Abstract
Background: Youth and emerging adults aged 18-29 year are one of the few groups with rising rates of new HIV infections in the United States (US), with those in the southern US being more vulnerable and at elevated risk of acquisition. This is dues to a confluence of factors including but not limited to low HIV testing rates, high levels of stigma, and high rates of poverty in the region. Thus, understanding where and how to reach youth and emerging adults in the under resourced southern US for prevention is essential for advancing the Ending the HIV Epidemic goals.
Methods: We audio-recorded, transcribed, thematically coded, and analyzed qualitative data from in-depth interviews and focus groups of youth and emerging adults (n=56) and prevention and outreach workers (n=12) in Alabama (2020-2022). Themes were triangulated between youth and provider datasets to identify shared recommendations for improving HIV testing acceptance.
Results: All (100%) of youth and emerging adult participants identified as Black (race), youth or emerging adults aged 18-29 years, resided in Alabama, and were men who were sexually engaged with men; 38% lived in a rural community. Three themes related to preferred HIV testing sites emerged: (1) meeting youth where they are in trusted physical and online community spaces (clubs, campuses, online apps); (2) creating safe, non-judgmental, stigma-free, and affirming testing environments, regardless of specific location, and (3) leveraging cultural events (balls, PRIDE events) that are “owned” by youth and emerging adults to build trust and promote the visibility of ASOs offering HIV testing services.
Conclusions: While both youth and providers highlighted trust, representation, and consistent community engagement as central to effective HIV testing outreach, the sharing of specific sites to test is highly informative and provides critical information on reaching those most affected by the HIV epidemic, youth and emerging adults in the southern US. The multiple recommendations to use online apps or digital health interventions, provide evidence for next generation modalities of engagement strategies while the concurrent emphasis on being visible at PRIDE events, ballroom parties, and on campuses provide the HIV prevention community clear direction that relying on any singular engagement method may be insufficient to address the persistent HIV epidemic among youth and emerging adults in the southern US.
Notes
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References:
Budhwani, Henna, B. Matthew Kiszla, Angulique Y. Outlaw, Robert A. Oster, Michael J. Mugavero, Mallory O. Johnson, Lisa B. Hightow-Weidman, Sylvie Naar, and Janet M. Turan. "Adapting a motivational interviewing intervention to improve HIV prevention among young, black, sexual minority men in Alabama: protocol for the development of the kings digital health intervention." JMIR Research Protocols 11, no. 7 (2022): e36655.
Turner, Suzanne D., Kelly Anderson, Morgan Slater, Laura Quigley, Martin Dyck, and Charlie B. Guiang. "Rapid point-of-care HIV testing in youth: a systematic review." Journal of Adolescent Health 53, no. 6 (2013): 683-691.
Tolou-Shams, Marina, Nanetta Payne, Christopher Houck, David Pugatch, Nancy Beausoleil, Larry K. Brown, and Project SHIELD Study Group. "HIV testing among at-risk adolescents and young adults: A prospective analysis of a community sample." Journal of Adolescent Health 41, no. 6 (2007): 586-593.
Petsis, Danielle, Jungwon Min, Yuan-Shung V. Huang, Aletha Y. Akers, and Sarah Wood. "HIV testing among adolescents with acute sexually transmitted infections." Pediatrics 145, no. 4 (2020): e20192265.
Nguyen, Trang Quyen, Carol A. Ford, Jay S. Kaufman, Peter A. Leone, Chirayath Suchindran, and William C. Miller. "HIV testing among young adults in the United States: Associations with financial resources and geography." American journal of public health 96, no. 6 (2006): 1031-1034.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Qualitative Research
Keywords:
Health Equity or Social Determinants of Health, Public and Community Health, Routine Diagnostic Tests, Health Screening, HIV Infections--Prevention and Control, Adolescence, Young Adult, Alabama, United States
Recommended Citation
Budhwani, Henna; Hogan, Gerard Thomas; Micheau, Alexis; Outlaw, Angulique Y.; Mugavero, Michael J.; Johnson, Mallory O.; Oster, Robert A.; Hightow-Weidman, Lisa B.; Naar, Sylvie; and Turan, Janet M., "Recommendations for HIV Testing Locations to Reach Youth and Emerging Adults: A Qualitative Study" (2026). International Nursing Research Congress (INRC). 71.
https://www.sigmarepository.org/inrc/2026/presentations_2026/71
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-27
Funder
National Institute of Mental Health
Recommendations for HIV Testing Locations to Reach Youth and Emerging Adults: A Qualitative Study
Toronto, Ontario, Canada
Background: Youth and emerging adults aged 18-29 year are one of the few groups with rising rates of new HIV infections in the United States (US), with those in the southern US being more vulnerable and at elevated risk of acquisition. This is dues to a confluence of factors including but not limited to low HIV testing rates, high levels of stigma, and high rates of poverty in the region. Thus, understanding where and how to reach youth and emerging adults in the under resourced southern US for prevention is essential for advancing the Ending the HIV Epidemic goals.
Methods: We audio-recorded, transcribed, thematically coded, and analyzed qualitative data from in-depth interviews and focus groups of youth and emerging adults (n=56) and prevention and outreach workers (n=12) in Alabama (2020-2022). Themes were triangulated between youth and provider datasets to identify shared recommendations for improving HIV testing acceptance.
Results: All (100%) of youth and emerging adult participants identified as Black (race), youth or emerging adults aged 18-29 years, resided in Alabama, and were men who were sexually engaged with men; 38% lived in a rural community. Three themes related to preferred HIV testing sites emerged: (1) meeting youth where they are in trusted physical and online community spaces (clubs, campuses, online apps); (2) creating safe, non-judgmental, stigma-free, and affirming testing environments, regardless of specific location, and (3) leveraging cultural events (balls, PRIDE events) that are “owned” by youth and emerging adults to build trust and promote the visibility of ASOs offering HIV testing services.
Conclusions: While both youth and providers highlighted trust, representation, and consistent community engagement as central to effective HIV testing outreach, the sharing of specific sites to test is highly informative and provides critical information on reaching those most affected by the HIV epidemic, youth and emerging adults in the southern US. The multiple recommendations to use online apps or digital health interventions, provide evidence for next generation modalities of engagement strategies while the concurrent emphasis on being visible at PRIDE events, ballroom parties, and on campuses provide the HIV prevention community clear direction that relying on any singular engagement method may be insufficient to address the persistent HIV epidemic among youth and emerging adults in the southern US.
Description
Youth and emerging adults in the southern US face rising HIV infection rates due to stigma, poverty, and low testing, with a concentrated epidemic among select sub-populations. Interviews and focus groups with youth and prevention and outreach workers in Alabama revealed three types of settings for HIV testing: trusted spaces (clubs, campuses, apps), ensure affirming testing environments, and leverage cultural events (PRIDE, balls) to increase visibility and willingness to accept HIV testing.