scholarly journals Acceptability and feasibility of self-sampling for the screening of sexually transmitted infections in cabana privacy shelters

2017 ◽  
Vol 29 (5) ◽  
pp. 461-465 ◽  
Author(s):  
Ellen Pittman ◽  
Hillary Purcell ◽  
Laura Dize ◽  
Charlotte Gaydos ◽  
Sherine Patterson-Rose ◽  
...  
Keyword(s):  
Health Care ◽  
Sexually Transmitted Infections ◽  
Health Care Access ◽  
Health Care Facilities ◽  
Sample Collection ◽  
Sexually Transmitted ◽  
Care Access ◽  
Before And After ◽  
Participant Characteristics ◽  
Doctor's Office

Screening for sexually transmitted infections (STIs) outside of traditional health-care facilities is limited by the privacy needed for sample collection. We explored the acceptability of privacy shelters for the self-collection of genital swabs and tested the use of privacy shelters during mobile STI screening. Attendees ≥14 years old at two outdoor community events completed a questionnaire that assessed participant characteristics, health-care access, and rating of acceptability of self-collecting penile or vaginal swabs in a privacy shelter and four other private spaces: portable restroom, health van, home, and doctor’s office. A privacy shelter was used during mobile STI screening. The majority (65%) of the 95 participants reported that using a privacy shelter was somewhat or very acceptable. No participant characteristics or health-care access factors were associated with the acceptability of privacy shelters. Women rated a privacy shelter more acceptable than a portable restroom or health van. Men rated a privacy shelter more acceptable than a portable restroom. During mobile STI screening, all 13 men and women who requested STI testing used the privacy shelter for self-sampling. Rating of acceptability before and after privacy shelter use was the same. Privacy shelters may enable STI screening without using a building or vehicle for sample collection.

scholarly journals Neighborhood Health Care Access and Sexually Transmitted Infections Among Women in the Southern United States

2018 ◽  
Vol 45 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Danielle F. Haley ◽  
Andrew Edmonds ◽  
Nadya Belenky ◽  
DeMarc A. Hickson ◽  
Catalina Ramirez ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Sexually Transmitted Infections ◽  
Health Care Access ◽  
Southern United States ◽  
Sexually Transmitted ◽  
Care Access

Sexually Transmitted Infections in the U.S. Military: A Sexual Health Paradigm to Address Risk Behaviors, Unintended Pregnancy, Alcohol Use, and Sexual Trauma

2021 ◽  
Author(s):  
Cherrie B Boyer ◽  
Charlotte A Gaydos ◽  
Amy B Geller ◽  
Eric C Garges ◽  
Sten H Vermund
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Health Care Access ◽  
The United States ◽  
Universal Health Care ◽  
Sexually Transmitted ◽  
Care Access ◽  
Control And Prevention ◽  
The Military ◽  
Universal Health

ABSTRACT To address the ongoing epidemic of sexually transmitted infections (STIs) in the United States, the National Academies of Sciences, Engineering, and Medicine (National Academies) conducted a consensus study on STI control and prevention in the United States to provide recommendations to the Centers for Disease Control and Prevention and the National Association of County and City Health Officials. The culminating report identified military personnel as one of the priority groups that require special consideration given the high prevalence of STIs and their associated behaviors (e.g., concurrent sexual partners and infrequent condom use) that occur during active duty service. Universal health care access, the relative ease and frequency of STI screening, and the educational opportunities within the military are all assets in STI control and prevention. The report offers a comprehensive framework on multiple and interrelated influences on STI risk, prevention, health care access, delivery, and treatment. It also provides an overview of the multilevel risk and protective factors associated with STIs that could be applied using a sexual health paradigm. The military context must integrate the multilevel domains of influences to guide the effort to fill current gaps and research needs. The Department of Defense, with its large clinical and preventive medicine workforce and its well-established universal health care system, is well positioned to enact changes to shift its current approach to STI prevention, treatment, and control. STI control based on highlighting behavioral, social, cultural, and environmental influences on service members’ sexual health and wellness may well drive better STI care and prevention outcomes.

scholarly journals Increased integrated testing for HIV, hepatitis C and sexually transmitted infections in health care facilities: results from the INTEGRATE Joint Action pilots in Lithuania, Romania and Spain

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
R. Matulionytė ◽  
M. L. Jakobsen ◽  
V. I. Grecu ◽  
J. Grigaitiene ◽  
T. Raudonis ◽  
...  
Keyword(s):  
Health Care ◽  
Hiv Testing ◽  
Sexually Transmitted Infections ◽  
Health Care Facilities ◽  
Alcohol Dependency ◽  
Pilot Studies ◽  
Sexually Transmitted ◽  
Integrated Testing ◽  
Care Facilities ◽  
Hcv Testing

Abstract Background Indicator condition guided HIV testing is a proven effective strategy for increasing HIV diagnosis in health care facilities. As part of the INTEGRATE Joint Action, we conducted four pilot studies, aiming to increase integrated testing for HIV/HCV/HBV and sexually transmitted infections, by introducing and expanding existing indicator condition guided HIV testing methods. Methods Pilot interventions included combined HIV/HCV testing in a dermatovenerology clinic and a clinic for addictive disorders in Lithuania; Increasing HIV testing rates in a tuberculosis clinic in Romania by introducing a patient information leaflet and offering testing for HIV/HCV/sexually transmitted infections to chemsex-users in Barcelona. Methods for implementing indicator condition guided HIV testing were adapted to include integrated testing. Testing data were collected retrospectively and prospectively. Staff were trained in all settings, Plan-do-study-act cycles frequently performed and barriers to implementation reported. Results In established indicator conditions, HIV absolute testing rates increased from 10.6 to 71% in the dermatovenerology clinic over an 18 months period. HIV testing rates improved from 67.4% at baseline to 94% in the tuberculosis clinic. HCV testing was added to all individuals in the dermatovenerology clinic, eight patients of 1701 tested positive (0.47%). HBV testing was added to individuals with sexually transmitted infections with a 0.44% positivity rate (2/452 tested positive). The Indicator condition guided HIV testing strategy was expanded to offer HIV/HCV testing to people with alcohol dependency and chemsex-users. 52% of chemsex-users tested positive for ≥ 1 sexually transmitted infection and among people with alcohol dependency 0.3 and 3.7% tested positive for HIV and HCV respectively. Conclusions The four pilot studies successfully increased integrated testing in health care settings, by introducing testing for HBV/HCV and sexually transmitted infections along with HIV testing for established indicator conditions and expanding the strategy to include new indicators; alcohol dependency and chemsex. HCV testing of individuals with alcohol abuse showed high positivity rates and calls for further implementation studies. Methods used for implementing indicator condition guided HIV Testing have proven transferable to implementation of integrated testing.

scholarly journals Health Care Access and Utilization Among U.S. Immigrants Before and After the Affordable Care Act

2018 ◽  
Vol 21 (2) ◽  
pp. 211-218 ◽  
Author(s):  
Arturo Vargas Bustamante ◽  
Jie Chen ◽  
Ryan M. McKenna ◽  
Alexander N. Ortega
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Health Care Access ◽  
Care Access ◽  
Before And After ◽  
The Affordable Care Act

scholarly journals Health Care Access and Sexually Transmitted Infection Screening Frequency Among At-Risk Massachusetts Men Who Have Sex With Men

2009 ◽  
Vol 99 (S1) ◽  
pp. S187-S192 ◽  
Author(s):  
Carey V. Johnson ◽  
Matthew J. Mimiaga ◽  
Sari L. Reisner ◽  
Ashley M. Tetu ◽  
Kevin Cranston ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Sexually Transmitted Infection ◽  
Health Care Access ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Care Access ◽  
Sex With Men ◽  
Screening Frequency

scholarly journals Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults

2017 ◽  
Vol 54 ◽  
pp. 004695801773403 ◽  
Author(s):  
Jae Kennedy ◽  
Elizabeth Geneva Wood ◽  
Lex Frieden
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Adults With Disabilities ◽  
Full Implementation ◽  
Care Access ◽  
Before And After ◽  
Working Age ◽  
The Affordable Care Act

The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as their previously limited insurance options. However, most published research on this population does not systematically look at effects before and after full implementation of the ACA. As the US Congress considers new health policy reforms, current and accurate data on this vulnerable population are essential. Weighted estimates, trend analyses and analytic models were conducted using the 1998-2016 National Health Interview Surveys (NHIS) and the 2014 Medical Expenditure Panel Survey. Compared with working-age adults without disabilities, those with disabilities are less likely to work, more likely to earn below the federal poverty level, and more likely to use public insurance. Average health costs for this population are 3 to 7 times higher, and access problems are far more common. Repeal of key features of the ACA, like Medicaid expansion and marketplace subsidies, would likely diminish health care access for working-age adults with disabilities.

scholarly journals Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil

2012 ◽  
Vol 45 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Marcos Túlio Raposo ◽  
Maria Ines Battistella Nemes
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Healthcare Services ◽  
National Database ◽  
Care Access ◽  
Treatment Default ◽  
Number Of Patients ◽  
Before And After ◽  
Chi Squared ◽  
Level Of Significance

INTRODUCTION: The aim of this study was to assess the epidemiological and operational characteristics of the Leprosy Program before and after its integration into the Primary healthcare Services of the municipality of Aracaju-Sergipe, Brazil. METHODS: Data were drawn from the national database. The study periods were divided into preintegration (1996-2000) and postintegration (2001-2007). Annual rates of epidemiological detection were calculated. Frequency data on clinico-epidemiological variables of cases detected and treated for the two periods were compared using the Chi-squared (χ2) test adopting a 5% level of significance. RESULTS: Rates of detection overall, and in subjects younger than 15 years, were greater for the postintegration period and were higher than rates recorded for Brazil as a whole during the same periods. A total of 780 and 1,469 cases were registered during the preintegration and postintegration periods, respectively. Observations for the postintegration period were as follows: I) a higher proportion of cases with disability grade assessed at diagnosis, with increase of 60.9% to 78.8% (p < 0.001), and at end of treatment, from 41.4% to 44.4% (p < 0.023); II) an increase in proportion of cases detected by contact examination, from 2.1% to 4.1% (p < 0.001); and III) a lower level of treatment default with a decrease from 5.64 to 3.35 (p < 0.008). Only 34% of cases registered from 2001 to 2007 were examined. CONCLUSIONS: The shift observed in rates of detection overall, and in subjects younger than 15 years, during the postintegration period indicate an increased level of health care access. The fall in number of patients abandoning treatment indicates greater adherence to treatment. However, previous shortcomings in key actions, pivotal to attaining the outcomes and impact envisaged for the program, persisted in the postintegration period.

scholarly journals It Is Complicated: The Medico-Social Journey of an Undocumented Pregnant Adolescent

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Helen Kest ◽  
Ashlesha Kaushik ◽  
Bushra Tehreem ◽  
David Goldberg
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Health Care Systems ◽  
Large Population ◽  
Health Resources ◽  
Secondary Syphilis ◽  
Sexually Transmitted ◽  
Pregnant Adolescent ◽  
Care Access ◽  
Social Insecurity

Adolescent pregnancies are a global health problem with over 16 million children born to this age group globally. Adolescent females also represent almost half of all adolescent global migrants. Adolescent pregnancy by itself is associated with poor health care access and morbidities; the additional risk of social insecurity in the case of undocumented adolescent migrants leads to higher risks for the mother and newborn. According to the CDC, adolescents comprise half of all new sexually transmitted diseases (STDs) including reported primary and secondary syphilis. Our case highlights the relationship between social insecurity for the undocumented adolescent migrant and excess risks for preventable mother-to-child transmission of communicable diseases. In formulating preventive measures and policies for the recent rise in sexually transmitted maternal diseases with resultant congenital infections, there is need for health care systems and providers to familiarize themselves with advocacy and other useful resources that will promote health care access for undocumented and other vulnerable adolescents. Additionally, local providers who work in areas with a large population of immigrant adolescents should utilize the untapped resources of these adolescents to develop youth community advocacy projects that link adolescents to health resources, including reproductive health.

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