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Montiel A, Ablona A, Klassen B, Card K, Lachowsky NJ, Brennan DJ, Grace D, Worthington C, Gilbert M. Reach of GetCheckedOnline among gay, bisexual, transgender and queer men and Two-Spirit people and correlates of use 5 years after program launch in British Columbia, Canada. Sex Transm Infect 2024; 100:208-215. [PMID: 38604697 PMCID: PMC11187377 DOI: 10.1136/sextrans-2023-056007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/09/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVES Understanding who uses internet-based sexually transmitted and blood-borne infection (STBBI) services can inform programme implementation, particularly among those most impacted by STBBIs, including gender and sexual minority (GSM) men. GetCheckedOnline, an internet-based STBBI testing service in British Columbia, Canada, launched in 2014. Our objectives were to assess reach, identify factors associated with use of GetCheckedOnline 5 years into implementation and describe reasons for using and not using GetCheckedOnline among GSM men. METHODS The Sex Now 2019 Survey was an online, cross-sectional survey of GSM men in Canada administered from November 2019 to February 2020. Participants were asked a subset of questions related to use of GetCheckedOnline. Multivariable binary logistic regression modelling was used to estimate associations between correlates and use of GetCheckedOnline. RESULTS Of 431 British Columbia (BC) participants aware of GetCheckedOnline, 27.6% had tested using the service. Lower odds of having used GetCheckedOnline were found among participants with non-white race/ethnicity (adjusted OR (aOR)=0.41 (95% CI 0.21 to 0.74)) and those living with HIV (aOR=0.23 (95% CI 0.05 to 0.76)). Those who usually tested at a walk-in clinic, relative to a sexual health clinic, had greater odds of using GetCheckedOnline (aOR=3.91 (95% CI 1.36 to 11.61)). The most commonly reported reason for using and not using GetCheckedOnline was convenience (78%) and only accessing the website to see how the service worked (48%), respectively. CONCLUSION Over a quarter of GSM men in BC aware of GetCheckedOnline had used it. Findings demonstrate the importance of social/structural factors related to use of GetCheckedOnline. Service promotion strategies could highlight its convenience and privacy benefits to enhance uptake.
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Affiliation(s)
- Andrés Montiel
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Aidan Ablona
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Ben Klassen
- Community Based Research Centre, Vancouver, British Columbia, Canada
| | - Kiffer Card
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Nathan J Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
- Community Based Research Centre, Vancouver, British Columbia, Canada
| | - David J Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Catherine Worthington
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Mark Gilbert
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- The University of British Columbia, Vancouver, British Columbia, Canada
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Lafferty L, Rautenbach C, McNulty A, Ryder N, Slattery C, Houghton R, Kenigsberg A, Murray C, Carrington N, Patel P. Client and staff perceptions of acceptability of MyCheck: a direct-to-pathology telehealth and e-testing service for comprehensive bloodborne virus and sexually transmissible infection screening. Sex Health 2024; 21:SH23194. [PMID: 38683938 DOI: 10.1071/sh23194] [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: 12/05/2023] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
Background Sydney Sexual Health Centre (SSHC) is the largest sexual health clinic in New South Wales (NSW), servicing clients at high risk of sexually transmissible infections and bloodborne viruses. SSHC piloted a direct-to-pathology pathway that facilitated bloodborne virus/sexually transmissible infection testing at one of the ~500 participating pathology collection centres located across NSW. This qualitative study sought to understand SSHC client and provider perspectives of acceptability of the MyCheck intervention. Methods Semi-structured in-depth interviews were conducted with 11 clients who underwent testing via the MyCheck pathway and eight staff members involved in implementing MyCheck. The seven components of Sekhon's Theoretical Framework of Acceptability informed this analysis. Results Participants broadly conveyed 'affective attitude' toward the MyCheck pathway. The telehealth intervention reduced client 'burden' and 'opportunity cost' through enabling greater testing convenience at a location suitable to them and provided timely results. Issues of 'ethicality' were raised by clients and staff as pathology centre staff were, on a few occasions, regarded as being judgmental of SSHC clients. 'Intervention coherence' issues were largely attributed to pathology centre personnel being unfamiliar with the intervention, with billing issues being a recurrent concern. Participants perceived MyCheck as an 'effective' testing pathway. SSHC staff were able to offer the intervention with ease through seamless IT integration ('self-efficacy'). Conclusion The MyCheck intervention was perceived by both SSHC clients and staff as an acceptable bloodborne virus/sexually transmissible infection testing pathway. However, further work is required to address stigma experienced by some clients when attending pathology collection centres.
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Affiliation(s)
- Lise Lafferty
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW 2052, Australia; and Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney, NSW 2052, Australia
| | - Clinton Rautenbach
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW 2052, Australia; and University of Johannesburg, PO Box 524, Auckland Park 2006, South Africa
| | - Anna McNulty
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia
| | - Nathan Ryder
- STI Programs Unit, NSW Ministry of Health, 150 Albion Street, Surry Hills, NSW 2010, Australia; and The Pacific Clinic, Level 2/670 Hunter Street, Newcastle West, NSW 2302, Australia
| | - Carolyn Slattery
- STI Programs Unit, NSW Ministry of Health, 150 Albion Street, Surry Hills, NSW 2010, Australia
| | - Rebecca Houghton
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia
| | - Aurelie Kenigsberg
- NSW Sexual Health Infolink, NSW Ministry of Health, Locked Mail Bag 2030, St Leonards, NSW 1590, Australia
| | - Carolyn Murray
- Centre for Population Health, NSW Ministry of Health, Locked Mail Bag 2030, St Leonards, NSW 1590, Australia
| | - Nigel Carrington
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia; and Centre for Population Health, NSW Ministry of Health, Locked Mail Bag 2030, St Leonards, NSW 1590, Australia
| | - Prital Patel
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW 2052, Australia
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Masonbrink AR, Abella M, Hall M, Gooding HC, Burger RK, Goyal MK. Sexually Transmitted Infection Diagnoses at Children's Hospitals During COVID-19. Hosp Pediatr 2024; 14:e1-e5. [PMID: 38130205 PMCID: PMC10750167 DOI: 10.1542/hpeds.2022-006750] [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] [Indexed: 12/23/2023]
Abstract
OBJECTIVES COVID-19 mitigation strategies resulted in changes in health care access and utilization, which could negatively impact adolescents at risk for sexually transmitted infections (STIs). We evaluated changes in STI diagnoses during adolescent visits at children's hospitals during COVID-19. METHODS We conducted a retrospective cohort study using the Pediatric Health Information System database comparing adolescent (11-18 years) hospital visits with an STI diagnosis by International Classification of Diseases, 10th revision, code during COVID-19 (2020) to pre-COVID-19 (2017-2019). Data were divided into spring (March 15-May 31), summer (June 1-August 31), and fall (September 1-December 31). Median weekly visits and patient characteristics were compared using median regression. RESULTS Of 2 747 135 adolescent encounters, there were 10 941 encounters with an STI diagnosis from 44 children's hospitals in 2020. There was a decrease in overall median weekly visits for STIs in spring during COVID-19 (n = -18.6%, P = .001) and an increase in overall visits in summer (11%, P = .002) during COVID-19. There were significant increases in inpatient median weekly visits for STIs in summer (30%, P = .001) and fall (27%, P = .003) during COVID-19. We found increases in Neisseria gonorrhoeae (50%, P < .001) and other STI diagnoses (defined as other or unspecified STI by International Classification of Diseases, 10th revision, code; 38%, P = .040) in fall COVID-19 (2020), and a decrease in pelvic inflammatory disease (-28%, P = .032) in spring COVID-19 (2020). CONCLUSIONS We found increases in median weekly adolescent inpatient visits with an STI diagnosis in summer and fall COVID-19 (2020). These findings were likely partially driven by changes in behaviors or health care access. Further work is needed to improve STI care and thus potentially improve related health outcomes.
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Affiliation(s)
- Abbey R. Masonbrink
- Department of Pediatrics, Children’s Mercy Hospital, University of Missouri-Kansas City, Kansas City, Missouri
| | - Margarita Abella
- Department of Pediatrics, Children’s Mercy Hospital, University of Missouri-Kansas City, Kansas City, Missouri
| | - Matt Hall
- Department of Pediatrics, Children’s Mercy Hospital, University of Missouri-Kansas City, Kansas City, Missouri
- Children’s Hospital Association, Lenexa, Kansas
| | | | - Rebecca K. Burger
- Division of Emergency Medicine, Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Monika K. Goyal
- Children’s National Hospital, George Washington University, Washington, District of Columbia
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Park BM, Chon MY, Lee HJ. Perceptions of Healthcare Safety Nets among Tertiary Hospital and Long-Term Care Hospital Nurses during the COVID-19 Pandemic: A Q-Methodological Approach. Healthcare (Basel) 2023; 11:2732. [PMID: 37893806 PMCID: PMC10606348 DOI: 10.3390/healthcare11202732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
This study was conducted to identify the types of perceptions toward healthcare safety nets. This study applied a Q-methodology. From a Q-population of 91 samples that included a review of the related literature and interviews with five tertiary hospital nurses and five long-term care (LTC) hospital nurses, 33 Q-samples were selected. The data were analyzed with the PC-QUANL program. We recruited 32 nurses in a tertiary hospital and 33 nurses in an LTC hospital. The perceptions of the healthcare safety net of tertiary hospital nurses were categorized into four types: (1) systematic system request; (2) realistic work support; (3) government support; and (4) emotional support. The perceived subjectivity of the healthcare safety net of LTC hospital nurses were categorized into four types: (1) reward system and facility environmental support; (2) realistic work support; (3) social prevention infrastructure support; and (4) government support. This study provides basic data for these different hospital settings, as well as to inform future government policy and system improvements in an era characterized by infectious diseases. Specifically, this study presents the types of perceptions of healthcare safety nets of nurses in two hospital settings that deliver care for patients.
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Affiliation(s)
- Bom-Mi Park
- Department of Nursing, Research Institute for Biomedical & Health Science, Konkuk University, Chungju-si 27478, Republic of Korea;
| | - Mi Young Chon
- Department of Nursing, Research Institute for Biomedical & Health Science, Konkuk University, Chungju-si 27478, Republic of Korea;
| | - Hyun-Jung Lee
- Department of Nursing, Seoul ST. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea;
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Pearson WS, Chan PA, Habel MA, Haderxhanaj LT, Hogben M, Aral SO. A Description of Telehealth Use Among Sexually Transmitted Infection Providers in the United States, 2021. Sex Transm Dis 2023; 50:518-522. [PMID: 37155609 PMCID: PMC10524588 DOI: 10.1097/olq.0000000000001826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Telehealth offers one approach to improving access to sexually transmitted infection (STI) prevention and care services. Therefore, we described recent telehealth use among those providing STI-related care and identified opportunities for improving STI service delivery. MATERIALS AND METHODS Using the DocStyles Web-based, panel survey conducted by Porter Novelli from September 14 to November 10, 2021, 1500 healthcare providers were asked about their current telehealth usage, demographics, and practice characteristics, and compared STI providers (≥10% of time spent on STI care and prevention) to non-STI providers. RESULTS Among those whose practice consisted of at least 10% STI visits (n = 597), 81.7% used telehealth compared with 75.7% for those whose practice consisted of less than 10% STI visits (n = 903). Among the providers with at least 10% STI visits in their practice, telehealth use was highest among obstetrics and gynecology specialists, those practicing in suburban areas, and those practicing in the South. Among providers whose practice consisted of at least 10% STI visits and who used telehealth (n = 488), the majority were female and obstetrics and gynecology specialists practicing in suburban areas of the South. After controlling for age, gender, provider specialty, and geographic location of their practice, providers whose practice consisted of at least 10% STI visits had increased odds (odds ratio, 1.51; 95% confidence interval, 1.16-1.97) of using telehealth compared with providers whose visits consisted of less than 10% STI visits. CONCLUSIONS Given the widespread use of telehealth, efforts to optimize delivery of STI care and prevention via telehealth are important to improve access to services and address STIs in the United States.
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Affiliation(s)
- William S. Pearson
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Philip A. Chan
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
- Department of Medicine, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Melissa A. Habel
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Laura T. Haderxhanaj
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Matthew Hogben
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sevgi O. Aral
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Valentim JLRS, Dias-Trindade S, Oliveira ESG, Moreira JAM, Fernandes F, Romão MH, Morais PSG, Caitano AR, Dias AP, Oliveira CAP, Coutinho KD, Ceccim RB, Valentim RAM. The relevancy of massive health education in the Brazilian prison system: The course "health care for people deprived of freedom" and its impacts. Front Public Health 2022; 10:935389. [PMID: 36033741 PMCID: PMC9399509 DOI: 10.3389/fpubh.2022.935389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Brazil has one of the largest prison populations globally, with over 682,000 imprisoned people. Prison health is a public health emergency as it presents increasingly aggravating disease rates, mainly sexually transmitted infections (STI). And this problem already affects both developed and developing nations. Therefore, when thinking about intervention strategies to improve this scenario in Brazil, the course "Health Care for People Deprived of Freedom" (ASPPL), aimed at prison health, was developed. This course was implemented in the Virtual Learning Environment of the Brazilian Health System (AVASUS). Given this context, this study analyzed the aspects associated with massive training through technological mediation and its impacts on prison health. Methods This cross-sectional study analyzed data from 8,118 ASPPL course participants. The data analyzed were collected from six sources, namely: (i) AVASUS, (ii) National Registry of Health Care Facilities (CNES), (iii) Brazilian Occupational Classification (CBO), (iv) National Prison Department (DEPEN); (v) Brazilian Institute of Geography and Statistics (IBGE); and the (iv) Brazilian Ministry of Health (MoH), through the Outpatient Information System of the Brazilian National Health System (SIA/SUS). A data processing pipeline was conducted using Python 3.8.9. Results The ASPPL course had 8,118 participants distributed across the five Brazilian regions. The analysis of course evaluation by participants who completed it shows that 5,190 (63.93%) reported a significant level of satisfaction (arithmetic mean = 4.9, median = 5, and standard deviation = 0.35). The analysis revealed that 3,272 participants (40.31%) are health workers operating in distinct levels of care. The prison system epidemiological data shows an increase in syphilis diagnosis in correctional facilities. Conclusions The course enabled the development of a massive training model for various health professionals at all care levels and regions of Brazil. This is particularly important in a country with a continental size and a large health workforce like Brazil. As a result, social and prison health impacts were observed.
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Affiliation(s)
- Janaína L. R. S. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil,Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
| | - Sara Dias-Trindade
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal,Centre for Interdisciplinary Studies, Faculty of Arts and Humanities, University of Coimbra, Coimbra, Portugal
| | - Eloiza S. G. Oliveira
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil,Institute of Human Formation with Technologies, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Paraná, Brazil
| | - José A. M. Moreira
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal,Department of Education and Distance Learning (DEED), Open University (Universidade Aberta), Lisbon, Portugal
| | - Felipe Fernandes
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil,*Correspondence: Felipe Fernandes
| | - Manoel H. Romão
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Philippi S. G. Morais
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Alexandre R. Caitano
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Aline P. Dias
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Carlos A. P. Oliveira
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil,Institute of Human Formation with Technologies, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Paraná, Brazil,International Council for Open and Distance Education, Oslo, Norway
| | - Karilany D. Coutinho
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Ricardo B. Ceccim
- Postgraduate Program in Education, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
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Nazir A, Masood W, Ahmad S, Nair AM, Aborode AT, Khan HD, Farid S, Raza MA, Audah KA. Rise of syphilis surge amidst COVID-19 pandemic in the USA: A neglected concern. Ann Med Surg (Lond) 2022; 80:104239. [PMID: 35937637 PMCID: PMC9339075 DOI: 10.1016/j.amsu.2022.104239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 10/24/2022] Open
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Hill BJ, Anderson B, Lock L. Chlamydial Infection Among Adolescents and Young Adults Receiving Sexual and Reproductive Health Care During the COVID-19 Pandemic. Sex Transm Dis 2022; 49:e50-e52. [PMID: 34535616 DOI: 10.1097/olq.0000000000001556] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The impact of the COVID-19 pandemic on adolescent and young adult chlamydial infection is unknown. Patient testing data were extracted from the electronic health records of 10 family planning clinics. Prepandemic and pandemic comparisons revealed an increase in observed chlamydial infection, with greater positivity among Black/African American female adolescent patients.
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Affiliation(s)
| | - Brie Anderson
- From the Planned Parenthood Great Plains, Overland Park, KS
| | - Li Lock
- From the Planned Parenthood Great Plains, Overland Park, KS
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Xiridou M, Heijne J, Adam P, Op de Coul E, Matser A, de Wit J, Wallinga J, van Benthem B. How the Disruption in Sexually Transmitted Infection Care Due to the COVID-19 Pandemic Could Lead to Increased Sexually Transmitted Infection Transmission Among Men Who Have Sex With Men in The Netherlands: A Mathematical Modeling Study. Sex Transm Dis 2022; 49:145-153. [PMID: 34475357 DOI: 10.1097/olq.0000000000001551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, the disruption in care for sexually transmitted infections (STIs) and the social distancing measures have led to reductions in STI testing and sexual behavior. We assessed the impact of these COVID-19-related changes on transmission of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among men who have sex with men (MSM) in The Netherlands. METHODS We developed a mathematical model for CT and NG transmission among MSM, accounting for COVID-19-related changes in sexual behavior and testing in 2020 to 2021. Changes in 2020 were estimated from data from the Dutch COVID-19, Sex, and Intimacy Survey among MSM and the National Database of STI Clinics. Because of the lack of data for 2021, we examined several scenarios covering a range of changes. RESULTS A reduction of 10% and 40% in STI testing of symptomatic and asymptomatic, respectively, individuals with a 10% to 20% reduction in numbers of casual partners (according to partner status and activity level) during the second lockdown, resulted in a 2.4% increase in CT prevalence, but a 2.8% decline in NG prevalence in 2021. A 5% and 30% reduction in STI testing of symptomatic and asymptomatic, respectively, individuals with the same reduction in casual partners resulted in a 0.6% increase in CT prevalence and a 4.9% decrease in NG prevalence in 2021. CONCLUSIONS The disruption in STI care due to COVID-19 might have resulted in a small increase in CT prevalence, but a decrease in NG prevalence. Scaling up STI care is imperative to prevent increases in STI transmission.
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Affiliation(s)
- Maria Xiridou
- From the Centre for Infectious Diseases Control, Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Janneke Heijne
- From the Centre for Infectious Diseases Control, Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Eline Op de Coul
- From the Centre for Infectious Diseases Control, Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | | | | | | | - Birgit van Benthem
- From the Centre for Infectious Diseases Control, Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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Leichliter JS, Cuffe KM, Kelley KR, Gift TL. Availability of Sexually Transmitted Disease and HIV Clinical Services: Ending the HIV Epidemic Versus Non-Ending the HIV Epidemic Jurisdictions, 2018. Sex Transm Dis 2022; 49:e13-e16. [PMID: 34030153 PMCID: PMC8667183 DOI: 10.1097/olq.0000000000001482] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACT We assessed sexually transmitted disease/human immunodeficiency virus (HIV) service availability at the primary sexually transmitted disease safety net clinic by phase I Ending the HIV Epidemic jurisdiction status. HIV testing was >90%. In Ending the HIV Epidemic jurisdictions, 22% of primary safety net clinics initiated and/or provided preexposure prophylaxis (PrEP), 46.6% provided PrEP education or referral only, and 29.9% did not provide any PrEP services.
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Affiliation(s)
- Jami S. Leichliter
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kendra M. Cuffe
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kathleen R. Kelley
- HIV, STI, & Viral Hepatitis Program, National Association of County and City Health Officials, Washington, DC
| | - Thomas L. Gift
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Gottschlich A, Smith LW, Caird H, Gilbert M, Grennan T, Ogilvie G. Attitudes and Preferences Regarding Non-Clinic-Based Self-Collection for Sexually Transmitted Infection Testing Among Clinic Attendees in British Columbia, Canada. Sex Transm Dis 2022; 49:15-21. [PMID: 34264904 DOI: 10.1097/olq.0000000000001513] [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: 11/25/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) are a global epidemic; although screening programs reduce transmission, barriers, including access and stigma, hinder success. The World Health Organization highlights the ability to maintain health without the direct support of a health care provider as one form of self-care, which can be applied to STI testing. Self-care through non-clinic-based self-collection for STI testing can address barriers while providing comprehensive care. Before implementation of innovative changes to screening approaches, it is important to understand if communities who rely on in-person care will self-collect outside of the clinic setting. This study investigated willingness to use non-clinic-based self-collection for STI testing among STI clinic attendees in British Columbia, Canada. METHODS Participants (n = 446) were recruited from STI clinics offering clinic-based self-collection for STI testing and completed a survey assessing self-care attitudes, including willingness to self-collect urine samples, throat swabs, and anogenital swabs outside of the clinic setting. Descriptive statistics, bivariable analyses, and multivariable models were conducted to investigate willingness to use non-clinic-based STI self-collection methods and associated correlates. RESULTS This population reported high willingness to use non-clinic-based self-collection methods for STI testing (urine samples, 73%; throat swabs, 67%; anogenital swabs, 65%). Those aged 35 to 54 years compared with 15 to 34 years were more likely to be willing (adjusted odds ratio, 1.87; 95% confidence interval, 1.03-3.50); those identifying as straight/mostly straight compared with gay/lesbian were less likely to be willing (adjusted odds ratio, 0.39; 95% confidence interval, 0.23-0.65). CONCLUSIONS Non-clinic-based self-collection for STI testing can address barriers to testing while maintaining quality care. Those currently receiving in-person care find these methods highly acceptable. These findings reinforce that self-collection for STI testing used in British Columbia clinics is acceptable to clients and may be extended to collection performed outside of the clinical setting.
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Bonato F, Ferreli C, Satta R, Rongioletti F, Atzori L. Syphilis and the COVID-19 pandemic: Did the lockdown stop risky sexual behavior? Clin Dermatol 2021; 39:710-713. [PMID: 34809778 PMCID: PMC7685935 DOI: 10.1016/j.clindermatol.2020.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Restrictive measures to contain the coronavirus disease 2019 (COVID-19) pandemic might produce different effects on other infective diseases, especially those affecting the most intimate sphere of sexuality. The epidemiology of syphilis could reflect the consequences of whether people are avoiding or not risky behaviors. To understand the course of syphilis during the COVID-19 outbreak, we performed a retrospective observational study of all new diagnoses observed at the STDs Service of the Dermatology Clinic at Cagliari, part of the Italian sentinel surveillance system. All incident cases diagnosed during the first 6 months of each year, from 2016 to 2020, thus including the recent lockdown period, were retrieved from the database. Of the 87 cases studied, 18 occurred during the first 6 months of 2020, almost all patients (88%) presenting with early phases of the disease and reporting unprotected sexual intercourses in spite of community containment and social distancing. Comparison with the previous 4 years found no significant statistical differences that hospital access and management limitations had not impaired the management of patients with syphilis. We alert the medical community of the possible increase of sexually transmitted diseases, as society returns to normal.
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Affiliation(s)
- Filippo Bonato
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Caterina Ferreli
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Roberta Satta
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Franco Rongioletti
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Laura Atzori
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
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13
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Gilbert M, Chang HJ, Ablona A, Salway T, Ogilvie GS, Wong J, Haag D, Pedersen HN, Bannar-Martin S, Campeau L, Ford G, Worthington C, Grace D, Grennan T. Accessing needed sexual health services during the COVID-19 pandemic in British Columbia, Canada: a survey of sexual health service clients. Sex Transm Infect 2021; 98:360-365. [PMID: 34740976 PMCID: PMC8577923 DOI: 10.1136/sextrans-2021-055013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/24/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives We assessed COVID-19 pandemic impacts on accessing needed sexual health services, and acceptability of alternative service delivery models, among sexual health service clients in British Columbia (BC), Canada. Methods We administered an online survey on 21 July–4 August 2020 to clients using a provincial STI clinic or internet-based testing service, GetCheckedOnline, in the year prior to March 2020. We used logistic regression to identify factors associated with having unmet sexual health needs (ie, not accessing needed services) during March–July 2020 and the likelihood of using various alternative service models, if available. Results Of 1198 survey respondents, 706 (59%) reported needing any sexual health service since March 2020; of these 706, 365 (52%) did not access needed services and 458 (66%) had avoided or delayed accessing services. GetCheckedOnline users (univariate OR (uOR)=0.62; 95% CI 0.43 to 0.88) or clients with more urgent needs (eg, treatment for new STI, uOR 0.40 (95% CI 0.21 to 0.7)) had lower odds of unmet sexual health needs. The most common factors reported for avoiding or delaying access were public messaging against seeking non-urgent healthcare (234/662, 35%), concern about getting COVID-19 while at (214/662, 32%) or travelling to (147/662, 22%) a clinic or lab and closure of usual place of accessing services (178/662, 27%). All factors were positively associated with having unmet sexual health needs, with public messaging showing the strongest effect (adjusted OR=4.27 (95% CI 2.88 to 6.42)). Likelihood of using alternative sexual health service models was high overall, with the most appealing options being home self-collection kits (634/706, 90%), receiving test kits or antibiotics at home (592/700, 85%) and express testing (565/706, 80%). Conclusions Of BC sexual health service clients needing services during March–July 2020, many had unmet needs. Offering alternative service delivery methods may help to improve access during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Mark Gilbert
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada .,School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Hsiu-Ju Chang
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Aidan Ablona
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Gina Suzanne Ogilvie
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.,Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Jason Wong
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Devon Haag
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Heather Nicole Pedersen
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Laurence Campeau
- Vancouver Island Health Authority, Victoria, British Columbia, Canada
| | - Geoffrey Ford
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Catherine Worthington
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Troy Grennan
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.,Division of Infectious Diseases, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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14
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João AL, Lencastre A, Calvão J, Rodrigues A, Fernandes C. COVID-19, fear and sexual behaviour: a survey in a tertiary STI clinic in Lisbon. Sex Transm Infect 2021; 97:549. [PMID: 33397799 PMCID: PMC7783365 DOI: 10.1136/sextrans-2020-054834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/12/2020] [Accepted: 12/22/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Ana Luísa João
- Dermatology Department, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
| | - André Lencastre
- Dermatology Department, Hospital de Cascais Dr Jose de Almeida, Alcabideche, Portugal
- Dermatology Department, Hospital da Luz, Lisboa, Portugal
| | - Joana Calvão
- Dermatology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Ana Rodrigues
- Dermatology Department, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
| | - Cândida Fernandes
- Dermatology Department, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
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15
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Rogers BG, Tao J, Maynard M, Chu C, Silva E, Toma E, Nagel K, Napoleon S, Chan PA. Characterizing the Impact of COVID-19 on Pre-Exposure Prophylaxis (PrEP) Care. AIDS Behav 2021; 25:3754-3757. [PMID: 34114166 PMCID: PMC8191705 DOI: 10.1007/s10461-021-03337-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 11/04/2022]
Abstract
COVID-19 is a public health crisis that has fundamentally altered health care provision. The purpose of this study was to examine the impact of COVID-19 on pre-exposure prophylaxis (PrEP) care. We reviewed all patient records for those who presented for PrEP care at a PrEP program in Providence, Rhode Island from September 1st, 2019 to May 29th, 2020. The number of PrEP encounters decreased but was not significantly different over time (ps > .05). Patients were still able to access PrEP clinical services during the COVID-19 pandemic. Implementing flexible and timely PrEP delivery approaches in this setting likely minimized the disruption of PrEP care during COVID-19.
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16
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Kuitunen I, Ponkilainen V. COVID-19-related nationwide lockdown did not reduce the reported diagnoses of Chlamydia trachomatis and Neisseria gonorrhoeae in Finland. Sex Transm Infect 2021; 97:550. [PMID: 33397798 PMCID: PMC7783371 DOI: 10.1136/sextrans-2020-054881] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/13/2020] [Accepted: 12/22/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Ilari Kuitunen
- Mikkeli Central Hospital, Mikkeli, Finland
- School of Medicine, University of Eastern Finland, Kuopio, Finland
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17
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Pagaoa M, Grey J, Torrone E, Kreisel K, Stenger M, Weinstock H. Trends in Nationally Notifiable Sexually Transmitted Disease Case Reports During the US COVID-19 Pandemic, January to December 2020. Sex Transm Dis 2021; 48:798-804. [PMID: 34224523 PMCID: PMC8459909 DOI: 10.1097/olq.0000000000001506] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND To describe changes in reported sexually transmitted diseases (STDs) during the US coronavirus disease 2019 pandemic, we compared the weekly number of reported nationally notifiable STDs in 2020 to 2019. METHODS We reviewed cases of chlamydia, gonorrhea, and primary and secondary (P&S) syphilis reported to the US National Notifiable Disease Surveillance System in 2020. For each STD, we compare the number of 2020 cases reported for a given Morbidity and Mortality Weekly Report (MMWR) week to the number of 2019 cases reported in the same week, expressing 2020 cases as a percentage of 2019 cases. We also calculated the percent difference between 2020 and 2019 cumulative case totals as of MMWR week 50 (week of December 9). RESULTS During MMWR weeks 1 to 11 (week of December 29, 2019-March 11, 2020), the weekly number of cases of STDs reported in 2020 as a percentage of the cases in the same week in 2019 was similar. However, 2020 numbers were much lower than 2019 numbers in week 15 (week of April 8; chlamydia, 49.8%; gonorrhea, 71.2%; and P&S syphilis, 63.7%). As of week 50, the 2020 cumulative totals compared with 2019 were 14.0% lower for chlamydia, 7.1% higher for gonorrhea, and 0.9% lower for P&S syphilis. CONCLUSIONS During March-April 2020, national case reporting for STDs dramatically decreased compared with 2019. However, resurgence in reported gonorrhea and syphilis cases later in the year suggests STD reporting may have increased in 2020, underscoring the importance of continued STD prevention and care activities.
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18
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Platt L, Elder H, Bassett IV, Molotnikov L, Klevens M, O'Connor E, Leach D, Roosevelt K, Hsu K. Chlamydia Treatment Practices and Time to Treatment in Massachusetts: Directly Observed Therapy Versus Pharmacy Prescriptions. J Prim Care Community Health 2021; 12:21501327211044060. [PMID: 34583572 PMCID: PMC8485271 DOI: 10.1177/21501327211044060] [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] [Indexed: 11/15/2022] Open
Abstract
Background Directly observed therapy (DOT) is recommended for the treatment of chlamydia, however pharmacy prescriptions are frequently used. Adherence to DOT and the association between treatment method and time to treatment is unknown. Methods We conducted a retrospective review of a randomized 2% of laboratory-confirmed chlamydia infections reported to the Massachusetts Department of Public Health from January 1, 2019 to May 31, 2019. Clinicians and pharmacies were contacted to ascertain treatment methods and timing. We assessed frequency of DOT and pharmacy prescriptions in the treatment of chlamydia infection in Massachusetts. We used log rank test to compare time to treatment initiation for patients receiving DOT versus pharmacy prescriptions. Data were stratified according to whether treatment was empiric or laboratory-driven. Key results We ascertained full outcomes for 199 patients. Eighty patients received DOT and 119 patients received pharmacy prescriptions. DOT was more common among those receiving empiric treatment and pharmacy prescriptions were more common among those receiving laboratory-driven treatment. The median time to treatment was 1.5 days for patients treated with DOT and 3 days for those treated with pharmacy prescriptions. For both groups, the median time to treatment for empiric therapy was 0 days and for laboratory-driven therapy was 4 days. The differences in time to treatment were not statistically significant. Conclusions Pharmacy prescriptions are frequently used for the treatment of chlamydia in Massachusetts. We did not observe a significant difference in the time to treatment between DOT and pharmacy prescriptions.
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Affiliation(s)
- Laura Platt
- Massachusetts General Hospital, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA.,Massachusetts Department of Public Health, Boston, MA, USA
| | - Heather Elder
- Massachusetts Department of Public Health, Boston, MA, USA
| | | | | | - Monina Klevens
- Massachusetts Department of Public Health, Boston, MA, USA
| | - Erin O'Connor
- Massachusetts Department of Public Health, Boston, MA, USA
| | - Dylan Leach
- Massachusetts Department of Public Health, Boston, MA, USA
| | | | - Katherine Hsu
- Massachusetts Department of Public Health, Boston, MA, USA.,Boston Medical Center Division of Pediatric Infectious Diseases, Boston, MA, USA
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19
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Impact of COVID-19 on income, prevention attitudes, and access to healthcare among male clients in a Sexually Transmitted Infections clinic. Braz J Infect Dis 2021; 25:101617. [PMID: 34508673 PMCID: PMC8426212 DOI: 10.1016/j.bjid.2021.101617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 08/01/2021] [Accepted: 08/12/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Mobility restrictions and overloaded health services during the COVID-19 pandemic compromised services dedicated to the prevention and care of HIV and other sexually transmitted infections (STI). In this study, we present client's responses to standardized questionnaires applied during the COVID-19 pandemic period as part of the strategy to measure impacts on social and sexual vulnerability, access to STI prevention services, and access to STI care. METHODS The questionnaires included variables on sociodemographics, behavior, risk perception, prevention attitudes, barriers to service-based HIV rapid test, reasons for taking an HIV self-test, and access to health services for STI diagnosis and treatment. We explored demographic variables associated with income reduction, reduced access to HIV/STI testing/treatment and increased vulnerability to HIV/STI. RESULTS 847 participants responded to the study questionnaire between May 2020 and January 2021. Most were young, cisgender male, and 63% self-reported as men who have sex with men. Income reductions were reported by 50%, with 30% reporting a decline over 50% of total income. An increase in heavy episodic drinking (>5 doses) was reported by 18%; 7% reported more sexual partners and 6% reported using condoms less often. Difficulties in obtaining HIV tests, tests for other STI and treatment for STI were reported by 5%, 6% and 6%, respectively. Lower schooling was significantly associated with income reduction (p = 0.004) and with reduced access to HIV/STI testing or STI treatment (p = 0.024); employment status was associated with income reduction (p < 0.001) and increased vulnerability to HIV/STI (p = 0.027). Having access to an expedite test result, avoiding physical attendance in health units during the pandemic, and undertaking the test with privacy with a trusted person were reported as motivators for HIV self-test. CONCLUSIONS Our findings are relevant to promote service improvements tailored to subgroups more likely to struggle with detrimental effects during and after the COVID-19 pandemic.
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20
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Park BM, Lee HJ. Healthcare Safety Nets during the COVID-19 Pandemic Based on Double Diamond Model: A Concept Analysis. Healthcare (Basel) 2021; 9:1014. [PMID: 34442151 PMCID: PMC8393212 DOI: 10.3390/healthcare9081014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 12/30/2022] Open
Abstract
The purpose of this study was to analyze the concept of the "healthcare safety net" during the COVID-19 pandemic. Walker and Avant's process of concept analysis was used in this systematic literature review. The attributes of the concept of a healthcare safety net during the COVID-19 pandemic were found to be: (a) capacity, (b) accessibility, (c) health equality, and (d) education. In consideration of these defining criteria, antecedents to the concept were identified as: (a) the COVID-19 pandemic, (b) health inequalities (internal factors and external factors), and (c) healthcare systems (health insurance, screening, protective equipment, medicine, and medical services). Consequences of the concept were: (a) meeting healthcare needs, (b) quality of life, and (c) a decrease in morbidity and mortality. A healthcare safety net is an important concept during the COVID-19 pandemic. In situations like COVID-19, healthcare safety nets are designed to meet safety needs, improve quality of life, and reduce patient turnover and mortality. Based on the results of this study, the development of standardized tools for measuring a healthcare safety net as well as that of policies and systems for resolving a healthcare safety net in the COVID-19 situation is recommended.
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Affiliation(s)
- Bom-Mi Park
- Department of Nursing, Konkuk University, Chungju-si 27478, Korea;
| | - Hyun-Jung Lee
- Department of Nursing, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul 06591, Korea
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21
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Johnson KA, Burghardt NO, Tang EC, Long P, Plotzker R, Gilson D, Murphy R, Jacobson K. Measuring the Impact of the COVID-19 Pandemic on Sexually Transmitted Diseases Public Health Surveillance and Program Operations in the State of California. Sex Transm Dis 2021; 48:606-613. [PMID: 33859146 DOI: 10.1097/olq.0000000000001441] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND As public health personnel and resources are redirected to COVID-19, sexually transmitted diseases (STD) programs have been unable to sustain pre-COVID-19 activities. METHODS We used California (CA) surveillance data to describe trends in case reporting for gonorrhea, chlamydia, and syphilis of any stage in the pre- versus post-COVID-19 eras (January-June 2019 and January-June 2020). We also analyzed data from an electronic survey administered by the CA STD Control Branch to local health jurisdictions in April, June, and September of 2020, assessing the impact of COVID-19 on STD programs. RESULTS There were sharp declines in cases of all reportable bacterial STDs occurring in conjunction with the March 19, 2020 CA stay-at-home order, most of which did not return to baseline by July. Comparing January-June 2020 to January-June of 2019, there were decreases in reported cases of chlamydia (31%), late syphilis (19%), primary/secondary syphilis (15%), early nonprimary nonsecondary syphilis (14%), and gonorrhea (13%). The largest percentage declines in STD case reporting were among Hispanic, Asian/Pacific Islander, and Black persons. Seventy-eight percent of local health jurisdiction respondents indicated that half or more of their workforce had been redeployed to COVID-19 by September 2020. CONCLUSIONS During the COVID-19 era, STD case reporting and programmatic functions have diminished throughout CA. Because this may contribute to decreases or delays in STD diagnosis and treatment-with resultant increases in STD transmission-providers and public health officials should prepare for potential increases in STD-related morbidity in the months and years to come.
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Affiliation(s)
| | - Nicole O Burghardt
- From the Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID), California Department of Public Health (CDPH), Richmond
| | - Eric C Tang
- From the Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID), California Department of Public Health (CDPH), Richmond
| | - Pike Long
- From the Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID), California Department of Public Health (CDPH), Richmond
| | | | - Denise Gilson
- From the Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID), California Department of Public Health (CDPH), Richmond
| | - Ryan Murphy
- From the Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID), California Department of Public Health (CDPH), Richmond
| | - Kathleen Jacobson
- From the Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID), California Department of Public Health (CDPH), Richmond
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22
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Berzkalns A, Thibault CS, Barbee LA, Golden MR, Khosropour C, Kerani RP. Decreases in Reported Sexually Transmitted Infections During the Time of COVID-19 in King County, WA: Decreased Transmission or Screening? Sex Transm Dis 2021; 48:S44-S49. [PMID: 33967230 PMCID: PMC8284355 DOI: 10.1097/olq.0000000000001463] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/28/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND In response to the COVID-19 pandemic, Washington State's Stay Home, Stay Healthy (SHSH) order was implemented on March 24, 2020. We hypothesized that pandemic mitigation measures might reduce sexually transmitted infection (STI) screening and/or transmission. METHODS We used King County, WA STI surveillance and sexual health clinic (SHC) data from January 1, 2019, to July 31, 2020. We calculated mean weekly case counts for gonorrhea, primary and secondary (P&S) syphilis, male urethral gonorrhea, and early latent (EL) syphilis for 3 periods in 2020: pre-SHSH (January 1-March 23), SHSH (March 24-June 5), and reopening (June 6-July 31). Primary and secondary syphilis and male urethral gonorrhea were used as proxies for sexual behavior, and EL syphilis was used as a proxy for STI screening. We compared SHC visits (2019 vs. 2020) and SHC gonorrhea treatment practices (across 2020 periods). RESULTS Compared with January to July 2019, from January to July 2020, reported cases of gonorrhea, male urethral gonorrhea, P&S syphilis, and EL syphilis decreased by 9%, 5%, 16%, and 22%, respectively. Mean weekly case counts of gonorrhea, male urethral gonorrhea, and EL syphilis decreased pre-SHSH to SHSH, but all returned to pre-SHSH levels during reopening. Sexual health clinic visits during SHSH were 55% lower in 2020 than in 2019. In the SHC during SHSH, ceftriaxone treatment of gonorrhea decreased, whereas cefixime/cefpodoxime treatment and gonorrhea treatment with no testing increased. CONCLUSIONS Decreases in reported STIs concurrent with COVID-19 SHSH may reflect a true decline in STI transmission. However, the larger decreases in asymptomatic infections indicate that much of the observed decrease was likely due to decreased screening.
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Affiliation(s)
| | | | | | - Matthew R. Golden
- From the Public Health—Seattle & King County
- Departments of Medicine
- Epidemiology, University of Washington, Seattle, WA
| | | | - Roxanne P. Kerani
- From the Public Health—Seattle & King County
- Epidemiology, University of Washington, Seattle, WA
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23
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Rogers B, Tao J, Murphy M, Chan PA. The COVID-19 Pandemic and Sexually Transmitted Infections: Where Do We Go From Here? Sex Transm Dis 2021; 48:e94-e96. [PMID: 33872225 PMCID: PMC8570344 DOI: 10.1097/olq.0000000000001445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Brooke Rogers
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Jun Tao
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Matthew Murphy
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Philip A. Chan
- Department of Medicine, Brown University, Providence, Rhode Island, USA
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24
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Pampati S, Emrick K, Siegler AJ, Jones J. Changes in Sexual Behavior, PrEP Adherence, and Access to Sexual Health Services Because of the COVID-19 Pandemic Among a Cohort of PrEP-Using MSM in the South. J Acquir Immune Defic Syndr 2021; 87:639-643. [PMID: 33512848 PMCID: PMC8533029 DOI: 10.1097/qai.0000000000002640] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had unforeseen consequences on the delivery of HIV and sexually transmitted disease (STD) prevention services. However, little is known about how the pandemic has impacted pre-exposure prophylaxis (PrEP)-using men who have sex with men (MSM). METHODS Data come from an online cohort of PrEP-using MSM in the Southern United States from October 2019 to July 2020. Participants were administered 10 surveys in total, including 1 ad hoc survey specifically on COVID-19. We conducted a cross-sectional analysis of this ad hoc survey (n = 56) and present changes in sexual behaviors and utilization of and access to sexual health services. Using linear mixed-effect regression models, we also analyzed data from the larger cohort and document how sexual behaviors and PrEP use varied longitudinally across several months. RESULTS A fifth of participants discontinued or changed how often they take PrEP because of COVID-19. A quarter of the cohort documented challenges when attempting to access PrEP, HIV testing, or STD testing. For all sexual behaviors examined longitudinally-number of male sexual partners, anal sex acts, condomless anal sex, and oral sex (all measured in the past 2 weeks)-there was a decrease from February to April followed by an increase from April to June. DISCUSSION Our findings suggest reduced access to and utilization of STD and HIV services coupled with a continuation of behaviors which confer STD/HIV risk. Ensuring appropriate delivery of STD/HIV prevention services during this pandemic is imperative.
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Affiliation(s)
- Sanjana Pampati
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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25
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In Support of the Publicly Funded Sexually Transmitted Infections Specialty Clinic-ASTDA Position Statement. Sex Transm Dis 2021; 47:503-505. [PMID: 32520881 DOI: 10.1097/olq.0000000000001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Tao J, Napoleon SC, Maynard MA, Almonte A, Silva E, Toma E, Chu CT, Cormier K, Strong S, Chan PA. Impact of the COVID-19 Pandemic on Sexually Transmitted Infection Clinic Visits. Sex Transm Dis 2021; 48:e5-e7. [PMID: 33181578 PMCID: PMC7736141 DOI: 10.1097/olq.0000000000001306] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 is responsible for a global pandemic and has impacted health care accessibility and delivery. Clinic data were reviewed for an STI clinic from September 2019 to May 2020. A significant decrease in rates of STI visits and treatments during the coronavirus disease 2019 pandemic was observed.
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Affiliation(s)
- Jun Tao
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Siena C. Napoleon
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | | | - Alexi Almonte
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Elizabeth Silva
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Emily Toma
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Christina T. Chu
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Kevin Cormier
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Sabrina Strong
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Philip A. Chan
- Department of Medicine, Brown University, Providence, Rhode Island, USA
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27
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Steffen R, Lautenschlager S, Fehr J. Travel restrictions and lockdown during the COVID-19 pandemic-impact on notified infectious diseases in Switzerland. J Travel Med 2020; 27:5912954. [PMID: 33152761 PMCID: PMC7543597 DOI: 10.1093/jtm/taaa180] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/09/2020] [Accepted: 09/22/2020] [Indexed: 01/06/2023]
Abstract
Based on notification data the impact of the COVID-19 lockdown in Switzerland was assessed. While the incidence of tick-borne encephalitis almost doubled as compared to 2016-2019, a reduction in all other infectious diseases was recorded. The lowest reduction rates (<25%) were noted for legionellosis, hepatitis A, chlamydia infection and gonorrhoea.
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Affiliation(s)
- Robert Steffen
- Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Traveller's Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX, USA
| | - Stephan Lautenschlager
- Dermatology and Venereology Outpatient Clinics, City Hospitals Waid and Triemli, Zurich, Switzerland
| | - Jan Fehr
- Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Traveller's Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Department of Infectious Diseases and Hospital Epidemiology, University Hospital, Zurich, Switzerland
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28
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Pampati S, Emrick K, Siegler AJ, Jones J. Changes in sexual behavior, PrEP adherence, and access to sexual health services due to the COVID-19 pandemic among a cohort of PrEP-using MSM in the South. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.11.09.20228494. [PMID: 33200145 PMCID: PMC7668758 DOI: 10.1101/2020.11.09.20228494] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background The COVID-19 pandemic has had unforeseen consequences on the delivery of HIV and STD prevention services. However, little is known about how the pandemic has impacted PrEP-using men who have sex with men (MSM). Methods Data come from an online cohort of PrEP-using MSM in the Southern United States from October 2019 to July 2020. Participants were administered ten surveys in total, including one ad hoc survey specifically on COVID-19. We conducted a cross-sectional analysis of this ad hoc survey (n=56) and present changes in sexual behaviors and utilization of and access to sexual health services. Using linear mixed-effects regression models, we also analyzed data from the larger cohort (n=78) and document how sexual behaviors and PrEP use varied longitudinally focusing on three months: February (pre-pandemic), April (early pandemic), and June (later in the pandemic). Results A fifth of participants discontinued or changed how often they take PrEP because of COVID-19. A quarter of the cohort documented challenges when attempting to access PrEP, HIV testing, or STD testing. For all sexual behaviors examined longitudinally-number of male sexual partners, anal sex acts, condomless anal sex, oral sex (all measured in the past 2 weeks)-there was a significant decrease from February to April followed by a significant increase from April to June. Discussion Our findings suggest reduced access to and utilization of STD and HIV services coupled with a continuation of behaviors which confer STD/HIV risk. Ensuring appropriate delivery of STD/HIV prevention services during this pandemic is imperative.
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Affiliation(s)
- Sanjana Pampati
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Kayla Emrick
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Aaron J. Siegler
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Jeb Jones
- Department of Epidemiology, Rollins School of Public Health, Emory University
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