HIV Testing and Prevention Services in Behavioral Health Organizations: A Multi-method Study Using the Consolidated...

Area of Science:

• Public Health
• Implementation Science
• Mental Health Services Research

Background:

• Increasing access to HIV testing and prevention services for individuals with serious mental illness (SMI) is a public health priority.
• Limited understanding exists regarding the factors influencing the implementation of these services within behavioral health organizations.

Purpose of the Study:

• To identify barriers and facilitators to implementing on-site HIV testing and Pre-exposure prophylaxis (PrEP) services in behavioral health organizations.
• To explore organizational determinants influencing service delivery for HIV prevention among clients with SMI.

Main Methods:

• A multi-method study combining quantitative surveys and qualitative interviews in King County, Washington.
• Utilized the Consolidated Framework for Implementation Research (CFIR) 2.0 for deductive qualitative analysis.
• Surveyed 16 organizations; conducted in-depth interviews with 21 staff, providers, and leaders from 3 organizations.

Main Results:

• Facilitators included positive organizational culture, non-judgmental care, long-term client relationships, and holistic care missions.
• Barriers comprised resource shortages, insufficient trained staff, infrastructure issues (billing, referrals), competing service priorities, and knowledge gaps.
• Providing on-site PrEP faced greater challenges (staff training, service complexity) than HIV testing.

Conclusions:

• Behavioral health organizations face significant barriers to implementing HIV testing and PrEP services.
• Leveraging existing strengths like organizational culture and client relationships can facilitate service integration.
• Capacity-building strategies, including training and partnerships, are essential for improving HIV prevention service delivery.