Community-academic implementation science partnership to examine adoption and impact of a patient-centered approach to sexual history.

Abstract

Progress toward ending the HIV epidemic has been slowed by suboptimal utilization of effective biomedical interventions (e.g., HIV testing, pre-exposure prophylaxis), especially for populations with the highest incidence. In 2021, the New York City Health Department initiated a multilevel implementation strategy, focused on promoting the GOALS Approach to Sexual History and Health-an antistigmatizing, client-centered strategy for sexual history taking-as a lever for increasing HIV intervention adoption, reach, and equity. Project Partnership to Increase Access, Client-Centered Care, and Equity in HIV Services is a community-academic implementation science partnership designed to investigate the impact of strategy enactment on implementation outcomes, including changes in intervention utilization (HIV testing, sexually transmitted infection testing, pre-exposure prophylaxis) in practice over time. This article presents preliminary implementation outcomes collected from the 19 programs (client N = 8,865) funded to adopt GOALS. Data indicate the successful enactment of systems-level strategies (infrastructure development, service mandates), program-level strategies (staff training, learning collaboratives), and provider-level strategies (utilization of the GOALS). By Quarter 5, the GOALS was being utilized in a median of 84% of visits across programs (interquartile range: 54%-97%), and GOALS utilization was positively associated with provider adoption of HIV prevention interventions in practice. Programs that struggled with implementation had less buy-in from leadership and lower commitment to provider training; programs with upward implementation trends had less experience delivering sexual health care and used a phased approach to foster support, focusing on the positive reaction to the GOALS among their clients. These data suggest that a multilevel implementation strategy focused on delivery of antistigma, client-centered sexual histories may be a potent implementation strategy for enhancing HIV prevention intervention adoption. (PsycInfo Database Record (c) 2025 APA, all rights reserved).