Amsterdam 2015
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| Abstract #2069 - Teen spirit: Adolescents and HIV | ||||
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Session: 46.3: Teen spirit: Adolescents and HIV (Parallel) on Friday @ 09.00-10.30 in C104 Chaired by Tonya Thurman, John Miller Authors: Presenting Author: Dr. David Cordova - University of Michigan, United States |
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| Additional Authors: | ||||
| Aim: Nearly three decades after the first reported cases of HIV in the United States, HIV/STI still remains a major public health concern. Adolescents are disproportionately affected by HIV/STI (CDC, 2014). Researchers have shown that effective sexual communication can ameliorate HIV/STI risk behaviors among adolescents. However, much of this research has focused on parent-adolescent (Cordova et al., 2014 Malcolm et al., 2014) and peer (Widman et al., 2014) sexual communication. Recent shifts in policy, including the Affordable Care Act, may provide key opportunities for primary care physicians to engage adolescents in sexual communication and HIV/STI prevention services (Institute of Medicine, 2012). Therefore, there is also a need to develop a fuller understanding of physician-adolescent communication processes, which may have HIV/STI prevention implications. In spite of this, few studies have examined the perspectives of both adolescents and physicians with respect to HIV/STI risk behaviors communication. The aim of this study was to conduct in-depth qualitative interviews with physicians and adolescents about facilitators and barriers to HIV/STI risk behaviors communication at a primary care clinic located in the Midwest, United States. | ||||
| Method / Issue: Data were drawn from two studies focused on developing and implementing HIV/STI preventive interventions in primary care. A total of 56 adolescents and 4 primary care physicians were included in this study. The majority of adolescents were female (71.4%) and 57.1% identified as Black/African American with a mean age of 17.91 (SD= 2.56). Primary care physicians were all female and primarily non-Hispanic white (75%) with a mean age of 43.75 (SD= 5.68). A total of 16 focus groups and 8 individual interviews were conducted. Data were transcribed verbatim and checked for accuracy. Analysis followed the tenets of thematic analysis (Guest, 2012). Trustworthiness of data was established following the guidelines of Morrow (2005). | ||||
| Results / Comments: Seven themes emerged from the data: (1) “Not wanting to be judged”: Adolescents’ experiences of perceived judgment from physicians, (2) “You wish you would have answered that question truthfully”: Adolescents’ regret of non-disclosure of HIV/STI risk behaviors, (3) “I really want to discuss HIV, but I’m not gonna say anything until the doctor asks”: Adolescents’ call for physician-initiated HIV/STI risk communication, (4) “You can’t treat them as kids and you can’t quite treat them as adults”: Developmentally appropriate preventive interventions, (5) “I’m not always certain that the right questions get queued up”: Physicians’ call for better flagging of adolescent risk behaviors, (6)Wanting face-to-face hand-off: The need to integrate public health and primary care, and (7) “Society doesn't see any value in prevention”: Physicians’ desire for increased resources for preventive care. | ||||
| Discussion: Relatively few studies examining barriers and facilitators to physician-adolescent communication about HIV/STI risk behaviors in primary care exist. Study findings highlight the nuances of perspectives from both physicians and adolescents. Future research should examine the role of physician-adolescent communication on HIV/STI risk behaviors in a quantitative multivariate design. Findings may be helpful to inform the development of preventive interventions aimed at improving physician-adolescent sexual communication in primary care. | ||||
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