Interventions to increase cervical screening uptake among immigrant women: A systematic review and meta-analysis.

Numerous intervention studies have attempted to increase cervical screening uptake among immigrant women, nonetheless their screening participation remains low. This systematic review and meta-analysis aimed to summarise the evidence on interventions to improve cervical screening among immigrant women globally and identify their effectiveness. Databases PubMed, EMBASE, Scopus, PsycINFO, ERIC, CINAHL and CENTRAL were systematically searched from inception to October 12, 2021, for intervention studies, including randomised and clinical controlled trials (RCT, CCT) and one and two group pre-post studies. Peer-reviewed studies involving immigrant and refugee women, in community and clinical settings, were eligible. Comparator interventions were usual or minimal care or attention control. Data extraction, quality appraisal and risk of bias were assessed by two authors independently using COVIDENCE software. Narrative synthesis of findings was carried out, with the main outcome measure defined as the cervical screening uptake rate difference pre- and post-intervention followed by random effects meta-analysis of trials and two group pre-post studies, using Comprehensive Meta-Analysis software, to calculate pooled rate ratios and adjustment for publication bias, where found. The protocol followed PRISMA guidelines and was registered prospectively with PROSPERO (CRD42020192341). 1,900 studies were identified, of which 42 (21 RCTS, 4 CCTs, and 16 pre-post studies) with 44,224 participants, were included in the systematic review, and 28 with 35,495 participants in the meta-analysis. Overall, the uptake difference rate for interventions ranged from -6.7 to 96%. Meta-analysis demonstrated a pooled rate ratio of 1.15 (95% CI 1.03-1.29), with high heterogeneity. Culturally sensitive, multicomponent interventions, using different modes of information delivery and self-sampling modality were most promising. Interventions led to at least 15% increase in cervical screening participation among immigrant women. Interventions designed to overcome logistical barriers and use multiple channels to communicate culturally appropriate health promotion messages are most effective at achieving cervical screening uptake among immigrant women.

Interim position statement on doxycycline post-exposure prophylaxis (Doxy-PEP) for the prevention of bacterial sexually transmissible infections in Australia and Aotearoa New Zealand - the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM).

Recent studies have provided evidence for the effectiveness of using doxycycline (Doxy-PEP) to prevent bacterial sexually transmissible infections (STI), namely chlamydia, gonorrhoea, and syphilis, among gay, bisexual, and other men who have sex with men who have experienced multiple STIs. However, there remain several unanswered questions around potential adverse outcomes from Doxy-PEP, including the possibility of inducing antimicrobial resistance in STIs and other organisms, and the possibility of disrupting the microbiome of people who choose to use Doxy-PEP. This interim position statement from the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine aims to outline the current evidence for Doxy-PEP, and to highlight potential adverse outcomes, to enable clinicians to conduct evidence-based conversations with patients in Australia and Aotearoa New Zealand who intend to use Doxy-PEP.

Immediate and Ongoing Impact of COVID-19 on Chlamydia Treatment in Australia.

BACKGROUND: The COVID-19 pandemic has impacted the sexual health and well-being of individuals, directly through risk of contracting COVID-19, and indirectly through government lockdowns. Government restrictions were especially strict and long-lasting in Australia, they also varied by state, offering an interesting opportunity to study the impacts of varying restrictions. This study compares the impact of the COVID-19 pandemic and resulting restrictions on chlamydia treatment prescriptions during 2020, through to July 2021 between different states and demographic groups in Australia. METHODS: The rate of prescriptions per 100,000 population filled each month from January 2017 to July 2021 from Australia's Pharmaceutical Benefits Scheme for Azithromycin with a restricted indication to treat Chlamydia trachomatis was used to measure chlamydia treatment. The impact of COVID-19 lockdowns was modeled using an interrupted time-series Poisson regression model. RESULTS: The data included 520,025 prescriptions to treat chlamydia, averaging 37.5 prescriptions per month per 100,000 population. Prescriptions declined 26% in April to May 2020 when initial COVID-19 lockdowns began in Australia; prescriptions increased in the following months but remained on average 21% below prepandemic (2017-2019) levels through to July 2021. Prescriptions declined the most in 1 Australian state, Victoria, both in the initial lockdown and the following period; generally, states with more COVID-19 cases saw bigger reductions in prescriptions. CONCLUSIONS: This is the first study to examine how treatment for chlamydia in Australia was impacted by the COVID-19 pandemic and restrictions not only in the immediate-term, but also ongoing up to July 2021, providing important information for planning for sexual health services in future pandemics.

Corrigendum: Knowledge, Attitude, and Practice Survey of COVID-19 Among Healthcare Students During the COVID-19 Outbreak in China: An Online Cross-Sectional Survey.

[This corrects the article DOI: 10.3389/fpubh.2021.742314.].

Determinants of COVID-19 Vaccine Acceptance and Hesitancy: A Health Care Student-Based Online Survey in Northwest China.

Background: With the spread of COVID-19 around the world, herd immunity through vaccination became a key measure to control the pandemic, but high uptake of vaccine is not guaranteed. Moreover, the actual acceptance of COVID-19 vaccination and associated factors remain uncertain among health care students in Northwest China. Methods: A cross-sectional survey of a sample of 631 health care students was performed using a questionnaire developed through Wen Juan Xing survey platform to collect information regarding their attitudes, beliefs, and acceptance of COVID-19 vaccination. Binary logistic regression analyses were performed to identify the association between vaccination willingness and demographics, attitudes, and beliefs to determine the factors that actually effect acceptance and hesitancy of COVID-19 vaccine among health care students. Results: Overall, 491 (77.81%) students actually received the COVID-19 vaccine, and of the 140 unvaccinated, 69 were hesitant and 71 rejected. Binary logistic regression analysis showed that the actually vaccinated individuals were those who mostly believed in the effectiveness of the COVID-19 vaccine (OR = 2.94, 95%CI: 1.37, 6.29), those who mostly felt it is their responsibility to receive the vaccine to protect others from infection (OR = 2.75, 95%CI: 1.45, 5.23), with less previous experience about other vaccines (OR = 1.70, 95%CI: 1.06, 2.72), students who mostly thought COVID-19 to be very severe (OR = 1.77, 95%CI: 1.07, 2.93), and students who mostly thought the COVID-19 vaccine was one of the best protection measures (OR = 1.68, 95%CI: 1.03, 2.76). Concerns about side effects of vaccines (OR = 0.30, 95%CI: 0.18, 0.51) and the use of personal protective behavior as an alternative to the COVID-19 vaccination (OR = 0.16, 95%CI: 0.06, 0.39) hindered the vaccine acceptance. Conclusions: Our study showed higher COVID-19 vaccine acceptance among healthcare students. However, the individuals with vaccine hesitancy and rejection were still worrying. Vaccine safety and effectiveness issues continue to be a major factor affecting students' acceptance. To expand vaccine coverage in response to the COVID-19 pandemic, appropriate vaccination strategies and immunization programs are essential, especially for those with negative attitudes and beliefs.

Knowledge, Attitude, and Practice Survey of COVID-19 Among Healthcare Students During the COVID-19 Outbreak in China: An Online Cross-Sectional Survey.

Background: The ongoing coronavirus disease (COVID-19) outbreak has placed the healthcare system and student training under considerable pressure. However, the plights of healthcare students in the COVID-19 period have drawn limited attention in China. Methods: A cross-sectional on-line survey was undertaken between January and March 2020 to explore the COVID-19 knowledge, attitude, and practice (KAP) survey among Chinese healthcare students. Demographic information and data on KAP were obtained using a self-reported questionnaire. The percentage KAP scores were categorized as good or poor. Independent predictors of good knowledge of COVID-19 were ascertained to use a logistic regression model. Results: Of the 1,595 participants, 85.9% (1,370) were women, 53.4% were junior college students, 65.8% majoring in nursing, and 29.8% had received training on COVID-19. The overall median percentage for good KAP was 51.6% with knowledge of 28.3%, attitude 67.8%, and practice 58.6%, respectively. Independent predictors of good knowledge of COVID-19 were being students ≥25 (95% CI = 0.27-0.93, P = 0.02), those taking bachelor degrees (95% CI = 1.17-2.07, P = 0.00), and those having participated in COVID-19 treatment training. Conclusions: The result of this study revealed suboptimal COVID-19-related KAP among healthcare students in China. To effectively control future outbreaks of COVID-19, there is a need to implement public sensitization programs to improve the understanding of COVID-19 and address COVID-19-related myths and misconceptions, especially among healthcare students.

Sexual and reproductive health knowledge, attitudes and behaviours of Chinese international students studying abroad (in Australia, the UK and the US): a scoping review.

International students within Australia are disproportionately affected by adverse sexual and reproductive health (SRH) outcomes. Chinese international students represent the majority of international students in Australia, and a large proportion of students in other high-income countries such as the United States and the United Kingdom, making them an important priority group. However, the SRH issues of this priority group have received little attention from international researchers. This review provides an overview of global studies surrounding the SRH knowledge, attitudes and behaviours of Chinese international students studying abroad. Ten articles were deemed relevant and findings from both the qualitative and quantitative data synthesis were categorised into six codes: (1) knowledge; (2) sources of information; (3) attitudes; (4) behaviours; (5) barriers; and (6) recommendations. The findings provide valuable understanding to inform the development of targeted, culturally sensitive and inclusive health promotion initiatives and policies. It is recommended that further research is conducted in this field to reduce evident health disparities.