Party and play: Associations between US male sex workers' internet advertising characteristics and advertising chemsex to prospective clients.

INTRODUCTION: It is broadly recognised that chemsex is more prevalent among men who have sex with men, but little is known about chemsex in the context of commercial sexual encounters between men. This study investigates sex worker advertising characteristics and their advertised willingness to engage in chemsex with clients. METHODS: Data were web scraped from the profiles of US-based male sex workers (N = 3773) advertising services on an internet advertising platform in February 2021. This study describes the association between chemsex advertising and advertised age, race/ethnicity, sexual orientation, encounter type and COVID-19 acknowledgement. RESULTS: 28.5% of sex workers (n = 1077) advertised chemsex, 64.7% of whom were 25-34 years-old (n = 697). The odds of chemsex advertising increased between ages 21-24 (aOR = 1.20, 95% CI 1.09-1.32) and declined among sex workers over 35 years-old (aOR = 0.97, 95% CI 0.95-1.00). Sex workers advertising as bisexual were more likely to advertise chemsex than those identifying as gay (aOR = 1.38, 95% CI 1.18-1.63). Sex workers acknowledging COVID-19 were less likely to advertise chemsex compared to those who did not (aOR = 0.65, 95% CI 0.48-0.89). Encounter type was associated with chemsex advertising among sex workers in this sample; sex workers not offering the "boyfriend experience" were more than 50% less likely to advertise chemsex than those who did offer the boyfriend experience (aOR = 0.47, 95% CI 0.36-0.61). DISCUSSION AND CONCLUSIONS: Chemsex advertising in this population is likely influenced by multiple sociodemographic and occupational characteristics. Identifying sex workers likely to engage in chemsex based on advertising data could inform targeted education and harm-reduction campaigns in this population.

A Systematic Review of HIV Pre-exposure Prophylaxis (PrEP) Implementation in U.S. Emergency Departments: Patient Screening, Prescribing, and Linkage to Care.

In the pursuit of ending the HIV epidemic, U.S. emergency departments (EDs) have emerged as a valuable setting to increase HIV testing and linkage to care. There is limited data available, however, describing the incorporation of HIV prevention initiatives in U.S. EDs. Over the last decade, HIV pre-exposure prophylaxis (PrEP) has significantly changed the HIV prevention landscape globally and very little is known about the provision of PrEP in U.S. EDs. To address this gap in the literature, we conducted a systematic review of peer-reviewed quantitative studies and conference abstracts spanning July 2012 - October 2022. Of 433 citations, 11 articles and 13 abstracts meet our inclusion criteria, representing 18 unique studies addressing PrEP screening, prescribing, and/or linkage to PrEP care.Most studies describe screening processes to identify PrEP-eligible patients (n = 17); most studies leveraged a patient's STI history as initial PrEP eligibility screening criteria. Fewer studies describe PrEP prescribing (n = 2) and/or linkage to PrEP care (n = 8).Findings from this systematic review highlight the potential for U.S. EDs to increase PrEP uptake among individuals at risk for HIV infection. Despite a growing number of studies exploring processes for incorporating PrEP into the ED setting, such studies are small-scale and time limited. Models providing prescribing PrEP in the ED show higher initiation rates than post-discharge engagement models. Electronic health record (EHR)-based HIV screening is valuable, but post-ED linkage rates are low. Our findings emphasize the need to establish best practices for initiating and supporting prevention effective PrEP use in the ED setting.

Advertising Patterns of internet-Based Male Sex Workers Who Have Sex With Men (MSMSW): The Association Between LGBTQIA+ Events and Advertising for Work During the 2022 Pride Season.

Research into populations of male sex workers who have sex with men (MSMSW) has historically been stymied given the illegal, stigmatized nature of the profession. The internet has shaped how many sex workers advertise their services to clients. Few studies, however, have leveraged internet advertising data to inform MSMSW-specific public health programming and/or outreach efforts. The primary aim of this study was to describe the association between MSMSW advertising during LGBTQIA+ events in U.S. cities during the 2022 pride season. Data were web-scraped at weekly intervals from an internet platform popular among MSMSW in 16 U.S. cities with scheduled LGBTQIA+ events over 18 weeks June to October 2022. For each city, a Poisson regression was fitted for the outcome of number MSMSW advertisements/week and the association with LGBTQIA+ pride events (binary, no/yes), adjusted for month. Cities with the greatest number of MSMSW advertisements were New York City, San Francisco, and Chicago, with 848.2 (SD = 48.0), 293.3 (SD = 34.7), and 252.3 (SD = 22.8) mean weekly advertisements, respectively. LGBTQIA+ events were significantly (p < .05) associated with an increased number of MSMSW advertisements in San Francisco (incidence rate ratios (IRRs) = 1.16, 95% confidence interval (CI) = 1.07-1.25, p < .001), New York City (IRR = 1.15, 95% CI = 1.05-1.26, p < .005), and Chicago (IRR = 1.25, 95% CI = 1.12-1.39, p < .001). In these jurisdictions, LGBTQIA+ events could represent opportunities to overcome barriers to reaching MSMSW; findings from this study may assist in identifying priority cities for MSMSW-specific sexual health initiatives.

Surgical Site Infection Is Not Associated with 1-Year Progression-Free Survival After Endoprosthetic Reconstruction for Lower-Extremity Osteosarcoma: A Secondary Analysis of PARITY Study Data.

BACKGROUND: Although there is evidence suggesting that postoperative infection confers a survival benefit in osteosarcoma treated with resection and endoprosthetic reconstruction, there have been no prospective studies to date to support these findings. This secondary analysis of Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) study data examines the relationship between surgical site infection (SSI) and disease progression within 12 months after limb salvage surgery. METHODS: The PARITY trial was an international, multicenter, prospective randomized controlled trial of 604 patients who underwent resection of a lower-extremity bone tumor and endoprosthetic reconstruction. Our primary outcome was progression-free survival (PFS) at 1 year following surgery among the patients with osteosarcoma. Subgroup analyses by disease stage at presentation and infection severity were also performed. Cox proportional hazard models were employed to examine the association between clinical and tumor characteristics, SSI, and PFS. Kaplan-Meier analysis was used to determine the effect of SSI on PFS. RESULTS: The 274 PARITY patients with osteosarcoma were included in this secondary analysis. Thirty-two (11.7%) of the patients presented with metastasis at baseline; 53 (19.3%) of the patients developed an SSI. There was no difference in 1-year PFS between patients with and without SSI. There was no decreased risk of disease progression at 1 year in patients with localized disease at baseline who developed an SSI (hazard ratio [HR] = 1.21; 95% confidence interval [CI] = 0.64 to 2.28). Infection was associated with increased disease progression at 1 year in patients with baseline metastases (HR = 4.26; 95% CI = 1.11 to 16.3). CONCLUSIONS: No positive association was detected between postoperative infection and PFS at 1 year following surgery in this secondary analysis of prospective data. However, this analysis suggests infection could be a risk factor for early disease progression in patients with baseline metastases, and future investigations may better elucidate the association between disease burden and the host immune response to advance immunotherapeutic strategies for osteosarcoma. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Ecological study: MSM sex worker advertising amidst Monkeypox in three U.S. cities.

The 2022 monkeypox (MPX) outbreak was a source of consternation and stress among men who have sex with men (MSM)-the population disproportionately affected by the recent MPX outbreak. Individuals at high-risk for MPX (e.g., MSM, sex workers) were prioritized for vaccination during early state and city health department vaccine initiatives across the U.S., but little is known about how the MSM sex work market was affected by the MPX outbreak in U.S. cities where MPX incidence was particularly high. To better characterize the potential relationship between MPX incidence and MSM sex worker advertising at the height of the U.S. MPX outbreak, we monitored advertising volume on an Internet advertising platform popular among MSM sex workers and compared these data to city and county health department MPX case reporting data during a 13-week period (July 2nd, 2022- September 24th, 2022) in three U.S. cities with peak MPX incidence: Chicago, New York City, and San Francisco. In each of these cities, we observed a decline in advertising during or immediately following study week(s) with the highest number of weekly MPX cases during the study period, recognizing that observed decreases in advertising could be attributed to transient increase(s) in advertising during large-scale LGBT festivals occurring during the study period.

Contemporary adult gerontology acute care nurse practitioner (AGACNP) practice: Findings from the 2020 American Association of Critical Care Nurses AGACNP practice analysis survey.

BACKGROUND: National standards for nurse practitioner licensure require certification programs to conduct practice analyses to ensure that certified nurse practitioners possess the necessary knowledge for entry-level practice. The practice analysis for the American Association of Critical Care Nurses Certification Corporation (AACN Cert Corp) adult-gerontology acute care nurse practitioner (AGACNP) credential is performed every five years by the AACN Certification Corporation. PURPOSE: The AACN Cert Corp conducted a practice analysis to confirm that current AGACNP practice is reflected in the ACNPC-AG test plan, and the examination is congruent with 2008 consensus model guidelines. This work describes findings from the 2020 AACN Cert Corp practice analysis and changes in AGACNP practice and academic preparation based on the survey data. METHOD: In 2020, AACN Cert Corp volunteer subject matter experts (SMEs) developed a survey of practice activities and competencies relevant to AGACNP practice. Patient care activities and competencies were rated by AGACNP respondents for criticality and frequency. AACN SMEs reviewed criticality and frequency ratings to determine the patient care problems, skills/procedures, and competencies to include in the updated AACN Cert Corp ACNPC-AG test plan. RESULTS: The 2020 AGACNP practice analysis survey and subsequent review resulted in the retention of 33 skills and procedures, 165 patient care problems, and all national competencies in the final ACNPC-AG test plan. CONCLUSIONS AND IMPLICATIONS: The 2020 AACN Cert Corp AGACNP practice analysis survey describes possible changes in AGACNP practice and academic preparation that have occurred since the 2016 survey, findings that may be associated with the ongoing COVID-19 pandemic.

The COVID-19 pandemic and male sex workers who have sex with men: associations between age and race and advertising for work in 2019-2021.

Despite government-mandated restrictions on business and social activities worldwide, some sex workers continued to see clients in person throughout the COVID-19 pandemic. To better understand this behaviour, we compiled publicly available data from Internet advertisements posted on a popular website before and during the pandemic by male sex workers providing services to men. We first collected data in March 2019 from 172 advertisements - the complete number available at that time - posted by male sex workers advertising services in the Atlanta region. We then assessed whether these same sex workers continued to advertise their availability at three subsequent points during the COVID-19 pandemic: April 2020, January 2021 and February 2021. We also determined whether age and race were associated with advertising presence at each time point. While advertising rates declined among sex workers in all race categories (Black, White and 'other'), results from our mixed effects logistic regression model show that the odds of older male sex workers continuing to advertise were greater than the odds for their younger counterparts. Further, the predicted probability of continued advertising was highest for White male sex workers. Our findings provide additional insights into male sex work during a global pandemic.

A review of top performing rural community and critical access hospitals' web resources for transgender patients in the United States.

OBJECTIVE: This cross-sectional study examined the prevalence of "LGBT" and "transgender" terminology and type of resources available to transgender patients on the websites of top performing rural/community hospitals and critical access hospitals in the U.S. The effect of hospital control (e.g. type of operating parent organization) on the presence of transgender resources on these websites was also evaluated. METHODS: The rural and critical access hospitals selected for inclusion in this study were those published on the Chartis Group's 2020 "top performing" hospital lists. Each hospital website was reviewed for the presence of "transgender" and "LGBT" terminology, as well several control terms commonly found on hospital websites. RESULTS: Findings suggest a lack of resources for sexual and gender minorities among rural community and critical access hospitals within this sample; the term "transgender" appeared on 26% of rural community hospitals and 21% of critical access hospitals (N = 200). There was no significant relationship between hospital classification and the type of transgender resources offered by the hospitals (p = 0.248). There was a significant relationship between hospital control and presence of the term "transgender" on the websites of critical access hospitals (p = 0.002, Fisher's Exact Test). CONCLUSIONS: Few facilities provided links to external resources for transgender patients, advertised LGBT-friendly providers, or provided any information pertaining to gender-affirming healthcare. Additional research is needed to determine what barriers or social forces prevent these hospitals from using their websites to create a more inclusive environment for transgender patients within the communities they serve.

Lost and Found in the Bronx.

As dying alone became the norm during the pandemic, nurses kept family connection alive.

Age- and Race-Related Differences in Advertised Health Behaviors Among Male Sex Workers in San Francisco Who Have Sex With Men.

ABSTRACT: Given the stigma surrounding sex work and the illegal nature of many aspects of commercial sex activity, empirical research is lacking regarding the health-related behaviors of sex workers, particularly male sex workers who have sex with men (MSM sex workers). To better understand the MSM sex worker community and their potential health needs, we analyzed certain sexual health-related behaviors as advertised online by MSM sex workers in the San Francisco area. Using descriptive and bivariate statistical tests, we examined whether age- and race-related differences existed among these sex workers in the following publicly advertised behaviors: use of pre-exposure prophylaxis and a willingness to engage in illicit drug use or condomless anal intercourse. Although we found no significant differences by race in terms of advertised pre-exposure prophylaxis use or willingness to engage in condomless sex, our results show statistically significant differences by race with respect to willingness to use drugs. This difference could be driven by the younger average age of the non-White sex workers in our sample. These findings help inform our understanding of MSM sex work and its associated risks.