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Provider Trust as a Catalyst for Adolescent HIV and Syphilis Testing
Trevor Hall1, Katherine G Quinn2, Wendi G Ehrman3
1School of Medicine, Medical College of Wisconsin.
Summary
Adolescent HIV and syphilis testing is low due to knowledge gaps and barriers like fear and logistics. Trusted providers offer a key opportunity for integrated education and testing interventions.
Area of Science:
- Adolescent health
- Infectious diseases
- Public health
Background:
- Adolescents experience high rates of sexually transmitted infections (STIs), including HIV and syphilis.
- Current STI testing rates among adolescents remain suboptimal.
- Low awareness of syphilis is a significant public health concern in this demographic.
Purpose of the Study:
- To identify facilitators and barriers to HIV and syphilis testing among adolescents.
- To explore adolescent perspectives on STI testing in an urban clinical setting.
Main Methods:
- Semistructured interviews were conducted with 15 adolescents aged 14-20 years.
- Participants were recruited from an urban pediatric clinic in Milwaukee.
- Thematic analysis was used to analyze qualitative data.
Main Results:
- Participants demonstrated strikingly low levels of knowledge regarding syphilis.
- Identified modifiable barriers included needle anxiety, fear of results, confidentiality concerns, and parental disclosure issues.
- Structural barriers such as transportation and scheduling conflicts also impeded testing.
- Trusted, nonjudgmental healthcare providers were consistently reported as facilitators for testing.
Conclusions:
- Significant knowledge gaps regarding syphilis and intersecting barriers to testing persist among adolescents.
- Provider relationships represent a crucial, feasible avenue for implementing brief, clinic-embedded HIV and syphilis education.
- Addressing adolescent STI testing requires a multifaceted approach that includes education and overcoming structural and psychological barriers.
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