José A Bauermeister, Seul Ki Choi, Willey Lin, Andrea Cheshure, Rebecca Giguere, Sara K Shaw Green, Jonathan Morgan, Milo St Ives, Isaac Richardson, Iván C Balán, M Isabel Fernández, Sylvie Naar
Youth-led mystery shopping captured experiential aspects of service quality often missed by traditional metrics and surfaced actionable gaps in prevention counseling. Our findings offer a rigorous diagnostic of Florida's HIV prevention infrastructure, underscoring how community-engaged quality assurance methods might be embedded in EHE strategies to ensure services are accessible, affirming and effective for those most at risk.
BACKGROUND: Ensuring culturally responsive HIV testing is essential to advancing the goals of the Ending the HIV Epidemic (EHE) initiative, particularly among young sexual minority men (YSMM), who continue to experience disproportionate HIV incidence.
METHODS: We conducted a youth-led mystery shopping study across six Florida counties between 2023 and 2025 to assess the quality of publicly funded HIV Counseling, Testing, and Referral (CTR) services. Using a validated assessment tool, trained YSMM completed 301 visits and evaluated site-level performance across ten domains.
RESULTS: While many sites demonstrated strengths in provider respect, visual inclusion, and PrEP information, consistent deficits emerged in safer sex counseling, relationship-centered dialogue, and medical form inclusivity across the state.
CONCLUSIONS: Youth-led mystery shopping captured experiential aspects of service quality often missed by traditional metrics and surfaced actionable gaps in prevention counseling. Our findings offer a rigorous diagnostic of Florida's HIV prevention infrastructure, underscoring how community-engaged quality assurance methods might be embedded in EHE strategies to ensure services are accessible, affirming and effective for those most at risk.