UNSTRUCTURED
Adolescents are disproportionately affected by sexually transmitted infections (STI), including HIV. Many youth with asymptomatic STI or related symptoms do not seek treatment and may not be screened if accessing the healthcare system for other reasons. We examined the feasibility and acceptability of a peer-driven, text messaging strategy to connect youth to STI and HIV services. Using an interrupted time series design consecutive patients at an adolescent medicine clinic were enlisted to send five text messages to peers they believed were sexually active and lived in the clinic's service area. Analyses conducted in 2015 used a generalized linear mixed model. Data were collected from 2013-2014. Of 153 patients approached to participate, 100 agreed to send text messages. Most (55%) reported no concerns with sending the text message. No adverse events or negative outcomes were reported. Adolescent STI testing, positive test results and reported risk behavior increased post intervention, although not statistically significant, likely because of the small sample size. Given low youth uptake of healthcare services and STI/HIV screening, in particular, new strategies are needed to address access barriers. Common approaches for reaching youth are resource-intensive and often miss youth not connected to school or community programs. The peer-based, text messaging strategy showed promise for both increasing the number of youth accessing health services and finding youth engaging in sexual risk behaviors and most in need of sexual health screening and services.