AIDS and Behavior

, Volume 19, Issue 10, pp 1919–1927 | Cite as

The Use of Mystery Shopping for Quality Assurance Evaluations of HIV/STI Testing Sites Offering Services to Young Gay and Bisexual Men

  • José A. BauermeisterEmail author
  • Emily S. Pingel
  • Laura Jadwin-Cakmak
  • Steven Meanley
  • Deepak Alapati
  • Michael Moore
  • Matthew Lowther
  • Ryan Wade
  • Gary W. Harper
Original Paper


Young men who have sex with men (YMSM) are at increased risk for HIV and STI infection. While encouraging HIV and STI testing among YMSM remains a public health priority, we know little about the cultural competency of providers offering HIV/STI tests to YMSM in public clinics. As part of a larger intervention study, we employed a mystery shopper methodology to evaluate the LGBT cultural competency and quality of services offered in HIV and STI testing sites in Southeast Michigan (n = 43).We trained and deployed mystery shoppers (n = 5) to evaluate the HIV and STI testing sites by undergoing routine HIV/STI testing. Two shoppers visited each site, recording their experiences using a checklist that assessed 13 domains, including the clinic’s structural characteristics and interactions with testing providers. We used the site scores to examine the checklist’s psychometric properties and tested whether site evaluations differed between sites only offering HIV testing (n = 14) versus those offering comprehensive HIV/STI testing (n = 29). On average, site scores were positive across domains. In bivariate comparisons by type of testing site, HIV testing sites were more likely than comprehensive HIV/STI testing clinics to ascertain experiences of intimate partner violence, offer action steps to achieve safer sex goals, and provide safer sex education. The developed checklist may be used as a quality assurance indicator to measure HIV/STI testing sites’ performance when working with YMSM. Our findings also underscore the need to bolster providers’ provision of safer sex education and behavioral counseling within comprehensive HIV/STI testing sites.


Men who have sex with men Cultural competency Performance Sex education 


Los hombres jóvenes que tienen sexo con otros hombres (JHCH) tienen mayor riesgo de contraer VIH y otras enfermedades transmitidas sexualmente (ETS). La promoción de pruebas de VIH/ETS entre los JHCH sigue siendo una prioridad de salud pública; sin embargo, sabemos poco acerca de la competencia cultural de los proveedores que ofrecen pruebas de VIH/ETS a JHCH en clínicas públicas. Como parte de un estudio de intervención, utilizamos la metodología del cliente misterioso para evaluar la competencia cultural y la calidad de los servicios ofrecidos durante el testeo de VIH y ETS en el sudeste de Michigan (n = 43). Entrenamos a 5 clientes misteriosos a evaluar los servicios ofrecidos al someterse a pruebas rutinarias de VIH/ETS. Dos clientes misteriosos visitaron cada clínica, registrando sus experiencias utilizando un instrumento que evaluó 13 dimensiones, incluyendo las características estructurales de la clínica y las interacciones con los proveedores. Utilizamos los puntajes del sitio para examinar las propiedades psicométricas del instrumento y evaluar si las puntuaciones diferían entre clínicas que sólo ofrecen la prueba del VIH (n = 14) y las clínicas que ofrecen las pruebas comprehensivas de VIH/ETS (n = 29). En promedio, los puntajes de las dimensiones fueron positivos. En comparaciones entre los dos tipos de clínica, las clínicas que sólo ofrecen VIH fueron más propensas que las clínicas con pruebas comprehensivas en tener puntajes mas positivos en las áreas de experiencias de violencia entre pareja, pasos para alcanzar los objetivos de sexo seguro, y educación sexual. El instrumento desarrollo puede ser utilizado como un índice para medir el desempeño de clínicas donde se le ofrecen pruebas de VIH/ETS a JHCH. Nuestros resultados también reiteran la necesidad de reforzar la provisión de educación sexual y consejería entre proveedores de pruebas de VIH/ETS.



We thank our Community Advisory Board and Youth Advisory Board for their contributions during the development and implementation of this project.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • José A. Bauermeister
    • 1
    Email author
  • Emily S. Pingel
    • 1
  • Laura Jadwin-Cakmak
    • 1
  • Steven Meanley
    • 1
  • Deepak Alapati
    • 1
  • Michael Moore
    • 1
  • Matthew Lowther
    • 1
  • Ryan Wade
    • 1
  • Gary W. Harper
    • 1
  1. 1.Department of Health Behavior & Health Education, Center for Sexuality and Health Disparities, School of Public HealthUniversity of MichiganAnn ArborUSA

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