Reducing the Discussion Divide by Digital Questionnaires in Health Care Settings: Disruptive Innovation for HIV Testing and PrEP Screening. J Acquir Immune Defic Syndr 2020 Nov 01;85(3):302-308
Date
07/24/2020Pubmed ID
32701822Pubmed Central ID
PMC7572720DOI
10.1097/QAI.0000000000002459Scopus ID
2-s2.0-85093538678 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
BACKGROUND: Health care provider assessment of patient sexual behavior and substance use is essential for determining appropriate prevention interventions-including HIV pre-exposure prophylaxis (PrEP)-for sexual minority men (SMM). We sought to explore acceptability and utility of using electronic surveys to conduct health behavior assessments in clinical settings among SMM.
METHODS: Among a US nationwide sample of SMM (n = 4187; mean age = 38.3 years; 60% white; 82% HIV-negative), we examined associations of demographics, recruitment venue, sexual behavior characteristics, and recent substance use with participants' comfort communicating verbally and through electronic survey with a health care provider about sexual and substance use behavior.
RESULTS: On average, SMM had greater comfort communicating through electronic survey vs. verbally. In our fully adjusted analysis, preference favoring electronic surveys more strongly than verbal communication differed by age (β = -0.07, P ≤ 0.001). SMM with a bachelor's degree or more (β = 0.04, P < 0.05), those recruited from nonclinical settings (β = 0.06, P ≤ 0.001), and those without primary care providers (β = 0.04, P < 0.05) favored electronic surveys more strongly in the fully adjusted multivariable model. SMM who reported any recent casual sex partners (β = 0.05, P < 0.01), those never tested for HIV (β = 0.03, P < 0.05), and HIV-negative/unknown men not on PrEP (compared with PrEP users; β = 0.09, P ≤ 0.001) also favored electronic surveys in the fully adjusted model.
CONCLUSIONS: Reducing communication barriers by incorporating electronic surveys into patient assessments could help identify HIV testing and PrEP needs for SMM most susceptible to HIV acquisition. Nonetheless, no one screening strategy is likely to work for most SMM, and multiple approaches are needed.
Author List
John SA, Petroll AE, Walsh JL, Quinn KG, Patel VV, Grov CAuthors
Steven A. John PhD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of WisconsinAndrew Petroll MD Professor in the Medicine department at Medical College of Wisconsin
Katherine Quinn PhD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Jennifer L. Walsh PhD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Communication
HIV Infections
Humans
Male
Middle Aged
Patient Acceptance of Health Care
Pre-Exposure Prophylaxis
Sexual Behavior
Sexual and Gender Minorities
Surveys and Questionnaires
United States
Young Adult