Facilitators of Self-Initiated HIV Testing Among Youths: A Qualitative Study

10.1097/jnr.0000000000000390

Oluwamuyiwa Winifred ADEBAYO；Joseph P. DE SANTIS；Karina A. GATTAMORTA；Natalia Andrea VILLEGAS

self-initiated HIV testing ； youth ； HIV testing ； qualitative descriptive

The Journal of Nursing Research

28卷5期（2020 / 10 / 01）

1 - 10

英文

Background: Youth experience disparities in HIV infection but have significantly low rates of HIV testing that lead to late diagnoses, increased transmission rates, and adverse health outcomes. There is limited knowledge regarding self-initiated HIV testing, which is a promising strategy for improving testing rates among youth. Purpose: This study aimed to identify the facilitators of self-initiated HIV testing among youth. Method: Thirty youths aged 18-24 years were recruited to participate in a qualitative descriptive study. Potential participants were recruited from a combination of HIV testing sites, including community testing events, a community-based organization, an adolescent health clinic, and a college campus. A demographic and sexual history questionnaire and audio-recorded interviews were used to collect data. Transcribed interviews were analyzed using qualitative content analysis. Results: Salient themes and subthemes that explain the study findings are as follows: testing within the context of a sexual relationship (e.g., infidelity), support and influence from social relationships (e.g., family support), taking the initiative for health (e.g., signs and symptoms of infection), HIV testing preferences (e.g., free testing), and HIV testing experiences (e.g., provision of other health services). Conclusions: The findings of this study advance scholarly understanding regarding the predictors of self-initiated testing and provide critical information necessary to further improve evidence-based nursing clinical practice and develop public health nursing interventions that target self-initiated HIV testing. Encouraging self-initiated HIV testing is an effective approach to increasing testing rates and, consequently, preventing new HIV transmissions in this vulnerable population.

1. Adebayo, O. W.,Gonzalez-Guarda, R. M.(2017).Factors associated with HIV testing in youth in the United States: An integrative review.Journal of the Association of Nurses in AIDS Care,28(3),342-362.
2. Adebayo, O. W.,Salerno, J. P.(2019).Facilitators, barriers, and outcomes of self-initiated HIV testing: An integrative literature review.Research and Theory for Nursing Practice,33(3),275-291.
3. Centers for Disease Control and Prevention. (2018). HIV testing. https://www.cdc.gov/hiv/testing/index.html
4. Centers for Disease Control and Prevention. (2019b). HIV among youth. https://www.cdc.gov/hiv/group/age/youth/index.html
5. Centers for Disease Control and Prevention. (2019a). Statistics overview. https://www.cdc.gov/hiv/statistics/overview/
6. Centers for Disease Control and Prevention. (2020). HIV testing. https://www.cdc.gov/hiv/testing/index.html
7. Cypress, B. S.(2017).Rigor or reliability and validity in qualitative research: Perspectives, strategies, reconceptualization, and recommendations.Dimensions of Critical Care Nursing,36(4),253-263.
8. Decker, M. R.,Rodney, R.,Chung, S.-E.,Jennings, J. M.,Ellen, J. M.,Sherman, S. G.(2015).HIV testing among youth in a high-risk city: Prevalence, predictors, and gender differences.AIDS Care,27(5),555-560.
9. Eisenberg, M. E.,Lust, K.,Mathiason, M. A.,Porta, C. M.(2017).Sexual assault, sexual orientation, and reporting among college students.Journal of Interpersonal Violence,886260517726414.
10. Fonner, V. A.,Denison, J.,Kennedy, C. E.,Oreilly, K.,Sweat, M.(2012).Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries.Cochrane Database of Systematic Reviews,12(9),CD001224.
11. Hagell, A.,Lamb, S.(2016).Developing an integrated primary health care and youth work service for young people in Lambeth: Learning from the Well Centre.Journal of Children's Services,11(3),233-243.
12. Inungu, J.,Lewis, A.,Younis, M. Z.,Wood, J.,O'Brien, S.,Verdun, D.(2011).HIV testing among adolescents and youth in the United States: Update from 2009 behavioral risk factor surveillance system.Open AIDS Journal,5,80-85.
13. Joore, I. K.,Geerlings, S. E.,Brinkman, K.,Van Bergen, J. E. A. M.,Prins, J. M.(2017).The importance of registration of sexual orientation and recognition of indicator conditions for an adequate HIV risk-assessment.BMC Infectious Diseases,17(1),178.
14. Jürgensen, M.,Tuba, M.,Fylkesnes, K.,Blystad, A.(2012).The burden of knowing: Balancing benefits and barriers in HIV testing decisions. A qualitative study from Zambia.BMC Health Services Research,12,2.
15. Leonard, L.,Berndtson, K.,Matson, P.,Philbin, M.,ArringtonSanders, R.,Ellen, J. M.(2010).How physicians test: Clinical practice guidelines and HIV screening practices with adolescent patients.AIDS Education and Prevention,22(6),538-545.
16. Leonard, N. R.,Rajan, S.,Gwadz, M. V.,Aregbesola, T.(2014).HIV testing patterns among urban YMSM of color.Health Education & Behavior,41(6),673-681.
17. Ma, M.,Malcolm, L.,Diaz-Albertini, K.,Klinoff, V. A.(2016).HIV testing characteristics among Hispanic adolescents.Journal of Community Health,41(1),11-14.
18. Murchison, G. R.,Boyd, M. A.,Pachankis, J. E.(2017).Minority stress and the risk of unwanted sexual experiences in LGBQ undergraduates.Sex Roles,77,221-238.
19. Pai, N. P.(2014).Perspective on HIV self-testing in North America: A tale of two countries-US and Canada.Retrovirology: Research and Treatment,6,7-15.
20. Phillips, G. II,Ybarra, M. L.,Prescott, T. L.,Parsons, J. T.,Mustanski, B.(2015).Low rates of human immunodeficiency virus testing among adolescent gay, bisexual, and queer men.Journal of Adolescent Health,57(4),407-412.
21. Phillips, G., II,Hightow-Weidman, L. B.,Arya, M.,Fields, S. D.,Halpern-Felsher, B.,Outlaw, A. Y.,Wohl, A. R.,Hidalgo, J.(2012).HIV testing behaviors of a cohort of HIV-positive racial/ethnic minority YMSM.AIDS and Behavior,16(7),1917-1925.
22. Polit, D.,Beck, C.(2012).Nursing research: Generating and assessing evidence for nursing practice.:Wolters Kluwer Health.
23. Rakhmanina, N.,Messenger, N.,Phillips, G., 2nd,Teach, S.,Morrison, S.,Hern, J.,Payne, J.,Ganesan, K.,Castel, A. D.(2014).Factors affecting acceptance of routine human immunodeficiency virus screening by adolescents in pediatric emergency departments.Journal of Adolescent Health,54(2),176-182.
24. Ren, X. L.,Wu, Z. Y.,Mi, G. D.,McGoogan, J.,Rou, K. M.,Zhao, Y.(2017).Uptake of HIV self-testing among men who have sex with men in Beijing, China: A cross-sectional study.Biomedical and Environmental Sciences: BES,30(6),407-417.
25. Salako, A. A.,Jeminusi, O. A.,Osinupebi, O. A.,Sholeye, O. O.,Abiodun, A. O.,Kuponiyi, O. T.(2012).Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in Sagamu, Southwestern Nigeria.Nigerian Journal of Clinical Practice,15(4),391-396.
26. Sandelowski, M.(2000).Whatever happened to qualitative description?.Research in Nursing & Health,23(4),334-340.
27. Schnall, R.,Rojas, M.,Travers, J.(2015).Understanding HIV testing behaviors of minority adolescents: A health behavior model analysis.Journal of the Association of Nurses in AIDS Care,26(3),246-258.
28. Talib, H. J.,Silver, E. J.,Coupey, S. M.,Bauman, L. J.(2013).The influence of individual, partner, and relationship factors on HIV testing in adolescents.AIDS Patient Care and STDs,27(11),637-645.
29. Teitelman, A. M.,Calhoun, J.,Duncan, R.,Washio, Y.,McDougal, R.(2015).Young women's views on testing for sexually transmitted infections and HIV as a risk reduction strategy in mutual and choice-restricted relationships.Applied Nursing Research,28(3),215-221.
30. U.S. Preventative Services and Task Force. (2013). Final update summary: Human immunodeficiency virus (HIV) infection: Screening. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/human-immunodeficiency-virushiv-infection-screening
31. Udeagu, C. N.,Shah, S.,Molochevski, M.(2017).Men who have sex with men seek timely human immunodeficiency virus confirmation and care after rapid human immunodeficiency virus self-test: Data from partner services program, New York City.Sexually Transmitted Diseases,44(10),608-612.
32. Van Handel, M.,Kann, L.,Olsen, E. O.,Dietz, P.(2016).HIV testing among US high school students and young adults.Pediatrics,137(2),e20152700.
33. Wallace, S. A.,McLellan-Lemal, E.,Harris, M. J.,Townsend, T. G.,Miller, K. S.(2011).Why take an HIV test? Concerns, benefits, and strategies to promote HIV testing among low-income heterosexual African American young adults.Health Education & Behavior,38(5),462-470.