Provider Trust as a Catalyst for Adolescent HIV and Syphilis Testing.

Adolescents are disproportionately affected by sexually transmitted infections, particularly HIV and syphilis, yet testing rates remain low. We conducted semistructured interviews with 15 adolescents (14-20 years old) at an urban pediatric clinic in Milwaukee to identify facilitators and barriers to HIV and syphilis testing. Data were analyzed using thematic analysis. Results highlight strikingly low levels of syphilis knowledge. Modifiable testing barriers include needle anxiety, fear of results, confidentiality and parental disclosure concerns, and structural challenges including transportation and scheduling conflicts. Despite barriers, nearly all participants described trusted, nonjudgmental providers that supported testing. Critical syphilis knowledge gaps and intersecting barriers persist, yet provider relationships create a feasible opportunity for brief, clinic-embedded HIV/syphilis education.