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1.
Swiss Med Wkly ; 152: w30192, 2022 06 20.
Article in English | MEDLINE | ID: covidwho-2202458

ABSTRACT

BACKGROUND: Changes in mental and sexual health among men having sex with men (MSM) due to the SARS-CoV-2 pandemic remain unclear. METHODS: Design: Longitudinal analysis of an ongoing, multicentre, pre-exposure prophylaxis (PrEP) cohort (NCT03893188) in Switzerland. Participants: HIV-negative MSM aged ≥18 who completed at least one questionnaire before and one after the start of the SARS-CoV-2 pandemic. Outcomes: Primary: mental health, defined as anxiety and depression scores assessed by the Patient Health Questionnaire-4. Secondary: sexual behaviour, well-being, PrEP use and disruption of care. Outcomes were assessed over seven periods corresponding to different SARS-CoV-2 prevention measures in Switzerland. We performed pairwise comparisons between periods (Wilcoxon signed rank test). RESULTS: Data from 1,043 participants were included. Whilst anxiety scores remained stable over time, depression scores worsened in the second wave and the second lockdown period compared to pre-pandemic scores. This was confirmed by pairwise comparisons (pre-SARS-CoV-2/second wave and pre-SARS-CoV-2/second lockdown: p <0.001). Downward trends in sexual activity,sexualized substance use, and a switch from daily to "event-driven" PrEP were found. Disruption of care affected 42.6% (790/1856) of daily PrEP users' follow-up visits. CONCLUSION: In this longitudinal analysis of a PrEP cohort enrolling MSM, depression scores worsened in the second wave and the second lockdown compared to the pre-pandemic period.


Subject(s)
COVID-19 , HIV Infections , Pre-Exposure Prophylaxis , Sexual Health , Sexual and Gender Minorities , COVID-19/prevention & control , Cohort Studies , Communicable Disease Control , HIV Infections/drug therapy , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Pandemics/prevention & control , SARS-CoV-2 , Sexual Behavior
2.
Int J Environ Res Public Health ; 19(22)2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2143128

ABSTRACT

There is an increasing interest in father-child interactions and their effects. Due to the rising number of working mothers, marital interruptions, divorces, and child custody arrangements, paternal duties and the relevance of fathering continue to be re-evaluated. As there are rising expectations for men to undertake more childcare and household responsibilities, it was hypothesized that the presence of a disabled or chronically ill child would have a significant impact on the couple's future family situation, marital conduct due to paternal dissatisfaction, and increased stress levels. Therefore, the purpose of this study was to examine paternal intimacy problems, stress levels, and couple satisfaction inside families that have children with cystic fibrosis. The study followed a cross-sectional design with five questionnaires that were answered by a total of 107 fathers of children with cystic fibrosis from the "cases" group as the reference group, and 124 fathers of healthy children from the "control" group. The statistically significant findings of the current study show that men who were taking care of their child with mucoviscidosis engaged less frequently in sexual activity. A significantly higher number of these respondents were smokers. A higher proportion of them reported marital distress (OR = 2.54) and inhibited sexual desire (OR = 2.02), all in association with a higher number of men taking psychiatric medication (7.5% vs. 1.6%). More than 40% of all respondents declared high levels of general stress and parenting distress, while the most frequently used coping mechanism for stress was avoidance-oriented (45.8% vs. 25.8%). Other important findings were the high levels of dissatisfaction and lower levels of marital quality on the SII scale, equivalent to the intimacy problems on the MIQ scale. It is likely that paternal stress is higher when parenting children with cystic fibrosis, and the lack of intervention in this vulnerable group seem to be associated with intimacy problems, couple dissatisfaction, and maladaptive coping mechanisms. It is recommended that these concerns should not only be raised for the mothers of children with mucoviscidosis, but also for the child's father or the male caretaker partner since they might experience the same problems as the opposite gender.


Subject(s)
Cystic Fibrosis , Personal Satisfaction , Female , Humans , Male , Cross-Sectional Studies , Cystic Fibrosis/epidemiology , Father-Child Relations , Sexual Behavior
4.
Sex Transm Dis ; 49(12): 844-850, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2117649

ABSTRACT

BACKGROUND: The purpose was to assess COVID-19 beliefs and attitudes and examine COVID-19-related changes in sexual behavior of men who have sex with men during 3 time periods: April-July 2020 (T1), August-December 2020 (T2), January-May 2021 (T3). METHODS: Data were analyzed from 157 men who have sex with men in Ohio recruited to participate in a longitudinal multisite network study of syphilis epidemiology in 3 US cities: Columbus, Ohio; Baltimore, Maryland; and Chicago, Illinois. In April 2020, a COVID-19 module was appended to existing baseline and follow-up surveys to assess beliefs, attitudes, and changes in sexual behavior. Sample characteristics were summarized. Correlations between demographic variables (age, racial identity) and COVID-19 outcomes were examined. RESULTS: In response to COVID-19 social distancing restrictions and self-reported anxiety, some men limited sexual activity at T1, but the majority (n = 105 [67%]) continued to engage in sex. The number of men engaging in sex increased over time (T2: n = 124 [79%]; T3: n = 121 [77%]). At T1, men not in a relationship more frequently reported having less sex compared with prepandemic (n = 39 [57%]). By T3, men in a relationship more frequently reported less sex (n = 32 [54%]). Increased anxiety about sex and condom use was positively correlated with identifying as a man of color (P < 0.001). Most of the sample reported either starting or increasing online sexual activity during each time period. CONCLUSIONS: Future efforts to target sexual health during a pandemic or other health emergencies should prioritize men of color and address the unique perspective of both single and partnered men.


Subject(s)
COVID-19 , Sexual Behavior , Sexual and Gender Minorities , Humans , Male , COVID-19/epidemiology , Homosexuality, Male , Ohio/epidemiology , Pandemics
5.
Sex Transm Dis ; 49(10): 687-694, 2022 10 01.
Article in English | MEDLINE | ID: covidwho-2117483

ABSTRACT

BACKGROUND: The COVID-19 pandemic adversely affected sexual health services. Given the burden of sexually transmitted infections (STIs) on sexual and gender minorities (SGMs), we estimated incidence of self-reported STI diagnoses and factors associated with STI diagnoses among SGMs during the pandemic's first year. METHODS: A cohort of 426 SGM persons, 25 years or older, recruited in Chicago, Milwaukee, Detroit, Minneapolis, and Houston completed 5 online surveys from April 2020 to February 2021. Persons self-reported on each survey all health care provider STI diagnoses. Kaplan-Meier was used to estimate the cumulative risk of STI diagnoses, stratified by human immunodeficiency virus (HIV) status. Factors associated with STI diagnoses were assessed with a longitudinal negative binomial regression. RESULTS: Median age was 37 years, and 27.0% were persons living with HIV (PLH). Participants reported 63 STIs for a cumulative incidence for PLH and HIV-negative persons of 0.19 (95% confidence interval [CI], 0.13-0.29) and 0.12 (95% CI, 0.09-0.17), respectively. Regardless of HIV, a younger age and changes in health care use were associated with STI diagnoses. Among HIV-negative persons, the rate of STI diagnoses was higher in Houston than the Midwest cities (adjusted relative risk, 2.37; 95% CI, 1.08-5.20). Among PLH, a decrease in health care use was also associated with STI diagnoses (adjusted relative risk, 3.53; 95% CI, 1.01-12.32 vs no change in health care services), as was Hispanic ethnicity and using a dating app to meet a sex partner. CONCLUSIONS: Factors associated with STI diagnoses during the COVID-19 pandemic generally reflected factors associated with STI incidence before the pandemic like geography, HIV, age, and ethnicity.


Subject(s)
COVID-19 , HIV Infections , Sexual and Gender Minorities , Sexually Transmitted Diseases , Adult , COVID-19/epidemiology , Cities , HIV Infections/diagnosis , HIV Infections/epidemiology , Homosexuality, Male , Humans , Male , Pandemics , Sexual Behavior , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/epidemiology , United States
6.
Sci Rep ; 12(1): 19421, 2022 Nov 12.
Article in English | MEDLINE | ID: covidwho-2119326

ABSTRACT

To investigate the impact and factors of home quarantine life on women's sexual lives and behaviors in different areas of China and analyze the prevalence of female sexual dysfunction (FSD) during the COVID-19 pandemic. We surveyed adult women who had a regular sexual life (including regular masturbation) and had been isolated at home for at least one month during the COVID-19 outbreak using online questionnaires. This survey recovered 678 complete questionnaires after screening. According to the findings, the overall score of the Female Sexual Function Inventory (FSFI) during the pandemic was 21.98 ± 6.38, the frequency of FSD was 61.9%, and the frequencies of FSD in Shanghai, Nanjing, and Ningxia were 60.6%, 75.2%, and 52.2%, respectively. The frequency of FSFI scores and other specific items (Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain) varied significantly across the three regions (P < 0.05). The overall frequency of FSD in the masturbation population was 34.4%, which was lower than the frequency of FSD in women having paired sexual intercourse (60.1%) (p < 0.05). Further analysis revealed that the occurrence of FSD during the pandemic was related to different age stages, menopause, mode of delivery, level of anxiety and depression, and sexual lifestyles. The COVID-19 pandemic has had a great impact on people's spiritual and sexual lives, which are caused by multiple different variables related to both the individual and the environment. We should emphasize the importance of sexual health in epidemics, and having a harmonious and stable sex life will help us survive the boring life of isolation.


Subject(s)
COVID-19 , Sexual Dysfunctions, Psychological , Adult , Female , Humans , Male , Sexual Dysfunctions, Psychological/epidemiology , Cross-Sectional Studies , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics , Quarantine , China/epidemiology , Sexual Behavior , Surveys and Questionnaires
7.
Reprod Health ; 19(1): 207, 2022 Nov 05.
Article in English | MEDLINE | ID: covidwho-2108804

ABSTRACT

The COVID-19 pandemic has aggravated pre-existing challenges associated with adolescents' sexual and reproductive health and rights (SRHR). Evolving evidence suggest that it could adversely impact the progress made towards improving sexual and reproductive health outcomes among young people. The pandemic has stalled achievements in reducing adolescent pregnancy and child marriage by reinforcing contextual and structural determinants of these reproductive health outcomes, especially among girls. The pandemic has increased disruptions to schooling, decreased access to sexual and reproductive health services and compounded pre-existing socio-economic vulnerabilities. The consequences of neglecting adolescent sexual and reproductive health services over the past 2 years, to focus on COVID-19, continue to emerge. This commentary argues for targeted and responsive approaches to adolescent SRHR that tackle preventable consequences resulting from inequities faced by adolescents globally, particularly girls.


Subject(s)
COVID-19 , Pregnancy in Adolescence , Sexual Health , Adolescent , Child , Pregnancy , Female , Humans , Reproductive Health , Pandemics , Sexual Behavior
8.
Glob Public Health ; 17(10): 2460-2467, 2022 10.
Article in English | MEDLINE | ID: covidwho-2097151

ABSTRACT

The pandemic as a portal has deeply changed life as we know it, including our homes. While countries continue to strengthen their health systems and policies, marginalized groups in local communities are absorbed, reassembled, and transformed in everyday 'portals' which generate mutually entangled and composite forces of unification and healing as well as forces of division and wounding. In this commentary, I argue that these forces can be taken as embodying a geopolitics of love already subsumed by intimate, proximal, and mediated relations, therefore leaving out aspects of love that are populated by voids, hollows, and liminalities. Here, I reflect upon Massey's spatial politics vis-a-vis Harrison's notion of non-relationality in order to puncture the representational limits of the geopolitical as a way to transform 'bad' love (i.e. love that eclipses pains, sufferings, and otherness) while simultaneously not succumbing to a desire for sameness underpinning 'good' love (i.e. love that promotes unification and healing). Specifically, I suggest that the nonrelationality of place making and its geographies of nowhereness may lead us back home to love as always already there.


Subject(s)
COVID-19 , Love , Humans , Policy , Politics , Sexual Behavior
9.
Child Adolesc Psychiatr Clin N Am ; 31(2): 261-275, 2022 04.
Article in English | MEDLINE | ID: covidwho-2093307

ABSTRACT

Black, Indigenous, and other Youth of Color (BIPOC youth) experience racism from a young age. These experiences have both immediate and long-term impacts on their health and wellbeing. Systemic racism contributes to the inequitable distribution of health resources and other social determinants of health, creating barriers to accessing care. Substance use disorders and sexual/nonsexual risk behaviors have been linked to experiences of racism in BIPOC youth. The legacy of generational racial trauma can frame behaviors and attitudes in the present, undermining health and survival in this group. BIPOC youth also face difficulties navigating spheres characterized as white spaces. Ethnic-racial socialization may promote resilience and help with coping in the context of racial stress. While many professional health organizations have embraced dismantling racism, a shift in the narrative on racial values will be critical for preventing adversity and achieving health equity for BIPOC youth.


Subject(s)
Racism , Adaptation, Psychological , Adolescent , African Americans , Humans , Sexual Behavior , Socialization
10.
J Pediatr Adolesc Gynecol ; 35(5): 575-584, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2084450

ABSTRACT

OBJECTIVE: The objective of this scoping review is to synthesize and identify gaps in existing research on accessibility of telemedicine-delivered contraceptive health services to female adolescents and young adults (AYAs) and acceptability of these services to AYA patients and their medical providers. METHODS: We searched the PubMed, Scopus, Embase, and CINAHL databases to extract relevant studies on telemedicine and provision of contraceptive services among non-institutionalized, non-chronically ill female AYAs, ages 10 through 24 years. RESULTS: We screened 154 articles, and 6 articles representing 5 studies met the full inclusion criteria. Three studies assessed telemedicine acceptability and accessibility from the perspective of providers, and 3 described patients' perceived accessibility and acceptability of a theoretical telemedicine visit. No studies directly assessed AYA patients' satisfaction with actual telemedicine visits for contraceptive services. Providers viewed telemedicine-delivered sexual and reproductive health (SRH) services as acceptable to themselves and AYA patients. Most AYAs reported that they would use telemedicine for SRH services, although they would prefer in-person care. All articles identified concerns about privacy and confidentiality as a barrier to SRH telemedicine care. CONCLUSIONS: Telemedicine-delivered contraceptive health services for AYAs were perceived as acceptable and accessible by providers and by most AYA patients, although patients reported a preference for in-person care. However, none of these findings are based on patients' actual experiences with SRH telemedicine. Further research is needed to directly assess the accessibility and acceptability of telemedicine-delivered contraceptive health services for female AYA patients.


Subject(s)
Adolescent Health Services , Reproductive Health Services , Telemedicine , Adolescent , Child , Contraceptive Agents , Female , Humans , Sexual Behavior , Young Adult
11.
BMJ Open ; 12(10): e066777, 2022 10 17.
Article in English | MEDLINE | ID: covidwho-2078991

ABSTRACT

OBJECTIVES: Sexual harassment among adolescent girls and young women (AGYW) is a prevalent and understudied form of gender-based violence (GBV) with negative impacts on health and well-being. The COVID-19 pandemic raised global concern about GBV within homes; less is known about how it affected GBV in public spaces. METHODS: Present analyses use cross-sectional data from a cohort of adolescents and young adults residing in Nairobi, Kenya, restricted to female participants. Data were collected August-October 2020 via phone after implementation of COVID-19 restrictions. Prevalence of past-year sexual harassment and harassment relative to COVID-19 restrictions were calculated for overall sample, and by individual, household, and pandemic-related factors. Multivariate negative binomial regression models examine correlates of (1) past-year sexual harassment and (2) increases in sexual harassment relative to COVID-19 restrictions. RESULTS: Overall, 18.1% of AGYW experienced past-year sexual harassment at the 2020 survey. Among this group, 14.6% experienced sexual harassment pre-COVID-19 only, 18.8% after only and 66.6% at both time points. Among the latter group, 34.9% reported more occurrences following COVID-19 restrictions, 20.5% reported less occurrences and 44.7% reported no change in occurrence. Overall, 42.0% of AGYW experienced an increase in sexual harassment while 58.0% experienced no increase since COVID-19. In adjusted models, past-year sexual harassment was associated with higher educational attainment (adjusted risk ratio, aRR 2.11; 95% CI 1.27 to 3.52) and inability to meet basic financial needs (aRR 1.67; 95% CI 1.05 to 2.66). Increased sexual harassment since COVID-19 was associated with having full control to leave the home (aRR 1.69; 95% CI 1.00 to 2.90). CONCLUSIONS: Sexual harassment among AGYW in Nairobi, Kenya was prevalent before and during COVID-19 restrictions. Safety in public spaces remains a highly gendered issue that impacts women's safety and ability to participate in public life. Prevention and support services to address sexual harassment remain an important element in ensuring safe, sustainable public spaces.


Subject(s)
COVID-19 , HIV Infections , Sexual Harassment , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Female , HIV Infections/epidemiology , Humans , Kenya/epidemiology , Pandemics , Sexual Behavior , Young Adult
12.
J Infect Public Health ; 15(9): 1001-1005, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2076418

ABSTRACT

BACKGROUND: This study was conducted to compare the number of cases of non-airborne/droplet-transmitted notifiable infectious disease (NID) before and after COVID-19 pandemic. METHODS: This study used an open database - National Notifiable Diseases Surveillance System to collect the epidemiological data of NIDs. Ten fecal-oral-, six vector-borne-, four direct-contact, and four sexually-transmitted NIDs between pandemic period (defined as from January 2020 to December 2021) and the pre-pandemic period (defined as the period from January 2018 to December 2019) were included for the analysis. RESULTS: Overall, the annual case number of these 24 non-airborne/droplet-transmitted NIDs was 19,186, 19,101, 19,567, and 19,863 in 2018, 2019, 2020 and 2021, respectively. The overall case number in the pandemic period was higher than those in pre-pandemic period (39,430 vs 38,287) and the monthly case number was significantly higher in pandemic period than pre-pandemic period (1643 vs 1595, p < 0.05). However, the lower case number in the pandemic period than those in pre-pandemic period was observed in overall ten fecal-oral-transmitted NIDs (1278 vs 1775), six vector-borne-NIDs (922 vs 2210), and four direct-contact transmitted NIDs (196 vs 344). In contrast, the case number of sexually-transmitted NIDs in the pandemic period was higher than those in pre-pandemic period (37,034 vs 33,958), particularly for gonorrhea (14,463 vs 8732). CONCLUSIONS: Most of the fecal-oral-, vector-borne, and direct-contact transmitted NIDs had declined during pandemic in Taiwan. In contrast, gonorrhea had large increase, and other NPIs were needed.


Subject(s)
COVID-19 , Gonorrhea , COVID-19/epidemiology , Gonorrhea/epidemiology , Humans , Pandemics , Sexual Behavior , Taiwan/epidemiology
13.
PLoS One ; 17(10): e0275068, 2022.
Article in English | MEDLINE | ID: covidwho-2065129

ABSTRACT

Covid-19 has been affecting people's lives on a social, economic, emotional, and sexual level. This study aims to investigate any change in how couples formed during the pandemic got to know the partner and experienced sexuality, including factors that could have influenced those changes in comparison with a pre-pandemic period. Particularly, focus groups (N = 26 women) were conducted and an online questionnaire (N = 120; 41 men and 79 women) was administered. Given the exploratory qualitative nature of the present research, no specific hypothesis was tested. Most of the sample reported an increase in sexual desire, sexual frequency, and quality of intercourse, perceiving an early development of intimacy. The results highlight the lack of stress and fear of contagion. The intense state of euphoria, typical of the initial phase of the relationship, has perhaps allowed the couples to overcome the obstacles due to the restrictions. This study underlines the role of being in love in the survival of the species, as it allows for the creation of steady relationships even in moments of danger.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Female , Humans , Male , Sexual Behavior/psychology , Sexual Partners/psychology , Sexuality/psychology
14.
AIDS ; 36(13): 1749-1759, 2022 11 01.
Article in English | MEDLINE | ID: covidwho-2051762

ABSTRACT

OBJECTIVE: To summarize the broad impact of the coronavirus disease 2019 (COVID-19) pandemic on HIV prevention and care in the United States with a focus on the status-neutral HIV care continuum. DESIGN: We conducted an editorial review of peer-reviewed literature on the topics of HIV-risk behaviors, sexually transmitted illness (STI) and HIV prevalence, HIV prevention and treatment trends, and evolving practices during the COVID-19 pandemic. METHODS: For relevant literature, we reviewed, summarized, and categorized into themes that span the HIV prevention and care continua, including sexual risk behaviors, mental health, and substance use. RESULTS: We identified important changes within each component of the HIV care continuum across the United States during the COVID-19 pandemic. Shifts in prevention practices, engagement with care, care provision, medication adherence, testing, and prevalence rates were observed during the pandemic. CONCLUSION: Although heightened disparities for people at risk for, and living with, HIV were seen during the COVID-19 pandemic, many health systems and clinics have achieved and maintained engagement in HIV prevention and care. This review highlights barriers and innovative solutions that can support durable and accessible health systems through future public health crises.


Subject(s)
COVID-19 , HIV Infections , Sexually Transmitted Diseases , COVID-19/epidemiology , COVID-19/prevention & control , Continuity of Patient Care , HIV Infections/epidemiology , HIV Infections/prevention & control , HIV Infections/psychology , Humans , Pandemics/prevention & control , Sexual Behavior , Sexually Transmitted Diseases/epidemiology , United States/epidemiology
15.
J Behav Med ; 45(5): 760-770, 2022 10.
Article in English | MEDLINE | ID: covidwho-2048387

ABSTRACT

Medical avoidance is common among U.S. adults, and may be emphasized among members of marginalized communities due to discrimination concerns. In the current study, we investigated whether this disparity in avoidance was maintained or exacerbated during the onset of the COVID-19 pandemic. We assessed the likelihood of avoiding medical care due to general-, discrimination-, and COVID-19-related concerns in an online sample (N = 471). As hypothesized, marginalized groups (i.e., non-White race, Latinx/e ethnicity, non-heterosexual sexual orientation, high BMI) endorsed more general- and discrimination-related medical avoidance than majoritized groups. However, marginalized groups were equally likely to seek COVID-19 treatment as majoritized groups. Implications for reducing medical avoidance among marginalized groups are discussed.


Subject(s)
COVID-19 , Healthcare Disparities , Pandemics , Patient Acceptance of Health Care , Social Marginalization , Vulnerable Populations , Adult , Body Mass Index , COVID-19/epidemiology , COVID-19/therapy , Ethnicity/statistics & numerical data , Female , Healthcare Disparities/statistics & numerical data , Humans , Male , Patient Acceptance of Health Care/statistics & numerical data , Racial Groups/statistics & numerical data , Sexual Behavior , Treatment Refusal/statistics & numerical data , United States/epidemiology , Vulnerable Populations/statistics & numerical data
16.
Sex Health ; 19(4): 329-335, 2022 08.
Article in English | MEDLINE | ID: covidwho-2050711

ABSTRACT

To make services more accessible, acceptable and affordable, sexual health service delivery models have embraced innovation, technology, outreach and decentralisation. In particular, some routine high-volume services, like asymptomatic testing for sexually transmitted infections (STIs), can be delivered in general practice, online or in non-clinical settings. On the surface, sexual health clinics, like hospitals or other primary care clinics, might appear to be operating on a model that has not changed significantly in recent times. However, globally sexual healthcare needs are rising both in volume and complexity, not all of which can be adequately met through decentralised care. Sexual health clinics themselves are the site of considerable innovation. The importance of sexual health clinics in the diagnosis and treatment of symptomatic STIs is likely to increase with the increasing burden of disease, the complexity of treatment guidelines and the emergence of new infections. Services essential to patient health such as immediate or complex clinical care, partner notification and safeguarding, and activities essential to the health system like research, training and supervision require expertise to be located where it can be accessed and maintained at reasonable cost. We do not know whether increasing some services outside existing models can safely compensate for reducing other services inside them.


Subject(s)
Sexual Health , Sexually Transmitted Diseases , Ambulatory Care Facilities , Contact Tracing , Humans , Sexual Behavior , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/therapy
17.
Sex Health ; 19(4): 309-318, 2022 08.
Article in English | MEDLINE | ID: covidwho-2050709

ABSTRACT

Partner notification (PN) remains a crucial prevention tool to reduce sexually transmitted infection (STI) transmission and prevent STI-related morbidity. Although there have been a variety of different approaches taken to facilitate the notification, testing and management of sexual contacts of STIs and HIV, there is an increasing acknowledgement that these interventions are unscalable and have relatively little impact on disease transmission. At the same time, an expanding body of evidence supports a shift in the emphasis of STI outreach-related work from an exclusive focus on PN to an approach that incorporates epidemiologic data collection, case management, and PN, an approach that is sometimes called partner services (PS). In this review, we appraise the current evidence base for different PN interventions for STIs in high-income nations, make recommendations for best practices, present a schema for how public health programs might prioritise PS for different programs, and identify priority research questions related to PN.


Subject(s)
HIV Infections , Sexually Transmitted Diseases , Contact Tracing , Developed Countries , HIV Infections/epidemiology , HIV Infections/prevention & control , Humans , Income , Sexual Behavior , Sexual Partners , Sexually Transmitted Diseases/epidemiology
18.
PLoS One ; 17(9): e0273776, 2022.
Article in English | MEDLINE | ID: covidwho-2043201

ABSTRACT

BACKGROUND: Manicaland province in eastern Zimbabwe has a high incidence of HIV. Completion of the seventh round of the Manicaland Survey in 2018-2019 provided the opportunity to assess the state of the epidemic prior to the start of the COVID-19 pandemic. The study aims were to: a) estimate HIV seroprevalence and assess whether prevalence has declined since the last round of the survey (2012-2013), b) describe and analyse the socio-demographic and behavioural risk factors for HIV infection and c) describe the HIV treatment cascade. METHODS: Participants were administered individual questionnaires collecting data on socio-demographic characteristics, sexual relationships, HIV prevention methods and treatment access, and were tested for HIV. Descriptive analyses were followed by univariate and multivariate analyses of risk factors for HIV seropositvity using logistic regression modelling based on the proximate-determinants framework. RESULTS: HIV prevalence was 11.3% [95% CI; 10.6-12.0] and was higher in females than males up to 45-49 years. Since 2012-2013 HIV prevalence has significantly declined in 30-44 year-olds in males, and 20-44 year-olds in females. The HIV epidemic has aged since 2012-2013, with an increase in the mean age of HIV positive persons from 38 to 41 years. Socio-demographic determinants of HIV prevalence were church denomination in males, site-type, wealth-status, employment sector and alcohol use in females, and age and marital status in both sexes. Behavioural determinants associated with increased odds of HIV were a higher number of regular sexual partners (lifetime), non-regular sexual partners (lifetime) and condom use in both sexes, and early sexual debut and concomitant STIs in females; medical circumcision was protective in males. HIV status awareness among participants testing positive in our study was low at 66.2%. ART coverage amongst all participants testing positive for HIV in our study was 65.0% and was lower in urban areas than rural areas, particularly in males. CONCLUSIONS: Prevalence has declined, and ART coverage increased, since 2012-2013. Majority of the associations with prevalence hypothesised by the theoretical framework were not observed in our data, likely due to underreporting of sexual risk behaviours or the treatment-as-prevention effect of ART curtailing the probability of transmission despite high levels of sexual risk behaviour. Further reductions in HIV incidence require strengthened primary prevention, HIV testing and linkage to risk behaviour counselling services. Our results serve as a valuable baseline against which to measure the impact of the COVID-19 pandemic on HIV prevalence and its determinants in Manicaland, Zimbabwe, and target interventions appropriately.


Subject(s)
COVID-19 , HIV Infections , Adult , Aged , COVID-19/epidemiology , Disease Outbreaks , Female , HIV Infections/prevention & control , Humans , Male , Pandemics , Prevalence , Seroepidemiologic Studies , Sexual Behavior , Zimbabwe/epidemiology
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