Pre-exposure Prophylaxis Persistence at a Diverse Sexual Health Clinic: Comparison of the pre-COVID-19 era to the COVID-19 era.

The COVID-19 pandemic interrupted health care delivery and exacerbated disparities. Many sexual health clinics transitioned to telemedicine, including for pre-exposure prophylaxis (PrEP). We conducted a retrospective cohort study of patients at an urban sexual health clinic to assess the likelihood and predictors of PrEP persistence in the year following PrEP initiation. We compared patients starting PrEP in the four months preceding the first COVID surge to those starting PrEP one year prior. We found lower PrEP persistence in the COVID cohort compared to the pre-COVID cohort (50.8% vs. 68.9%, respectively). In both cohorts, most care was provided through in-person visits and telemedicine was rare. In the pre-COVID cohort, older patients and those identifying as non-Hispanic White were more likely to persist on PrEP. In the COVID cohort, these disparities in PrEP persistence were not observed. Flexible models of care may facilitate equitable care engagement and re-engagement.

Rallying Against Racism: Hospitals Join the Fight for Racial Justice.

This article highlights the timely situation that resident physicians, faculty, and staff are facing after the recent highly publicized murders of Black Americans and its impact on our healthcare communities. We discuss our experiences of how the hospital can serve as a meeting place for anti-racism, as well as how anti-racist events at the hospital can raise public consciousness and be catalysts for creating a more inclusive, diverse, and welcoming environment for all members of hospital communities.

Cognition and self-control: cognitive control of painful sensory input.

Eighty Ss were first tested for base-level response to a pain-producing stimulus and then were re-tested on the same pain stimulus after receiving 1 of 8 experimental treatments. The 8 treatments were arranged in a 2 x 2 x 2 factorial design: presence or absence of hypnotic induction procedure; presence or absence of instructions for anesthesia; and presence or absence of demands for honest reports. Neither the hypnotic-induction procedure nor the demands for honesty affected the Ss'reports of the degree of pain experienced. The anesthesia instructions--"think of the hand as numb and insensitive as if it were a piece of rubber..."--produced an equal degree of pain reduction in hypnotic and non-hypnotic Ss and in Ss who were and those who were not exposed to demands for honesty. The results indicate that (a) Ss' reports of pain are less affected by demands for honesty and are more closely related to their actual experiences than has been previously assumed and (b) instructions which direct Ss to exercise cognitive control over painful sensory input are effective (with or without 'hypnosis') in reducing the experience of pain.