Adolescent Experiences of Clinician–Patient HIV/STI Communication in Primary Care

Córdova, David; Lua, Frania Mendoza; Ovadje, Lauretta; Fessler, Kathryn Bondy; Bauermeister, José A.; Salas-Wright, Christopher P.; Vaughn, Michael G.

doi:10.1080/10410236.2017.1339379

Cited by 24 publications

(24 citation statements)

References 46 publications

(64 reference statements)

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“…Adding a STI prevention infrastructure and capacity-building lens to the implementation of patient portals offers new strategies for addressing longstanding racial disparities. Such interventions may focus on reducing the stigma around STI health communication among youth, their sex partners, and their health care providers [6,[48][49][50]. However, the success of future interventions requires public health priorities focused on patient portal access to STI PHRs and incentives to design patient portal platforms to support sexual and reproductive health among Black youth.…”

Section: Discussionmentioning

confidence: 99%

Digital technology to address HIV and other sexually transmitted infection disparities: Intentions to disclose online personal health records to sex partners among students at a historically Black college

et al. 2020

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Patient portals are creating new opportunities for youth to disclose high-fidelity sexually transmitted infection (STI) laboratory test result histories to sex partners. Among an online survey sample, we describe latent constructs and other variables associated with perceived behavioral intentions to disclose STI test history using patient portals. Participants were co-ed students aged 18 to 25 years (N = 354) attending a southern United States Historically Black College and University in 2015. Three reliable latent constructs were identified by conducting psychometric analyses on 27 survey items. Latent constructs represent, a) STI test disclosure valuation beliefs, b) communication practices, and c) performance expectancy beliefs for disclosing with patient portals. Multivariable logistic regression was used to estimate the relationship of latent constructs to perceived behavioral intentions to disclose STI test history using patient portals. Approximately 14% (48/354) reported patient portal use prior to study and 59% (208/354) endorsed behavioral intentions to use patient portals to disclose STI test history. The latent construct reflecting performance expectancies of patient portals to improve communication and accuracy of disclosed test information was associated with behavioral intentions to disclose STI test histories using patient portals [adjusted odds ratio (AOR) = 1.15; 95% CI = 1.08 to 1.22; p <0.001]. Latent constructs representing communication valuation beliefs and practices were not associated with intentions. Self-reporting prior STI diagnosis was also associated with intentions to disclose using patient portals (AOR = 2.84; 95% CI = 1.15 to 6.96; p = 0.02). Point of care messages focused on improvements to validating test results, communication, and empowerment, may be an effective strategy to support the adoption of patient portals for STI prevention among populations of college-aged Black youth.

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Section: Discussionmentioning

confidence: 99%

Digital technology to address HIV and other sexually transmitted infection disparities: Intentions to disclose online personal health records to sex partners among students at a historically Black college

et al. 2020

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“…Saturation can be defined as reaching a point in the analytic process where no new themes emerge from the data (Bowen, 2008). Although preliminary analysis indicated that we achieved saturation, we conducted one additional focus group interview as researchers have done when conducting focus groups with adolescents (Córdova et al, 2017). The size of each focus group ranged from three to five participants.…”

Section: Methodsmentioning

confidence: 99%

The Acceptability of Biobehavioral Research With Latino Youth in the United States

Johnson

Salas-Wright

Córdova

et al. 2018

Journal of Adolescent Research

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In this study, we explored Latinx adolescents’ knowledge and perceptions of biobehavioral research and their willingness to participate in such studies. We conducted four focus groups in the summer of 2014 with Latinx adolescents in Texas between the ages of 12 and 17 years ( n = 17; 53% male; M age = 14.6 years [ SD = 1.66]) who were recruited from a community-based clinic. Five themes emerged from our content analysis: (a) protection of human subjects is important to participants, (b) comfort with providing different types of biological data varies depending on different factors, (c) engagement in biobehavioral research should be grounded in a cultural lens, (d) providing bilingual research staff is essential, and (e) adolescents have various motivations for participating. Findings highlighted how various factors could serve as both barriers and facilitators to participation. Our study provides insight into strategies for conducting biobehavioral research with Latinxs, who are the fastest growing group of adolescents in the United States and experience disparities in health-risk behaviors that can be better understood through research approaches that integrate biological and psychological measures. Without considering the perspectives of historically marginalized or understudied populations, we jeopardize the quality and validity of research findings, and risk harming participants.

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“…Unfortunately, adolescent ED patients who decline HIV testing are rarely, if ever, offered a second chance to test during the same ED visit. Further, young patients are often hesitant to report risk behaviors or even discuss HIV-related issues with medical staff [ 15 , 16 ], and staff are often uncomfortable discussing sexual behavior with young patients [ 16 ], especially with sexual minority adolescents [ 17 ]. Young ED patients, especially those accompanied by their parents, are unlikely to initiate requests for HIV testing [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Mobile Augmented Screening to Increase HIV Testing Among Emergency Department Patients as Young as 13 Years

Aronson¹,

Zhang

Rajan

et al. 2021

Cureus

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Because adolescents and emerging adults are frequently not offered HIV testing, and often decline tests when offered, we developed and tested a tablet-based intervention to increase HIV test rates among emergency department (ED) patients aged 13-24 years. Pediatric and adult ED patients in a high volume New York City hospital (N = 295) were randomized to receive a face-to-face HIV test offer, or to complete a tablet-based intervention that contained an HIV test offer delivered via computer. Test rates in both conditions were then compared to historic test rates in the same ED during the previous six months. Among participants aged 19 years and younger who were offered HIV testing and declined before enrollment in the study, participants in the tablet-based condition were 1.7 times more likely to test for HIV compared to participants in the face-to-face condition. Participants aged 19 years and younger were three times as likely to test for HIV compared to patients the same age who were treated in the previous six months (26.39%, n = 71 study participants vs. 10.29%, n = 189 prior patients, OR = 3.13, 2 = 54.76, p < 0.001). Protocols designed to offer HIV testing to all eligible patients can significantly increase adolescent test rates compared to standard practice. Because tablets are equally effective compared to face-to-face offers, and in some cases more so, EDs may consider tablet-based interventions that require fewer staff resources and may integrate more easily into high-volume workflows.

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Adolescent Experiences of Clinician–Patient HIV/STI Communication in Primary Care

Cited by 24 publications

References 46 publications

Digital technology to address HIV and other sexually transmitted infection disparities: Intentions to disclose online personal health records to sex partners among students at a historically Black college

Digital technology to address HIV and other sexually transmitted infection disparities: Intentions to disclose online personal health records to sex partners among students at a historically Black college

The Acceptability of Biobehavioral Research With Latino Youth in the United States

Mobile Augmented Screening to Increase HIV Testing Among Emergency Department Patients as Young as 13 Years

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