Integrated Health Services (IHS): A Structural Intervention to Improve HIV/STI Screening and PrEP Navigation in Primary Care
My Brother's Keeper, Inc.
Summary
The goal of this clinical trial is to learn whether integrating routine, opt-out HIV and STI testing and pre-exposure prophylaxis (PrEP) navigation into primary care increases use of these services among adults ages 18 to 45 receiving care at Federally Qualified Health Centers in Mississippi. The main questions it aims to answer are: 1. Does the integrated model increase HIV and STI testing compared with standard care? 2. Does the integrated model increase PrEP navigation activity for eligible patients? 3. How do patients and clinic staff experience the integrated model in terms of satisfaction, comfort discussing sexual health, and feasibility in daily workflows? Researchers will compare a standard-care period to a period when the integrated model is in place to see if the integrated model improves service use and patient experience. Participants will: 1. Receive usual primary care, with HIV/STI testing and PrEP discussions offered as a routine, opt-out part of care during the integrated period 2. Be invited, if eligible, to complete a brief survey about their clinic experience 3. For staff, be invited to take part in a short survey or interview about clinic workflows and the integrated model
Description
This is a quasi-experimental, mixed-methods implementation study designed to evaluate an integrated sexual and reproductive health (SRH) model that embeds routine, opt-out HIV and sexually transmitted infection (STI) testing and pre-exposure prophylaxis (PrEP) navigation into primary care workflows at two Federally Qualified Health Centers (FQHCs) in Canton and Yazoo City, Mississippi. The study focuses on adults ages 18-45 receiving primary care at participating clinics, a population experiencing high HIV/STI burden and structural barriers to SRH services, including limited routine testing, l…
Eligibility
- Age range
- 18–45 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Adults ages 18 to 45 years. * Receiving primary care services at participating Federally Qualified Health Center (FQHC) clinics in Canton or Yazoo City, Mississippi. * Able to understand and read English (for participation in surveys and interviews). * For staff key informants: current clinical, administrative, or support role at a participating FQHC site with responsibilities related to primary care, HIV/STI services, or care coordination. Exclusion Criteria: * Younger than 18 years or older than 45 years. * Critically ill, psychiatrically unstable, or lacking capacit…
Interventions
- BehavioralIntegrated HIV/STI Testing and PrEP Navigation Model
Clinic-level implementation of an integrated sexual and reproductive health model that embeds routine, opt-out HIV and sexually transmitted infection (STI) testing and pre-exposure prophylaxis (PrEP) navigation into primary care at Federally Qualified Health Centers. The intervention includes: (1) standing orders for nurses and peer navigators to initiate HIV/STI testing and PrEP navigation for eligible adults ages 18-45; (2) enhanced electronic health record prompts and templates to support opt-out testing and documentation of offers, completions, and declinations; (3) embedded peer navigation and daily team huddles to coordinate linkage and follow-up; and (4) training and technical assistance for clinic staff on workflows, cultural responsiveness, and stigma-reduction related to sexual health and PrEP.
Location
- My Brother's Keeper, Inc.Ridgeland, Mississippi