scholarly journals Developing a Typology of HIV/STI Testing Patterns Among Gay, Bisexual, and Queer Men: A Framework to Guide Interventions

2019 ◽  
Vol 30 (4) ◽  
pp. 610-621 ◽  
Author(s):  
Rayner Kay Jin Tan ◽  
Nashwinder Kaur ◽  
Mark I-Cheng Chen ◽  
Chen Seong Wong
Keyword(s):  
Thematic Analysis ◽  
External Factors ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Sti Testing ◽  
Semistructured Interviews ◽  
Testing Patterns ◽  
Purposive Sample ◽  
Inductive Thematic Analysis

Although factors associated with HIV/sexually transmitted infection (STI) testing among gay, bisexual, and queer (GBQ) men are well-established in the literature, few studies have attempted to delineate the processes underlying different patterns of testing. We conducted a qualitative study involving 35 semistructured interviews with a purposive sample of GBQ men in Singapore from October 2017 to July 2018. Topics explored included formative sexual experiences, relationships, and experiences of HIV/STI testing. Interviews were audio-recorded, transcribed, coded, and analyzed through inductive thematic analysis. A typology comprising four distinct HIV/STI testing patterns was identified from the data, categorized based on the regularity of testing, relative to internal or external factors that motivate testing behaviors. These include triggered episodic testing, influenced episodic testing, institutionalized regular testing, and value-based regular testing. The typology highlights the preconditions that underlie different testing patterns and provides a framework for developing interventions that promote HIV/STI testing among GBQ men.

Leadership in physiotherapy: experiences of leaders of physiotherapy professional organisations

BMJ Leader ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. 115-122
Author(s):  
Emer McGowan ◽  
Emma Stokes
Keyword(s):  
Leadership Development ◽  
Thematic Analysis ◽  
Leadership Roles ◽  
Semistructured Interviews ◽  
The World ◽  
Future Leaders ◽  
Professional Leadership ◽  
The Many ◽  
Purposive Sample ◽  
Inductive Thematic Analysis

BackgroundThe changing demands of healthcare and ongoing advances in practice and technology require corresponding change and development of the physiotherapy profession. Physiotherapy professional organisations perform many important functions in ensuring the ongoing growth and success of the profession. The leaders of these organisations therefore have key roles in progressing the physiotherapy profession in their country. To date, however, there has been very little written about these physiotherapy leaders and their work for the profession.PurposeTo explore the professional leadership journeys of international physiotherapy leaders and their experiences of leading physiotherapy professional organisations.MethodsSemistructured interviews were conducted with a purposive sample of 16 physiotherapy leaders from a range of physiotherapy professional organisations from around the world. The interviews were analysed using inductive thematic analysis.ResultsThree main themes were found in the analysis of the data: ‘Leadership roles, behaviours and challenges’, ‘Perceptions of the profession of physiotherapy’ and ‘Leadership development’.ConclusionsThe physiotherapy leaders describe interesting and varied roles that can also be challenging and demanding. They recognise the many challenges facing the physiotherapy profession internationally and the need for physiotherapists to more effectively advocate for the profession and demonstrate leadership. Leadership development opportunities and mentoring may be potential strategies to enable the development of future leaders of the physiotherapy profession.

Sexually transmitted infection testing awareness, uptake and diagnosis among urban refugee and displaced youth living in informal settlements in Kampala, Uganda: a cross-sectional study

2019 ◽  
Vol 46 (3) ◽  
pp. 192-199 ◽  
Author(s):  
Carmen Helen Logie ◽  
Moses Okumu ◽  
Simon Mwima ◽  
Peter Kyambadde ◽  
Robert Hakiza ◽  
...  
Keyword(s):  
Young Women ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Sti Testing ◽  
Social Ecological ◽  
Related Stigma

BackgroundSexually transmitted infection (STI) prevention needs among urban refugee and displaced youth are understudied. The study objective was to explore factors associated with the STI prevention cascade (STI services awareness, testing, diagnosis) among urban refugee and displaced youth in Kampala, Uganda.MethodsWe implemented a cross-sectional survey with youth aged 16–24 years in informal settlements in Kampala. We conducted bivariate and multivariable logistic regression analyses to identify social ecological (intrapersonal, interpersonal, community) level factors associated with STI testing services awareness, lifetime STI testing, and lifetime STI diagnosis.ResultsParticipants (n=445; mean age 19.3, SD 2.6, years) included young women (n=333, 74.8%) and young men (n=112, 25.2%). Less than half (43.8%) were aware of community STI services. One-quarter (26.1%) reported lifetime STI testing. Of these, 39.5% reported a lifetime STI diagnosis. In multivariable analyses among young women, age, lifetime sex partners, and lower adolescent sexual and reproductive health (SRH)-related stigma were associated with STI services awareness; and age, lower adolescent SRH-related stigma, and food security were associated with STI testing. Among young men, time in Uganda and lower HIV-related stigma were associated with STI services awareness; and age, condom self-efficacy, and increased adolescent SRH-related stigma were associated with testing. Lifetime sex partners, lower condom self-efficacy, and lower adolescent SRH-related stigma were associated with lifetime STI diagnosis.ConclusionsSocial ecological factors including stigma (adolescent SRH-related, HIV-related) were associated with STI testing and diagnosis among young urban refugees. Gender, age and stigma-tailored strategies can advance the STI prevention cascade among urban young refugees.

scholarly journals Acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

2020 ◽  
pp. bmjsrh-2020-200687
Author(s):  
Tom Nadarzynski ◽  
Ynez Symonds ◽  
Robert Carroll ◽  
Jo Gibbs ◽  
Sally Kidsley ◽  
...  
Keyword(s):  
Online Survey ◽  
Home Delivery ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Contraceptive Pills ◽  
Remote Management ◽  
Delivery Services ◽  
The Cost ◽  
To Receive

ObjectivesThe digitalisation of sexual and reproductive health (SRH) services offers valuable opportunities to deliver contraceptive pills and chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and ‘medication-by-post’ in SRH.Study designAn online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates.ResultsThere were 1281 participants (74% female and 49% <25 years old). Some 8% of participants reported having received medication via post and 83% were willing to receive chlamydia treatment and contraceptive pills by post. Lower acceptability was observed among participants who were: >45 years old (OR 0.43 (95% CI 0.23–0.81)), screened for STIs less than once annually (OR 0.63 (0.42–0.93)), concerned about confidentiality (OR 0.21 (0.90–0.50)), concerned about absence during delivery (OR 0.09 (0.02–0.32)) or unwilling to provide blood pressure readings (OR 0.22 (0.04–0.97)). Higher acceptability was observed among participants who reported: previously receiving medication by post (OR 4.63 (1.44–14.8)), preference for home delivery over clinic collection (OR 24.1 (11.1–51.9)), preference for home STI testing (OR 10.3 (6.16–17.4)), ability to communicate with health advisors (OR 4.01 (1.03–15.6)) and willingness to: register their real name (OR 3.09 (1.43–10.6)), complete online health questionnaires (OR 3.09 (1.43–10.6)) and use generic contraceptive pills (OR 2.88 (1.21–6.83)).ConclusionsPostal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated.

Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

2016 ◽  
Vol 28 (6) ◽  
pp. 573-583 ◽  
Author(s):  
Jamie Frankis ◽  
Lisa Goodall ◽  
Dan Clutterbuck ◽  
Abdul-Razak Abubakari ◽  
Paul Flowers
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Anal Intercourse ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Male Sex ◽  
Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

scholarly journals 1296. Potential use of Sexually Transmitted Infection (STI) Testing for Expanding HIV Pre-Exposure Prophylaxis (PrEP) at an Urban Hospital Center

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S396-S396
Author(s):  
Robert Pitts ◽  
Robert Holzman ◽  
Richard Greene ◽  
Emily Lam ◽  
Ellie Carmody ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Medical Center ◽  
Positive Test ◽  
Prescription Data ◽  
Urban Hospital ◽  
Enrichment Programs ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Sexually Transmitted ◽  
Sti Testing

Abstract Background Despite the high efficacy of PrEP, it continues to be underutilized. We examined the extent to which patients with a documented positive test for STIs were provided PrEP at an urban municipal medical center. Methods We reviewed data of all patients seen between January 1, 2014 and July 30, 2017 who were &gt; 18 years old and had an initial HIV negative test and ≥1 positive test for Chlamydia, Gonorrhea, or Syphilis. We examined PrEP prescription data by gender, race/ethnicity, and clinic location. Differences between groups were compared using Chi-squared analysis and logistic regression. Results Of 1,142 initially HIV− patients who were identified as having a positive STI result, 52% were female, 89% either Black or Hispanic, with a median age of 40 years (quartiles 30, 47). 58% had Medicare/Medicaid and 34% were self-pay or uninsured (Table 1). Only 25 (2.1%) of 1,142 patients who had ≥1 STI test positive were prescribed PrEP. No women received PrEP. Whites (aOR: 21.7 [95% CI:4.4, 107, P &lt; 0.001] and Hispanics (aOR:6.64 [95% CI:1.35, 32.8, P = 0.02] were both more likely to receive PrEP than Blacks, after adjusting for age, sex, marital status, and insurance. All PrEP prescriptions originated from the Medicine, Emergency, or HIV specialty clinics although most STI testing was obtained in Emergency and Obstetrical/Gynecological clinics (Table 2). Conclusion There were significant missed opportunities for HIV prevention among patients with STIs within the medical center, particularly among Hispanic and Black patients. Enrichment programs to educate providers and increase PrEP prescriptions may have a major impact on expanding HIV prevention, especially for women. Disclosures All authors: No reported disclosures.

College students’ preferences for information on self-initiated sexually transmitted infection testing

2020 ◽  
pp. 001789692095969
Author(s):  
Oluwamuyiwa Winifred Adebayo ◽  
Jocelyn C Anderson ◽  
Britney M Wardecker
Keyword(s):  
College Students ◽  
Sexually Transmitted Infection ◽  
Qualitative Content Analysis ◽  
Low Cost ◽  
Transmitted Disease ◽  
Structured Interview ◽  
Sexual History ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing

Objective: The purpose of this study was to identify preferences for content, method of delivery and frequency of information to encourage self-initiated sexually transmitted infection (STI) testing. Design: Qualitative study involving individual in-depth interviews with 35 college students aged 18–24 years. Setting: A university in Central Pennsylvania, USA. Method: Data were collected using a demographic and sexual history questionnaire, Sexually Transmitted Disease Knowledge Questionnaire and a semi-structured interview guide. Transcribed interviews were analysed using qualitative content analysis. Results: Findings from the study document STI testing information preferences as they relate to self-initiated testing. The majority of participants preferred receiving STI testing information through email. Themes within their accounts included Actionable Information Content, Frequently Accessed Delivery Method, and Routine STI Testing Information. Conclusion: The high incidence of STIs among US college students is an indication of the need to increase diagnosis and treatment to reduce transmission. Study findings have implications for the development and evaluation of low-cost interventions to improve the uptake of STI testing and reduce STI burden among college students.

Safeguarding outcomes of 16 and 17-year-old service users of Sexual Health London (SHL.uk), a pan-London online sexual health service

2020 ◽  
Vol 31 (14) ◽  
pp. 1373-1379
Author(s):  
Sara Day ◽  
Ryan Kinsella ◽  
Sophie Jones ◽  
Victoria Tittle ◽  
Tara Suchak ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Sexual Health ◽  
Social Services ◽  
Child Protection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Sti Testing ◽  
Sexual Health Service ◽  
Sexual Health Clinics

Guidance around how to safeguard young people using online sexual health services (e-SHSs) is limited. Sexual Health London (SHL.uk) is an e-SHS, integrated with London’s sexual health clinics (SHCs), offering users aged 16 years and above sexually transmitted infection (STI) testing. For a safeguarding risk assessment, under 18s must complete a safeguarding e-triage, and any concern raised results in a ‘call back’ (CB) by the SHL.uk team. The safeguarding outcomes of CBs between 8 January 2018 and 18 September 2018 were reviewed; 261/454 (57.5%) users never triggered a CB on their e-triage (non-CB group) and 193/454 (42.5%) users triggered one or more CB(s) (CB group). Safeguarding concerns disclosed predominantly related to drug/alcohol use and partner's age imbalance. Successful telephonic risk assessment took place in 84.5% CB cases. Safeguarding outcomes comprised referrals to: SHC in 35.5%; child protection team in 8.5%; social services in 7%. STI positivity was 16.4% and 15.2% in the CB and non-CB groups, respectively. Although a high number of safeguarding triggers were disclosed, only a small proportion warranted referral for further support/intervention. Using e-triage with telephony support to screen and safeguard adolescents accessing an e-SHS was acceptable to users and enabled their clinical and safeguarding needs to be safely met. e-SHS integration within a network of SHCs further supported this model.

scholarly journals 1529. Sexually-Transmitted Infection Testing and Positivity among Adults Receiving HIV Pre-Exposure Prophylaxis within an Integrated Health Care Delivery System in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S765-S765
Author(s):  
Mark A Schmidt ◽  
John F Dickerson ◽  
Suzanne B Schmidt ◽  
Maureen O’Keeffe-Rosetti ◽  
Judy L Donald ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Transmitted Infection ◽  
Record System ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Exposure Prophylaxis ◽  
The Impact

Abstract Background The goal of this project was to assess the frequency of sexually-transmitted infection (STI) testing and positivity among adult individuals initiating HIV Pre-Exposure Prophylaxis (PrEP) within Kaiser Permanente Northwest (KPNW). Methods We identified KPNW members, 18 years of age and older, who initiated PrEP (tenofovir+emtricitabine) between January 1, 2015 – December 31, 2018. Using data elements abstracted from the electronic health record system, we assessed demographic characteristics of those initiating PrEP and the rate of testing and positivity for HIV, chlamydia (CT) and gonorrhea (GC) and syphilis within a window around 120 days after PrEP initiation. Results Overall, 685 members initiated PrEP during our study period, 661 (96.5%) of whom were male. Mean and median ages were 38 and 36 years, respectively, with those 25-34 years of age comprising the highest proportion (241; 35.2%). The 460 PrEP initiators (67.2% of total) who continued use beyond 120 days were significantly older than those who discontinued use (39 vs. 36 years, p=0.0008). Among continuous users, 78.3% were tested for CT+GC and 83.9% were tested for syphilis roughly 120 days post-initiation, with positivity proportions of 6.9%, 6.7%, and 2.3%, respectively. Among those discontinuing, 39.6% were tested for CT+GC and 37.3% were tested for syphilis, with positivity proportions of 10.1%, 9.0%, and 2.4%, respectively. HIV testing was completed for 87.4% of continuous PrEP users and 40.9% of those who discontinued use; and we identified a total of three individuals who tested positive for HIV, all among the latter group. Manual chart review of these individuals confirmed that HIV exposure and infection occurred after PrEP discontinuation. Conclusion We found high rates of STI testing among individuals receiving PrEP, in accordance with recommendations. Our findings of a lower STI prevalence among PrEP users is encouraging, although further work is required to assess the impact of differential testing rates and age between those who continue and discontinue PrEP use as well as reasons for PrEP discontinuation. Regular testing remains an important part of comprehensive PrEP care management and should continue to be encouraged to identify and treat STI among those at high risk for disease. Disclosures All Authors: No reported disclosures

scholarly journals Sexually transmitted infection diagnoses, sexualised drug use and associations with pre-exposure prophylaxis use among men who have sex with men in the UK

2020 ◽  
Vol 31 (3) ◽  
pp. 254-263
Author(s):  
Matthew P Hibbert ◽  
Caroline E Brett ◽  
Lorna A Porcellato ◽  
Vivian D Hope
Keyword(s):  
Drug Use ◽  
Sexually Transmitted Infection ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Sex With Men ◽  
Exposure Prophylaxis

Previous research has focused on acceptability of pre-exposure prophylaxis (PrEP) use, but few community-based studies have been conducted regarding actual use, and PrEP use in the context of sexualised drug use remains understudied. A national online cross-sectional study recruited men who have sex with men (MSM) via social media (April–June 2018). Multivariable logistic regression was used to investigate factors associated with PrEP use. Bivariate analyses compared engaging in condomless anal intercourse (CAI) under the influence of specific drugs and recent sexually transmitted infection (STI) diagnoses (past 12 months) between MSM taking PrEP and those not. Overall, 6% (99/1581) MSM reported current PrEP use. Factors associated with PrEP use were increasing age, recent genitourinary medicine (GUM) attendance (95% versus 45%, aOR = 6.25, 95%CI 2.05, 19.03), an HIV test in the past three months (89% versus 23%, aOR = 14.22, 95%CI 6.76, 29.90), and recent engagement in chemsex (21% versus 4%, aOR = 3.56, 95%CI 1.78, 7.11). MSM taking PrEP were more likely to have had an STI diagnosis (42% versus 8%), most commonly chlamydia (26% versus 3%) and gonorrhoea (25% versus 4%). Considering the elevated levels of self-reported STI diagnoses among those on PrEP, there was a high level of engagement with sexual health services, which may help reduce onward STI transmission.

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