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BackgroundCervical cancer is the fourth most common cancer affecting women worldwide. In the 1980s, it was found that the sexually transmitted disease human papillomavirus causes over 90% of all cervical cancer cases. Since that discovery, diagnostic technologies have been developed for the detection of human papillomavirus DNA in cervical samples. However, significant sociocultural and structural barriers remain. Considerable strides have taken place in recent years to address these barriers, such as the self-collection for human papillomavirus–based cervical screening method. ObjectiveThe purpose of this review is to synthesize qualitative evidence around the self-collection method and identify strategies to increase acceptability and feasibility in different settings. This qualitative synthesis will be used to better understand how to conceptualize and implement more effective, accessible, and socially and culturally acceptable cervical screening programs and policies globally. MethodsA systematic search will be conducted in Global Health, Cochrane, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ProQuest, ScienceDirect, EMBASE, EMCARE, Medline (OVID), Scopus, and Web of Science. Published and peer-reviewed articles will be included. Two reviewers will independently screen and assess the studies. The data will be coded and analyzed using a thematic synthesis process. The socioecological model will be used to organize emergent themes at the micro and macro levels. The results will be presented in narrative and tabular form. ResultsThe article search and data extraction were completed in May 2020. The data were analyzed in June 2020. The review will be submitted for publication in Fall 2020. ConclusionsThis review will present the global evidence of the perspectives and experiences of various key stakeholders and how these perspectives and experiences impact their decision-making process to perform or accept self-collection for human papillomavirus–based cervical screening. The review will provide guidance to implementation researchers as well as implications for future research. Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42019109073; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=109073 International Registered Report Identifier (IRRID)DERR1-10.2196/21093

Owing to the historical and ongoing impacts of colonisation, there is a large health equity gap in sexual and reproductive health (SRH) outcomes between Aboriginal and Torres Strait Islander peoples and non‐Indigenous populations. Whilst qualitative research has identified the barriers and enablers to sexual healthcare engagement among young Aboriginal and Torres Strait Islander people in remote settings, little is known about the ways in which young people navigate sexual healthcare in a regional setting. This study aims to address this gap. Sixty‐five young (aged 15–29) Aboriginal and Torres Strait Islander people participated in semistructured interviews across three regional communities in New South Wales, Australia. The candidacy framework informed this analysis. A large proportion of participants expressed having agency and resources to attend health services for SRH needs (primarily STI testing and contraception). Women in particular described being supported by social networks to access SRH services. Male participants were less likely to identify their own candidacy for healthcare. Services that were culturally safe and had trustworthy, nonjudgemental staff and a feeling of community were easier to access (more permeable). Factors that decreased accessibility were confidentiality concerns, difficulty making appointments, and lack of visibility of services, or what they offer. Using the candidacy framework, this study identified the importance of culturally safe service provision, reducing barriers to accessing appointments and the provision of nonjudgemental care in engaging young Aboriginal and Torres Strait Islander people in SRH care. This study also highlighted the various strategies and actions that young Aboriginal and Torres Strait Islander people are already taking to protect their sexual health and that of their partners. [ABSTRACT FROM AUTHOR]

Background: Sydney Sexual Health Centre (SSHC) is the largest sexual health clinic in New South Wales (NSW), servicing clients at high risk of sexually transmissible infections and bloodborne viruses. SSHC piloted a direct-to-pathology pathway that facilitated bloodborne virus/sexually transmissible infection testing at one of the ~500 participating pathology collection centres located across NSW. This qualitative study sought to understand SSHC client and provider perspectives of acceptability of the MyCheck intervention. Methods: Semi-structured in-depth interviews were conducted with 11 clients who underwent testing via the MyCheck pathway and eight staff members involved in implementing MyCheck. The seven components of Sekhon's Theoretical Framework of Acceptability informed this analysis. Results: Participants broadly conveyed 'affective attitude' toward the MyCheck pathway. The telehealth intervention reduced client 'burden' and 'opportunity cost' through enabling greater testing convenience at a location suitable to them and provided timely results. Issues of 'ethicality' were raised by clients and staff as pathology centre staff were, on a few occasions, regarded as being judgmental of SSHC clients. 'Intervention coherence' issues were largely attributed to pathology centre personnel being unfamiliar with the intervention, with billing issues being a recurrent concern. Participants perceived MyCheck as an 'effective' testing pathway. SSHC staff were able to offer the intervention with ease through seamless IT integration ('self-efficacy'). Conclusion: The MyCheck intervention was perceived by both SSHC clients and staff as an acceptable bloodborne virus/sexually transmissible infection testing pathway. However, further work is required to address stigma experienced by some clients when attending pathology collection centres. Sydney Sexual Health Centre (SSHC) piloted MyCheck, a direct-to-pathology pathway that facilitated bloodborne virus/sexually transmissible infection testing at participating pathology collection centres located across New South Wales. This qualitative study sought to understand perspectives of acceptability of the MyCheck intervention among SSHC clients and providers'. The MyCheck intervention was perceived by both SSHC clients and staff as an acceptable bloodborne virus/sexually transmissible infection testing pathway. However, further work is required to address stigma experienced by some clients when attending pathology collection centres. [ABSTRACT FROM AUTHOR]

Enumeration of disease is a key management tool. Setting of targets, like for hepatitis C elimination, have deep meaning and effect. We use the case of elimination in New South Wales (NSW), Australia to examine key informants' understandings of the use of targets, and the evidence that informs them, to drive action in elimination. Twenty‐eight key informants working in NSW, elsewhere in Australia and internationally in high‐income countries participated in a semi‐structured qualitative interview in 2022. Analysis was informed by scholarship calling for examination of the ways in which science constructs what is thought possible in action. Participants pointed to the power of quantified evidence and targets and their complex effects, and questioned the usefulness and certainty derived from these at the "pointy end" of elimination. Although a range of targets exist in global and local strategies, reaching testing targets was the assumed solution to achieving elimination. Achieving elimination was thought to require "off piste" and experimental approaches that went beyond available evidence. The different types of work that participants felt necessary for late‐stage elimination may require additional metrics to explain return on investment ratios. What threshold would be used to reduce efforts in elimination was a major concern. These data indicate that understandings of the evidence underpinning elimination targets and how to achieve them are far from settled. At this point, elimination efforts may need to rely on locally produced and community‐driven evidence and shift from evidence‐based to evidence‐making paradigm. [ABSTRACT FROM AUTHOR]

This paper critically reflects on conducting research with people in prison, including gaining trust and building rapport, and the power imbalances of conducting research in the prison setting. Navigating trust and power is key to successful prison-based research, but these navigations are not confined to the researcher–participant interaction and extend to include researcher entry into the prison and earlier processes such as the ethics application submission. Existing 'how-to' guides for prison-based research often draw on ethnographic studies which allow substantial time for the interviewer to build rapport with key prison contacts, including officers, as well as opportunity for people in prison to become familiar with the ethnographer's presence prior to data collection. Drawing on prison-based research experience from three qualitative health studies pertaining to people in prison living with hepatitis C and/or history of injecting drug use (the primary risk factor for hepatitis C transmission), I consider challenges of access and strategies for on-the-spot rapport building with people in prison. The approaches outlined may be applicable to research with other population groups in which power imbalances may exist. [ABSTRACT FROM AUTHOR]

It is now well-recognised that antimicrobial resistance (AMR), or the ability of organisms to resist currently available antibiotics and other antimicrobial drugs, represents one of the greatest dangers to human health in the 21st Century. As of 2022, AMR is a top-10 global public health threat. Various national and transnational initiatives have been implemented to address accelerating AMR, and the pressure to find local and global solutions is increasing. Despite this urgency, surprisingly limited progress is being made in rolling back or even slowing resistance. A multitude of perspectives exist regarding why this is the case. Key concerns include an enduring dependency on market-driven drug development, the lacklustre governance and habitual over-prescribing of remaining antimicrobial resources, and rampant short-termism across societies. While rarely presented in such terms, these disparate issues all speak to the social production of vulnerability. Yet vulnerability is rarely discussed in the AMR literature, except in terms of 'disproportionate effects' of AMR. In this paper, we offer a reconceptualisation of vulnerability as manifest in the AMR scene, showing that vulnerability is both a predictable consequence of AMR and, critically, productive of AMR to begin with. We underline why comprehending vulnerability as embodied, assembled, multivalent and reproduced through surveillance matters for international efforts to combat resistance. [ABSTRACT FROM AUTHOR]

One of the key issues in the alcohol and other drug (AOD) treatment sector concerns the reported difficulties that clients have in accessing treatment. This paper draws on qualitative interview data collected from clients undergoing treatment (n = 20) and stakeholders (n = 15) of five specialist non‐government AOD treatment services in New South Wales, Australia, to offer an in‐depth perspective about treatment entry experiences. We identified four key themes of positive treatment entry experiences: the presence of high‐quality online information which enabled clients to best match themselves to treatment; flexible and simple intake procedures with skilled and welcoming staff; the presence and quality of social and other resources (such as families, peers and private health insurance) which enabled quicker access; and prior experience in the treatment system which helped clients to gain important knowledge and skills to improve future access. We discuss implications of these findings, including that waiting lists significantly exacerbate inequity, but that this could be ameliorated by providing peer‐support to those trying to gain entry, especially clients who do not have family and friends for help during this period. The findings also point to the way that client self‐determination is central to all positive treatment entry experiences, and that supporting clients to find 'the right fit' in relation to treatment options improves their experiences. [ABSTRACT FROM AUTHOR]