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Acceptability of HIV testing for adolescents and young adults by delivery model: a systematic review

Peter Thomas Leistikow, Vidhi Patel, Christian Nouryan, Joseph Steven Cervia
DOI: 10.1136/jim-2021-002056 Published 25 February 2022
Peter Thomas Leistikow
1 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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Vidhi Patel
1 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
2 Institute of Health Innovations and Outcomes Research, Northwell Health, New Hyde Park, New York, USA
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Christian Nouryan
1 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
2 Institute of Health Innovations and Outcomes Research, Northwell Health, New Hyde Park, New York, USA
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Joseph Steven Cervia
3 Medicine and Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
4 Senior Medical Director, HealthCare Partners IPA & MSO, Garden City, New York, USA
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Abstract

HIV infections are prevalent among adolescents and young adults, of whom 44% remain unaware of their diagnosis. HIV screening presents numerous challenges including stigma, fear, and concerns about confidentiality, which may influence young people’s acceptance of HIV screening and linkage to care differently from individuals in other age groups. It is imperative to understand which care delivery models are most effective in facilitating these services for youth. This systematic review analyzes the rates of HIV test acceptance and linkage to care by care delivery model for adolescents and young adults. Studies were classified into emergency department (ED), primary care/inpatient setting, community-based program, or sexually transmitted infection clinic models of care. From 6395 studies initially identified, 59 met criteria for inclusion in the final analyses. Rate of test acceptance and linkage to care were stratified by model of care delivery, gender, race, age ranges (13–17, 18–24 years) as well as site (North America vs rest of the world). A significant difference in acceptance of HIV testing was found between care models, with high rates of test acceptance in the ED setting in North America and primary care/hospital setting in the rest of the world. Similarly, linkage to care differed by model of care, with EDs having high rates of linkages to HIV care in North America. Future studies are needed to test mechanisms for optimizing outcomes for each care delivery model in addressing the unique challenges faced by adolescents and young adults.

Footnotes

  • Contributors Study design and concept: JSC, PTL, CN. Sabrina Khan contributed to screening of a random title and abstract sample to ensure precision of screening, as well as full-text review of studies screened by PTL. PTL, CN, and VP contributed to data collection, data analysis, generating of tables and figures, and manuscript writing. PTL wrote the main manuscript text. All authors (PTL, JSC, CN, VP) contributed to the final revision of the manuscript. PTL is guarantor for the published manuscript's contents.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Data availability statement

No data are available. Data sharing is not applicable to this article as no new data were created for this study.

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Vol 70 Issue 3 Table of Contents
Journal of Investigative Medicine: 70 (3)
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Acceptability of HIV testing for adolescents and young adults by delivery model: a systematic review
Peter Thomas Leistikow, Vidhi Patel, Christian Nouryan, Joseph Steven Cervia
Journal of Investigative Medicine Mar 2022, 70 (3) 829-836; DOI: 10.1136/jim-2021-002056

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Acceptability of HIV testing for adolescents and young adults by delivery model: a systematic review
Peter Thomas Leistikow, Vidhi Patel, Christian Nouryan, Joseph Steven Cervia
Journal of Investigative Medicine Mar 2022, 70 (3) 829-836; DOI: 10.1136/jim-2021-002056
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Acceptability of HIV testing for adolescents and young adults by delivery model: a systematic review
Peter Thomas Leistikow, Vidhi Patel, Christian Nouryan, Joseph Steven Cervia
Journal of Investigative Medicine Mar 2022, 70 (3) 829-836; DOI: 10.1136/jim-2021-002056
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