102 - Substance Use and Risk Perceptions are Prospectively Associated with HIV Testing Behavior in Youth of Color Presenting to an Urban Adult Emergency Department
Friday, April 28, 2023
5:15 PM – 7:15 PM ET
Poster Number: 102 Publication Number: 102.15
Isioma D. Nwonye, Johns Hopkins Hospital Emergency Department Research & Innovation, Baltimore, MD, United States; Katie N. Huynh, Johns Hopkins University School of Medicine, Vancouver, WA, United States; Rachel Alinsky, Johns Hopkins University School of Medicine, Washington, DC, United States; Mustapha Saheed, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Christopher J. Hammond, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Renata Sanders, Johns Hopkins School of Medicine, Baltimore, MD, United States; Erik Peevy, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Gaby Dashler, Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Mitchell A. Goldstein, Johns Hopkins, Baltimore, MD, United States; Marc Fishman, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Marla Oros, Mosaic Group, Towson, MD, United States; Yu-Hsiang Hsieh, Johns Hopkins University School of Medicine, Baltimore, MD, United States
Research Assistant Johns Hopkins Hospital Emergency Department Research & Innovation Baltimore, Maryland, United States
Background: Substance use (SU) and HIV risk behaviors are common among adolescents and young adults (AYA), especially those of color. Rates of past-year HIV testing among US AYA aged 18-24 years remain low (19%), despite CDC guidelines recommending annual HIV testing. Emergency Departments (EDs) provide an opportunity to address the multiple needs of AYA via intervention programs that target co-existing SU, HIV risk behaviors, and HIV testing, particularly for AYA of color at-risk for HIV. Objective: To identify sociodemographic, clinical, and attitudinal characteristics that are predictive of HIV testing in 1 year following completion of an integrated HIV/SU intervention program for urban AYA of color presenting to the ED. Design/Methods: An urban adult ED has implemented HIV testing program since 2013 and a screening, brief intervention, and referral to treatment (SBIRT) program for substance use disorder (SUD) in 2019. An adjunctive pilot HIV prevention program was integrated into the SBIRT program for AYA of color in 2021. The prevention included a peer navigator administered motivational interviewing session with targeted educational messaging to improve SUD/HIV awareness, reduce risk behaviors, and promote routine HIV testing. All enrollees completed self-report measures assessing risk perceptions on SU and safe sex. HIV testing within 1 year following enrollment was determined via chart review. Two-tailed Fisher exact test was performed. Results: For this ongoing pilot, 63 AYA of color who presented to the ED between April and August 2021 were enrolled and 15 (24%) were tested for HIV during the index ED visit. Of those remaining 48 participants, 7 (15%) received HIV testing within 1 year after enrollment. The majority of the 48 were female (65%), and self-identified black (83%). Of the 16 enrollees who screened positive for SU, none received HIV testing during the follow-up as compared to 7 (22%) of 32 screened without SU received testing (p=0.091). None of the participants who perceived “no or low risk” for sex without a condom, binge drinking, use of non-prescribed, or injection drugs, received HIV testing during the follow-up as compared to 18%, 17%, 16%, and 17% of those who perceived those as “moderate or high risk” behaviors received testing, respectively (p values >0.05). No sociodemographic factors were associated with HIV testing.
Conclusion(s): In this pilot, 15% of AYA of color received HIV testing during 1-year follow-up, suggesting a need exists for ED HIV/SBIRT program given there is a trend that HIV testing might be correlated with SU, and sexual and SU risk perceptions.
