HIV Testing Program Activities and Challenges in Four U.S. Urban Areas.

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• The "Ending the HIV Epidemic: A Plan for America" initiative emphasizes expanded HIV testing in high-burden areas.
• Understanding the strengths, challenges, and innovations in HIV testing services (HTS) is crucial for public health planners.

Purpose of the Study:

• To identify and analyze the strengths, challenges, and innovations of HIV testing services.
• To inform strategies for strengthening HTS in alignment with national HIV prevention goals.

Main Methods:

• Conducted semistructured interviews with 120 HTS staff and community members in four major US jurisdictions.
• Utilized qualitative coding methods to identify recurring themes in interview transcripts.

Main Results:

• Identified program strengths: integration with other services, prioritized testing, tailored incentives, diverse outreach, and provider partnerships.
• Highlighted challenges: stigma, fear, disparities, funding-induced competition, accessibility issues, redundant testing, and lack of innovation.
• Observed that the studied jurisdictions partially addressed these identified challenges.

Conclusions:

• Cross-jurisdictional collaboration, involving state and federal partners, is essential for developing effective HTS strategies.
• Leveraging program data can further enhance the identification of successful approaches to strengthen HIV testing services nationwide.