High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study.

Background: Daily oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, but no study has evaluated combination prevention interventions with PrEP for transgender women (TGW) and men who have sex with men (MSM) who sell sex. Methods: The Combination Prevention Effectiveness (COPE) study was a community-based, non-randomized implementation study in Bangkok and Pattaya, Thailand. Participants were HIV-negative MSM and TGW aged 18-26 years who reported exchanging sex with men in the prior 12 months and who met 2014 U.S. Public Health Service PrEP eligibility criteria. The intervention included quarterly HIV testing, semiannual testing for sexually transmitted infections, provision of condoms with lubricant, and the opportunity to initiate or end daily oral PrEP use at any time during study participation. Participants taking PrEP received monthly adherence counseling and short message service reminders. The primary outcome was HIV incidence rate ratio (IRR) on PrEP vs. not on PrEP. Secondary outcomes were PrEP initiation, PrEP use at 12 months, and PrEP adherence. Findings: From October 2017 to August 2019, 846 participants were enrolled: 531 (62.8%) immediately initiated PrEP; 104 (12.3%) subsequently initiated PrEP, and 211 (24.9%) never initiated PrEP. Among those initiating PrEP within 30 days of enrollment; 85.9% were on PrEP at the 12-months. When taking PrEP, participants reported adherent PrEP use at 94.2% of quarterly assessments. Ten HIV seroconversions occurred without PrEP use (incidence rate [IR] = 3.42 per 100 person-years [PY]; 95% CI = 1.64-6.30), while zero cases occurred with PrEP use (IR = 0.0 per 100PY; 95% CI = 0.0-0.62), with IRR = 0.0 (95% CI = 0.0-0.22; p < 0.001). Interpretation: Young Thai MSM and TGW who exchange sex can have high PrEP uptake, persistence and adherence, and low HIV incidence when offered in supportive community-based settings. Funding: U.S. National Institute of Allergy and Infectious Diseases; Centers for Disease Control and Prevention.

Diverse contexts and social factors among young cisgender men and transgender women who sell or trade sex in Bangkok and Pattaya, Thailand: formative research for a PrEP program implementation study.

HIV incidence is high and persistent among cisgender men who have sex with men (MSM) and transgender women (TGW) who have sex with men, particularly among those who sell or trade sex. In preparation for an open-label combination HIV pre-exposure prophylaxis (PrEP) program for these groups, we conducted formative research to explore the context of sex work/trade and factors that affect implementation of PrEP interventions. This study analyzed interviews with 20 young (aged 18-26 years) MSM and TGW who sell/trade sex and three sex work venue managers in Bangkok and Pattaya, Thailand. Participants described diverse contexts of sex work/trade, including in multiple informal and formal sex venues. Several participants reported mobility across provinces and out of the country, which led to intermittent sex work/trade. TGW sex workers reported challenges with access and cost of femininizing hormones and limited employment opportunities. Factors that could facilitate or challenge PrEP program implementation included HIV stigma, the role of venue management in sexual health practice, lack of PrEP knowledge, lower perceived HIV risk, and interest in personal health and wellbeing. Program implementers must consider myriad factors to successfully implement PrEP among young MSM and TGW engaged in sex work or trade in Thailand.

Design and Implementation of a COVID-19 Case Investigation Program: An Academic-Public Health Partnership, Arizona, 2020.

From May through July 2020, Arizona was a global hotspot for new COVID-19 cases. In response to the surge of cases, local public health departments looked for innovative ways to form external partnerships to address their staffing needs. In collaboration with the Maricopa County Department of Public Health, the Arizona State University Student Outbreak Response Team (SORT) created and implemented a virtual call center to conduct public health case investigations for COVID-19. SORT officially launched a dedicated COVID-19 case investigation program after 3 weeks of program design and training. From June 29 through November 8, 2020, SORT recruited and trained 218 case investigators, completed 5000 case patient interviews, and closed 10 000 cases. Our team also developed process improvements to address disparities in case investigation timeliness. A strong infrastructure designed to accommodate remote case investigations, paired with a large workforce, enabled SORT to provide additional surge capacity for the county's high volume of cases. University-driven multidisciplinary case investigator teams working in partnership with state, tribal, and local public health staff members can be an effective tool for supporting a diverse and growing public health workforce. We discuss the essential design factors involved in building a university program to complement local COVID-19 response efforts, including workflows for case management, volunteer case investigator recruitment and training, secure technology platforms for conducting case investigations remotely, and robust data-tracking procedures for maintaining quality control and timely case reporting.

Are scientists biased against Christians? Exploring real and perceived bias against Christians in academic biology.

Christians are one of the most underrepresented groups in science, and one potential explanation is that scientists have a bias against Christian students, which could discourage and actively prevent Christian students from becoming scientists. Although there is a general perception in society that there is bias against Christians in science, we do not know whether science students, who frequently interact with scientists, perceive this bias. Further, no researchers have attempted to experimentally document the existence of bias against Christians in science. To address these gaps in the literature, we designed three studies. In the first study, we found that college science students report a perceived bias against Christians in science and that evangelical Christians perceive greater bias than Catholic and non-Christian students. Then in two studies, biology professors evaluated Ph.D. program applicants and we examined whether the professors rated a student less favorably when the student revealed a Christian religious identity. We found no statistically significant differences in how biology professors rated a student who was President of the Christian Association compared to a student who was President of the Atheist Association or a student who was President of the Activities Association. However, in Study 3, biology professors did rate a Christian student who went on a mission trip with Campus Crusade for Christ as less hireable, less competent, and less likeable than a student who did not reveal a Christian identity. Taken together, these studies indicate that perceived bias against Christians in science may contribute to underrepresentation of Christians but actual bias against Christians in science may be restricted to a specific type of Christianity that scientists call fundamentalist and/or evangelical.

Experiences of Judeo-Christian Students in Undergraduate Biology.

A major research thrust in science, technology, engineering, and mathematics (STEM) education is focused on how to retain students as STEM majors. The accumulation of seemingly insignificant negative experiences in STEM classes can, over time, lead STEM students to have a low sense of belonging in their disciplines, and this can lead to lower retention. In this paper, we explore how Judeo-Christian students in biology have experiences related to their religious identities that could impact their retention in biology. In 28 interviews with Judeo-Christian students taking undergraduate biology classes, students reported a religious identity that can conflict with the secular culture and content of biology. Some students felt that, because they are religious, they fall within a minority in their classes and would not be seen as credible within the biology community. Students reported adverse experiences when instructors had negative dispositions toward religion and when instructors were rigid in their instructional practices when teaching evolution. These data suggest that this may be a population susceptible to experiences of cultural conflict between their religious identities and their STEM identities, which could have implications for retention. We argue that more research should explore how Judeo-Christian students' experiences in biology classes influence their sense of belonging and retention.