Openness to church-based firearm safety interventions among Protestant Christian firearm owners.

OBJECTIVES: Protestant Christians are more likely to own firearms and not store them locked/unloaded compared to those from other religions. This study examines how Protestant Christians view the relationship between their religious and firearm beliefs and how that informs openness to church-based firearm safety interventions. STUDY DESIGN: Grounded theory analysis of 17 semi-structured interviews with Protestant Christians. METHODS: Interviews, conducted August-October 2020, focused on firearms owned, carrying/discharge/storage behaviors, Christian belief compatibility with firearm ownership, and openness to church-based firearm safety interventions. Audio-recorded interviews were transcribed verbatim and analyzed using grounded theory techniques. RESULTS: Participant perspectives varied on firearm ownership motivations and compatibility of Christian values with firearm ownership. Variation in these themes and in openness to church-based firearm safety interventions resulted in clustering of participants into three groups. Group 1 owned firearms for collecting/sporting purposes and intricately connected their Christian identity with firearm ownership, but they were not open to intervention due to perceived high firearm proficiency. Group 2 did not connect their Christian identity to their firearm ownership; some believed these identities were incompatible, so were also not open to intervention. Group 3 owned firearms for protection and believed church, as a community hub, was an excellent location for firearm safety interventions. CONCLUSIONS: The clustering of participants into groups varying in openness to church-based firearm safety interventions suggests it is feasible to identify Protestant Christian firearm owners open to intervention. This study presents a first step in coupling firearm owner characteristics with community-based, tailored interventions with promise for efficacy.

A retrospective time trend study of firearm and non-firearm homicide in Cape Town from 1994 to 2013.

BACKGROUND: Gunshot injuries from interpersonal violence are a major cause of mortality. In South Africa (SA), the Firearms Control Act of 2000 sought to address firearm violence by removing illegally owned firearms from circulation, stricter regulation of legally owned firearms, and stricter licensing requirements. Over the last few years, varied implementation of the Act and police corruption have increased firearm availability. OBJECTIVES: To investigate whether changes in firearm availability in SA were associated with changes in firearm homicide rates. METHODS: This was a retrospective time trend study (1994 - 2013) using postmortem data. Time trends of firearm and non-firearm homicide rates were analysed with generalised linear models. Distinct time periods for temporal trends were assigned based on a priori assumptions regarding changes in the availability of firearms. RESULTS: Firearm and non-firearm homicide rates adjusted for age, sex and race exhibited different temporal trends. Non-firearm homicide rates either decreased or remained stable over the entire period. Firearm homicide increased at 13% annually from 1994 through 2000, and decreased by 15% from 2003 through 2006, corresponding with changes in firearm availability in 2001, 2003, 2007 and 2011. A 21% annual increase in firearm homicide after 2010 coincided with police fast-tracking new firearm licence applications. Cape Town's coloured population experienced a significantly greater increase than other population groups following additional exposure to illegal firearms from 2007. CONCLUSIONS: The strong association between firearm availability and homicide, and the reversal of a decreasing firearm homicide trend during a period of lax enforcement, provide further support for the association between reduced firearm homicide and stricter regulation.

Sexual and demographic determinants for herpes simplex virus type 2 among fishermen along Lake Victoria, Kenya.

OBJECTIVES: To determine the prevalence and correlates of herpes simplex virus type 2 (HSV-2) seropositivity among fishermen along the shores of Lake Victoria in Kisumu district, Kenya. METHODS: Sera from a random sample of 250 fishermen from 18 beaches were collected after a detailed sociodemographic interview. HSV-2 infection was tested by Kalon HSV-2 ELISA. RESULTS: The HSV-2 seroprevalence was 63.9%. In multivariate analysis, fishermen were more likely to be infected with HSV-2 if they were HIV positive (prevalence ratio (PR) 1.27; 95% CI 1.06 to 1.52) compared with those testing HIV negative, were aged 18-20 (PR 0.49; 95% CI 0.24 to 0.99) and older than 40 (PR 1.66; 95% CI 1.30 to 2.14) years compared with those aged 21-25 years, perceived their last two sexual partners to have a sexually transmitted infection (STI; PR 1.27; 95% CI 1.06 to 1.52) compared with those who did not and were more likely to be circumcised (PR 1.49; 95% CI 1.19 to 1.86). CONCLUSIONS: HSV-2 seroprevalence is high among this population and is associated with HIV serostatus, age, perception about partner's STI status and circumcision.

Epidemiology of human papillomavirus infection among fishermen along Lake Victoria Shore in the Kisumu District, Kenya.

OBJECTIVES: The epidemiology of human papillomavirus (HPV) infection in men in Kenya is largely uncharacterized. We set out to determine the prevalence and determinants of HPV infection among sexually active fishermen along Lake Victoria in the Kisumu district of Kenya. METHODS: Genital swabs were obtained from 250 consenting fishermen from 18 beaches and a detailed sociodemographic questionnaire was administered. HPV positivity was determined by polymerase chain reaction amplification and detected by dot blot hybridisation with generic HPV and beta-globin probes. HPV positive samples were genotyped using the Roche Linear array assay. RESULTS: Overall, 144 (57.6%) fishermen had detectable HPV DNA, 106 (42.4%) were infected with oncogenic HPV types, with HPV-16 being the most frequent type (12.4%). Among HPV positive men, 105 (72.9%) were infected with more than one HPV type and 20 (13.9%) were infected with more than six different types. HIV seropositive men (PR 1.49, 95% CI 1.19 to 1.86) and those divorced or separated (PR 1.62, 95% CI 1.13 to 2.33) were more likely to be infected with HPV. HIV infection (PR 1.22, 95% CI 1.01 to 1.47) was the only factor independently associated with infection with multiple types of HPV. CONCLUSION: The prevalence of oncogenic HPV infection is high among this population and is associated with HIV serostatus and marital status. This community could benefit from enhanced sexually transmitted infection and HIV prevention interventions.

Comparative epidemiology of Chlamydia trachomatis infection among men attending sexually transmitted disease clinics with and without indication for testing.

Understanding the epidemiology of Chlamydia trachomatis infection in men without indication for testing (without symptoms, signs, or a report of sexual contact with an infected partner) is of crucial importance to reduce the heavy burden of this infection, particularly because this group of men is not usually offered testing in different clinical settings. Using electronic medical records of two STD clinics in Connecticut, 2000-02, this study identified the risk factors of C. trachomatis infection in men with and without indication for testing. In both groups, men who were younger than 30, African-American, or had a prior history of C. trachomatis infection were significantly more likely to be infected. Since a system for routine reproductive health care of young men does not currently exist, health-care providers need to promote an increased awareness of C. trachomatis infection among their male patients who are at increased risk of infection.

Barriers to completion of tuberculosis treatment among prisoners and former prisoners in St. Petersburg, Russia.

SETTING: St. Petersburg, Russian Federation. OBJECTIVES: To identify barriers to the completion of tuberculosis (TB) treatment among prisoners and former prisoners in St Petersburg, Russia. DESIGN: Questionnaires were administered to 60 prisoners and 40 former prisoners. Interviews were performed with prison and TB dispensary staff. Treatment follow-up rates were estimated by matching prison release records against attendance records from all 17 St. Petersburg-based TB dispensaries over an 18-month period. RESULTS: Of 80 released prisoners with active TB in 2002, 21 (26.3%) appeared in dispensary attendance records. Barriers to the completion of TB treatment overall were homelessness, unemployment, alcoholism, drug addiction and difficulty tolerating TB medications with co-morbid illnesses such as human immunodeficiency virus and hepatitis. Prisoners and former prisoners ranked help with obtaining an internal passport and money first, followed closely by food and a job, as the most desirable incentives to completing TB treatment. CONCLUSIONS: A future program for soon-to-be released and released prisoners in St. Petersburg that offers an array of desirable flexible social welfare services and incentives has the potential to attract and retain patients within TB treatment, but continued efforts must also be made to include drug treatment, job training and keeping former prisoners out of prison.

Condom effectiveness for prevention of Chlamydia trachomatis infection.

BACKGROUND/OBJECTIVES: A growing body of evidence is increasingly demonstrating the effectiveness of condoms for sexually transmitted infection (STI) prevention. The purpose of the present analysis was to provide a disease specific estimate for the effectiveness of condoms in preventing Chlamydia trachomatis infection while controlling for known exposure to infection. METHODS: Condom effectiveness for C trachomatis was estimated using a medical record database from a public sexually transmitted disease clinic (n = 1455). Clients were classified as having known exposure to C trachomatis if they presented to the clinic as a contact to an infected partner. RESULTS: Among clients with known exposure, 13.3% of consistent condom users were diagnosed with C trachomatis infection compared to 34.4% of inconsistent condom users (adjusted odds ratio = 0.10; 95% CI: 0.01 to 0.83). Among clients with unknown exposure, there was no observed protective effect of condoms. CONCLUSIONS: This study provides further evidence that condoms are effective in preventing C trachomatis infection by reporting a disease specific estimate and restricting analyses to individuals with known exposure.