Sexually Transmitted And Blood-borne Infections Research Articles

The impact of the COVID-19 pandemic on social determinants of health, mental health, and substance use among key populations affected by sexually transmitted and blood-borne infections in Canada.

We assessed the impact of the COVID-19 pandemic on social determinants of health, mental health, substance use, and access to mental health and harm reduction services among key populations disproportionately impacted by sexually transmitted and blood-borne infections (STBBI). Online surveys (2021‒2022) were conducted in Canada among people who use drugs or alcohol (PWUD); African, Caribbean, and Black people (ACB); and First Nations, Inuit, and Métis peoples (FNIM). Descriptive analyses were conducted on social determinants of health, substance use, and access to services, stratified by changes in mental health status since the start of the pandemic. A total of 3773 participants (1034 PWUD, 1556 ACB, and 1183 FNIM) completed the surveys, with 45.6% reporting a major/moderate impact of the pandemic on their ability to pay bills and 53% experiencing food insecurity since the start of the pandemic. Half (49.4%) of participants reported deteriorating mental health. A higher increase in substance use and related behaviours was seen in those with worsening mental health. Among those using substances, two thirds (69.4%) of those with worsening mental health reported increasing their use of substances alone, compared to 46.9% of those with better/similar mental health. Access to mental health and harm reduction services was low. These intersecting health issues are among the risk factors for STBBI acquisition and act as barriers to care. Equitable interventions and policies addressing downstream and upstream determinants of health, with meaningful and sustainable leadership from key populations, may improve their health and well-being, to lower STBBI impact and improve future pandemic responses.

Reach of GetCheckedOnline among gay, bisexual, transgender and queer men and Two-Spirit people and correlates of use 5 years after program launch in British Columbia, Canada

ObjectivesUnderstanding who uses internet-based sexually transmitted and blood-borne infection (STBBI) services can inform programme implementation, particularly among those most impacted by STBBIs, including gender and sexual minority (GSM) men. GetCheckedOnline,...

Perspectives on digital testing services for sexually transmitted and blood-borne infections from Two-Spirit, gay, bisexual, transgender, and other queer Black, Indigenous, people of colour living in Ontario, Canada

ABSTRACT Objectives Increased sexually transmitted and blood-borne infections (STBBI) testing can reduce the burden of disease among Two-Spirit, gay, bisexual, transgender, and other queer Black, Indigenous, people of colour (2SGBTQ+ BIPOC). However, this population encounters barriers, such as discrimination, when accessing in-person STBBI testing services. Digital STBBI testing, such as self-testing/collection kits ordered online and digital requisitions, may address some of these barriers. Our aim was to understand acceptability of free digital STBBI testing among 2SGBTQ+ BIPOC living in Ontario, Canada. Design We approached this analysis using Implementation Science and Critical Race Theory. We conducted interviews and focus groups with 21 2SGBTQ + BIPOC individuals from 2020–2021. Participants were asked about their perceptions of the benefits and drawbacks of digital STBBI testing, populations that would benefit from using these services, and recommendations for how these services may be implemented in Ontario. Interviews and focus groups were transcribed verbatim and analyzed using reflexive thematic analysis. Results Six themes emerged. Digital STBBI testing services: (1) May reduce oppression experienced by 2SGBTQ + BIPOC when testing in-person; (2) Should address the unique needs that 2SGBTQ + BIPOC experience due to other intersecting identities they possess; (3) Should adapt their services to suit the varying cultural contexts and living circumstances of 2SGBTQ + BIPOC; (4) Should be accessible to 2SGBTQ + BIPOC who hold diverse or no documentation; (5) Should be offered in multiple languages; (6) May be inaccessible to those without Internet access or devices. Conclusion Digital STBBI testing is one strategy that may reduce discrimination experienced by 2SGBTQ + BIPOC when getting tested in-person. However, digital STBBI testing services may not address all the needs of 2SGBTQ + BIPOC. Racism and other forms of oppression embedded into in-person and digital testing services will need to be addressed to meet the needs of this diverse population.

Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial.

People who use drugs are disproportionally affected by sexually transmitted and blood-borne infections (STBBIs). While the benefits of methadone in reducing injecting-risk behaviours are well documented, less is known on its impacts on sexual-related risks, as well as its comparative effectiveness to buprenorphine/naloxone, particularly in the context of highly potent opioids. The aim of this study was to estimate the relative effects of buprenorphine/naloxone and methadone on injecting and STBBI risks among people with prescription-type opioid use disorder (POUD). Secondary analysis of a pan-Canadian pragmatic 24-week randomized clinical trial comparing methadone and buprenorphine/naloxone models of care among 272 people with POUD (including licit or illicit opioid analgesics, fentanyl). The Risk Behaviour Survey was used to collect injecting and sexual risks at baseline, and weeks 12 and 24. In total, 210 participants initiated treatment (103 buprenorphine/naloxone and 107 methadone). At baseline, 113/205 (55.1%) participants reported recently injecting drugs, 37/209 (17.7%) unsafe injection practices and 67/162 (41.4%) high-risk sex. Both methadone and buprenorphine/naloxone were associated with reductions in the prevalence of injection drug use and high-risk sex at weeks 12 and 24 with no interactions between treatment arm and time. Methadone and buprenorphine/naloxone were similarly effective in reducing injecting and sexual risk behaviours among people with POUD. clinicaltrials.gov NCT03033732.

DépistaFest: The evaluation of an inclusive, positive, and playful STBBI screening campaign's effectiveness.

Young adults are disproportionately affected by sexually transmitted and blood-borne infections (STBBIs), and rates of STBBI screening in this population are persistently low. The present study examined the effectiveness of Club Sexu's social marketing campaign, DépistaFest, in increasing STBBI screening, screening intentions, and general STBBI and STBBI screening knowledge among young adults in Quebec, Canada. Grounded in the health belief model, the campaign provided practical and scientifically accurate information on STBBIs and screening using an inclusive, positive, and playful approach. A sample of 686 participants (M = 28.0years old) was recruited through Club Sexu's social media to complete an online survey assessing campaign exposure, recent STBBI screening, screening intentions, and general STBBI and screening knowledge. Logistic regressions and ANCOVAs were performed to examine group differences on outcome variables. Compared to nonexposed participants, those who were exposed to the campaign were 2.11 times more likely to report having been tested in the past 6months, and 2.07 times more likely to report planning to get tested in the next 6months. Exposed participants were also more likely to correctly answer general STBBI knowledge questions and reported higher levels of self-perceived STBBI screening knowledge than nonexposed participants. The findings support the effectiveness of an STBBI prevention campaign grounded in the health belief model. Future STBBI prevention campaigns aimed at young adults would benefit from destigmatizing STBBIs and normalizing STBBI screening using an inclusive, positive, and playful approach.

A Rapid Ethnography to Inform a Biobehavioural HIV Preventions Study Among Venezuelan Migrant Sex Workers in Peru: A Protocol of Formative Multidisciplinary Methods

The Venezuelan refugee crisis has triggered Latin America’s largest mass migration, displacing over a fifth of the country’s population. A significant number of migrants have sought refuge in neighboring countries like Peru. Within this context, Venezuelan migrants confront an array of vulnerabilities, including xenophobia and economic hardship, which have compelled some to sex work for their livelihoods. Venezuelan sex workers (VSWs) in Peru face amplified challenges, including heightened risks for HIV and sexually transmitted and blood-borne infections (STBBIs) and exposure to various forms of violence. Addressing the urgent need to comprehend and enhance HIV and STBBI preventive services tailored to this marginalized group in Peru’s capital is paramount. Our biobehavioural HIV prevention study combines sequential mixed methods: we start with a rapid ethnography, followed by semi-structured interviews and finally incorporate cross-sectional surveys with HIV and STBBI testing. The present study protocol presents the integrated and initial rapid ethnographic component of the study which explores the dynamics of street-based sex work in Lima and the sociocultural narratives surrounding VSWs. Data collection will involve systematic fieldnote taking including non-person photos during in-person and virtual participant observation. This comprehensive approach will provide a nuanced understanding of the complex landscape of sex work and HIV/STBBI vulnerabilities among VSWs in Lima. The rapid ethnography endeavors to offer valuable insights that can underpin evidence-based healthcare interventions, specifically tailored to cater to the unique requirements of this marginalized population.

2663. Comprehensive at-home Sexually Transmitted and Blood Borne Infection (STBBI) Testing Program: A Pilot Initiative

Abstract Background Sexually transmitted and blood borne infection (STBBIs) remain a growing concern in North America with rates increasing dramatically since 2000. Although self-testing has been demonstrated to be valid and acceptable, no fully remote STBBI testing programs are available in Canada. To evaluate feasibility and acceptability of at-home STBBI testing, we implemented a fully remote, web-based platform of risk-responsive, non-invasive STBBI diagnostics in a large Canadian health zone. Methods A web-based risk assessment and intake form was developed using RedCap software through a community-facing website (athomestitesting.ca) in partnership with a local sexual health centre. Demographic, sexual practices, and medical history were collected from interested participants through the platform. Diagnostic kits inclusive of testing for gonorrhea/chlamydia (urine and self-swabs of vagina/pharyngeal/rectal) and syphilis/HIV/Hepatitis C (dried blood spot) were mailed to participants based on their survey responses, along with instructions and supplies for collection and return. Outcomes to be assessed include feasibility and acceptability of the web-based platform, testing and positivity rates for STIs, and time to testing and treatment (for positive cases). Results In the first month to date with limited launch, eleven participants completed the intake survey and were mailed testing kits through the platform. Of the completed testing, no new STIs were identified. The median age of the cohort was 38 years old (IQR 32, 41) and six identified as men, four as women and one non-binary. Regarding gender identity, seven identified as gay/queer/bisexual and three as straight/heterosexual. In a follow-up survey, all participants to date stated reported satisfaction or extremely satisfaction with the online testing. Conclusion The platform model demonstrates feasibility in the early pilot phase with acceptability based on participant responses. Next steps include expanded launch of the platform and assessment of testing rates and feasibility of a web-based model for STI diagnostics. Disclosures Caley B. Shukalek, MD, MSc, MPH, Gilead Sciences: Advisor/Consultant|Gilead Sciences: Grant/Research Support|Gilead Sciences: Honoraria|Merck Canada: Grant/Research Support|Merck Canada: Honoraria|PurposeMed Inc: Advisor/Consultant|PurposeMed Inc: Ownership Interest Ranjani Somayaji, M.D., CF Foundation: Grant/Research Support|CIHR: Grant/Research Support|Oncovir: Data and Safety Monitoring Board Fees|Vertex Pharmaceuticals: Advisor/Consultant|Vertex Pharmaceuticals: Grant/Research Support|Vertex Pharmaceuticals: Honoraria

A cross-sectional survey exploring HIV and HCV prevalence among men who purchase sex in Dnipro, Ukraine

BackgroundHIV programming in Ukraine largely targets “key population” groups. Men who purchase sex are not directly reached. The aim of our study was to explore the prevalence of sexually transmitted and blood-borne infections (STBBIs) among men who purchase sex from female sex workers.MethodsFollowing geographic mapping and population size estimation at each “hotspot”, we conducted a cross-sectional bio-behavioural survey with men who purchase sex between September 2017 and March 2018 in Dnipro, Ukraine. Eligibility criteria included purchasing sex services at a “hotspot” and being ≥ 18 years. Participants completed a structured questionnaire, followed by HIV/HCV rapid testing and a dried blood spot (DBS) sample collection for confirmatory serology.ResultsThe study enrolled 370 participants. The median age was 32 (interquartile range [IQR] = 27–38) and the median age of first purchase of sexual services was 22 (IQR = 19–27). Over half (56%) of participants reported ever testing for HIV; four participants (2%, N = 206) reported having tested positive for HIV, with three out of the four reporting being on ART. Forty percent of participants had ever tested for HCV, with three (2%, N = 142) having ever tested positive for HCV. In DBS testing, nine participants (2.4%) tested positive for HIV and 24 (6.5%) tested positive for ever having an HCV infection.ConclusionPrevalence of HIV and HCV in this population was high. Given high rates of study enrolment and testing, efforts should be made to reach men who purchase sex with expanded STBBI programming.

Retrospective review of rates of sexually transmitted and blood-borne infection (STBBI) testing in provincial corrections facilities in Newfoundland and Labrador.

Sexually transmitted and blood borne infection (STBBI) testing is recommended for people who are incarcerated (PWAI). We sought to determine the rate of STBBI testing during admissions to provincial correctional institutions in Newfoundland and Labrador (NL). This retrospective cohort study collected the identification of all admissions records in provincial correctional facilities in NL between July 1, 2020 and June 31, 2021 using the Provincial Corrections Offender Maintenance System database. Admissions to provincial detention centers were excluded. Records were linked with STBBI results, when available, within the electronic medical record (Meditech) using demographics. Testing rates, STBBI positivity rates, and univariate analysis of predictors for STBBI testing were completed. Of the 1,824 admissions identified, 1,716 were available for linkage to laboratory results. Admissions to detention centers (n = 105) were excluded. Any STBBI test result was available for 72 (4.5%) of admissions. No admission had complete testing for all STBBI. Facility testing rates ranged from 1.9 to 11.2% and 37.5% of STBBI tests had any positive results. Sixteen out of the 21 (76.2%) hepatitis C virus (HCV) antibody positives received HCV RNA testing, and 11/16 (88.8%) were HCV RNA positive. Institution (p = 0.001) and sex (p = 0.004) were found to be significant predictors of STBBI testing, while age was not significant (p = 0.496). STBBI testing rates were low in provincial correctional facilities in NL, and STBBI prevalence, especially for HCV, was high among those tested. Strategies to increase the rate of testing could contribute to STBBI control in corrections facilities.

Inaakonigeng ige-zhiwebiki’ba: Self-determining our path on the future of Indigenous STBBI research with the Feast Centre

The future of Indigenous STBBI (sexually transmitted and blood-borne infections) research must address the unique needs of diverse First Nations, Inuit, and Métis (FNIM) communities across Canada. This requires the expansion of culturally responsive research approaches centred on FNIM ways of being, knowing, and doing. The Feast Centre for Indigenous STBBI Research (Feast Centre) is dedicated to expanding the use of FNIM research methods in response to the unique needs of distinct Indigenous communities and foregrounds the voices of Indigenous Peoples living with or affected by STBBI. Indigenous Peoples in Canada experience higher rates of STBBI compared to other populations, and this is linked to significant health disparities, meaning that conventional public health approaches are not meeting the needs of Indigenous communities. Canada’s colonial health policies sustain health disparities through a lack of culturally responsive approaches to STBBI prevention, treatment, and care. In this article we examine Indigenous STBBI initiatives foundational to the Feast Centre by focusing on the outcomes of a CAAN Communities, Alliances & Networks–led national Indigenous community consultation, the findings of the project’s Indigenous HIV and AIDS scoping review, and vital theoretical insights from Indigenous STBBI literature. We provide key recommendations that emphasize culturally responsive approaches to STBBI research that strive to meet community-identified needs while cultivating the inherent strengths of FNIM communities. We envision these key recommendations within the theoretical framework of Indigenous futurisms in ways that reconceptualize Indigenous STBBI research through cultural strengths and offer guidance for the direction of future research.

Differential uptake and effects of digital sexually transmitted and bloodborne infection testing interventions among equity-seeking groups: a scoping review

BackgroundDigital sexually transmitted and bloodborne infection (STBBI) testing interventions have gained popularity. However, evidence of their health equity effects remains sparse. We conducted a review of the health equity effects...

Evaluating the Impact of the COVID-19-Related Public Health Restrictions on Access to Digital Sexually Transmitted and Blood-Borne Infection Testing in British Columbia, Canada: An Interrupted Time Series Analysis.

Evidence of long-term impacts of COVID-19-related public health restrictions on digital sexually transmitted and blood-borne infection (STBBI) testing utilization is limited. We assessed these impacts on GetCheckedOnline (a digital testing resource for STBBIs) relative to all STBBI tests in British Columbia (BC). Interrupted time series analyses were conducted using GetCheckedOnline program data comparing monthly test episodes (STBBI tests per requisition) among BC residents, stratified by BC region, and testers' sociodemographic and sexual risk profiles, for the prepandemic (March 2018-February 2020) and pandemic periods (March 2020-October 2021). Trends in GetCheckedOnline testing per 100 STBBI tests in BC regions with GetCheckedOnline were analyzed. Each outcome was modeled using segmented generalized least squared regression. Overall, 17,215 and 22,646 test episodes were conducted in the prepandemic and pandemic periods. Monthly GetCheckedOnline test episodes reduced immediately after restrictions. By October 2021 (end of the pandemic period), monthly GetCheckedOnline testing increased by 21.24 test episodes per million BC residents (95% confidence interval, -11.88 to 54.84), and GetCheckedOnline tests per 100 tests in corresponding BC regions increased by 1.10 (95% confidence interval, 0.02 to 2.17) above baseline trends. After initial increases among users at higher STBBI risk (symptomatic testers/testers reporting sexual contacts with STBBIs), testing decreased below baseline trends later in the pandemic, whereas monthly GetCheckedOnline testing increased among people 40 years or older, men who have sex with men, racialized minorities, and first-time testers via GetCheckedOnline. Sustained increases in utilization of digital STBBI testing during the pandemic suggest fundamental changes in STBBI testing in BC, highlighting the need for accessible and appropriate digital testing, especially for those most affected by STBBIs.

Patterns of Event-Level Concurrent Substance Use During Sex Among Gay, Bisexual, and Other Men Who Have Sex with Men in Metro Vancouver.

This study identified patterns of sexualized substance use among gay, bisexual, and other men who have sex with men (gbMSM) and examined associated risk factors for sexually transmitted and blood borne infections (STBBI). Data were from a longitudinal cohort recruited using respondent-driven sampling between Feb-2017 and Feb-2019. Participants reported on events with up to five of their most recent sexual partners. Latent class analysis examined patterns of concurrent substance use 2h prior to or during sex. Multinomial regression identified demographic, partner-level, and event-level factors associated across 11,877 sexual events reported by 757 participants. Most combinations of substance use were rare, but most drugs were frequentlycombined with other drugs when they were used prior to or during a sexual event. Six latent classes of concurrent event-level substance use were identified. The referent class (58.8% of events) was characterized by limited use of any drugs. The Common Drug Use class (12.1%) was characterized by use of alcohol, cannabis, and poppers and the Licit Drug Use class (21.6%) was characterized by use of alcohol alone. The Party 'N' Play (PnP) class (2.3%) was characterized by use of crystal methamphetamine GHB, Poppers, and Erectile Drugs; The Multi-use (3.5%) class was characterized by the PnP substances plus alcohol and ecstasy; and the Cannabis + class was characterized by use of Cannabis, Erectile Drugs, and Ecstasy. Relative to the referent class, all other classes were associated with events with more behavioural and network risk factors for STBBIs-highlighting the need for harm reduction interventions for gbMSM who use these drugs.

Disruptions of sexually transmitted and blood borne infections testing services during the COVID-19 pandemic: accounts of service providers in Ontario, Canada

BackgroundSince the onset of the COVID-19 pandemic in March 2020 in Canada, the availability of sexual health services including sexually transmitted and blood-borne infection (STBBI) testing has been negatively impacted in the province of Ontario due to their designation as “non-essential” health services. As a result, many individuals wanting to access sexual healthcare continued to have unmet sexual health needs throughout the pandemic. In response to this, sexual health service providers have adopted alternative models of testing, such as virtual interventions and self-sampling/testing. Our objective was to investigate service providers’ experiences of disruptions to STBBI testing during the COVID-19 pandemic in Ontario, Canada, and their acceptability of alternative testing services.MethodsBetween October 2020-February 2021, we conducted semi-structured virtual focus groups (3) and in-depth interviews (11) with a diverse group of sexual health service providers (n = 18) including frontline workers, public health workers, sexual health nurses, physicians, and sexual health educators across Ontario. As part of a larger community-based research study, data collection and analysis were led by three Peer Researchers and a Community Advisory Board was consulted throughout the research process. Transcripts were transcribed verbatim and analysed with NVivo software following grounded theory.ResultsService providers identified the reallocation of public health resources and staff toward COVID-19 management, and closures, reduced hours, and lower in-person capacities at sexual health clinics as the causes for a sharp decline in access to sexual health testing services. Virtual and self-sampling interventions for STBBI testing were adopted to increase service capacity while reducing risks of COVID-19 transmission. Participants suggested that alternative models of testing were more convenient, accessible, safe, comfortable, cost-effective, and less onerous compared to traditional clinic-based models, and that they helped fill the gaps in testing caused by the pandemic.ConclusionsAcceptability of virtual and self-sampling interventions for STBBI testing was high among service providers, and their lived experiences of implementing such services demonstrated their feasibility in the context of Ontario. There is a need to approach sexual health services as an essential part of healthcare and to sustain sexual health services that meet the needs of diverse individuals.

Acceptability of an existing online sexually transmitted and blood-borne infection testing model among gay, bisexual and other men who have sex with men in Ontario, Canada.

Gay, bisexual and other men who have sex with men (GBM) are disproportionately affected by sexually transmitted and blood-borne infections (STBBI) due to stigma and other factors such as structural barriers, which delay STBBI testing in this population. Understanding acceptability of online testing is useful in expanding access in this population, thus we examined barriers to clinic-based testing, acceptability of a potential online testing model, and factors associated with acceptability among GBM living in Ontario. Sex Now 2019 was a community-based, online, bilingual survey of GBM aged ≥15. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated using modified Poisson regression with robust variances. Multivariable modelling was conducted using the Hosmer-Lemeshow-Sturdivant approach. Among 1369 participants, many delayed STBBI testing due to being too busy (31%) or inconvenient clinic hours (29%). Acceptability for online testing was high (80%), with saving time (67%) as the most common benefit, and privacy concerns the most common drawback (38%). Statistically significant predictors of acceptability for online testing were younger age (PR = 0.993; 95%CI: 0.991-0.996); a greater number of different sexual behaviours associated with STBBI transmission (PR = 1.031; 95%CI: 1.018-1.044); identifying as an Indigenous immigrant (PR = 1.427; 95%CI: 1.276-1.596) or immigrant of colour (PR = 1.158; 95%CI: 1.086-1.235) compared with white non-immigrants; and currently using HIV pre-exposure prophylaxis (PrEP) compared to not currently using PrEP (PR = 0.894; 95%CI: 0.828-0.965). Acceptability of online testing was high among GBM in Ontario. Implementing online STBBI testing may expand access for certain subpopulations of GBM facing barriers to current in-person testing.

Assessing the acceptability of dried blood spot testing for HIV and STBBI among Métis people in a community driven pilot project in Alberta, Canada

Little literature exists on culturally grounded approaches for addressing human immunodeficiency virus (HIV) and sexually transmitted and blood-borne infections (STBBI) among Métis people. The goal of this mixed-methods research was to explore the experiences of Métis community members participating in a dried blood spot testing (DBST) for HIV/STBBI pilot for Métis communities in Alberta, Canada, with the aim of assessing the acceptability of this testing method. Grounded in community-based and Indigenous research approaches and working in partnership with a Métis community-based organization, data collection included a survey and four gathering circles with Métis DBST recipients at one of two community events, and semi-structured interviews with three DBST providers. Twenty-six of the 30 DBST recipients completed surveys, and 19 DBST recipients participated in gathering circles. Survey results suggest DBST is a highly acceptable STBBI testing method to Métis community members. Thematic analysis of gathering circle and interview transcripts revealed four broad themes related to the participants' experiences with DBST related to its acceptability (i. ease of DBST process, ii. overcoming logistical challenges associated with existing STBBI testing, iii. Reducing stigma through health role models and event-based, and iv. Métis-specific services). These findings illustrate the potential for DBST to be part of a culturally grounded, Métis-specific response to HIV and STBBI.

Comparative performance data for multiplex SARS-CoV-2 serological assays from a large panel of dried blood spot specimens

The extent of the COVID-19 pandemic will be better understood through serosurveys and SARS-CoV-2 antibody testing. Dried blood spot (DBS) samples will play a central role in large scale serosurveillance by simplifying biological specimen collection and transportation, especially in Canada. Direct comparative performance data on multiplex SARS-CoV-2 assays resulting from identical DBS samples are currently lacking. In our study, we aimed to provide performance data for the BioPlex 2200 SARS-CoV-2 IgG (Bio-Rad), V-PLEX SARS-CoV-2 Panel 2 IgG (MSD), and Elecsys Anti-SARS-CoV-2 (Roche) commercial assays, as well as for two highly scalable in-house assays (University of Ottawa and Mount Sinai Hospital protocols) to assess their suitability for DBS-based SARS-CoV-2 DBS serosurveillance. These assays were evaluated against identical panels of DBS samples collected from convalescent COVID-19 patients (n = 97) and individuals undergoing routine sexually transmitted and bloodborne infection (STBBI) testing prior to the COVID-19 pandemic (n = 90). Our findings suggest that several assays are suitable for serosurveillance (sensitivity >97% and specificity >98%). In contrast to other reports, we did not observe an improvement in performance using multiple antigen consensus-based rules to establish overall seropositivity. This may be due to our DBS panel which consisted of samples collected from convalescent COVID-19 patients with significant anti-spike, -receptor binding domain (RBD), and -nucleocapsid antibody titers. This study demonstrates that biological specimens collected as DBS coupled with one of several readily available assays are useful for large-scale COVID-19 serosurveillance.

Inaakonigeng ige-zhiwebiki’ba: Self-determining our path on the future of Indigenous STBBI research with the Feast Centre

The future of Indigenous STBBI (sexually transmitted and blood-borne infections) research must address the unique needs of diverse First Nations, Inuit, and Métis (FNIM) communities across Canada. This requires the expansion of culturally responsive research approaches centred on FNIM ways of being, knowing, and doing. The Feast Centre for Indigenous STBBI Research (Feast Centre) is dedicated to expanding the use of FNIM research methods in response to the unique needs of distinct Indigenous communities and foregrounds the voices of Indigenous Peoples living with or affected by STBBI. Indigenous Peoples in Canada experience higher rates of STBBI compared to other populations, and this is linked to significant health disparities, meaning that conventional public health approaches are not meeting the needs of Indigenous communities. Canada’s colonial health policies sustain health disparities through a lack of culturally responsive approaches to STBBI prevention, treatment, and care. In this article we examine Indigenous STBBI initiatives foundational to the Feast Centre by focusing on the outcomes of a CAAN Communities, Alliances & Networks–led national Indigenous community consultation, the findings of the project’s Indigenous HIV and AIDS scoping review, and vital theoretical insights from Indigenous STBBI literature. We provide key recommendations that emphasize culturally responsive approaches to STBBI research that strive to meet community-identified needs while cultivating the inherent strengths of FNIM communities. We envision these key recommendations within the theoretical framework of Indigenous futurisms in ways that reconceptualize Indigenous STBBI research through cultural strengths and offer guidance for the direction of future research.

Sexual behaviors at home and abroad: an online survey of Canadian young adult travelers

BackgroundFor young adults, travel- an accessible and aspirational experience- may be accompanied by high-risk lifestyle behaviors abroad, which in turn, increases the risk of sexually transmitted and blood-borne infections (STBBI). This study aimed to examine sexual and risk behaviors of young Canadian adults both at-home and during international travel.MethodsSexually-active Canadians, aged 18-25 years (N = 646) who travelled abroad in 2016, completed an online, cross-sectional survey analyzed by descriptive statistics. Outcome measures included young Canadian adults’ lifestyle risk and sexual behaviors at-home and abroad.ResultsSexual behaviors, both penetrative and non-penetrative activities, decreased significantly (p < 0.001; McNemar test) abroad compared to at-home. International travel elicited a statistically significant increase in alcohol consumption compared to at-home (Wilcoxon, z = − 11.341, p < 0.001). Partner type (new trip-acquired partner) abroad was associated with a greater number of travel-acquired sexual partners (Mann-Whitney, U = 4901, p < 0.001), inconsistent condom use during penetrative sex (U = 7215, p = 0.009), and sex under the influence of alcohol (Test of Two Proportions, p < 0.001).ConclusionsAlthough many young Canadian respondents practiced abstinence in their 2016 travel, for sexually-active travelers, new partner-type was related to high risk sexual behaviors. Young Canadians exhibited sexual risk behaviors both at-home and while travelling; suggesting the need for both domestic and pre-travel sexual health interventions.

Croyances associées à la participation à une activité de dépistage des infections transmissibles sexuellement et par le sang chez des élèves de 4e et 5e secondaire

Introduction: In Quebec, in recent years, a steady rise in cases of chlamydia and a rapid grow of cases of gonorrhoea among young people aged 15 to 24 years have been observed. Asymptomatic screening for sexually transmitted and blood-borne infections (STBBI) is one way to prevent their spread. However, despite the accessibility of STBBI screening services, including in school settings, the participation rate of young people aged 15 to 24 remains modest. Objective: Using the Theory of Planned Behavior, identify beliefs that predict the intention of secondary 4 and 5 students to consult with the school nurse to participate in STBBI screening. Method: 294 students in Secondary 4 and 5 completed a self-administered questionnaire that included the constructs of the Theory of Planned Behavior, in addition to the moral norm and the anticipated regret. Results: The results of the multiple regression analyses show that 5 beliefs are more related to the intention of youth to participate in an STBBI screening activity: "being reassured (if I don't have an STBBI)", "wasting my time", "the support of people important to me", "fear of having an STBBI" and "being shy". Discussion and conclusion: The results suggest that a communication strategy targeting 5 specific beliefs could increase the intention of the secondary 4 and 5 youth to participate in an STBBI screening activity.