Assessment of Rabies Control Attitudes During the COVID-19 Pandemic through Partial Least Square-Structural Equation Modeling

The COVID-19 pandemic disrupts rabies control activities in the community. A new approach is needed to control rabies during the COVID-19 pandemic through digital health interventions by conducting digital surveillance and education. This study aimed to determine key attitude indicators in controlling rabies during the COVID-19 pandemic. A cross-sectional study on 166 participants in Denpasar City with a total of 31 indicators measuring five variables: perceptions of the benefits of rabies control (6 indicators), perceptions of rabies risk (6 indicators), perceptions of obstacles to rabies control (5 indicators), perceptions of the need for technology (7 indicators), and attitudes toward rabies control (7 indicators) were analyzed using partial least square-structural equation modeling. The results revealed that 80.7% of participants owned a dog, and sources of rabies information were from social media (45%), the internet (33.7%), and rabies volunteers (33.1%). The model explained that perception of the benefits of rabies control and the need for technology had a direct effect on attitudes toward rabies control (p-value<0.001 and 0.015). In brief, perceived benefits and the need for technology influence attitudes toward rabies control during the COVID- 19 pandemic.

Behavioral Changes, Adaptation, and Supports among Indonesian Female Sex Workers Facing Dual Risk of COVID-19 and HIV in a Pandemic.

The objective of this study is to explore the impacts of COVID-19 and changes taking place among the Indonesian female sex worker (FSW) community during the COVID-19 pandemic and the predictors of these changes. We conducted a cross-sectional online survey and selected the participants using a purposive snowball sampling technique. Incentives were provided to participants in the form of a 5 USD e-wallet balance. Variables of interest included adaptation to online sex work, adherence to COVID-19 prevention measures during sex work, number of clients, income reduction, social support, condom access, and condom use frequency. Sociodemographic data and COVID-19 fear index values were also collected. Final analysis included 951 FSWs, of whom 36.4% of had adapted to online sex work and 48.6% had practiced COVID-19 prevention measures. Major reductions in client frequency and income were reported by 67.8% and 71.1% of respondents, respectively. However, only 36.3% of FSWs reported they had ever received any form of social support from any parties, public or private. Meanwhile, 16.7% encountered difficulties in accessing condoms and 12.5% reported less frequent condom use during the pandemic. Easy access to condoms was the main factor influencing the frequency of condom use. As expected, staying in employment protected FSWs from major income loss, while education and younger age predicted adaptive behavioral changes, such as taking up online sex work. The COVID-19 pandemic has disrupted access to socioeconomic support systems and HIV prevention services among FSWs and has further exposed them to the dual jeopardy of HIV and COVID-19 infections.

Perceived Social Norms as Determinants of Adherence to Public Health Measures Related to COVID-19 in Bali, Indonesia.

Introduction: Before the widespread availability of an effective COVID-19 vaccine, it is crucial to control the rate of transmission by ensuring adherence to behavioral modifications, such as wearing masks, physical distancing, and washing hands, all of which can be implemented as public health measures. Focusing on the conditions in Bali, this study explored the level of compliance to public health measures targeted at COVID-19 and identified the determinants of compliance via the values, rules, and knowledge approach. Materials and Methods: This cross-sectional study conducted an online survey using the Google Form application from June 29 to July 5, 2020. The minimum required sample size was 664. Inclusion criteria were set as follows: 18 years of age or older and residing in Bali during the data collection period. Adherence was measured based on nine protocol indicators that were rated using a four-point Likert scale. A multiple linear regression analysis was then conducted to determine the associated factors of adherence to public health measures. Results: Of the 954 survey respondents, data from 743 were included for analysis. The average level of adherence to public health measures was 32.59 (range of 20-36). The linear regression analysis showed that perceived health benefits from public health measures, being female, and having COVID-19 test histories were significantly associated with adherence to public health measures. Conclusions: For public health measures targeted at COVID-19, adherence was strongly associated with perceived social norms, in which individuals played social community roles by adapting to standardized public health measures. It is thus imperative for governments to support and monitor public health measures during the COVID-19 pandemic.