Adolescent Preferences for a Pediatric Primary Care-based Sexually Transmitted Infection and HIV Prevention Intervention.

Purpose: We sought to elicit perspectives on HIV and sexually transmitted infection (STI) prevention among adolescents with recent STIs in primary care to optimize acceptability and effectiveness in designing a novel HIV/STI prevention intervention.

Methods: We enrolled 13-19 year-olds with recent gonorrhea, chlamydia, trichomonas, and/or syphilis in a multimethods cross-sectional study at two primary care clinics. Participants completed surveys and interviews.

Advancing the community plan to end the HIV Epidemic in Philadelphia: a qualitative descriptive evaluation of low-threshold PrEP services in sexual health clinics.

Background: Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method and a key component of Philadelphia's Community Plan to End the HIV Epidemic (EHE). However, significant barriers to accessing PrEP exist among people at risk for HIV. Low-threshold models for PrEP services that minimize barriers to entry and service engagement could help bolster access to PrEP through community-based clinics.

Quality appraisal of spatial epidemiology and health geography research: A scoping review of systematic reviews.

A scoping review of peer-reviewed literature was conducted to understand how systematic reviews assess the methodological quality of spatial epidemiology and health geography research. Fifty-nine eligible reviews were identified and included. Variations in the use of quality appraisal tools were found.

Spatial methods for measuring access to health care.

Access to health care is a universal human right and key indicator of health system performance. Spatial access encompasses geographic factors mediating with the accessibility and availability of health services. Equity of health service access is a global issue, which includes access to the specialized nursing workforce.

Perspectives From Community-Based HIV Service Organization Leaders on Priorities in Serving Sexual and Gender Minority Populations.

Sexual and gender minority (SGM) populations experience discrimination and care-related barriers when seeking appropriate sexual health services. Using rapid assessment procedures we conducted site visits with 11 community-based HIV service agencies to identify priorities, assets, and needs related to serving SGM clients and assessed the alignment of these services with the city's local Ending the HIV Epidemic plan. We identified and mapped themes across agencies into the Consolidated Framework for Implementation Research domains of inner and outer settings: client-facing materials; priorities in serving SGM communities; SGM policies and protocols; collecting sexual orientation and gender identity data; training and education; and funding and scope of programs.

The application of spatial measures to analyse health service accessibility in Australia: a systematic review and recommendations for future practice.

Background: Australia's inequitable distribution of health services is well documented. Spatial access relates to the geographic limitations affecting the availability and accessibility of healthcare practitioners and services. Issues associated with spatial access are often influenced by Australia's vast landmass, challenging environments, uneven population concentration, and sparsely distributed populations in rural and remote areas.

Pediatric Resident Perspectives on Long-Acting Reversible Contraception Training: A Cross-Sectional Survey of Accreditation Council for Graduate Medical Education Trainees.

Purpose: Although pediatricians are primary care providers for most adolescents, pediatric residents receive limited training on long-acting reversible contraceptive (LARC) methods. This study aimed to characterize pediatric resident comfort with placing contraceptive implants and intrauterine devices (IUDs) and assess pediatric resident interest in obtaining this training.

Methods: Pediatric residents in the United States were invited to participate in a survey assessing comfort with LARC methods and interest in LARC training during pediatric residency.

The Relationship Between Directly Observed Therapy for Chlamydia Infections and Retesting Rates in an Adolescent Population.

Background: Chlamydia trachomatis is the most common reportable sexually transmitted infection in the United States, with >60% of reported cases occurring in individuals aged 15 to 24 years. US practice guidelines recommend directly observed therapy (DOT) for the treatment of chlamydia in adolescents, but almost no research has been done to evaluate whether DOT results in improved outcomes.

Methods: We conducted a retrospective cohort study of adolescents who sought care at 1 of 3 clinics within a large academic pediatric health system for a chlamydia infection.

Provider perspectives on clinical decision support to improve HIV prevention in pediatric primary care: a multiple methods study.

Background: Clinical decision support (CDS) is a promising intervention for improving uptake of HIV testing and pre-exposure prophylaxis (PrEP). However, little is known regarding provider perspectives on acceptability, appropriateness, and feasibility of CDS for HIV prevention in pediatric primary care, a key implementation setting.

Methods: This was a cross-sectional multiple methods study utilizing surveys and in-depth interviews with pediatricians to assess acceptability, appropriateness, and feasibility of CDS for HIV prevention, as well as to identify contextual barriers and facilitators to CDS.

Adolescent Access to Federally Funded Clinics Providing Confidential Family Planning Following Changes to Title X Funding Regulations.

Importance: In May 2019, new federal regulations regarding Title X funding were introduced. There has been no formal evaluation of the impact of this regulatory shift as it pertains to minors' access to services.

Objective: To explore the geography of federally funded clinics providing confidential reproductive care to adolescents following changes to Title X funding regulations.

Strengthening HIV Prevention Services Through an Implementation Science Approach: Perspectives From the HIV Testers in Philadelphia.

Background: Strengthening HIV prevention services is a key priority of the Ending the HIV Epidemic plan. Informed by the Consolidated Framework for Implementation Research, we examined HIV testers' perceived barriers and facilitators to implementing HIV prevention services, including testers' strengths and weaknesses; enabling factors within the inner and outer settings; and willingness to adopt potential implementation strategies.

Methods: In 2019, the Penn Center for AIDS Research (CFAR) partnered with the Philadelphia Department of Public Health (PDPH) to examine system-level challenges and opportunities experienced by PDPH-funded HIV testers (individuals conducting HIV testing) in Philadelphia.

A retrospective study of HIV pre-exposure prophylaxis counselling among non-Hispanic Black youth diagnosed with bacterial sexually transmitted infections in the United States, 2014-2019.

Introduction: Youth account for a disproportionate number of new HIV infections; however, pre-exposure prophylaxis (PrEP) use is limited. We evaluated PrEP counselling rates among non-Hispanic Black youth in the United States after a bacterial sexually transmitted infection (STI) diagnosis.

Methods: We conducted a retrospective cohort study of Black youth receiving care at two academically affiliated clinics in Philadelphia between June 2014 and June 2019.

"I Think That I Have a Good Understanding of How to Protect Myself": A Qualitative Study About HIV Risk Perceptions Among Men and Gender Diverse Individuals Who Have Sex With Men.

This qualitative study aimed to determine how men and gender diverse individuals who have sex with men describe their perceived risk of HIV and what factors influence this risk assessment. We conducted in-depth, virtual interviews with 18 HIV-negative individuals from Philadelphia, eligible for or taking PrEP. The interviews assessed the participants' understanding of their HIV risk, using thematic analysis to deductively code and extract themes.

Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences.

Background: Data regarding the acceptability, feasibility, and quality of telehealth among adolescents and young adults (AYA) and their parents and caregivers (caregivers) are lacking.

Objective: The aim of this study was to assess the noninferiority of telehealth versus in-person visits by comparing acceptability with respect to efficiency, effectiveness, equity, patient-centeredness, and confidentiality.

Methods: Cross-sectional web-based surveys were sent to caregivers and AYA following video visits within an Adolescent Medicine subspecialty clinic in May-July 2020.

Incidence of syphilis infection and syphilis-related care utilization among adolescents and young adults living with HIV.

Background: Incidence of syphilis has been rising in recent years and disproportionately affects young adults, racial/ethnic minority men, and people living with HIV. This study describes patterns of syphilis infection and syphilis-related care utilization among adolescents and young adults living with HIV (AYALH) in Philadelphia.

Methods: We conducted a retrospective cohort study of AYALH receiving care at an adolescent-specialty clinic who received a syphilis test and/or benzathine penicillin for syphilis treatment from 2011 to 2018 ( = 335).

The Impact of the COVID-19 Pandemic on Sexually Transmitted Infection/Human Immunodeficiency Virus Testing Among Adolescents in a Large Pediatric Primary Care Network.

Disruptions in sexually transmitted infection (STI) testing infrastructure during the COVID-19 pandemic threaten to impact STI service delivery for adolescents. Within a large pediatric primary care network, we compared STI testing encounters between the pandemic period and an analogous prepandemic period. The STI test counts decreased and test positivity increased during the pandemic period.

Outcomes of a Rapid Adolescent Telehealth Scale-Up During the COVID-19 Pandemic.

Purpose: To describe the first 30 days of rapid adolescent telehealth scale-up in response to the coronavirus (COVID-19) pandemic at a single academic medical center and assess for disparities in visit completion rates by patient characteristics.

Methods: Visit outcome and patient demographic data were obtained via electronic health record (EHR) reports. Telehealth visit completion rates were compared by patient characteristics using the chi-square test and t-test.

Family Characteristics in Sex Communication and Social Support: Implications for Emerging Adult Men Who Have Sex with Men's PrEP Engagement.

While emerging adulthood (ages 18-25) is marked by increased independence from parents, parental support remains a strong correlate of positive sexual health outcomes for heterosexual youth. With the emergence of pre-exposure prophylaxis (PrEP), few studies have examined the potential for parent-child sex communication and PrEP adoption among emerging adult men who have sex with men (MSM). We aimed to describe the extent to which parents/family characteristics play supportive roles in emerging adult MSM's current PrEP use.

Myotherapy student clinical placements: A review beyond the teaching clinic.

Background: Student clinical placements can offer an enriching learning experience, better preparing "work ready" graduates; however, it is unknown whether the type of clinical placement undertaken impacts the learning experience. Myotherapy degrees differ in their clinical practicum units, dependant on the undergraduate program they have enrolled in to. External clinical placements are common in allied health professional qualifications, offering industry experience and professional development.

Comparing Different Measures of Retention in Care Among a Cohort of Adolescents and Young Adults Living with Behaviorally-Acquired HIV.

Young people living with HIV (YLWH) have some of the lowest rates of retention in HIV care, putting them at risk for negative health outcomes. To better understand retention in care in this age group, we conducted a retrospective cohort analysis of YLWH initiating care at a multidisciplinary, adolescent-focused HIV clinic (N = 344). Retention was calculated using a variety of definitions, and relationships between different definitions were assessed.