Contact Tracing: Barriers and Facilitators.

Contact tracing-the process of identifying, isolating, and managing infected persons and their contacts-is a recognized public health measure for controlling the transmission of infectious diseases. In the context of the COVID-19 pandemic, contact tracing has received intense attention. We provide a brief overview of the history of contact tracing during several major disease outbreaks in the past century: syphilis and other sexually transmitted infections, HIV infection, tuberculosis, Ebola virus disease, and COVID-19. Our discussion on the barriers to and facilitators of contact tracing offers a perspective on societal and institutional roles and dynamics, stigma as a major barrier to effective tracing efforts, and how the nature and epidemiology of the infection itself can affect its success. We explore the evolution and adaptation of contact tracing and provide insights for future programming and research. (Am J Public Health. 2022;112(7):1025-1033. https://doi.org/10.2105/AJPH.2022.306842).

Considerations for the Design of Pre-exposure Prophylaxis (PrEP) Interventions for Women: Lessons Learned from the Implementation of a Novel PrEP Intervention.

Pre-exposure prophylaxis (PrEP) uptake among women in the United States has been low. To increase uptake, we developed a peer outreach and navigation PrEP intervention. Semi-structured qualitative interviews with 32 cisgender women and 3 transgender women were conducted to assess the intervention. We used a thematic approach to identify barriers to, and facilitators of the intervention. Facilitators included interest in PrEP, offer of health and social services, the intervention's women-focused approach, and peer outreach and navigation. Barriers were perceived HIV risk, concerns about medication side effects or interactions, housing insecurity and travel, co-occurring health-related conditions, and caregiving responsibilities. We recommend that future interventions consider packaging PrEP in local community settings, such as syringe exchange programs; include services such as food and housing assistance; use peers to recruit and educate women; integrate a culturally appropriate women's focus; and consider providing same-day PrEP.

A Pilot Study to Evaluate a Novel Pre-exposure Prophylaxis Peer Outreach and Navigation Intervention for Women at High Risk for HIV Infection.

Pre-exposure prophylaxis (PrEP) uptake remains woefully low among U.S. women at high risk for HIV acquisition. We evaluated a pilot intervention which involved Peers providing brief PrEP education and counseling at mobile syringe exchange sites and at sex worker and syringe exchange drop-in centers followed by navigation to PrEP care. Peers recruited English-proficient, self-identified women (i.e., cisgender and transgender women and persons with other transfeminine identities) over a 3-month period and delivered the intervention to 52 HIV-negative/status unknown participants. Thirty-eight participants (73.1%) reported PrEP interest, 27 (51.9%) accepted the offer of a PrEP appointment, 13 (25.0%) scheduled a PrEP appointment, 3 (5.8%) attended an initial PrEP appointment, and none were prescribed PrEP. We found a gap between PrEP interest and connecting women to PrEP care. Further study is needed to understand this gap, including exploring innovative approaches to delivering PrEP care to women at highest risk for HIV.

A State-Level Examination of School Nurses' Perceptions of Condom Availability Accompanied by Sex Education.

School nurses are often sources of health-care support for teens with sexually transmitted infections (STIs) and unintended pregnancies. However, providing prevention (e.g., condoms) and teaching technical skills (e.g., condom use) needed to reduce high-risk sexual behavior may require a change in perceptions and policies. This study used a cross-sectional study design to assess nurses' perceptions of condom availability accompanied by sex education programs among high school nurses (n = 87) in Kansas. Results showed that school nurses in this study supported condom availability, were comfortable providing condoms, and felt condom availability was within the scope of their job but were less likely to provide condoms because of external barriers. Common barriers include administration, parents, cost, community support, and policies. School nurses, by virtue of their access to the majority of Kansas' adolescents, have the potential to provide sex education and tools such as condoms, so young people can prevent STIs and unintended pregnancies.

COVID-19 Knowledge Among Sexual and Gender Minority Adults in New York City.

Purpose: This study describes sources of COVID-19 vaccine information and COVID-19 knowledge among sexual and gender minority (SGM) adults in New York City (NYC). Methods: A sample of 986 SGM adults in NYC completed an online survey between June 25 and December 1, 2021. Participants indicated their top three sources of COVID-19 vaccine information from a list of 10 options. Participants were also categorized into low or high COVID-19 knowledge using a 14-item questionnaire. We described knowledge sources, then conducted bivariate and multivariable logistic regression to identify characteristics associated with greater knowledge. Results: The mean age of participants was 29 years (range 18-68 years). Only 12.5% identified their health care provider as a main COVID-19 vaccine information source. Social media (54.9%) and TV news channels (51.4%) were most reported as a main COVID-19 vaccine information source. COVID-19 vaccine knowledge was moderate, with four of eight questions showing correct responses in approximately 70% or more participants. In the multivariable logistic regression model, having at least some college education (adjusted odds ratio [aOR]: 2.34, 95% confidence interval [CI]: 1.55-3.52), attaining a master's degree (aOR: 3.28, 95% CI: 1.93-5.57), reporting a household income of $25,000-$49,999 per year (aOR: 1.68, 95% CI: 1.14-2.46), and having health insurance (aOR: 2.12, 95% CI: 1.51-2.96) were significantly associated with high COVID-19 knowledge. Conclusion: Our sample demonstrated high levels of COVID-19 knowledge, particularly among educated individuals and those with health insurance. Primary access to health information was through social media and TV news channels.

COVID-19 Vaccine Uptake and Factors Associated With Being Unvaccinated Among Lesbian, Gay, Bisexual, Transgender, Queer, and Other Sexual Identities (LGBTQ+) New Yorkers.

Routine data on vaccine uptake are not disaggregated by lesbian, gay, bisexual, transgender, queer, and other sexual identities (LGBTQ+) populations, despite higher risk of infection and severe disease. We found comparable vaccination uptake patterns among 1032 LGBTQ+ New Yorkers and the general population. We identified critical socioeconomic factors that were associated with vaccine hesitancy in this economically vulnerable population.