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Changes in the time of COVID-19: a quality improvement initiative to maintain services at a youth sexual health clinic
  1. Andrew C Lim1,
  2. Meghana Venkatesh1,
  3. Danielle L Lewald2,
  4. Patricia J Emmanuel1,
  5. Lisa Sanders1
  1. 1 Department of Pediatrics, University of South Florida College of Medicine, Tampa, Florida, USA
  2. 2 Healthy Start Coalition of Hillsborough County, Tampa, FL, USA
  1. Correspondence to Dr Lisa Sanders, Pediatrics, University of South Florida College of Medicine, Tampa, Florida, USA; lisasanders{at}


Objectives Adolescents and young adults (AYAs) face difficulties accessing sexual and reproductive health services. These difficulties were exacerbated for a variety of reasons by the COVID-19 pandemic. We document strategies and outcomes implemented at an urban youth sexual health clinic in Florida that allowed uninterrupted provision of services while protecting against spread of COVID-19.

Methods The plan–do–study–act (PDSA) model was used to implement COVID-19 interventions designed to allow continued service delivery while protecting the health and safety of staff and patients. This method was applied to clinic operations, community referral systems and community outreach to assess and refine interventions within a quick-paced feedback loop.

Results During the COVID-19 pandemic, changes made via PDSA cycles to clinical/navigation services, health communications and youth outreach/engagement effectively responded to AYA needs. Although overall numbers of youth served decreased, all youth contacting the clinic for services were able to be accommodated. Case finding rates for chlamydia, gonorrhoea, syphilis and HIV were similar to pre-pandemic levels.

Conclusions Quality improvement PDSA initiatives at AYA sexual health clinics, particularly those for underserved youth, can be used to adapt service delivery when normal operating models are disrupted. The ability for youth sexual health clinics to adapt to a changing healthcare landscape will be crucial in ensuring that under-resourced youth are able to receive needed services and ambitious Ending the HIV Epidemic goals are achieved.

  • sexual health
  • COVID-19
  • HIV

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  • Handling editor Jamie Scott Frankis

  • Contributors All authors contributed to the conceptualisation and design of this quality improvement process. Material preparation, data collection and analysis were performed by ACL, DLL, MV and LS. The first draft of the manuscript was written by ACL and DLL. All authors commented on previous versions of the manuscript, contributed to the reviewer requested edits and read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.