Effects of COVID-19 measures on access to HIV/STI testing and condoms among adults in Sweden: a cross-sectional online survey.

AIMS: To investigate the self-reported impact of COVID-19 measures on access to testing for HIV and other sexually transmitted infections (STIs) and condoms and factors associated with reduced access among adults in Sweden. METHODS: Cross-sectional data were collected in late 2020 through a web panel with adults (18-49 years) in Sweden as part of the International Sexual Health And REproductive health survey (I-SHARE) (N=1307). The primary outcome was self-reported access to HIV/STI testing and condoms during COVID-19 measures. Logistic regression was used to assess adjusted odds ratios of experiencing reduced access to HIV/STI testing and condoms in relation to sociodemographic characteristics, changes in sexual behaviours and COVID-19-related factors. RESULTS: Of the 1138 sexually active respondents, 17% wanted an HIV/STI test, and of those over half (57%) reported reduced access during the COVID-19 measures in 2020. Compared with cis-women, transgender or non-binary respondents were more likely to experience lower access to testing. Among those who usually used condoms (n=568), 23% reported hampered condom access due to COVID-19 restrictions. Reduced condom access was associated with identifying as non-cis gender and a cis-man compared with cis-woman, non-heterosexual orientation, being foreign-born and financially worried. CONCLUSIONS: Findings indicate that access to HIV/STI testing and condoms among sexually active adults of reproductive age in Sweden was disrupted during the COVID-19 pandemic in 2020 with varied impact depending on sexual orientation, gender identity or socioeconomic situation. This signals the importance of ensuring equitable access to sexual and reproductive health services and commodities in future crises response.

Making it "work": mothers' perceptions of workplace breastfeeding and pumping at Dutch universities.

BACKGROUND: Dutch breastfeeding rates are below World Health Organization's recommendations and targets despite the benefits for individuals and society. Increasing the rates is complex due to multiple breastfeeding determinants, of which maternal education and employment are dominant. This study aimed to identify the perceptions and experiences of mothers employed at Dutch universities regarding barriers and enablers to workplace breastfeeding and pumping. METHODS: The study adopted a descriptive, qualitative research design. Thirteen semi-structured online interviews, underpinned by the Social Ecological Model, were conducted in 2020 with three experts and ten academic employees from five universities who had breastfed or pumped at work within the past five years. Qualitative data were examined through a thematic analysis. RESULTS: Four main themes were identified: physical work environment, social support, work culture and organisation, policies and legal rights. Most mothers had more negative than positive experiences combining breastfeeding with work. They were unable to exercise their rights as a breastfeeding employee due to inappropriate and inaccessible lactation rooms, a lack of communication and information-provision, other people's lack of awareness, inflexible working hours and unadjusted workloads, especially for teaching positions. All participants found the duration of Dutch maternity leave too short. CONCLUSIONS: Universities need to increase institutional efforts at multiple levels and meet their legal obligations to support breastfeeding employees. Workplace interventions should be combined with more political commitment to normalise breastfeeding, monitor compliance with maternity protection provisions at work and prolong parental leave to encourage breastfeeding continuation.