Sexually Transmitted Infections Education Research Articles

The National STD Curriculum Podcast as a Method to Increase STI Education for Health Care Professionals.

Podcasts are a valuable educational tool that are convenient and provide on-demand learning. We launched the National Sexually Transmitted Disease Curriculum (NSTDC) Podcast in 2020 to educate healthcare professionals on sexually transmitted infections (STIs) with an emphasis on content from peer-reviewed literature relevant to clinical practice. We describe the reach and usage data for 31 podcast episodes produced during the first 29 months. Information was obtained via Google Analytics, Apple Podcasts, the podcast hosting platform Buzzsprout, and the Health Professional Application for Training form for listeners who were registered on the NSTDC website. There were more than 21,000 downloads, with an average of 686 downloads per episode. Although 85% of downloads occurred in the United States, podcast visitors were located in 57 countries. The three most reported professions/disciplines were registered nurse (39.0%), advanced practice nurse (22.5%), and physician (11.3%). Forty-eight percent of visitors had a primary programmatic focus of STDs, 24% HIV/AIDs, and 18% primary care. The NSTDC Podcast is a highly utilized resource for mobile and on-demand learning for health care professionals who want to expand their knowledge on STIs.

Adolescent Preferences for a Pediatric Primary Care-based Sexually Transmitted Infection and HIV Prevention Intervention

PurposeWe sought to elicit perspectives on HIV and sexually transmitted infection (STI) prevention among adolescents with recent STIs in primary care to optimize acceptability and effectiveness in designing a novel HIV/STI prevention intervention. MethodsWe enrolled 13-19 year-olds with recent gonorrhea, chlamydia, trichomonas, and/or syphilis in a multimethods cross-sectional study at two primary care clinics. Participants completed surveys and interviews. We used an integrated analytic approach deductively coding data using the Integrated Behavioral Model, then inductively coding to identify themes not represented in the Integrated Behavioral Model. ResultsParticipants (n = 35) were 85% cisgender female, 14% cisgender male, 1% transgender female; 25% identified as lesbian, bisexual, or queer. Most (97%) identified as non-Latinx Black. None used condoms consistently, 26% were aware of pre-exposure prophylaxis (PrEP), and 31% were never HIV tested. Five key themes emerged. 1) Mental health was central to HIV prevention behavior uptake and coping with STI diagnosis. 2) Youth desired prevention counseling that allowed decisional autonomy and individualized goal setting. 3) Negative social norms around condoms and absent norms around HIV testing and PrEP limited method uptake. 4) Both confidence and concrete skills were needed to initiate prevention methods. 5) Youth desired education at the time of STI diagnosis to improve subsequent prevention decision making. DiscussionKey intervention design considerations included 1) integrating mental health assessment and referral to services, 2) promoting individualized goal setting, 4) building communication skills, 4) providing navigation and material support for PrEP uptake and HIV testing, and 5) augmenting comprehensive STI and HIV prevention education.

Nursing students' knowledge and attitudes on sexually transmitted infections prevention at training institution in Namibia.

Insufficient knowledge about sexually transmitted infections (STIs) among nursing students can impact patient care and outcomes. To address this, comprehensive STI education is crucial. This study aimed to assess knowledge and attitudes of nursing students regarding STI prevention and control. The research was conducted at a nursing training institution in Windhoek, Namibia. The research employed a cross-sectional design with 73 participants. Outcomes revealed that 63.0% had satisfactory knowledge and 79.5% exhibited positive attitudes. A significant association was noted between knowledge and participants' sex. Male participants displayed poor knowledge (70%). No significant relationship existed between demographic characteristics and attitudes. The study concluded lower than expected knowledge regarding STIs among nursing students that implicated patients' care. Integrating STI education into nursing curricula can improve students' competences that enhance patients' care.

Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study

BackgroundSouth Africa maintains an integrated health system where syndromic management of sexually transmitted infections (STI) is the standard of care. An estimated 2 million cases of Neisseria gonorrhoeae (N. gonorrhoeae) occur in South Africa every year. Point-of-care diagnostic tests (POCT) may address existing STI control limitations such as overtreatment and missed cases. Subsequently, a rapid lateral flow assay with fluorescence-based detection (NG-LFA) with a prototype reader was developed for N. gonorrhoeae detection showing excellent performance and high usability; however, a better understanding is needed for device implementation and integration into clinics.MethodsA qualitative, time-series assessment using 66 in-depth interviews was conducted among 25 trained healthcare workers involved in the implementation of the NG-LFA. Findings were informed by the Normalization Process Theory (NPT) as per relevant contextual (strategic intentions, adaptive execution, and negotiation capacity) and procedural constructs (coherence, cognitive participation, collective action, reflexive monitoring) to examine device implementation within primary healthcare levels. Interviews were audio-recorded, transcribed, and then analyzed using a thematic approach guided by NPT to interpret results.ResultsOverall, healthcare workers agreed that STI POCT could guide better STI clinical decision-making, with consideration for clinic integration such as space constraints, patient flow, and workload. Perceived NG-LFA benefits included enhanced patient receptivity and STI knowledge. Further, healthcare workers reflected on the suitability of the NG-LFA given current limitations with integrated primary care. Recommendations included sufficient STI education, and appropriate departments for first points of entry for STI screening.ConclusionsThe collective action and participation by healthcare workers in the implementation of the NG-LFA revealed adaptive execution within the current facility environment including team compositions, facility-staff receptivity, and STI management experiences. User experiences support future clinic service integration, highlighting the importance of further assessing patient-provider communication for STI care, organizational readiness, and identification of relevant departments for STI screening.

Trends in STI testing and diagnosis rates during the COVID-19 pandemic at a large urban tertiary care center, and the role of the emergency department in STI care.

The COVID-19 pandemic has had profound effects on access to care, including outpatient sexually transmitted infection (STI) testing and treatment. Many vulnerable populations already relied on the emergency department (ED) for much of their care prior to the pandemic. This study examines trends in STI testing and positivity before and during the pandemic at a large urban medical center and evaluates the role of the ED in providing STI care. This is a retrospective review of all gonorrhea, chlamydia, and trichomonas tests from November 1, 2018, through July 31, 2021. Demographic information and location and results of STI testing were extracted from the electronic medical record. Trends in STI testing and positivity were examined for 16 month periods before and after the COVID-19 pandemic started (March 15, 2020), with the latter divided into the early pandemic period (EPP: March 15 -July 31, 2020) and late pandemic period (LPP: August 1, 2020 - July 31, 2021). Tests per month decreased by 42.4% during the EPP, but rebounded by July 2020. During the EPP, the proportion of all STI testing originating in the ED increased from 21.4% pre-pandemic to 29.3%, and among pregnant women from 45.2% to 51.5%. Overall STI positivity rate increased from 4.4% pre-pandemic to 6.2% in the EPP. Parallel trends were observed for gonorrhea and chlamydia individually. The ED represented 50.5% of overall positive tests, and as much as 63.1% of positive testing during the EPP. The ED was the source of 73.4% of positive tests among pregnant women, which increased to 82.1% during the EPP. STI trends from this large urban medical center paralleled national trends, with an early decrease in positive cases followed by a rebound by the end of May 2020. The ED represented an important source of testing for all patients, and especially for pregnant patients, throughout the study period, but even more so early in the pandemic. This suggests that more resources should be directed towards STI testing, education, and prevention in the ED, as well as to support linkage to outpatient primary and obstetric care during the ED visit.

Increased Incidence of Congenital Syphilis

Background: Congenital syphilis occurs when a pregnant mother passes the syphilis infection to their child during pregnancy. This treatable sexually transmitted infection (STI) is the leading cause of stillbirths and neonatal deaths (Trivedi et al., 2020). According to the CDC (2021), the incidence ofcongenital syphilis increased 254% from 2016 to 2020. The key factors include decreased funding for STI education, decreased access to care, limited resources such as transportation and health insurance, stigma that is associated with diagnosis and treatment and legal issues that may be present such as undocumented migrants (Contraceptive Technology Update, 2022). Objective: Increase the education for STI prevention and treatment to decrease the incidence of congenital syphilis.Methods: Through the research design Plan/Do/Study/Act increased education will help to bring awareness of prevention and treatment to women of childbearing ages. Inclusion of community resources such as community centers, rural health clinics, health departments and schools will assist in capturing a more diverse population as well as a greater number of patients. Education will occur as a standard at child appointments, prenatal screenings, during health classes and at community centers. Comparison ofcongenital syphilis diagnosis from pre- and post- education implementation will provide data to indicate significance. Conclusion: Through implementation of extended education points the healthcare team can reach a greater number of patients and ensure swift and adequate treatment. Syphilis is a treatable infection and when detected and treated in a timely manner will lessen the risk to the unborn child. Utilizing healthcare and community services can provide the necessary education for eliminating poor outcomes for neonates.

Associations between Awareness of Sexually Transmitted Infections (STIs) and Prevalence of STIs among Sub-Saharan African Men and Women.

Treatments for HIV and other STIs are not readily available in sub-Saharan Africa and other resource-limited areas, where the prevalence of HIV and other STIs is high. In the absence of treatment and laboratory infrastructure to monitor treatment efficacy, increasing awareness of STIs and STI screening are crucial components of STI prevention programs. In the current study, we sought to estimate the awareness of STIs in resource-limited countries and evaluate the strength of the association between the awareness of STIs and STIs infection. We did a secondary analysis of data obtained from 2019 women and 794 men enrolled in a community-based study that was conducted from November 2002 to March 2003 in the Moshi Urban District of Northern Tanzania. We found gonorrhea, syphilis, and HIV/AIDS were well-known among the study participants. However, their awareness of other STIs, including herpes, was very low. We also found that the awareness of STIs was not associated with STIs in men, but women who had prior knowledge of gonorrhea, syphilis, and HIV had a twofold higher risk of testing positive for an STI. Education programs aimed at increasing awareness of STIs are needed in the region. The majority of the existing STI education programs in the region focus exclusively on HIV/AIDS. The expansion of the existing AIDS/HIV education programs needs to be strengthened to include information about other STIs.

Feasibility, acceptability, and short-term impact of a brief sexually transmitted infection intervention targeting U.S. Military personnel and family members

BackgroundOver the past 10 years, incidence of sexually transmitted infections (STIs) has increased to record numbers in the United States, with the most significant increases observed among adolescents and young adults. The US military, where the majority of active duty personnel are 18–30 years old, has seen similar increases. However, the US military does not yet have a standardized, service-wide program for STI education and prevention.MethodsThe KISS intervention (Knocking out Infections through Safer-sex and Screening) was adapted from an evidence-based intervention endorsed by the US Centers for Disease Control and Prevention and consisted of a one-time, small group session. Content included STI/HIV knowledge and prevention, condom use skills, and interpersonal communication techniques. The intervention was pilot tested for feasibility and acceptability among a population of service members and medical beneficiaries at Joint Base Lewis-McChord in Washington state.ResultsA total of 79 participants aged 18–30 years were consented to participate in the pilot study and met entry criteria, 66/79 (82.5%) attended the intervention session, and 46/66 (69.7%) returned at 3 months for the final follow-up assessment. The intervention sessions included 31 male (47.0%) and 35 female (53.0%) participants. Almost all participants felt comfortable discussing sexual issues in the group sessions, reported that they intended to practice safer sex after the intervention, and would also recommend the intervention to friends. Knowledge about STI/HIV prevention significantly increased after the intervention, and intervention effects were maintained at 3 months. About one-fifth of participants tested positive for N. gonorrhea or C. trachomatis infection at enrollment, while none had recurrent STIs at the final visit. Use of both male and female condoms increased after the intervention.ConclusionsThe KISS intervention was feasible to implement in the military setting and was acceptable to the active duty service members and other medical beneficiaries who participated in the pilot project. Further studies are needed to determine if the KISS intervention, or others, effectively decrease STI incidence in active duty personnel and would be appropriate for more widespread implementation.Trial RegistrationRetrospectively registered as the pilot phase of clinicaltrials.gov NCT04547413, “Prospective Cohort Trial to Assess Acceptability and Efficacy of an Adapted STI/HIV Intervention Behavioral Intervention Program in a Population of US Army Personnel and Their Medical Beneficiaries—Execution Phase.”

Human Papillomavirus associated prevention: knowledge, attitudes, and perceived risks among men who have sex with men and transgender women in Pakistan: a qualitative study

ObjectivesMen who have sex with men (MSM) and transgender individuals are at higher risk of genital warts and anal cancer due to sexually transmitted human papillomavirus infection. This study explores MSM and transgender women’s perceptions of Human papillomavirus (HPV) infection and HPV prevention strategies (screening and vaccination) in Pakistan.DesignA qualitative study using focus group discussions (FGD) with self-identified MSM, male sex workers and transgender women were conducted between March 2019 to August 2019 in Karachi, Pakistan.MethodsParticipants were recruited from community-based organization (CBO) working for MSM and transgender women. A total of 38 men and 10 transgender women took part in 6 FGDs. Discussions were recorded, translated, transcribed verbatim and analyzed using content analysis.ResultsThree themes were identified from the emerging analysis. These are, 1) Knowledge and risk perceptions about STIs and HPV, 2) Beliefs and attitudes towards HPV prevention, 3) Participant’s recommendations for HPV vaccination and anal Pap screening. Participants described lack of knowledge of HPV and its health consequences as HIV is the only focus of attention of the government and the local CBOs. None of participants had heard about HPV prevention including vaccination and anal Pap screening for men but expressed a positive attitude towards prevention. Genital warts and anal cancer were perceived as severe potential consequences of a known risk behaviors. All participants stated they would be interested in taking an HPV vaccine but acknowledged that the provision of services for sexually transmitted infections (STI) are inadequate to meet the needs of key populations and are not prioritized by the government. The main perceived barriers to access HPV prevention included cost and challenges to access public health care services or openly discussing one’s sexual orientation with health care providers. Participants generally preferred the CBO for more professional, unbiased staff attitudes that respect patients’ integrity, confidentiality and privacy. Most participants thought that in case the government is non-cooperative, CBOs should work in the interest of HPV eradication and generate funds through international funding.ConclusionsThe findings from this study can help public health policy and researchers to understand this minority’s perspective on HPV prevention. Given the low level of knowledge about HPV infection and its negative health consequences there is a need of HPV education combined with STI education and awareness through HPV brochures to educate the target population effectively.

Sexually transmitted infection (STI) research priority-setting: a two-stage study including the perspectives of patients, the public, clinicians and stakeholders

ObjectivesPatient and public involvement (PPI) in research priority-setting remains limited, especially for non-HIV STI. We identify and compare the top 10 patient and public STI research priorities with those of...

Artificial intelligence and sexual health in the USA

Artificial intelligence and sexual health in the USA

Correlates of sexually transmitted infection knowledge among late adolescents.

Undergraduate students (n = 419) at a large public Midwestern university completed an online survey that assessed general STI knowledge using an established modified scale, demographics, sexual health and behavioural factors, and sources of STI information. Exploratory bivariate analyses were first conducted followed by a multiple linear regression examining the correlates initially identified as significantly and strongly associated with STI knowledge. Although many factors were significantly correlated with STI knowledge, gender, nationality, sexual identity, STI testing history, knowing someone diagnosed with an STI, prior school-based STI education, and receiving STI information from a healthcare provider were most strongly associated (P < 0.001 with medium or large effect sizes). All but prior school-based STI education were predictive of STI knowledge score (P = 0.103), with nationality (β = 0.172, P = 0.003) and gender (β = 0.147, P = 0.002) being the strongest predictors. Late adolescents' STI knowledge was universally low, but disparities existed and were related to a variety of characteristics. These findings expand the current literature on young people's STI knowledge and provide needed information to prioritise populations and methods for educational interventions in order to enhance STI knowledge among youth.

1544. Sexually Transmitted Infection Laboratory Testing and Education Trends Among Physician Office Visits in the United States, 2009-2016

BackgroundRates of sexually transmitted infections (STIs) have been rising in the United States (US). Physician offices play an important role in providing both STI prevention and education, as well as STI laboratory testing options for patients who present at risk. However, few studies have documented the extent to which physician’s offices have contributed to prevention and testing efforts. We address this gap by evaluating STI testing and education provided in US physician offices from 2009 to 2016.MethodsThis was a cross-sectional study of the Centers for Disease Control and Prevention’s National Ambulatory Medical Care Survey (NAMCS) from 2009 to 2016. Data weights were applied to extrapolate sample data to national estimates. Testing for HIV, HPV, Chlamydia (2009 – 2016) and Hepatitis and Gonorrhea (2014 – 2016) were presented as testing visits per 1,000 total visits. Subgroup analyses were performed for age group, sex, and geographical region by individual STI test and receipt of STI prevention education.ResultsA total of 7.6 billion visits were included for analysis, of which 0.6% included an STI test. Testing rates increased over the study period for Chlamydia (R2=0.27), HPV (R2=0.28), and HIV (R2=0.51). Peak testing occurred in 2015 for all tests. STI prevention education was provided to 0.5% of patients. Females were tested at a higher rate for all STIs (4.2%) compared to males (0.4%). Females also received more STI prevention education overall (0.6% versus 0.4%, respectively). While the age group 25 – 24 accounted for highest Hepatitis (15.9%) and HPV (11.3%) testing rates, the 15 – 24 age group had the highest overall testing rate (9.4%). STI testing was highest in the South region (Figure 1). ConclusionSTI testing in US physician offices increased in recent years. Females accounted for the majority of STI testing and STI prevention education. Testing was more frequent among patients 15 – 24 years old and those seen in the South region. Further research should be conducted to determine reasons for differences in testing and education amongst sex, age group, and geographic region.Disclosures All Authors: No reported disclosures

Evaluating the Use of Monetary Incentive in Text-Delivered Sexually Transmitted Infection Education

Background: The Centers for Disease Control and Prevention (CDC) reported increases in chlamydia, gonorrhea, and syphilis from 2016 to 2017 despite numerous testing and education programs. In addition, young adults are at an increased risk of STIs.Aim: To describe the effectiveness of monetary incentives provided to college females for engaging with automated mobile messaging delivered education over the course of six weeks concerning sexually transmitted infections (STIs).Methods: A longitudinal cohort study was conducted at a large Southeastern, public university in the United States. One hundred and fifty-six female college students (18-24 years in age) participated in a mobile messaging and marketing automation platform delivered once a week for six weeks. Engagement with weekly education was measured by clicks on educational content.Results: Out of the six messages, χ2 analysis revealed that paid participants were more likely to engage with the STI education in weeks two, four, five, and six. In this study, simple linear regression ANOVA confirmed that compensation was the main extrinsic motivator for engagement rather than other factors, such as the delivery method.Conclusions: Monetary incentive can increase engagement with STI education in college females while mobile messaging also has the potential.

Sexually Transmitted Infections among First-Generation College Students

Background Because of the social and systemic barriers encountered by first-generation college students, this population is at risk for poorer health outcomes. However, there is no identified research investigating whether this includes sexually transmitted infections (STIs). The aim of the study was to identify whether first-generation students were more likely than non-first-generation students to report a history of STIs. Methods Participants (n = 634) were undergraduate university students at a public institution in the Southeast United States. Using secondary data analysis, this study assessed the relationship between first-generation student status and reported a history of STIs. Participants completed a Qualtrics survey including demographics, first-generation student status, and history of STI(s). Results First-generation college students are over twice as likely as non-first-generation college students to report a history of STIs after controlling for relevant background variables. Discussion First-generation college students represent a population that colleges, universities, and high schools can prioritize for STI education, prevention, and testing.

Prevalence of Neisseria gonorrhoeae infection among women of reproductive age in sub-Saharan Africa: a systematic review and meta-analysis

Objective Neisseria gonorrhoeae infection is a global, major public health problem. It is the second leading bacterial sexually transmitted infection (STI) in sub-Saharan Africa and worldwide. As study findings on the topic are inconsistent, we conducted a systematic review and meta-analysis to determine the pooled prevalence of N. gonorrhoeae infection in sub-Saharan Africa among reproductive-aged women. Methods Published studies were systematically retrieved from PubMed, Embase, CINHAL and Science Direct. Their quality was measured using the Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data, and the score of each included study had to meet at least 4.5 out of 9 indicators of quality. Results The meta-analysis of 35 studies showed that the pooled prevalence of N. gonorrhoeae infection among reproductive-aged women in sub-Saharan Africa was 3.28% (95% confidence interval 2.61%, 3.94%). Conclusion The prevalence of N. gonorrhoeae infection was higher than that found in other studies carried out in the region. The results suggest that greater attention should be paid to the primary prevention of N. gonorrhoeae. We recommend the implementation of STI education for reproductive-aged women and the use of specific and rapid diagnostic testing for N. gonorrhoeae infection in STI clinics. N. gonorrhoeae screening and treatment should be integrated into in- and outpatient clinics to reduce infection among reproductive-aged women.

Examining HIV and STIs Related Knowledge Among Male Adolescents in Saudi Arabia

Background: Sexually Transmitted Infection (STI) is a major global cause of acute illness, long-term disability and death, with serious medical and psychological consequences. Knowledge and awareness about the transmission of sexual disease play an important role in the prevention of the disease. Very little is known about HIV and STI in adolescents and associated factors in Saudi Arabia. Objective: The aim of this study was to examine the association between self-rated STI knowledge and HIV and STI knowledge test scores, as well as to investigate the association between adolescents’ HIV and STI knowledge and their demographic background and sexually related behaviors. Methods: A multi-stage cross-sectional study was conducted using a self-administered questionnaire, recruiting 453 male adolescents (15 and 20 years) from private and public male high schools in Riyadh, the capital city of Saudi Arabia. Results: More than half (53.4%) of the adolescents reported their STI knowledge as excellent or good (42%). However, based on the total score scale of HIV and STI knowledge, 64.3% had a poor level of knowledge. The sexual information sources commonly cited were friends (70%) and internet (40.0%); and the least cited sources were fathers (16%) and mothers (15%). The logistic regression analysis revealed that adolescents’ father and mother education (&gt;12 years) were positively associated with adolescent’s HIV and STI knowledge level (OR= 1.6, 95% CI: 1.1-2.4, p= 0.040) and (OR= 1.8, 95% CI: 1.2-2.8, p= 0.010). No significant association was found between adolescents’ HIV and STI knowledge and their sexual behaviors and attitudes. Conclusion: Findings suggest that a high proportion of male adolescents have poor HIV and STI related knowledge. Poor knowledge and reliance on potentially unreliable informational sources coupled with an over-estimate perception of STI expertise suggests that improvements in STI and HIV education should be addressed. Additional research is needed to help identify factors (beyond knowledge) associated with sexual behavior and attitudes that may increase the risk for STIs and HIV among adolescents.

First Responses to the Symptoms of Sexually Transmitted Infections and Treatment-Seeking Behavior Among Men Who Have Sex With Men in 13 Cities in China.

Data are scarce on sexually transmitted infection (STI) treatment-seeking behavior among men who have sex with men (MSM) in China. The purpose of the study was to characterize the first response to STI symptoms, treatment-seeking behavior, and its associated factors among MSM in China. A cross-sectional study with convenience sampling design was conducted in 13 cities from April to July 2017. Face-to-face interviews were conducted to collect information on demographics, STI symptoms, and treatment-seeking behavior. Logistic regression analysis was conducted to evaluate variables associated with not seeking treatment. Among 3925 recruited participants, 628 (16.0%) reported STI symptoms in the past 12 months and were included in the analysis. Upon or after being notified of the symptoms, MSM sought help from various sources or self-tested using rapid testing kits. Only 322(51.3%) went to see a doctor in clinic. In multiple logistic regression analyses, younger age, lower income, less STI knowledge (adjusted odds ratio [AOR], 1.8; 95% confidence interval [CI], 1.2-2.5), not knowing own STI risk (AOR, 1.8; 95% CI, 1.2-2.7), no symptoms of anogenital ulcers (AOR, 2.3; 95% CI, 1.3-3.8) or anogenital warts (AOR, 2.4; 95% CI, 1.6-3.7), no syphilis testing in the past 12 months (AOR, 2.1; 95% CI, 1.5-3.0) were associated with higher probability of not seeking treatment in clinics. We found a high prevalence of STI symptoms among MSM and only half sought treatment. Prevention efforts should promote STI education, testing, and adequate treatment-seeking behavior.

The Impact of Pre-Exposure Prophylaxis on Sexual Communication and Sexual Behavior of Urban Gay and Bisexual Men.

Pre-exposure prophylaxis (PrEP) has altered the public health landscape for gay, bisexual, and other men who have sex with men (GBM) by significantly increasing protection against HIV infection. Early epidemiologic data showed GBM generally used PrEP as prescribed, i.e., as an additional protective tool over and above barrier protection, although subsequent reports have been equivocal. Irrespective of population-level trends, some GBM appear to have reevaluated their HIV risk tolerance and changed their interactions with sex partners. Scant published data have focused on factors that influence PrEP-using GBM's decisions about sexual behavior-including condom use as well as sex with HIV-positive partners-and sexual communication practices. Thus, in this study, we investigated those research concerns qualitatively via content analysis of individual interviews conducted with 103 GBM in New York City (M age 32.5 years, 50% White, 64% on PrEP > 6months). Emergent themes reflect (1) participants' strong HIV knowledge; (2) changing GBM community norms about condom use on PrEP; (3) increased focus on risk tolerance with individual differences in post-PrEP condom use; (4) appreciation for routine sexually transmitted infection (STI) screening in PrEP care concomitant with some STI knowledge deficits; (5) decreased stigma concerning, and greater comfort with, HIV-positive sex partners; and (6) increased confidence discussing HIV status and condom use preferences with partners. Findings have implications for future research as well as for clinical practice, such as enhanced STI education and provider-initiated discussions about risk compensation, serosorting, and sexual communication skills.

Determinants of use of mobile phones for sexually transmitted infections (STIs) education and prevention among adolescents and young adult population in Ghana: implications of public health policy and interventions design

BackgroundSexually Transmitted Infections (STIs) are a major public health challenge globally especially among adolescents and young adults in lower-middle-income countries (LMICs) in Africa including Ghana. In light of this, mobile phone innovations are advocated to enhance public health education and prevention of STIs in developing health systems.ObjectiveThis study assessed mobile phone usage among adolescents and young adult populations pursuing tertiary education and their use of these technologies in the education and prevention of STIs.MethodThis was a cross-sectional analytical study among 250 adolescents and young adults aged 18–24 at Ghana’s premier and biggest public University. The study was however conducted in only one public university in the Greater Accra region which potentially poses generalizability challenges due to socio-cultural and economic differences in other regions of the country. Data was collected using structured questionnaire and data analysis done with STATA (version 12.0). Univariate probit regression (VCE, Robust) analysis was used to determine factors associated with adolescents and young adult population’s usage of mobile phones in the education and prevention of STIs.ResultsOut of the 250 adolescents and young adults interviewed, 99% owned mobile phones. Out of this number, 58% them were smartphone users. Also, it was found that male young adults (Coef. = 1.11, p = 0.000) and young adults who owned a smartphone (Coef. = 0.46, p = 0.013) were more likely to use mobile phones for education and prevention of STIs.ConclusionMobile phone penetration among young adults is nearly 100% in line with the national trend. Additionally, these young adults largely believe in the use of mobile phone programmes for STIs education and prevention. Moreover, respondents were found to be more comfortable using mobile applications than traditional text messaging or phone calls in STIs education and prevention. Future mobile phone programmes for STIs education and prevention should consider innovating customized mobile applications to promote acceptability by the youth and enhance sustainability of such interventions on STIs in Ghana. Even though this study was conducted in only one public university in Ghana, the findings are nonetheless informative and future researchers could consider using a larger sample size across private and public universities in other regions of the country.