HIV PrEP Coverage Among Black Adults: A Concept Analysis of the Inequities, Disparities, and Implications.

Background: Significant racial disparities exist in HIV pre-exposure prophylaxis (PrEP) coverage in the United States (U.S), with Black individuals experiencing seven times higher new HIV infection rates compared to their White counterparts. Despite being the highest priority population at risk for HIV, Black adults have the lowest PrEP coverage, impacting the overall progress toward meeting the ending the HIV epidemic (EHE) goals in the U.S. Methods: Utilizing the Walker and Avant method, this concept analysis examined existing literature and U.S. Centers for Disease Control and Prevention resources to explore HIV PrEP coverage. Results: Findings highlighted a lack of clarity in the concept, resulting in four operational definitions. To address this ambiguity, a conceptual definition of HIV PrEP coverage was proposed, focusing on equitable access to PrEP medication among sexually active individuals aged 18-64 years, particularly those traditionally underserved and would benefit from PrEP. This inclusive definition aims to align with the dynamics of sexual behavior in racial minority groups. Key attributes of this conceptual definition include estimates of PrEP use, access, need, cost, side effects, frequency of HIV testing, and self-efficacy. Antecedents entail HIV status, testing behaviors, transmission risks, and communication with health care providers. Consequences involve perceptions of risk, screening routines, provider biases, stigma, and potential HIV transmission reduction. Conclusion: Analyzing HIV PrEP coverage offers useful insights into social and structural factors exacerbating health inequities in the field of HIV prevention and control. This concept analysis underscores the importance of unified sexual health communication, diverse approaches to PrEP access for racial minorities, and improved sexual health policies for Black adults. Moreover, understanding and advocating for equity in HIV PrEP coverage is crucial for addressing the existing racial disparities and achieving the EHE objectives in the U.S.

Measuring Knowledge of Fertility Preservation in Women With Cystic Fibrosis: Instrument Development and Psychometric Analysis.

OBJECTIVE: To describe the development, evaluation, and psychometric properties of a new instrument that measures fertility preservation (FP) knowledge in women with cystic fibrosis (CF) titled the Knowledge of FP in Women With CF Instrument (KFP-WCFI). DESIGN: The 10-item KFP-WCFI was developed and evaluated through a cross-sectional survey. SETTING: Participants were recruited nationally from CF Foundation-accredited CF clinics and via snowball sampling. PARTICIPANTS: Fifty women with CF ages 18 through 35 years completed the instrument. MEASUREMENTS: Construct validity was assessed using confirmatory factor analysis (CFA). In the CFA, the model fit was evaluated using standardized root mean square residual, root mean square error of approximation, and comparative fit index. Cronbach's alpha was used to examine internal consistency reliability. The criterion validity was assessed using inferential statistics. RESULTS: The CFA with two subscales, General Fertility Knowledge and Transplant-Related Fertility Knowledge, demonstrated good fit, with a standardized root mean square residual of 0.07, root mean square error of approximation of 0.06, and comparative fit index of 0.97, indicating good construct validity of the instrument. This instrument demonstrated internal consistency reliability with a Cronbach's alpha of .91 for the General Fertility Knowledge subscale and .64 for the Transplant-Related Fertility Knowledge subscale. Women who reported a pregnancy scored higher than women who did not report a pregnancy (p = .02), suggesting criterion validity. CONCLUSION: The newly developed KFP-WCFI appears to be a valid and reliable instrument that can be used to measure self-assessed FP knowledge in women with CF.

Adolescent Chlamydia Rates by Region, Race, and Sex: Trends From 2013 to 2017.

INTRODUCTION: Chlamydia is the most common bacterial sexually transmitted infection in the United States. Adolescents (ages 15-19 years) have the highest infection rate, second only to young adults (ages 20-24 years). The purpose of this secondary data analysis is to examine trends from 2013 to 2017 in adolescent chlamydia rates by region, race, and sex. METHOD: Adolescent chlamydia rate data were obtained from the Center for Disease Control's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention database. Descriptive statistics were used to analyze the trends. RESULTS: The overall trend in male and female adolescent chlamydia rates increased from 2013 to 2017. Specifically, the trend increased faster in males, White adolescents, and those in the Northeast and Midwest regions of the country. DISCUSSION: Health care providers are uniquely positioned to positively affect adolescent chlamydia rates through targeted sexual health discussions and increased screening for sexually transmitted infections.

Adolescents' perceptions of sexual health education programs: An integrative review.

INTRODUCTION: Adolescents are key stakeholders in sexual health education, yet they are rarely consulted when developing sexual health programs. Their voices are integral to improving the delivery of relevant and appropriate school-based sexual health education to promote safer adolescent sexual behaviors. METHODS: An integrative review was conducted utilizing three databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete, PubMed, and Education Resources Information Center (ERIC). The PRISMA and matrix method were used to search the literature and synthesize the findings from 16 articles regarding adolescent perceptions of school-based sexual health education. RESULTS: The main themes that emerged from this review included: (a) factors influencing adolescent perceptions of sexual health education programs, (b) characteristics of good sexual health education programs, and (c) areas of improvement in sexual health education programs. CONCLUSION: Adolescents overwhelmingly requested honest, comprehensive content delivered by nonjudgmental, well-educated health professionals in a comfortable environment.