Temporary changes in STI & HIV testing & diagnoses across different phases of the COVID-19 pandemic, Chicago IL.

Introduction: While the U.S. has seen a sustained rise in STI cases over the past decade, the impact of the COVID-19 on STIs and HIV is unclear. Methods: To examine the short- and medium-term impacts of COVID-19 and HIV and STI testing and diagnosis, we compared pre-pandemic trends to three periods of the pandemic: early- pandemic, March-May 2020; mid-pandemic June 2020-May 2021; and late-pandemic, June 2021-May 2022. We compared average number of monthly tests and diagnoses, overall and by gender, as well as the monthly change (slope) in testing and diagnoses. Results: We find that after decreases in average monthly STI and HIV testing and diagnoses during the early- and mid-pandemic, cases were largely back to pre-pandemic levels by the late-pandemic, with some variation by gender. Conclusion: Changes in testing and diagnoses varied by phase of the pandemic. Some key populations may require additional outreach efforts to attain pre-pandemic testing levels.

Impact of the COVID-19 pandemic on access to HIV testing and condom use among two-spirit, gay, bisexual, and queer (2SGBQ+) men in Manitoba.

This cross-sectional online survey (n = 347) examined the impact of the COVID-19 pandemic on access to HIV testing and condom use among Two-Spirit, gay, bisexual, and queer (2SGBQ+) men in Manitoba. Logistic regression assessed the relationship between socio-demographics and the impact of COVID-19 on access to HIV testing and condom use. Among those who answered a question on testing (n = 282), 27.7% reported reduced access to HIV testing. Among those who answered questions on condom use (n = 327), 54.4% reported decreased use of condoms. Compared to living in Winnipeg, living in a medium-sized city (Brandon) and in rural and remote areas were both associated with higher odds of reporting reduced access to HIV testing due to COVID-19. Participants who were dating (vs. married or partnered) were significantly more likely to report reduced access to HIV testing, but less likely to report decreased use of condoms, while younger age was associated with decreased use of condoms. Service providers must be prepared to respond to the impact of COVID-19 on HIV testing and condom use among younger, sexually active 2SGBQ + men, as well as those who live in small, rural, and remote areas in Manitoba.

Comprehensive HIV/AIDS knowledge and HIV testing among men in sub-Saharan Africa: a multilevel modelling.

This study investigated the association between comprehensive HIV/AIDS knowledge and HIV testing among men in sub-Saharan Africa (SSA). Data were taken from the most recent (2010-2019) Demographic and Health Survey men's recode files of 29 countries in SSA. A total of 104,398 men who had complete information on all the variables of interest were included in the study. The outcome variable was HIV testing. A multilevel logistic regression analysis was conducted to determine the association between comprehensive HIV/AIDS knowledge and HIV testing. The results of the fixed effects model were presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The average prevalences of HIV testing and comprehensive HIV/AIDS knowledge among men in SSA were 53.5% and 50.8% respectively. Rwanda and Niger recorded the highest (93.6%) and lowest prevalences (9.8%) respectively. The prevalence of comprehensive HIV/AIDS knowledge among men in the 29 countries was 50.8%, with the highest in Rwanda (76.4%) and the lowest in Benin (31.1%). Men who had no comprehensive HIV/AIDS knowledge were less likely to test for HIV compared with those who had comprehensive HIV/AIDS knowledge (AOR=0.59, CI: 0.57-0.60). Men who were older than 20 years, married or cohabiting, with at least secondary education, in the richest wealth quintile, exposed to mass media, used condoms and with multiple sexual partners were more likely to test for HIV. To improve HIV testing among men in SSA, this study recommends that policymakers and stakeholders step up comprehensive HIV/AIDS knowledge sensitization and education using effective tools such as mass media.

Provider Perspectives on Barriers to Routine HIV Testing of Adolescent and Young Adult Patients in Emergency Department Settings.

HIV testing rates among US youth aged 13-24 years are sub-optimal, with high rates of missed testing opportunities in emergency departments (EDs). We assessed barriers to routine HIV testing of youth in urban ED settings from the perspective of healthcare providers. Ten physicians and nurses were recruited from the pediatric and adult EDs at a high-volume hospital in New York City, USA to complete in-depth interviews to provide their perspectives on barriers to routine HIV testing of youth ages 13 to 24 in EDs. Interviews were conducted using a semi-structured interview guide with questions and probes. All interviews were conducted via Zoom due to the COVID-19 pandemic and were audio-recorded and transcribed verbatim. Transcripts were coded independently by two researchers using an inductive thematic analysis approach. Participants often offered HIV testing to youth in the ED based on their perceptions of patients' HIV risk, with pediatric providers sometimes discouraging adolescents they perceived to be at low HIV risk from testing. Participants cited other priorities, logistics of blood-based testing, and discomfort discussing HIV as other reasons for not offering HIV testing to all youth in the ED. Efforts are needed to encourage providers to offer HIV testing to all youth regardless of perceived risk, as the ED often serves as youths' only point of contact with the healthcare system. Emphasis on this and the importance of early detection, along with institutional change, clear guidance, and support for the testing process may help increase youth testing and avoid missed HIV diagnosis opportunities.

Factors Associated with HIV Testing Among People Who Inject Drugs: Findings from a Multistate Study at the Start of the COVID-19 Pandemic.

Few studies have examined HIV testing among people who inject drugs (PWID) during the COVID-19 pandemic. This study examines factors associated with PWID who have been recently (past six months) tested for HIV during the COVID-19 pandemic. PWID were recruited between August 2020 and January 2021 from 22 drug treatment and harm reduction programs in nine states and the District of Columbia. We used logistic regression to identify correlates of recent HIV testing among PWID (n = 289). Most (52.9%) PWID reported having been recently tested for HIV. Factors associated with recent HIV testing included: having attended college [adjusted odds ratio (aOR) 2.32, 95% confidence interval (95% CI) 1.32-4.10], weekly hunger (aOR 2.08, 95% CI 1.20-3.60), crystal methamphetamine injection (aOR 2.04, 95% CI 1.05-3.97), and non-metropolitan residence (aOR 0.33, 95% CI 0.13, 0.88). Findings suggest HIV testing initiatives should be expanded during times of crisis, such as global pandemics.

The effect of neighborhood characteristics on HIV risk behaviors, HIV testing, and Covid-19 incidence in Louisiana

Both the HIV pandemic and the COVID-19 pandemic have highlighted underlying racial and socioeconomic health disparities in Louisiana, as well as in the United States. Neighborhood factors, such as community violence and social vulnerability, likely play a significant role in these disparities.The goals of this study were to examine the relationship between community violence exposure and HIV sexual risk behaviors and to examine the impact of neighborhood-level social vulnerability on HIV testing practices and COVID-19 incidence.Data from the National HIV Behavioral Surveillance System, the CDC Social Vulnerability Index (SVI) Database, and the Louisiana Department of Health were analyzed. The CDC SVI was used to measure neighborhood-level social vulnerability, which comprises four related factors: socioeconomic status, household composition and disability, minority and language, and housing characteristics and transportation.First, the relationship between community violence exposure and HIV sexual risk behaviors was examined among an age-diverse population of heterosexually active adults. A positive association was observed between community violence exposure and HIV sexual risk behaviors. Gender did not modify this relationship.Second, the relationship between neighborhood-level social vulnerability and recent HIV testing history was examined. Neighborhood-level socioeconomic status was the only social vulnerability factor observed to be associated with recent HIV testing, where individuals residing in lower socioeconomic neighborhoods had lower odds of receiving a recent HIV test than those residing in higher socioeconomic neighborhoods. This association diminished as age increased.Third, the relationship between social vulnerability and COVID-19 incidence during the first six months of the COVID-19 pandemic within Louisiana census tracts was examined. All four factors measuring social vulnerability were found to be associated with COVID-19 incidence;Louisiana census tracts with higher levels of overall social vulnerability exhibited higher levels of COVID-19 incidences. The results of this study provide further evidence that neighborhood characteristics can influence health behaviors (e.g., sexual risk behaviors), access to healthcare (e.g., HIV testing), and health outcomes (e.g., COVID-19 infections). In conclusion, future public health initiatives should focus on identifying and removing barriers to health within identified vulnerable neighborhoods. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Maintaining HIV testing and treatment services in Zambia during COVID-19: a story of success and resilience.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is caused by a virus called severe acute respiratory syndrome coronavirus. As countries struggled to control the spread of the virus through among other measures closure of health facilities, repurposing of health care workers, and restrictions on people's movement, HIV service delivery was affected. OBJECTIVES: To assess the impact of COVID-19 on HIV service delivery in Zambia by comparing uptake of HIV services before and during COVID-19. METHODS: We used repeated cross-sectional quarterly and monthly data on HIV testing, HIV positivity rate, people living with HIV initiating ART and use of essential hospital services from July 2018 to December 2020. We assessed quarterly trends and measured proportionate changes comparing periods before and during COVID-19 divided into three different comparison time frames: (1) annual comparison 2019 versus 2020; (2) April to December 2019 versus same period in 2020; and (3) Quarter 1 of 2020 as base period versus each of the other quarters of year 2020. RESULTS: Annual HIV testing dropped by 43.7% (95%CI 43.6-43.7) in 2020 compared to 2019 and was similar by sex. Overall, annual recorded number of newly diagnosed PLHIV fell by 26.5% (95% CI 26.37-26.73) in 2020 compared to 2019, but HIV positivity rate was higher in 2020, 6.44% (95%CI 6.41-6.47) compared to 4.94% (95% CI 4.92-4.96) in 2019. Annual ART initiation dropped by 19.9% (95%CI 19.7-20.0) in 2020 compared to 2019 while use of essential hospital services dropped during the early months of COVID-19 April to August 2020 but picked up later in the year. CONCLUSION: While COVID-19 had a negative impact on health service delivery, its impact on HIV service delivery was not huge. HIV policies that were implemented before COVID-19 on testing made it easier to adopt COVID-19 control measures and to continue providing HIV testing services without much disruption.

Impact of COVID-19 Pandemic on HIV Testing Uptake Among Key Populations Enrolled in Targeted Intervention Program in Maharashtra, India.

The COVID-19 pandemic posed unprecedented challenges to HIV services globally. We evaluated the impact of the COVID-19 pandemic on the uptake of HIV testing in the Targeted Intervention (TI) program in Maharashtra-a high HIV burden state in India. Annual HIV testing was sustained during the pandemic year (2020-2021), at levels similar to the pre-pandemic year (2019-2020), among Female Sex Workers (FSW), Men having Sex with Men (MSM), Transgender (TG), and Truckers; but not among Migrants and Intravenous Drug Users (IDU). There was an acute decline during the lockdown across all typologies. Sharp recovery was seen among FSW, MSM, and TG during the early months of the un-lockdown. The community-based screening (CBS) approach primarily contributed to this recovery. Among migrants and truckers, recovery was delayed. There was an overall reduction of 58% in annual HIV-positive registrations. The community-based networks, participatory structures, and processes of HIV programs played an essential role in reaching the community during the pandemic.

Compounding vulnerabilities: victimization and discrimination is associated with COVID-19 disruptions to HIV-related care among gay, bisexual, and other men and transgender and nonbinary people who have sex with men in Kazakhstan.

Gay, bisexual, and other men and transgender and nonbinary people who have sex with men (MSM and TSM) are disproportionately impacted by the HIV epidemic in Kazakhstan. MSM and TSM in Kazakhstan also face high levels of discrimination and victimization, known barriers to engagement in HIV prevention and care. We examined data from surveys with 455 MSM and TSM collected May -- October 2020 to determine whether access to HIV testing and treatment was disproportionately limited among those exposed to victimization and discrimination during the early COVID-19 pandemic. Odds of reporting COVID-19 disruptions to HIV-related care access were significantly higher (OR: 1.96; 95% CI: 1.25-3.06; P = .003) among those who experienced recent sexual or gender-based victimization, and recent discrimination (OR: 2.93; 95% CI: 1.65-5.23; P < .001), compared to those who did not experience victimization or discrimination, respectively. Odds of reporting disruptions among those who experienced both victimization and discrimination were significantly higher (OR: 3.59; 95% CI: 1.88-6.86; P < .001) compared to those who experienced neither . Associations remained significant after adjustment for potentially confounding factors. Findings suggest the COVID-19 pandemic is compounding vulnerability among MSM and TSM in Kazakhstan - highlighting need for intervention efforts targeting the most marginalized groups.

Peer community health workers improve HIV testing and ART linkage among key populations in Zambia: retrospective observational results from the Z-CHECK project, 2019-2020.

INTRODUCTION: Zambia has made tremendous progress towards HIV epidemic control; however, gaps remain among key populations (KPs), such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and people in prisons and enclosed settings due to cultural, social and legal barriers. The University of Maryland, Baltimore Zambia Community HIV Epidemic Control for Key Populations (Z-CHECK) project aimed to improve HIV case-finding, linkage and treatment adherence at the community level for KPs in Zambia. We describe Z-CHECK strategies and examine HIV positivity yield and antiretroviral therapy (ART) linkage among KPs to inform ongoing programme improvement. METHODS: Z-CHECK recruited, trained and deployed peer community health workers (CHWs) for KP groups, with ongoing mentorship in community engagement. CHWs offered HIV testing in safe spaces and escorted newly HIV-diagnosed clients for same-day ART initiation. Z-CHECK also reached out to KP community leaders and gatekeepers for KP mobilization and trained healthcare workers (HCWs) on KP services and sensitivity. We conducted a retrospective observational review of routinely collected aggregate data for KPs aged ≥15 years at high risk for HIV transmission across five districts in Zambia from January 2019 to December 2020. RESULTS: Z-CHECK provided HIV testing for 9211 KPs, of whom 2227 were HIV positive (positivity yield, 24%). Among these, 1901 (85%) were linked to ART; linkage for MSM, FSW, PWID and people in prisons and enclosed settings was 95%, 89%, 86% and 65%, respectively. Programme strategies that contributed to high positivity yield and linkage included the use of peer KP CHWs, social network testing strategies and opportunities for same-day ART initiation. Challenges to programme implementation included stigma and discrimination among HCWs, as well as KP CHW attrition, which may be explained by high mobility. CONCLUSIONS: Peer CHWs were highly effective at reaching KP communities, identifying persons living with HIV and linking them to care. Engaging KP community gatekeepers resulted in high diffusion of health messages and increased access to health resources. The mobility of CHWs and HCWs is a challenge for programme implementation. Innovative interventions are needed to support PWID and people in prisons and enclosed settings.

Impact of COVID-19 on the Belgian HIV epidemic: slowdown of HIV transmission and testing and adaptation of care.

BACKGROUND: To gain insight into the impact of the COVID-19 pandemic and containment measures on the HIV epidemic and services, this study aims to describe HIV trends in 2020 and compare them with previous years. METHODS: Belgian national HIV surveillance data 2017-2020 were analysed for trends in HIV testing, HIV diagnoses, VL measurements, ART uptake and PrEP purchase. Descriptive statistics from 2020 are compared to annual averages from 2017 to 2019 (proportional difference, %). RESULTS: In 2020, 725 HIV infections were diagnosed in Belgium (- 21.5% compared to 2019). The decline was most pronounced during the first lockdown in April-May but also present in July-December. The number of HIV tests performed decreased by 17.6% in 2020, particularly in March-May and October-December (- 57.5% in April and -25.4% in November 2020 compared to monthly 2017-19 numbers). Diagnosis of acute HIV infections decreased by 47.1% in 2020 (n = 27) compared to 2019 (n = 51). Late HIV diagnoses decreased by 24.7% (95% CI [- 40.7%; -9.7%]) in 2020 compared to 2019. Of patients in care in 2019, 11.8% interrupted HIV care in 2020 compared to 9.1% yearly in the 3 previous years. The number of HIV patients with VL monitoring per month dropped in March-May 2020, whilst proportions of VL suppression and ART coverage remained above 86% and 98.5% respectively in 2020. PrEP purchases, number of purchasers and starters dropped during April-May 2020 (respectively - 45.7%, - 47.4%, - 77.9% in April compared to February 2020). CONCLUSIONS: The significant decrease in HIV diagnoses in Belgium in 2020 coincided with the COVID-19 pandemic and following containment measures, particularly in April-May during the first lockdown. A slowdown of HIV transmission due to reduced HIV risk exposure is suggested by the halving in diagnosis of acute HIV infections in March-December 2020 compared to the previous year, and the adaptive decrease in PrEP use and PrEP initiation from April onwards. Despite a slight increase in HIV care interruptions, the indicators of quality of HIV care remained stable. Access to prevention, testing and care for all people living with HIV and at risk of acquiring HIV is a priority during and after times of pandemic.

Acceptability, Feasibility, and Efficacy of Telehealth Interventions for HIV Testing and Treatment in Adult Populations.

Introduction: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the rapid adoption of telehealth to provide HIV care and treatment. However, limited information exists about the feasibility, acceptability, and efficacy of telehealth interventions at different points of the HIV care continuum. Methods: A systematic search was conducted of Ovid MEDLINE, PsycINFO, and CINAHL databases to synthesize evidence regarding the feasibility, acceptability, and efficacy of videoconferencing and video-based interventions for HIV testing and treatment in adult populations. Seventeen articles published through July 2021 were included in the review. We used descriptive methods to analyze data, and findings were reported using frequencies and percentages. Results: Findings show that videoconferencing and video-based interventions are generally feasible and acceptable. Videoconferencing is effective in improving adherence to HIV treatment and in promoting HIV testing. In addition, video-based interventions were effective in promoting HIV testing, treatment initiation, and adherence to medication. Both modalities enhanced linkage and retention in treatment for HIV-positive patients. Conclusions: Video-based and videoconferencing interventions are beneficial in HIV testing and treatment. However, the scarcity of primary studies employing these telehealth modalities means that there is a need for more research in these areas. Also, reviewed studies suffered from several limitations, including reliance on subjective measures, lack of standardized ways of evaluating acceptability and feasibility, use of small sample sizes, and short follow-up durations. In addition, there was less representation of studies from resource-limited settings disproportionately affected by HIV and AIDS. Thus, future research should focus on addressing these challenges.

HIV Testing Among Gay, Bisexual, and Other Men Who Have Sex with Men During the COVID-19 Pandemic in China: Implications for Promoting HIV Self-Testing Among Key Populations.

The COVID-19 pandemic has created additional barriers to accessing sexual health services among gay, bisexual, and other men who have sex with men (GBMSM) in China. Yet, little is known about the frequency of HIV testing and how GBMSM get tested during the pandemic. We surveyed an online sample of GBMSM recruited on a gay networking app in China. Among 956 sexually active, 70.1% had received an HIV test in the past 6 months. Among these, 61.0% reported having undergone HIV self-testing (HIVST). Young GBMSM aged 18-24 years old were more likely to receive a recent HIV test, and the number of sexual partners was associated with recent HIV testing [adjusted odds ratio (AOR) = 1.14, 95% confidence interval (CI): 1.03-1.20]. Among those who had a recent HIV test, young GBMSM and those who had anal sex with both main partner and casual partners were more likely to utilize HIVST (AOR = 1.83, 95% CI: 1.16-2.84), as well as GBMSM who did not use a condom the last time engaged in anal sex (AOR = 1.57, 95% CI: 1.06-2.34). Among GBMSM never tested for HIV, a majority perceived low risk of HIV, while some suggested that they did not know where to get tested or they were scared of finding out they had HIV. HIVST has the potential to fill the gap in HIV testing among Chinese GBMSM, and future HIV testing programs should emphasize HIV education, accurate information dissertation, and timely point-to-care services.

Delayed HIV diagnosis during the COVID-19 pandemic in Poland: A call for targeted HIV testing for those under suspicion of SARS-CoV-2.

OBJECTIVES: The aim of this study was to analyse patients newly diagnosed with HIV who were originally admitted to hospitals with suspicion of COVID-19. METHODS: This was a retrospective case series undertaken at four sites. Only adults with new HIV diagnosis and COVID-19 exclusion hospitalized in 2020-2021 were included. Demographic, clinical and laboratory data were collected from medical records. RESULTS: Twenty-five patients were included in the analysis: 19 men (76%), 11 of Ukrainian origin (44%). The median age was 38.5 years (range 25-59). The mode of HIV transmission was heterosexual for 11 (44%) patients, eight (32%) were men who have sex with men and three (12%) were people who inject drugs. The median duration of symptoms prior to hospital presentation was 20.6 days (range 3-90). The median number of SARS-CoV-2 tests per patient was 2.62 (range 1-7). All SARS-CoV-2 tests were negative. Screening for HIV was performed on average on the 18th day of hospitalization (range 1-36 days). Twenty-three patients (92%) were late presenters, 22 (88%) had advanced disease, and 19 (76%) were in the AIDS stage. The median CD4 T-cell count was 72 cells/µL (range 3-382). The rate of positive HIV testing at the two sites where it was available for people with suspected COVID-19 was 0.13% (7/5458 during the study period). CONCLUSIONS: We strongly recommend introducing the HIV screening test in the diagnostic algorithm for every patient suspected of having COVID-19, presenting with clinical and/or radiological pulmonary symptoms.

Changes in HIV Testing Utilization Among Chinese Men Who Have Sex With Men During the COVID-19 Pandemic in Shenzhen, China: An Observational Prospective Cohort Study.

Background: The Coronavirus Diseases 2019 (COVID-19) directly affects HIV prevention and sexual health services utilization among men who have sex with men (MSM). This study investigated changes in human immunodeficiency virus (HIV) testing utilization among MSM before and after the COVID-19 pandemic received initial control in Shenzhen, China. Methods: This study was a sub-analysis of a prospective observational cohort study conducted among MSM in Shenzhen, China between August 2020 and May 2021. Participants were recruited through outreaching in gay venues, online recruitment, and peer referral. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. This study was based on 412 MSM who reported to be HIV-negative/unknown sero-status at baseline, 297 (72.1%) of them completed the follow-up online survey. Multilevel logistic regression models (level 1: sources of recruitment; level 2: individual participants) were fitted. Results: When comparing follow-up data with baseline data, a significant increase was observed in the uptake of any type of HIV testing (77.9% at Month 6 vs. 59.2% at baseline, p < 0.001). After adjusting for age group, education level, current employment status and monthly personal income, two predisposing factors were associated with higher uptake of HIV testing during the follow-up period. They were: (1) condomless anal intercourse with male non-regular male sex partners at follow-up only (AOR: 5.29, 95%CI: 1.27, 22.01) and (2) sanitizing before and after sex at baseline (AOR: 1.26, 95%CI: 1.02, 1.47). Regarding enabling factors, utilization of HIV testing (AOR: 3.90, 95%CI: 2.27, 6.69) and STI testing (AOR: 2.43, 95%CI: 1.20, 4.93) 6 months prior to the baseline survey was associated with higher uptake of HIV testing during the follow-up period. Having the experience that HIV testing service providers reduced service hours during the follow-up period was also positively associated with the dependent variable (AOR: 3.45, 95%CI: 1.26, 9.41). Conclusions: HIV testing utilization among MSM might rebound to the level before the COVID-19 outbreak after the pandemic received initial control in China. This study offered a comprehensive overview to identify potential reasons that can influence the uptake of HIV testing among Chinese MSM.

The effect of neighborhood characteristics on HIV risk behaviors, HIV testing, and Covid-19 incidence in Louisiana

Both the HIV pandemic and the COVID-19 pandemic have highlighted underlying racial and socioeconomic health disparities in Louisiana, as well as in the United States. Neighborhood factors, such as community violence and social vulnerability, likely play a significant role in these disparities.The goals of this study were to examine the relationship between community violence exposure and HIV sexual risk behaviors and to examine the impact of neighborhood-level social vulnerability on HIV testing practices and COVID-19 incidence.Data from the National HIV Behavioral Surveillance System, the CDC Social Vulnerability Index (SVI) Database, and the Louisiana Department of Health were analyzed. The CDC SVI was used to measure neighborhood-level social vulnerability, which comprises four related factors: socioeconomic status, household composition and disability, minority and language, and housing characteristics and transportation.First, the relationship between community violence exposure and HIV sexual risk behaviors was examined among an age-diverse population of heterosexually active adults. A positive association was observed between community violence exposure and HIV sexual risk behaviors. Gender did not modify this relationship.Second, the relationship between neighborhood-level social vulnerability and recent HIV testing history was examined. Neighborhood-level socioeconomic status was the only social vulnerability factor observed to be associated with recent HIV testing, where individuals residing in lower socioeconomic neighborhoods had lower odds of receiving a recent HIV test than those residing in higher socioeconomic neighborhoods. This association diminished as age increased.Third, the relationship between social vulnerability and COVID-19 incidence during the first six months of the COVID-19 pandemic within Louisiana census tracts was examined. All four factors measuring social vulnerability were found to be associated with COVID-19 incidence;Louisiana census tracts with higher levels of overall social vulnerability exhibited higher levels of COVID-19 incidences. The results of this study provide further evidence that neighborhood characteristics can influence health behaviors (e.g., sexual risk behaviors), access to healthcare (e.g., HIV testing), and health outcomes (e.g., COVID-19 infections). In conclusion, future public health initiatives should focus on identifying and removing barriers to health within identified vulnerable neighborhoods. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Intention to use and acceptability of home-based sexual health care among men who have sex with men who previously attended clinic-based sexual health care.

The COVID-19 pandemic has temporarily disrupted access to clinic-based sexual health care for men who have sex with men (MSM) in the Netherlands. The importance of home-based sexual health care has been underpinned as an extension of clinic-based care. This paper aims to assess intention to use, and acceptability of home-based sexual health care among MSM who previously attended clinic-based sexual health care. In November 2020, 424 MSM who had attended an STI clinic pre-pandemic were invited to participate in an online survey; 154 MSM completed the survey (response 36%). Intention to use self-sampling STI/HIV tests was assessed (median; scale 0-100) and compared across sociodemographic and sexual behavior characteristics by Kruskal-Wallis H tests. Descriptive analyses provided insights in acceptability of home-based sexual health care. Of participants (median age 47), 60.4% (93/154) tested for STI/HIV in the past 6 months, most of them attended a clinic. The median score on intention to use self-sampling tests was 86.5 (SD = 33.4) and did not differ by sociodemographic or sexual behavioral characteristics (all p-values > 0.1). Participants were positive toward online sexual health counseling (median attitude = 75.0, SD = 29.6) and their main preferred topics were PrEP use and STI/HIV testing. MSM who attended clinic-based care expressed intention to use self-sampling tests and a positive attitude toward online sexual health counseling. Home-based sexual health care elements are not currently integrated within Dutch clinic-based sexual health care and should be considered an addition for continued provision of care and extended reach of MSM.

Changes in HIV testing trends in Poland during COVID-19 pandemic.

INTRODUCTION: At the beginning of COVID-19 pandemic, due to lockdown, limited mobility, as well as changes in the activity profile of some laboratories, the restriction also applied to access to various screening tests, including HIV screening tests. AIM: The aim of the study was to assess HIV testing trend during COVID-19 pandemic in laboratories in Poland and its comparison to the preceding years, with special focus on testing in the network of Voluntary Testing and Counselling (VCT) sites serving population with higher behavior risk, which increase the possibility of HIV infection. MATERIAL AND METHODS: Analysis of the changes in HIV tests number was based on the results of the annual survey of HIV tests conducted among the laboratories throughout the country. The questionnaire included data on screening and positive tests by testing site type, age group and gender. In addition, we extracted data collected in comprehensive National AIDS Centre database, based on epidemiological and behavior data collected by VCT on people who come for testing. RESULTS: There are approximately 400,000 HIV tests annually run in general population in last years. COVID-19 pandemic, which occurred in beginning of 2020 did not have a huge impact on HIV test number among these population, because there was observed 1% decreased. Pandemic COVID-19, due to few lockdown reduced the HIV tests number among VCT clients - population with higher HIV risk infection. Tests number decreased by 44% compare to previous year, due to temporal closed of these centres. Data analysis shows that due to the pandemic, the structure of the surveyed people changed, especially in terms of age and gender, and the place where the study was performed. CONCLUSION: We confirmed low HIV testing rates in general population and low positivity rate over the studied period. The positivity rate was higher in the testing site network targeting individuals engaging in high risk behaviors. Changes observed in HIV testing trends in recent years have been affected by the COVID-19 pandemic.

Acceptability and feasibility of leveraging community-based HIV counselling and testing platforms for same-day oral PrEP initiation among adolescent girls and young women in Eastern Cape, South Africa.

INTRODUCTION: Community-based delivery of HIV pre-exposure prophylaxis (PrEP) to South African adolescent girls and young women's (AGYW) could increase access but needs evaluation. We integrated PrEP services via home-based services and pop-up tents into existing community-based HIV testing services (CB-HTS) in Eastern Cape Province, South Africa. METHODS: After accessing CB-HTS via a "pop-up" tent or home-based services, HIV-negative AGYW aged 16-25 years were invited to complete a baseline questionnaire and referred for PrEP services at a community-based PrEP site co-located with pop-up HTS tents. A 30-day supply of PrEP was dispensed. PrEP uptake, time-to-initiation, cohort characteristics and first medication refill within 90 days were measured using descriptive statistics. RESULTS: Of the 1164 AGYW who tested for HIV, 825 (74.3%) completed a questionnaire and 806 (97.7%) were referred for community-based PrEP. Of those, 624 (77.4%) presented for PrEP (482/483 [99.8%] from pop-up HTS and 142/323 [44.0%] from home-based HTS), of which 603 (96.6%) initiated PrEP. Of those initiating PrEP following home-based HTS, 59.1% initiated within 0-3 days, 25.6% within 4-14 days and 15.3% took ≥15 days to initiate; 100% of AGYW who used pop-up HTS initiated PrEP the same day. Among AGWY initiating PrEP, 37.5% had a detectable sexually transmitted infection (STI). Although AGYW reported a low self-perception of HIV risk, post-hoc application of HIV risk assessment measures to available data classified most study participants as high risk for HIV acquisition. Cumulatively, 329 (54.6%) AGYW presented for a first medication refill within 90 days of accepting their first bottle of PrEP. CONCLUSIONS: Leveraging CB-HTS platforms to provide same-day PrEP initiation and refill services was acceptable to AGYW. A higher proportion of AGYW initiated PrEP when co-located with CB-HTS sites compared to those referred following home-based HTS, suggesting that proximity of CB-HTS and PrEP services facilitates PrEP uptake among AGYW. The high prevalence of STIs among those initiating PrEP necessitates the integration of STI and HIV prevention programs for AGYW. Eligibility for PrEP initiation should not be required among AHYW in high HIV burden communities. Community-based service delivery will be crucial to maintaining access to PrEP services during the COVID-19 pandemic and future health and humanitarian emergencies.