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Attitudes and behaviors related to the COVID-19 pandemic and the climate change crisis might be driven by similar political beliefs and attitudes. The current study used a neo-Gramsci perspective to examine how political attitudes may be linked to COVID-19 prevention and climate change attitudes and behaviors. A longitudinal online survey in the US assessed climate change and COVID-19 attitudes and behaviors, and wave 7 (2021) data were used to predict outcomes at wave 8 (2022) among 572 respondents. There were significant correlations among the variables of political ideology, climate change concerns, COVID-19 vaccine hesitancy, COVID-19 skepticism, COVID-19 vaccine as a personal choice, COVID-19 conspiracy, political correctness, percent of Republican friends, and dislike of the Democratic Party. In the multivariate models, COVID-19 vaccination as a personal choice was significantly associated with the four outcomes: vaccination status, climate change actions, vaccine hesitancy, and climate change concerns. COVID-19 skepticism was significantly associated with vaccination status, vaccine hesitancy, and climate change concerns. These findings suggest that there are similar drivers of COVID-19 prevention and climate change attitudes and behaviors, and interventions need to be tailored to target individual-level and societal-level factors. © 2023 by the authors.
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Social isolation is prevalent among community dwelling older adults. Low income older adults living in subsidized housing may have increased risk for social isolation. To examine resident experiences and perspectives relating to their social connections during the COVID-19 pandemic, we conducted semi-structured interviews with 13 older adults (62+) who are English, Spanish, and Mandarin speaking recruited from a large non-profit affordable housing organization with communities in 22 states. Twelve housing communities were identified based on distributions of socio-demographic factors and prevalence of self-reported social isolation l in the housing community's annual survey of residents in order to maximize site diversity. We used qualitative thematic analysis methods to examined participants' views about their social connections before and during the COVID-19 pandemic, as well as their personal and the housing community's strategies to mitigate experiences of social isolation. Emerging themes include loss of common facilities and opportunities to socialize with other residents due to COVID-19 restrictions, and increased use of technology to stay connected.
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OBJECTIVES: This study examines the relationship between COVID-19 disclosure stigma and COVID-19 testing hesitancy and assesses their changes between November 2020 and 2021. STUDY DESIGN: This was a longitudinal cohort. METHODS: A total of 355 participants completed four study waves between November 2020 and November 2021. Factor analyses and Cronbach's alpha assessed the factor structure and internal consistency of the COVID-19 Disclosure Stigma scale. Paired t-tests and McNemar's Chi-squared test assessed change between the study waves. Multivariable logistic regression models examined the relationship between COVID-19 disclosure stigma and testing hesitancy at four study waves. RESULTS: COVID-19 disclosure stigma declined significantly between the last study waves (P = 0.030). The greatest disclosure concern was reporting a positive test to close contacts (range: 19%-21%) followed by disclosure to friends (range: 10%-15%) and family (range: 4%-10%). Over the course of the four study waves, COVID-19 testing hesitancy when symptomatic ranged from 23% to 30%. Older age, female gender, and having received a COVID-19 vaccine were associated with decreased odds of testing hesitancy. Greater COVID-19 disclosure stigma and more conservative political ideology showed a consistent relationship with increased odds of COVID-19 testing hesitancy. CONCLUSIONS: Study findings suggest that many people anticipate feeling stigmatized when disclosing positive test results, especially to close contacts. A substantial percentage of study participants reported hesitancy to be tested when symptomatic. This study identifies a need for interventions that normalize COVID-19 testing (e.g. engaging leaders with conservative followings), provide strategies for disclosing positive results, and allow anonymous notification of potential COVID-19 exposure.
Subject(s)
COVID-19 , Disclosure , Female , Humans , United States/epidemiology , Longitudinal Studies , COVID-19 Testing , COVID-19/diagnosis , COVID-19 VaccinesABSTRACT
Background: The impact of COVID-19 mitigation measures on STI transmission and racial disparities remains unknown. The objectives were to examine trends in sex and drug risk behaviors, access to sexual health services and STI positivity overall and by race during-compared to pre-pandemic among urban sexual minorities (MSM). Methods: Sexually-active MSM aged 18-45 years were administered a behavioral survey and STI testing at three-month intervals. Participants completing > one during-pandemic (April-December 2020) and one pre-pandemic study visit (before March 13, 2020) occurring < six months apart were included. Generalized estimating equations with modified Poisson regression models compared outcomes during-compared to pre-pandemic visits. Results: Among 231 MSM, reports of > three sex partners declined [adjusted Prevalence Ratio (aPR): pandemic-1(p1) 0.68, 95% CI (0.54-0.86);pandemic-2(p2) 0.65 (0.51-0.84);pandemic-3(p3) 0.57 (0.43-0.75)];similar findings were observed among Black and non-Black MSM. Black, but not non-Black MSM, reported sustained decreases in substance use (aPR: p1 0.90 (0.79-1.03);p2 0.74 (0.62-0.89);p3 0.82 (0.67-0.99)], and increased HIV/PrEP care engagement [aPR: p1 1.20 (1.07-1.34);p2 1.24 (1.11-1.39);p3 1.30 (1.16-1.47)]. Reported STI testing (overall and by race) decreased [aPR: p1 0.68 (0.57-0.81);p2 0.78 (0.67-0.92)], then rebounded [aPR: p3 1.01 (0.87-1.18)]. Overall, neither chlamydia [aPR: p2 1.62 (0.75-3.46);p3 1.13 (0.24-1.27)] nor gonorrhea [aPR: p2 0.87 (0.46-1.62) p3 0.56 (0.24-1.27)] positivity significantly changed during vs. pre-pandemic. Conclusion: We observed sustained decreases in STI risk behaviors but minimal change in STI positivity during compared to pre-pandemic. Findings underscore the urgent need for novel strategies to deliver STI prevention services without in-person interactions among MSM.
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Since mass COVID-19 testing may be challenging for resource-scarce settings, effective disease management in developing countries need to resolve to different measures, which can be identified and prioritised by understanding health seeking behavior of a country's population. As the common practice of many developing nations' citizens is contacting local pharmacists and nonofficial health providers firstly when having health problems, these local health gatekeepers should be involved as first point of case detection, while accurate information regarding COVID-19 prevention and control can also be delivered through them in timely manner. Utilising local health gatekeepers has indeed been at the core of current success story of Vietnam in COVID-19 management. One of the examples of how understanding health seeking behavior of population can result in effective strategies for detecting and controlling SARS-COV-2 infections is the case of Vietnam. A low middle income country with health system facing numerous constrains, Vietnam has so far managed to keep the number of SARS-COV-2 confirmed infected cases at 382 and no mortality as of 18 July 2020, through effective utilization of the network of nonofficial, community-based health facilities and pharmacies, based on the knowledge that majority of the Vietnamese population would prefer going to these local, nonofficial health workforce when having health problems. They believe that current success The story will encourage similar resources around the world to pay more attention health-seeking behaviors of their populations and their impact on disease management when developing and implementing measures to monitor and detect COVID-19.
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Vaccine hesitancy could become a significant impediment to addressing the COVID-19 pandemic. The current study examined the prevalence of COVID-19 vaccine hesitancy and factors associated with vaccine intentions. A national panel survey by the National Opinion Research Center (NORC) was designed to be representative of the US household population. Sampled respondents were invited to complete the survey between May 14 and 18, 2020 in English or Spanish. 1,056 respondents completed the survey - 942 via the web and 114 via telephone. The dependent variable was assessed by the item "If a vaccine against the coronavirus becomes available, do you plan to get vaccinated, or not?" Approximately half (53.6%) reported intending to be vaccinated, 16.7% did not intend, and 29.7% were unsure. In the adjusted stepwise multinominal logistic regression, Black and Hispanic respondents were significantly less likely to report intending to be vaccinated as were respondents who were females, younger, and those who were more politically conservative. Compared to those who reported positive vaccine intentions, respondents with negative vaccine intentions were significantly less likely to report that they engaged in the COVID-19 prevention behaviors of wearing masks (aOR = 0.53, CI = 0.37-0.76) and social distancing (aOR = 0.22, CI = 0.12-0.42). In a sub-analysis of reasons not to be vaccinated, significant race/ethnic differences were observed. This national survey indicated a modest level of COVID-19 vaccine intention. These data suggest that public health campaigns for vaccine uptake should assess in greater detail the vaccine concerns of Blacks, Hispanics, and women to tailor programs.
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Novel coronavirus disease 19 (COVID-19) is a global threat to millions of lives. Enormous efforts in knowledge production have been made in the last few months, requiring a comprehensive analysis to examine the research gaps and to help guide an agenda for further studies. This study aims to explore the current research foci and their country variations regarding levels of income and COVID-19 transmission features. This textual analysis of 5780 publications extracted from the Web of Science, Medline, and Scopus databases was performed to explore the current research foci and propose further research agenda. The Latent Dirichlet allocation was used for topic modeling. Regression analysis was conducted to examine country variations in the research foci. Results indicate that publications are mainly contributed by the United States, China, and European countries. Guidelines for emergency care and surgical, viral pathogenesis, and global responses in the COVID-19 pandemic are the most common topics. There is variation in the research approaches to mitigate COVID-19 problems in countries with different income and transmission levels. Findings highlighted the need for global research collaborations among high- and low/middle-income countries in the different stages of pandemic prevention and control.
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BackgroundCOVID-19 mitigation measures may indirectly impact sexually transmitted infection (STI) transmission. Social distancing may impact number/type of sex partnerships and access to STI testing and treatment. The objective was to compare the number of reported sex partnerships and gonorrhea and chlamydia prevalence pre- and during-pandemic among a cohort of gay, bisexual and other men-who-have-sex-with-men (MSM) in Baltimore, Maryland, a U.S. city with sustained STI epidemics.MethodsThis study was nested in a cohort study of sexually active MSM aged 18–45, and included participants who had at least one study visit after March 13, 2020 (during-pandemic) and ≤ six months between their first during-pandemic and last pre-pandemic visit. Wilcoxon and McNemar tests for paired data were used for statistical testing.ResultsAmong 417 MSM enrolled in the cohort, 220 (52.8%) were included. 213 (96.8%) had a visit between April 6-June 30, 2020 (during-pandemic1);185 (84.1%) had a visit between July 1-September 30, 2020 (during-pandemic2), including seven who missed the during-pandemic1 visit. The majority were Black (73.2%) and aged 24–35 (56.4%);42% were living with HIV. Compared to pre-pandemic, the median number of total and casual male sex partners (past three months) significantly declined during-pandemic1 and during-pandemic2 (Total partners: pre-pandemic: 2.0 (range: 0–75);during-pandemic1: 1.0 (0–25), p<0.0001;during-pandemic2: 1.0 (0–20) p<0.0001;Casual partners: pre-pandemic: 1.0 (0–75);during-pandemic1: 0.0 (0–25) p<0.0001, during-pandemic2: 1.0 (0–20), p=0.004). Among those tested both pre- and during-pandemic2, (n=96) STI prevalence was similar (gonorrhea: 14.1% vs. 15.8%, p=0.847;chlamydia: 7.0% vs. 9.5%, p=0.527).ConclusionsAlthough overall and casual sex partnerships declined significantly during- compared to pre-pandemic, STI prevalence was similar. The observed decreased sex partnerships may not have substantially altered transmission dynamics or were offset by increased prevalence due to limited access to testing/treatment. Improved understanding of how COVID-19 mitigation measures alter STI transmission dynamics is needed.
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OBJECTIVES: Migrant workers are one of the most vulnerable population groups during the coronavirus disease 2019 (COVID-19) pandemic. This study investigated knowledge and awareness of COVID-19 among Indonesian migrant workers (IMWs) in Macao (SAR), Hong Kong (SAR), and Taiwan. STUDY DESIGN: This was a cross-sectional study. METHODS: Data were collected through an online survey in February and March 2020 to gain information on (1) participants' sociodemographic characteristics, (2) experience and awareness regarding COVID-19 information, and (3) knowledge and understanding of COVID-19. A series of Chi-squared, t-test, and logistic regression analyses were conducted. RESULTS: The survey was completed by 491 participants (92.1% female). Knowledge of COVID-19 was obtained from multiple sources, including a large proportion from online social media. However, participants who obtained information from their employer, local social networks, and migrant organisations answered a greater number of questions correctly. One-third of participants reported receiving hoax, fake news, and incorrect information and obtained information from unverified sources. Participants were most interested in information about how to cure COVID-19, and 57.8% knew that no specific drug or vaccine was currently available. Almost all participants correctly identified fever and wearing a facemask as the main COVID-19 symptom and prevention strategy, respectively. Participants with senior high school or higher education and who worked as domestic or care workers had a greater knowledge of COVID-19 than their counterparts. CONCLUSIONS: Public health communication strategies using multiple channels, including employers and community organisations, would help to minimise COVID-19 knowledge gaps. In addition, it is recommended that digital literacy content is added to public health campaigns.