Public health, surveillance policies and actions to prevent community spread of COVID-19 in Denmark, Serbia and Sweden.

Aim: This study investigates the non-medical public health and surveillance policies and actions for tackling the community spread of COVID-19 pandemic in Denmark, Serbia and Sweden during the first five months of the pandemic in 2020. Method: The study is inspired by a process-tracing design for case study with a focus on the non-medical measures and surveillance strategies implemented by the three countries. The comprehensive collection and study of national documents formed the basis of the document analysis. Results: The Danish strategy was to prolong the transmission period, preventing high numbers of infected cases from impacting their healthcare capacity. The government's strategy was characterized by strict governance elements, health guidelines and behavioural recommendations. In Serbia, the main strategy was to prevent the spread and control of the infectious disease by shifting all human and material resources towards the function of controlling the spread. Serbia applied the strictest measures in the fight against coronavirus in relation to other countries in the region and in Europe. The Swedish strategy focused more on recommendations than requirements to motivate the public to modify their behaviours voluntarily. Sweden's loose pandemic strategy implementation focused on voluntary and stepwise action rather than legislation and compulsory measures. Conclusions: The public health policies and actions implemented to prevent community spread of COVID-19 in Denmark, Serbia and Sweden varied during the first five months of the pandemic. The differences in their response were due to delays in implementation, inconsistencies in perspectives towards the outbreak and the capacity of each country in terms of their pandemic preparedness and response.

HIV-related risk behaviors among Roma youth in Serbia: results of two community-based surveys.

PURPOSE: The Roma constitute a large ethnic minority in Serbia, and are one of the poorest and most marginalized groups in Europe. Roma youth may be at high risk for hepatitis C, HIV, and other sexually transmitted infections, but little is known about the prevalence of these infectious diseases, HIV-related knowledge, and risky sexual behaviors in this vulnerable population. METHODS: We used a respondent-driven sampling to conduct biobehavioral surveys of Roma youth (aged 15-24 years) in Belgrade and Kragujevac, and to document HIV-related knowledge and risky sexual behaviors, health-seeking behaviors, and seroprevalence of HIV, hepatitis C virus (HCV), and syphilis. RESULTS: Four hundred eleven Roma youth participated in this study. One participant had HIV, four had HCV, and none had syphilis. Risky sexual behaviors were highly prevalent, especially among male subjects: 36.2% (Belgrade) and 45.1% (Kragujevac) had sexual debut before the age of 15 years; 53.9% (Belgrade) and 61.1% (Kragujevac) had more than one sexual partner in the past year; 11.5% (Belgrade) and 4.6% (Kragujevac) reported engaging in commercial sex; and 4.0% (Belgrade) and 3.2% (Kragujevac) reported having anal sex with other men. Among female subjects aged <25 years, 33.5% (Belgrade) and 25.7% (Kragujevac) reported having an abortion. One-quarter of all participants answered all five HIV knowledge questions correctly. CONCLUSIONS: Fortunately, the current prevalence of HIV, HCV, and syphilis is low; however, the high prevalence of reported risky behaviors suggests that Roma youth in Serbia are at high risk of contracting sexually transmitted infections.