevention education. When young people are offered testing, many decline because they believe (perhaps incorrectly) they are not at risk or because they fear being stigmatized. Our proposed MAS will enable care providers to privately and discretely offer routine HIV testing and counseling, including prevention education, to high need, diverse adolescent and young adult populations at a low cost. Further, because federal law requires public and private insurers to cover routine HIV testing, healthcare providers who use our proposed MAS to test an increased number of youth can potentially generate significant additional revenue through increased insurance reimbursements. The MAS will consist of 3 components. A tablet-based intervention including a brief video (approximately 5 minutes) designed to increase adolescent HIV testing, automated text-messages to facilitate linkage to care for those who test positive, and text-based education for those who test negative or decline testing. Our team has created multiple NIH-funded interventions to increase HIV testing among patients in high volume, urban emergency departments (EDs). Patients, including youth who initially declined testing, cited the privacy and clarity of our technology-based approach as reasons they ultimately agreed to test for HIV. During the Phase I grant period we conducted formative research with young ED patients, and then created the video portion of the MAS. Preliminary evaluations indicate the video was highly acceptable, led to significant knowledge increases, and encouraged testing. We now plan an effectiveness trial during the Phase II period. Digital Health Empowerment is a minority and woman owned SBC. Principals So-Young Oh and Ian David Aronson, Ph.D. have more than 10 years experience developing technology products together, including video- based health interventions and other digital content, for commercial, non-profit, and university clients. We seek to build upon this expertise, along with the initial success of our Phase I work, to: complete full intervention development; and evaluate the product through a randomized controlled trial with ED patients aged 13 – 24 (N=350), as well as qualitative interviews with a subset of young patients (n=40) and ED staff (n=10).