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Background: Following the COVID-19 pandemic declaration, the World Health Organization recommended suspending neglected tropical diseases (NTD) control activities as part of sweeping strategies to minimise COVID-19 transmission. Understanding how NTD programs were impacted and resumed operations will inform contingency planning for future emergencies. This is the first study that documents how South-East Asian and Pacific NTD programs addressed challenges experienced during the COVID-19 pandemic. Methodology/Principal findings: Data was collected through semi-structured interviews with 11 NTD Program Coordinators and related personnel from Fiji, Papua New Guinea, The Philippines, Timor-Leste, and Vanuatu. Constructivist grounded theory methods were drawn on to generate an explanation of factors that enabled or hindered NTD program operations during the COVID-19 pandemic. The COVID-19 pandemic disrupted NTD programs in all countries. Some programs implemented novel strategies by partnering with services deemed essential or used new communications technology to continue (albeit scaled-back) NTD activities. Strong relationships to initiate cross-program integration, sufficient resources to implement adapted activities, and dedicated administrative systems were key enabling factors for recommencement. As the COVID-19 pandemic continued, exacerbating health resources scarcity, programs faced funding shortages and participants needed to find efficiencies through greater integration and activity prioritisation within their NTD units. Emphasising community-led approaches to restore trust and engagement was critical after widespread social anxiety and disconnection. Conclusions/Significance: Sustaining effective NTD programs during a global emergency goes beyond managing immediate activity disruptions and requires attention to how NTD programs can be better ensconced within wider health programs, administrative, and social systems. This study underscores the importance of pre-emergency planning that reinforces NTD control programs as a critical service at all health systems levels, accompanied by governance arrangements that increase NTD staff control over their operations and strategies to maintain strong community relationships. Ensuring NTD units are supported via appropriate funding, personnel, and bureaucratic resources is also required. Author summary: Disruptions to health services during the COVID-19 pandemic may delay progress in neglected tropical diseases (NTDs) control by several years. Current studies of how NTD programs responded to the challenges arising from the COVID-19 pandemic are largely from African settings and focus on earlier periods during the pandemic when policy advice was most stringent. In contrast, this study documents how NTD staff and other related personnel in five South-East Asian and Pacific countries adapted to changing situations throughout the pandemic. We found a difference in the strategies NTD programs initially used to manage the immediate challenges of strict new public health measures compared to those used later in the pandemic's evolution when seeking to recommence usual programs. Initially, some NTD programs devised new ways of offering modified services, primarily though cross-program integration with other health services that were allowed to continue operating. When operations re-commenced, NTD programs faced financial challenges that meant human and resource efficiencies in these units needed to be found. The cumulative impact of pandemic-related restrictions and misinformation eroded community trust in health programs more broadly and required NTD staff to rebuild local relationships. The lessons learned in these settings may help NTD programs in these and other regions prepare for prolonged future emergencies. [ABSTRACT FROM AUTHOR]

Objective: The type of health education messages that communities and individuals seek to have communicated about the human papillomavirus (HPV) vaccine is important if vaccine programmes are to succeed, especially in settings such as Papua New Guinea (PNG), which have a high burden of cervical cancer, low health literacy and negative experiences of earlier vaccination programmes. This study sought to identify the health education messages that are viewed as most appropriate in such a context. Methodology: A qualitative study using gender-specific focus group discussions (N = 21) and semi-structured interviews (N = 82) was undertaken in three sites in PNG. Sites included both rural and urban locations in Milne Bay, Eastern Highlands and Western Highlands Provinces. Results: Two divergent discourses emerged. One group of participants, largely young people, felt communication messages should stress that HPV is a preventable sexually transmitted infection, which can cause cervical cancer. The other group, mainly members of the older population, believed that messaging should focus on the vaccine as a prevention strategy for cervical cancer. A small minority wanted both aspects of the vaccine discussed. Conclusion: Sensitivity needs to be taken when engaging with communities which have negative experiences of earlier infant immunisation programmes. Ensuring that the health communication needs and priorities of different sections of the populations are taken into account is key to the successful introduction and roll-out of HPV vaccination in this setting.

Aims: This article reports on an evaluation of a community-controlled peer education project led by a drug user organization (DUO) that aimed to contribute to hepatitis C prevention. This article also examines broader contextual issues, particularly the funding and governance arrangements affecting the conduct of peer education. Method: This project was evaluated in three sites in New South Wales, Australia. Monthly activity reports were completed by peer educators. Interviews were conducted with five groups of stakeholders: peer educators, peers, staff of the DUO, staff of non-government and government organizations that were partners in this project. Findings: Of the 3373 events categorized, 37% (n = 1154) were categorized by peer educators as being about hepatitis C, 39% (n = 1234) about safer injecting techniques and 24% (n = 760) about other issues. Peer educators described strategies they used particularly when their peers did not want to discuss hepatitis C or had other priorities. Conclusions: This project was successful in disseminating harm reduction information to the targeted community through the recruitment, training and support of peer educators. The results suggest the importance of broadening programme funding parameters to enable services to tailor their work to specific needs, while working towards the shared goal of hepatitis C prevention.

This article examines findings from a qualitative study exploring the experiences of young adults with disabilities regarding their perceptions of interpersonal discrimination on public transport in two Australian states. Interpersonal discrimination by members of the public included contests for accessible seating, receiving unwanted physical assistance, bullying and intimidation. Participants reported that transport staff engaged in verbal abuse and hostile interactions including questioning the young person's disability. These experiences appeared to be influenced by narrow perceptions of disability, visibility or otherwise of the young person's impairment, limited understanding of the needs of young people with disabilities, and the age and gender of the person behaving in a discriminatory way. The discriminatory experiences were reported to have had a negative impact on the social and economic participation of these young adults in their communities. The participants of the study disclosed diverse experiences of interpersonal discrimination by the travelling public and transport officials. Interpersonal discrimination impacted on some of the young adults' capacity to move about freely, as they sought to avoid exposure to prejudicial attitudes and verbal abuse. Heightened concerns about getting to and from activities safely affected the young adults' willingness to use public transport for their daily activities. Eliminating day-to-day interpersonal discrimination that young adults with disabilities experience on public transport requires legislative, policy and societal change. [ABSTRACT FROM AUTHOR]

Childhood is a time when children begin to constitute themselves as gendered subjects largely according to social norms that are rigidly framed within dominant discourses of heteronormative binary gender. This paper is based on the life histories of 42 sexuality and gender diverse adult men and transgender women conducted in PNG. Findings offer insight into the ways in which boys transgressed gender norms through dress, play, work within the home and in dance. We argue that gender transgression in childhood is not a contemporary phenomena and such childhood experiences of boys in PNG should be recognised as part of the country's rich cultural diversity. [ABSTRACT FROM AUTHOR]

Introduction. Despite Aboriginal Australians being over-represented in populations of people living with hepatitis C (HCV), there is a dearth of research to guide policy and programme development in the area of care and treatment, particularly relating to new HCV treatments. Method. In-depth interviews were conducted with 39 people identifying as Aboriginal Australians and living with HCV in New South Wales. Results. Participants' experiences were characterised by a lack of detailed or appropriate information provided at diagnosis, high levels of stigma associated with HCV and low overall knowledge of HCV as reported for themselves and their communities. Despite poor diagnosis experiences, participants had undertaken changes to their lifestyle, especially in relation to alcohol use, in order to promote liver health. Concerns about treatment side effects and efficacy impacted participants' decisions to undertake treatment. Eleven participants had undertaken HCV treatment in a variety of care models with a peer worker and in prison. Conclusions. The similarities between concerns and experiences of Aboriginal people and other populations living with HCV do not suggest that services and strategies to engage these populations should also be the same. These results suggest that further engagement of the primary care sector in HCV care is important as well as increasing Aboriginal community knowledge of HCV. A variety of service models should be available to meet individuals' preferences, including those offered within Aboriginal community controlled health services emphasising holistic notions of health, and supported by information and communication programmes using principles of health literacy relevant to Aboriginal people. [ABSTRACT FROM AUTHOR]

Background: Previous research has documented patient experiences of hepatitis C virus (HCV) diagnosis to be without sufficient pretest and post-test discussions - health professionals have expressed a need for training in this area., Objective: This study aimed to examine the diagnosis experiences of 24 people diagnosed with HCV in the preceding 2 years., Methods: Face-to-face interviews of 24 participants (recruited through advertising) were conducted., Results: Overall, the HCV diagnosis experience of participants was poor. Participant narratives of HCV diagnosis were characterised by confusion in relation to tests that were performed and the implications of test results. Post-test discussions were inadequate - there was a reported lack of information, support and referral provided to participants., Discussion: Most clinicians do not receive specialised training in hepatitis C but may be involved in diagnoses in their careers. The impact of negative diagnosis experiences for patients can be serious and long term. These findings highlight areas of suboptimal diagnosis experience and suggest training and support needs of health professionals.