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Istiko SN, Remata S, Ndayizeye A, Moreno MEV, Kirunda V, Hollingdrake O, Osborne R, Hou JZ, Abell B, Mullens AB, Gu Z, Debattista J, Vujcich D, Lobo R, Parma G, Howard C, Durham J. Developing critical HIV health literacy: insights from interviews with priority migrant communities in Queensland, Australia. CULTURE, HEALTH & SEXUALITY 2024; 26:936-951. [PMID: 37950430 DOI: 10.1080/13691058.2023.2265960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs).
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Affiliation(s)
- Satrio Nindyo Istiko
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Simeon Remata
- Queensland Positive People, Brisbane, Queensland, Australia
- ACON, Sydney, New South Wales, Australia
| | - Aimable Ndayizeye
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Miguel Eduardo Valencia Moreno
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Vanessa Kirunda
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Olivia Hollingdrake
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Richard Osborne
- Department of Health and Medical Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jenny Zhengye Hou
- Faculty of Creative Industries, Education, and Social Justice, School of Communication/Digital Media Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bridget Abell
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amy B Mullens
- Centre for Health Research, School of Psychology and Wellbeing, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Daniel Vujcich
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Roanna Lobo
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Gianna Parma
- True Relationships & Reproductive Health, Brisbane, Queensland, Australia
| | - Chris Howard
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Jo Durham
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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Li J, Liu Y, Nehl E, Tucker JD. A behavioral economics approach to enhancing HIV preexposure and postexposure prophylaxis implementation. Curr Opin HIV AIDS 2024; 19:212-220. [PMID: 38686773 DOI: 10.1097/coh.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
PURPOSE OF REVIEW The 'PrEP cliff' phenomenon poses a critical challenge in global HIV PrEP implementation, marked by significant dropouts across the entire PrEP care continuum. This article reviews new strategies to address 'PrEP cliff'. RECENT FINDINGS Canadian clinicians have developed a service delivery model that offers presumptive PEP to patients in need and transits eligible PEP users to PrEP. Early findings are promising. This service model not only establishes a safety net for those who were not protected by PrEP, but it also leverages the immediate salience and perceived benefits of PEP as a natural nudge towards PrEP use. Aligning with Behavioral Economics, specifically the Salience Theory, this strategy holds potential in tackling PrEP implementation challenges. SUMMARY A natural pathway between PEP and PrEP has been widely observed. The Canadian service model exemplifies an innovative strategy that leverages this organic pathway and enhances the utility of both PEP and PrEP services. We offer theoretical insights into the reasons behind these PEP-PrEP transitions and evolve the Canadian model into a cohesive framework for implementation.
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Affiliation(s)
- Jingjing Li
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health
| | - Yaxin Liu
- Department of Psychology, Emory University, Atlanta, Georgia
| | - Eric Nehl
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health
| | - Joseph D Tucker
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA
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Schindele AC, Källberg H, Areskoug Josefsson K, Lindroth M. Perceived knowledge gained from school-based sexuality education - results from a national population-based survey among young people in Sweden. Sex Health 2023; 20:566-576. [PMID: 37925747 DOI: 10.1071/sh23093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND School-based sexuality education is a core component of securing young people's right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one's sexual health is associated with knowledge gained from school-based sexuality education and social determinants. METHODS The data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used. RESULTS Our results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one's sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities. CONCLUSIONS Young people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy.
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Affiliation(s)
- Anna ChuChu Schindele
- Faculty of Health and Society, Institution for Social Work, Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden; and Unit for Sexual Health and HIV Prevention, Department of Communicable Disease Control and Health Protection, The Public Health Agency of Sweden, Stockholm, Sweden
| | - Henrik Källberg
- Unit for Analysis, Department of Public Health Analysis and Data Management, The Public Health Agency of Sweden, Stockholm, Sweden
| | - Kristina Areskoug Josefsson
- Department of Health Sciences, University West, Trollhättan, Sweden; and Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway
| | - Malin Lindroth
- Faculty of Health and Society, Institution for Social Work, Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden; and Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway
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Shahrahmani H, Kariman N, Keshavarz Z, Ahmadi A, Nasiri M. Sexual health literacy and its related factors among couples: A population-based study in Iran. PLoS One 2023; 18:e0293279. [PMID: 37910538 PMCID: PMC10619804 DOI: 10.1371/journal.pone.0293279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023] Open
Abstract
Sexual health literacy is one of the factors that affect sexual health. Several factors can influence sexual health literacy. As a result, the current study was carried out to determine sexual health literacy and its associated factors among Iranian couples. In 2022, 410 couples of reproductive age were referred to comprehensive health service centers and private clinics in Kerman city for the descriptive-analytical study. The study questionnaires included sexual health literacy for adults, sexual knowledge and attitude scale, marital intimacy scale, sexual intimacy scale, depression anxiety stress scale, sexual self-efficacy, the multidimensional scale of perceived social support, and socioeconomic status. Finally, multiple linear stepwise regression models were used to determine the factors related to sexual health literacy using the SPSS software version 22. According to the findings of this study, the mean(SD) of sexual health literacy in couples was 68.76(12.96), which was a desirable level. Furthermore, the findings revealed that sexual self-efficacy (B = 0.649، P<0.001), sexual knowledge and attitude (B = 0.217، P<0.001), the ability to identify reliable and non-reliable sources (B = -3.116، P<0.001), feelings of shame and embarrassment for obtaining sexual information (B = 1.860، P = 0.011), social support (B = 0.127، P<0.001) and the obscenity of sexual issues in family (B = 1.764، P = 0.015) were the final predictors of sexual health literacy in couples. It is suggested that researchers and health managers consider these factors when designing interventions to promote sexual health literacy.
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Affiliation(s)
- Hadis Shahrahmani
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nourossadat Kariman
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Keshavarz
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefeh Ahmadi
- Department of Counselling in Midwifery, Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Malihe Nasiri
- Department of Biostatistics, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Thongnopakun S, Manwong M, Visanuyothin S, Wattanaburanon A, Suwannarat W, Magteppong W. Development and Validation of a Sexual Health Literacy Measurement Tool for Pregnancy Prevention Among Adolescents (SHL-PPA). J Multidiscip Healthc 2023; 16:2417-2430. [PMID: 37641706 PMCID: PMC10460610 DOI: 10.2147/jmdh.s420640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
Purpose Several measurement tools have been developed for health literacy. However, little emphasis has been placed on the development of sexual health literacy (SHL) in adolescents. This paper describes the development and validation of an SHL measurement tool for pregnancy prevention among adolescents (SHL-PPA). Methodology This study explores research and development (R&D) and presents three stages of R&D, including a literature review, the Delphi approach, and a valid and reliable questionnaire. Three groups were used for the population and sampling: 18 experts, five competent people, and 654 adolescents. An online self-assessment tool was used. The data analysis methods used were median, interquartile range, content validity index, Cronbach's alpha coefficient, and exploratory factor analysis. Results The results show that the definition of SHL for adolescents was "cognitive, social, and cultural skills that determine the motivation and ability of an adolescent to access and sufficiently understand sexual health information and services, which results in them being capable of sexual health assessment and making decisions to prevent pregnancy". The final devised SHL-PPA included 33 items and the three following components: 1) accessibility to sexual health information and services, 2) an understanding of sexual health information and services and appraisal of sexual health to prevent pregnancy, and 3) applying the obtained sexual health information and skills to prevent pregnancy. Conclusion This study proves that the SHL-PPA is appropriate for Generation Z teenagers, particularly for online self-assessment of SHL. An online self-evaluation using the SHL-PPA demonstrated that related organizations should develop online activities or programs to improve teenage girls' pregnancy-prevention behavior.
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Affiliation(s)
| | - Mereerat Manwong
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani, Thailand
| | | | | | | | - Worarat Magteppong
- Faculty of Nursing, Rajamangala University of Technology, Pathumthani, Thailand
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Maasoumi R, Jamali B, Zarei F, Tavousi M. Prerequisites of sexual health literacy promoting service: a qualitative study in Iran. BMC Health Serv Res 2023; 23:3. [PMID: 36597059 PMCID: PMC9809051 DOI: 10.1186/s12913-022-09018-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Sexual health literacy is one of the determinants of the rate, factors, and outcomes of problems associated with sexual health and reproductive. The prerequisite of having and promoting this type of literacy is the appropriate organization and access to sexual health services. The current study was conducted with the objective of describing the perceptions and experiences of health care providers and recipients of sexual health literacy promoting services. METHODS The current qualitative study was conducted on 37 individuals in the form of 3 individual in-depth and semi-structured interviews and 4 focus group discussions (26 individuals) with service recipients (women of reproductive age), and 8 in-depth and semi-structured interviews with service providers in Amol from September 2019 to March 2020. The recorded interviews were transcribed and analyzed through content analysis. RESULTS Data analysis resulted in the extraction of the theme titled "prerequisites of sexual health literacy promoting service" which consisted of two subthemes 'client-oriented service' and 'efficient service'. In the client-oriented service attention must be paid to the client's age, sex, needs and socio-cultural background. Efficient service is a service which is based on continuing sexual education, can reconstruct sexual attitudes, is professional, team-based, integrated into other services, and has a follow-up structure. CONCLUSIONS The results outline the requirements for sexual health literacy promoting services which should be taken into consideration during the policymaking, planning and design of relevant health programs.
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Affiliation(s)
- Raziyeh Maasoumi
- grid.411705.60000 0001 0166 0922Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Nursing and Midwifery Research Care Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Jamali
- grid.467532.10000 0004 4912 2930Department of Nursing and Midwifery, Comprehensive Health Research Center, Babol Branch, Islamic Azad University, Babol, Iran
| | - Fatemeh Zarei
- grid.412266.50000 0001 1781 3962Department of Health Education and Health Promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahmood Tavousi
- grid.417689.5Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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Readability of online monkeypox patient education materials: Improved recognition of health literacy is needed for dissemination of infectious disease information. Infect Dis Health 2022; 28:88-94. [PMID: 36564245 PMCID: PMC9770025 DOI: 10.1016/j.idh.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Health literacy is key to navigating the current global epidemic of misinformation and inaccuracy relating to healthcare. The American Medical Association (AMA) suggests health information should be written at the level of American sixth grade. With the monkeypox outbreak being declared a Public Health Emergency of International Concern (PHEIC) in July 2022, we sought to assess the readability of online patient education materials (PEMs) relating to monkeypox to see if they are at the target level of readability. METHODS A search was conducted on Google.com using the search term 'Monkeypox'. The top 50 English language webpages with patient education materials (PEMs) relating to monkeypox were compiled and categorised by country of publication and URL domain. Readability was assessed using five readability tools: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and, Simple Measure of Gobbledygook Index (SMOG). Unpaired t-test for URL domain, and one-way ANOVA for country were performed to determine influence on readability. RESULTS Three of the five tools (FRES, GFI, CLI) identified no webpages that met the target readability score. The FKGL and SMOG tools identified one (2%) and two (4%) webpages respectively that met the target level. County and URL domain demonstrated no influence on readability. CONCLUSION Online PEMs relating to monkeypox are written above the recommended reading level. Based on the previously established effect of health literacy, this is likely exacerbating health inequalities. This study highlights the need for readability to be considered when publishing online PEMs.
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Panahi R, Dehghankar L, Amjadian M. Investigating the structural validity and reliability of the sexual health literacy for adults (SHELA) questionnaire among a sample of women in Qazvin, Iran. BMC Womens Health 2022; 22:524. [PMID: 36527109 PMCID: PMC9756511 DOI: 10.1186/s12905-022-02112-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The correct measurement of sexual health literacy requires an instrument with desirable psychometric properties and fitness to the sociocultural context. Despite acceptable psychometric properties of the sexual health literacy for adults questionnaire in the mixed population of men and women, the validity and reliability of this questionnaire in the female population were not determined. Therefore, considering differences in the study population, this study aimed to determine the structural validity and reliability of the questionnaire among women. METHODS The present study was a methodological and psychometric study of instruments conducted among 310 women referring to healthcare centers in Qazvin, Iran in 2020. Sampling was done using a one-step cluster method. We used Cronbach's alpha coefficient, Pearson correlation coefficient, and confirmatory and exploratory factor analyses to determine the reliability, convergence validity, and construct validity of the questionnaire respectively. Also, the Sexual Quality of Life-Female questionnaire (SQOL-F) and the Female Sexual Function Index (FSFI) were used to evaluate the convergence validity. Data were analyzed using SPSS 20, and STATA 13. RESULTS Exploratory factor analysis identified three factors including, "reading and understanding", "evaluation and application of information", and "skills of access" which together accounted for 70.85% of the whole variance. Based on the results of confirmatory factor analysis, this questionnaire had overall goodness of fit too. (RMSEA = 0.071, CFI = 0.928, TLI = 0.919, SRMR = 0.041, X2/df = 2.501). Convergent validity of the questionnaire showed a correlation of 0.121-0.243 between the questionnaire's dimensions with the FSFI and the SQOL-F questionnaires respectively. Also, the results showed that the questionnaire had proper internal consistency (Cronbach's alpha was 0.981) for measuring sexual health literacy in women. CONCLUSIONS The 39-item sexual health literacy assessment questionnaire consisting of 3 factors in the present study was endowed with sufficient validity and reliability, and it can be used for precisely assessing women's sexual health literacy.
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Affiliation(s)
- Rahman Panahi
- grid.411600.2Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Dehghankar
- grid.412606.70000 0004 0405 433XDepartment of Nursing, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohiadin Amjadian
- grid.484406.a0000 0004 0417 6812Department of English Language, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Power J, Lea T, Melendez-Torres GJ, Lyons A, Norman T, Hill AO, Bourne A. Health literacy, financial insecurity and health outcomes among people living with HIV in Australia. Health Promot Int 2022; 37:6823574. [DOI: 10.1093/heapro/daac161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Summary
It is well documented that lower socio-economic status is associated with poorer health outcomes, while health literacy is considered important for improving health. What is less clear, is the extent to which greater health literacy can improve health outcomes among people for whom poverty or financial insecurity are important barriers to health. The paper presents findings from an Australian survey of people living with HIV (PLHIV) (N = 835) in which we explored the relationship between financial insecurity and health outcomes, looking at the extent to which health literacy mediates this relationship. The study drew on a comprehensive definition of health literacy, measuring participant’s confidence to communicate with healthcare providers, navigate the health system and take an active stance in relation to their health. Findings showed that financial insecurity was associated with lower health literacy and poorer self-reported physical and mental health. Health literacy mediated 16.2% of the effect of financial insecurity on physical health scores and 16.6% of the effect of financial insecurity on mental health scores. This suggests that programmes which seek to build health literacy among PLHIV may improve health outcomes among PLHIV who are struggling financially. Health literacy programmes are likely to be effective if they build confidence and resourcefulness among people to engage with health information, decision-making and care.
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Affiliation(s)
- Jennifer Power
- Australian Research Centre in Sex, Health and Society, La Trobe University , Building NR6, Bundoora, Melbourne , Australia
| | - Toby Lea
- Australian Research Centre in Sex, Health and Society, La Trobe University , Building NR6, Bundoora, Melbourne , Australia
- Centre for Social Research in Health, UNSW Sydney , John Goodsell Building, Sydney, NSW , Australia
| | | | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University , Building NR6, Bundoora, Melbourne , Australia
| | - Thomas Norman
- Australian Research Centre in Sex, Health and Society, La Trobe University , Building NR6, Bundoora, Melbourne , Australia
| | - Adam O Hill
- Australian Research Centre in Sex, Health and Society, La Trobe University , Building NR6, Bundoora, Melbourne , Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University , Building NR6, Bundoora, Melbourne , Australia
- Kirby Institute, UNSW , Wallace Wurth Building, Kensington, NSW , Australia
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Manwong M, Thongnopakun S, Rodjarkpai Y, Wattanaburanon A, Visanuyothin S. Sexual health literacy and preventive behaviors among middle-school students in a rural area during the COVID-19 situation: A mixed methods study. Health Promot Perspect 2022; 12:178-185. [PMID: 36276420 PMCID: PMC9508389 DOI: 10.34172/hpp.2022.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background: This study explored the association between sexual health literacy (SHL) and preventive behaviors of pregnancies and sexually transmitted diseases (STDs) among middle-school students during the COVID-19 outbreak to aid in the development of an informative program. Methods: Mixed-method study with stratified two-stage cluster sampling was used to obtain 730 students from 20 middle schools in a rural province of Thailand. Online self-administered questionnaire was used to collect data from February 2020 to February 2021. Two brainstorming sessions were conducted with a purposeful sample of 25 stakeholders. Multiple linear regressions were used to assess the relationships. Results: The associated significant factors with the preventive behaviors were sex (b=2.06, 95% CI: 1.07, 3.05), nightlife (b=-2.33, 95% CI: -3.99, -0.67), drinking alcoholic beverages (b=2.24, 95% CI: -3.24, -1.23), sexual intercourse experience (b=-2.64, 95% CI: -4.56, -0.72), and SHL (b=0.12, 95% CI: 0.08, 0.16). The stakeholders recommended an edutainment online program via Facebook. Conclusion: This study investigated factors associated with SHL and preventive behaviors among middle school students. The most effective variable in this model was SHL. Therefore, a trial of an online program emphasizing SHL improvement should be examined for effectiveness among these students and seems appropriate, considering their rural area context and middle-school status.
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Affiliation(s)
- Mereerat Manwong
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani, Thailand
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Brennan DJ, Kesler MA, Davies AWJ, Ablona A, Collict D. Online Sexual Health Information Seeking Patterns Differentiated by Social Location and Physical Location among Gay and Bisexual Men in Ontario, Canada. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:627-643. [PMID: 38596392 PMCID: PMC10903633 DOI: 10.1080/19317611.2022.2091076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 04/11/2024]
Abstract
Objective This research aimed to understand the varying needs of diverse gay and bisexual men (GBM) in relation to online sexual health information-seeking dependent upon differing social sociodemographic variables and geographic location. Methods A total of 1802 GBM in Ontario participated in this study. Multivariable regressions were conducted to analyze differences in information-seeking based on ethnicity group, HIV status, recent sexual behavior and regionality (urban and rural location). Results There were significant differences in online sexual health information-seeking content based on these demographic variables. Conclusions Implications for sexual health outreach and service provision for diverse GBM are discussed as well.
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Affiliation(s)
- David J. Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Maya A. Kesler
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Adam W. J. Davies
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Aidan Ablona
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - David Collict
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
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Chan C, Bavinton BR, Prestage GE, Broady TR, Mao L, Rule J, Wilcock B, Holt M. Changing Levels of Social Engagement with Gay Men Is Associated with HIV Related Outcomes and Behaviors: Trends in Australian Behavioral Surveillance 1998-2020. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2509-2521. [PMID: 35672592 PMCID: PMC9293873 DOI: 10.1007/s10508-022-02310-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 05/30/2023]
Abstract
Changes to how gay, bisexual, and other men who have sex with men (GBM) connect with each other and with their communities have implications for HIV prevention. Social engagement with gay men (defined as having friends who are gay men and spending time with them) has been associated with HIV related outcomes over time among Australian GBM. Using data collected in national, repeated, cross-sectional surveys of GBM between 1998 and 2020 (N = 161,117), analyses of trends in the prevalence of gay social engagement (GSE) in Australia were conducted using linear regression. To assess changing associations with GSE at different time points in the HIV epidemic, three cross-sectional analyses were conducted on factors associated with high and low GSE in 1999/2000, 2009/2010, and 2019/2020 using bivariate and multivariable logistic regression. GSE (scored from 0 to 7) declined among all participants from 4.76 in 1998 to 4.04 in 2020 (p < 0.001) with a steeper decline among GBM aged under 25 years from 4.63 in 1998 to 3.40 in 2020 (p < 0.001). In all timepoints, high GSE was associated with older age, being university educated, full time employment, identifying as gay, recent HIV testing, and PrEP uptake. While mostly associated with protective behaviors, high GSE was also associated with some practices that may put GBM at risk of HIV infection such as drug-enhanced sex and group sex in the most recent timepoint. Changing levels of GSE have implications for health promotion among GBM, particularly how to engage GBM less connected to gay social networks.
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Affiliation(s)
- Curtis Chan
- Kirby Institute, UNSW Sydney, Level 6 Wallace Wurth Building High Street, Kensington, Sydney, NSW, 2052, Australia.
| | - Benjamin R Bavinton
- Kirby Institute, UNSW Sydney, Level 6 Wallace Wurth Building High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Garrett E Prestage
- Kirby Institute, UNSW Sydney, Level 6 Wallace Wurth Building High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Timothy R Broady
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - John Rule
- National Association of People with HIV Australia, Sydney, Australia
| | - Ben Wilcock
- Australia Federation of AIDS Organisations, Sydney, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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Lee-Foon NK, Logie CH, Siddiqi A, Grace D. Exploring young Black gay, bisexual and other men who have sex with men's PrEP knowledge in Toronto, Ontario, Canada. CULTURE, HEALTH & SEXUALITY 2022; 24:301-314. [PMID: 33196378 DOI: 10.1080/13691058.2020.1837958] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
Despite significant advances in the HIV treatment and prevention landscape such as pre-exposure prophylaxis (PrEP), young Black-Canadian gay, bisexual and other sexual minority men continue to experience disproportionately high rates of HIV infection. While research has explored the factors associated with their higher HIV exposure and the efficacy of STI/HIV prevention programmes, there remains a paucity of research on their knowledge of HIV prevention strategies such as PrEP. We interviewed twenty-two young men and used a constructivist grounded theory approach to qualitatively analyse these young men's PrEP knowledge. Intersectionality and the social ecological model allowed us to explore how social locations (e.g. race, sexual orientation), interacted with individual, interpersonal and community contexts to shape their understanding. Our analysis revealed two interrelated barriers to PrEP knowledge and uptake. The first centred on the ineffectiveness of institutions in disseminating PrEP information to participants. The second focused on the impact of participants' social locations and perceptions of PrEP users based on their PrEP knowledge. Findings suggest the need for more targeted, culturally congruent PrEP dissemination strategies and PrEP prescription policies that acknowledge the various social locations and ecologies in which young Black gay, bisexual and other men who have sex with men reside.
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Affiliation(s)
- Nakia K Lee-Foon
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, Factor Inwentash School of Social Work University of Toronto, Toronto, Ontario, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
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Maasoumi R, Jamali B, Tavousi M, Haeri Mehrizi A, Zarei F. The status of sexual health literacy in Iranian women: A cross-sectional study. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2022. [DOI: 10.4103/jnms.jnms_87_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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15
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Brennan DJ, Kesler M, Lachowsky NJ, Davies A, Georgievski G, Adam BD, Collict D, Hart TA, Salway T, Griffiths D. Sociodemographic and Psychological Predictors of Seeking Health Information Online among GB2M in Ontario: Findings from the #iCruise Project. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 34:337-350. [PMID: 38596527 PMCID: PMC10903557 DOI: 10.1080/19317611.2021.2000087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 09/22/2021] [Accepted: 10/23/2021] [Indexed: 04/11/2024]
Abstract
Objectives The current study examines the experiences of gay, bisexual, two-spirit and other men who have sex with men (GB2M) who use networking applications and their engagements with online sexual health outreach workers disseminating healthcare information through these digital spaces. Methods The iCruise study was a longitudinal mixed-methods study across Ontario, Canada which collected data on online sexual health information seeking behaviors. Results Results offer insight into differences in information seeking behaviors among diverse groups of queer men. Conclusions Implications for the dissemination of health information based on the results of information seeking patterns is discussed as well.
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Affiliation(s)
- David J. Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Maya Kesler
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nathan J. Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Adam Davies
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Canada
| | - Georgi Georgievski
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Barry D. Adam
- Department of Sociology, Anthropology and Criminology, University of Windsor, Windsor, Canada
| | - David Collict
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Trevor A. Hart
- Department of Psychology, Ryerson University, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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16
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Sexual Health Literacy and the Related Factors among Women in Qazvin, Iran. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2021. [DOI: 10.52547/jech.8.4.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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Crowe S, Barker E, Roberts M, Lloyd L, de Barros CM, Rebelo-Harris B, Meads C, Saunders CL. Are we asking the right questions? Working with the LGBTQ+ community to prioritise healthcare research themes. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:64. [PMID: 34556178 PMCID: PMC8460395 DOI: 10.1186/s40900-021-00298-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Conversations about research priorities with members of the public are rarely designed specifically to include people who identify as Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) and are not researchers. METHODS Generally, to address this gap, and specifically, to inform future research for CLS, we carried out a rapid review of published research priority sets covering LGBTQ+ topics, and an online workshop to prioritise identified themes. RESULTS Rapid review: results. The rapid review identified 18 LGBTQ+ research priority sets. Some focussed on specific populations such as women or men, younger or older people or people living within families. Five addressed transgender and gender non- conforming populations. All of the research priority sets originated from English-speaking, high and middle-income countries (UK, US, Canada, and Australia), and date from 2016 onwards. Prioritization approaches were wide-ranging from personal commentary to expert workshops and surveys. Participants involved in setting priorities mostly included research academics, health practitioners and advocacy organisations, two studies involved LGBTQ+ public in their process. Research priorities identified in this review were then grouped into themes which were prioritised during the workshop. Workshop: results. For the workshop, participants were recruited using local (Cambridge, UK) LGBTQ+ networks and a national advert to a public involvement in research matching website to take part in an online discussion workshop. Those that took part were offered payment for their time in preparing for the workshop and taking part. Participants personal priorities and experiences contributed to a consensus development process and a final ranked list of seven research themes and participants' experiences of healthcare, mental health advocacy, care homes, caring responsibilities, schools and family units added additional context. CONCLUSIONS From the workshop the three research themes prioritised were: healthcare services delivery, prevention, and particular challenges / intersectionality of multiple challenges for people identifying as LGBTQ+. Research themes interconnected in many ways and this was demonstrated by the comments from workshop participants. This paper offers insights into why these priorities were important from participants' perspectives and detail about how to run an inclusive and respectful public involvement research exercise. On a practical level these themes will directly inform future research direction for CLS.
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Affiliation(s)
| | | | | | - Lucy Lloyd
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, East Forvie Building, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
| | | | | | - Catherine Meads
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Catherine L Saunders
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, East Forvie Building, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
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Grace D, Nath R, Parry R, Connell J, Wong J, Grennan T. '… if U equals U what does the second U mean?': sexual minority men's accounts of HIV undetectability and untransmittable scepticism. CULTURE, HEALTH & SEXUALITY 2021; 23:1270-1286. [PMID: 32701019 DOI: 10.1080/13691058.2020.1776397] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
The everyday meaning and use of HIV 'undetectability' raises significant questions about the social and sexual significance of this state of viral suppression. We conducted in-depth, semi-structured interviews with 25 sexual minority men living in Vancouver, Canada, including men living with HIV. Interviews were audio-recorded, transcribed verbatim and analysed using grounded theory. Most participants understood being undetectable to signify that someone living with HIV is at a 'low,' 'lower,' or 'slim to no' risk of sexually transmitting HIV, as opposed to meaning 'uninfectious' or 'untransmittable'. Men discussed how undetectability was communicated in-person and online, including via sexual networking apps, and revealed how it is sometimes confused or conflated with another biomedical advance in HIV-prevention, namely pre-exposure prophylaxis (PrEP). HIV-negative men expressed significant scientific scepticism, a reluctance to incorporate a partner's low viral load or undetectable HIV status into their sexual decision-making, and an enduring fear associated with knowingly having sex with someone who is HIV-positive. We describe this as a form of untransmittable scepticism. While international campaigns have worked to communicate the scientific message that 'undetectable equals untransmittable' (U = U), the sexual stigma attached to HIV remains durable among some gay, bisexual, queer and other men who have sex with men.
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Affiliation(s)
- Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ronita Nath
- BC Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Robin Parry
- BC Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - James Connell
- BC Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jason Wong
- BC Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Troy Grennan
- BC Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Middleton A, Pothoulaki M, Woode Owusu M, Flowers P, Mapp F, Vojt G, Laidlaw R, Estcourt CS. How can we make self-sampling packs for sexually transmitted infections and bloodborne viruses more inclusive? A qualitative study with people with mild learning disabilities and low health literacy. Sex Transm Infect 2021; 97:276-281. [PMID: 33906976 PMCID: PMC8165145 DOI: 10.1136/sextrans-2020-054869] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/15/2021] [Accepted: 03/12/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives 1.5 million people in the UK have mild to moderate learning disabilities. STIs and bloodborne viruses (BBVs) are over-represented in people experiencing broader health inequalities, which include those with mild learning disabilities. Self-managed care, including self-sampling for STIs/BBVs, is increasingly commonplace, requiring agency and health literacy. To inform the development of a partner notification trial, we explored barriers and facilitators to correct use of an STI/BBV self-sampling pack among people with mild learning disabilities. Methods Using purposive and convenience sampling we conducted four interviews and five gender-specific focus groups with 25 people (13 women, 12 men) with mild learning disabilities (July–August 2018) in Scotland. We balanced deductive and inductive thematic analyses of audio transcripts to explore issues associated with barriers and facilitators to correct use of the pack. Results All participants found at least one element of the pack challenging or impossible, but welcomed the opportunity to undertake sexual health screening without attending a clinic and welcomed the inclusion of condoms. Reported barriers to correct use included perceived overly complex STI/BBV information and instructions, feeling overwhelmed and the manual dexterity required for blood sampling. Many women struggled interpreting anatomical diagrams depicting vulvovaginal self-swabbing. Facilitators included pre-existing STI/BBV knowledge, familiarity with self-management, good social support and knowing that the service afforded privacy. Conclusion In the first study to explore the usability of self-sampling packs for STI/BBV in people with learning disabilities, participants found it challenging to use the pack. Limiting information to the minimum required to inform decision-making, ‘easy read’ formats, simple language, large font sizes and simpler diagrams could improve acceptability. However, some people will remain unable to engage with self-sampling at all. To avoid widening health inequalities, face-to-face options should continue to be provided for those unable or unwilling to engage with self-managed care.
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Affiliation(s)
- Alan Middleton
- Nursing & Community Health, School of Health 7 ife Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Maria Pothoulaki
- Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK
| | | | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Fiona Mapp
- The Institute for Global Health, University College London, London, UK
| | - Gabriele Vojt
- Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK
| | - Rebecca Laidlaw
- Nursing & Community Health, School of Health 7 ife Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Claudia S Estcourt
- Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK
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"You Do It without Their Knowledge." Assessing Knowledge and Perception of Stealthing among College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103527. [PMID: 32443504 PMCID: PMC7277099 DOI: 10.3390/ijerph17103527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
Abstract
In recent years, the act of nonconsensual condom removal, termed stealthing, has become commonly discussed on social and print media; yet, little to no evidence exists on the current knowledge and perception of stealthing among young adults. As such, we assessed what college students know and feel regarding stealthing. We employed an exploratory mixed-method analysis where focus groups were followed by a quantitative survey. A qualitative assessment was conducted using grounded theory analyses and questions for a quantitative survey were developed based on emergent themes from focus groups. Quantitative data was analyzed using descriptive and bivariate analyses with alpha less than 0.05 to denote significance. Though limited knowledge exists, participants felt that stealthing was a violation of their privacy, trust, sexual consent, and their ability to make a health decision, and should be considered an assault. Participants noted stealthing may have become acceptable due to its popularity in social media and young adult culture, especially porn. We also found sex differences in the perception of stealthing being considered a sexual assault with lower rates among males as compared to females. Our results demonstrate that there is a need for health educators to assess the prevalence of such a behavior among college students and policy makers to assess the legal implications of nonconsensual condom removal.
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Young I, Valiotis G. Strategies to support HIV literacy in the roll-out of pre-exposure prophylaxis in Scotland: findings from qualitative research with clinical and community practitioners. BMJ Open 2020; 10:e033849. [PMID: 32350011 PMCID: PMC7213852 DOI: 10.1136/bmjopen-2019-033849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Limited understanding of pre-exposure prophylaxis (PrEP), coupled with negative public discourse, are significant barriers to its introduction. What works to support PrEP awareness and broader HIV literacy among diverse communities in the context of biomedical HIV prevention remains unclear. This article considers how PrEP can be translated across diverse communities and what the HIV literacy challenges might be in the current context of PrEP provision. SETTING We developed an HIV literacy informed community tool to support the roll-out of PrEP in Scotland. We undertook qualitative research with practitioners in urban and rural settings across nine Scottish health boards. PRIMARY OUTCOME MEASURE To examine HIV literacy challenges in the context of PrEP provision. PARTICIPANTS Interviews and focus groups with community (n=19) and clinical (n=13) practitioners working with gay and bisexual men and African communities were undertaken between March and October 2017 concerning PrEP support, stigma and HIV literacy. RESULTS HIV literacy in the context of PrEP needs to consider more than the provision of individually targeted information. Practitioners identified and responded to stratified communities and social norms of knowledge, which influenced messaging, support and informed how practitioners enabled PrEP engagement and dialogue. Social barriers in HIV literacy, including structural stigmas relating to HIV and homophobia, shaped practitioner concerns and support for community members' willingness to engage with PrEP. CONCLUSION Critical HIV literacy in the age of PrEP is a complex social practice. Attention needs to be paid to how information is provided and facilitates engagement, rather than simply what information is given.By exploring practitioner use of the Know about PrEP tool, we have shown how consideration of the patterns of access to services and information, the delivery of and support for engagement with PrEP information and the wider strategies employed to negotiate ongoing structural social barriers can support more equitable and diverse PrEP community conversations.
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Affiliation(s)
- Ingrid Young
- Centre for Biomedicine, Self and Society, Usher Institute, University of Edinburgh, Edinburgh, UK
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