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Objective: Offering comprehensive lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual (LGBTQIA+) friendly and sex-positive student health centers are central to institutions of higher education being able to retain and support students. Positive sexual experiences for LGBTQIA + students can have an impact on academic success but many LGBTQIA+ students are discriminated against and are often victims of microaggressions. Participants: Twenty undergraduate students enrolled in a LGBTQIA+ health course. Methods: Students in an LGBTQIA+ Health undergraduate course at a private Northeastern university assessed what mattered most to them when it came to creating a sex-positive healthcare environment that promotes LGBTQIA+ inclusiveness and removes perceived barriers. Results: The themes included expanding mental health care, greater involvement of culturally-competent provider, establishing a stigma-free clinical environment, re-imagining the clinic waiting room, and facilitating sexual health advocacy. Conclusion: Re-envisioning the role of student health centers is critical for ensuring every student has a fair and just opportunity to achieve their full health potential.

HIV point of care testing (POCT) is a common approach to expanding testing into non-specialised settings. Dental services have untapped potential to screen for health conditions including HIV. However, the perspectives of UK dental patients, dental professionals, and people with HIV are unknown. Ten focus groups were undertaken with dental patients, professionals, and people with HIV. The Framework method was used to analyse the qualitative data. Six themes were generated from the focus group data. The themes explored perceptions of HIV, the purpose, appropriateness, and acceptability of HIV testing in dental settings, and new processes that would need to be established in order to successfully implement point of care HIV testing in UK dental settings. Training needs were identified including communication skills and updates to current knowledge about HIV. HIV testing in dental settings is generally acceptable to dental patients, dental professionals, and PWH. However, of concern were logistical challenges and the risk of patients surprised at being offered an HIV test during a visit to the dentist. Nonetheless, the public health benefits of the intervention were well understood, i.e., early detection of HIV and initiation of treatment to improve health outcomes. Dental teams were able to generate novel solutions that could help to overcome contextual and logistical challenges to implementing HIV testing in dental settings. [ABSTRACT FROM AUTHOR]

Despite the adoption of pre-exposure prophylaxis (PrEP) as a crucial HIV intervention, uptake remains suboptimal among men who have sex with men, a sexual minority group, due to barriers like cost and stigma. Peer change agents (PCAs) disseminate PrEP information within their social networks. This study explores the reciprocal effects of an online community-based participatory intervention on PCAs, focusing on their transformed PrEP uptake perceptions—leadership efficacy, social network dynamics, attitudes, perceived benefits and barriers and self-efficacy. Leveraging insights from the PrEP Chicago Study, our research addresses a key gap in community-based participatory interventions for PrEP uptake: the transformative experiences and perception shifts of PCAs involved in these interventions. We engaged 20 men who have sex with men, aged 18–45, as PCAs in a one-group pretest–posttest design intervention, which disseminated PrEP communications within their preferred online networks. We utilized the PrEP Chicago Study's 45 Likert items, tailored to reveal the PCAs' transformative potential. Data on PrEP uptake perceptions, sociodemographics and social media use were captured and analyzed using the Wilcoxon matched-pairs signed-rank test, a nonparametric method. PCAs demonstrated significant changes in their PrEP uptake perceptions, including leadership capacity, social network dynamics, attitudes toward PrEP, perceived benefits, barriers and self-efficacy. Our intervention highlights the reciprocal transformation PCAs undergo when disseminating PrEP information. This study adds a new dimension to community-based PrEP interventions and underscores the need for continued refinement of peer-led strategies to optimize the transformative potential of PCAs. [ABSTRACT FROM AUTHOR]

Objectives: The incidence of nasopharyngeal cancer (NPC) has been declining in the United States (US) in recent years. However, little is known about the latest trends in NPC mortality in the US population. This study aimed to examine the trends in NPC mortality rate by age, sex, race and ethnicity and US Census Region from 1999 to 2020. Methods: Mortality data were extracted from the Centers for Disease Control and Prevention's Wide‐ranging Online Data for Epidemiologic Research (WONDER) database. Decedents whose cause of death was NPC were identified using the International Classification of Diseases Codes, 10th Revision: C11.0‐C11.9. Trends in age adjusted mortality rates (AAMR) from NPC were assessed using a joinpoint regression model. Annual Percentage Changes (APC) and Average Annual Percentage Changes were examined overall and by age, sex, race and ethnicity and census region. Results: From 1999 through 2020, a total of 14 534 NPC deaths were recorded in the US (AAMR = 0.2 per 100 000; 95% CI: 0.2, 0.2). Overall trends remained stationary throughout the study period. Since 2006, recent trends declined by 6.1% per year (95% CI: −8.4, −3.7) among Non‐Hispanic Whites, and by 2.7% per year among Non‐Hispanic Blacks, Asians/Pacific Islanders and Hispanics. Trends either stabilized or declined by sex, age and US Census Region. Similar results were obtained when the analysis was restricted to decedents aged 65 years and above. Conclusions: Stationary or declining trends in NPC mortality could be due to the falling incidence of the disease and/or advances in medical diagnosis and treatment. Considering the enigmatic nature of NPC, future studies should explore the genetic and sociodemographic factors associated with the trends reported in this study. [ABSTRACT FROM AUTHOR]

Objective: Offering comprehensive lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual (LGBTQIA+) friendly and sex-positive student health centers are central to institutions of higher education being able to retain and support students. Positive sexual experiences for LGBTQIA + students can have an impact on academic success but many LGBTQIA + students are discriminated against and are often victims of microaggressions. Participants: Twenty undergraduate students enrolled in a LGBTQIA+ health course. Methods: Students in an LGBTQIA + Health undergraduate course at a private Northeastern university assessed what mattered most to them when it came to creating a sex-positive healthcare environment that promotes LGBTQIA + inclusiveness and removes perceived barriers. Results: The themes included expanding mental health care, greater involvement of culturally-competent provider, establishing a stigma-free clinical environment, re-imagining the clinic waiting room, and facilitating sexual health advocacy. Conclusion: Re-envisioning the role of student health centers is critical for ensuring every student has a fair and just opportunity to achieve their full health potential. [ABSTRACT FROM AUTHOR]

HIV remains a public health challenge, despite investments in treatment and prevention tools to reduce new HIV infections and end the epidemic. Many evidence-based biomedical and behavioral interventions target urban sexual minority men, including men who have sex with men. There is a dearth of HIV-prevention interventions, particularly those that seek to increase uptake of pre-exposure prophylaxis (PrEP), that have been adapted for sexual minority men in the suburbs. PrEP Long Island, a peer change agent intervention to increase PrEP use among suburban sexual minority men, was adapted from a similar intervention, PrEP Chicago. PrEP Long Island study protocol documents were based on publicly available documents outlining the PrEP Chicago intervention. We present the choices and rationales for our decisions on when, to what extent, and how to geographically adapt a public health intervention. While most guidance on intervention adaptations is related to cultural and linguistic considerations, more recommendations are needed for place-based changes, including how well intervention fidelity functions as well as strategies for adapting evaluation materials. [ABSTRACT FROM AUTHOR]

Purpose: Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) cultural competency and awareness in healthcare settings have been recognized for minimizing health disparities, yet their integration within the oral health community has been minimal. Furthermore, despite evidence showing the compatibility of rapid HIV testing (RHT) in the oral health setting, actual uptake by dentists has been limited. The purpose of this qualitative study was to document New York State dental directors' perspectives and attitudes regarding issues relevant to the LGBTQ patient care and RHT.Materials and Methods: Semi-structured interviews (N=10) were conducted with New York State dental directors practicing in areas of high HIV prevalence. A deductive and inductive qualitative approach was used to develop an interview guide, in accordance with the Theory of Planned Behavior, that elicited their perspectives, attitudes, and perspectives on RHT and LGBTQ issues.Results: Thematic analysis of the interviews revealed that many dentists cited limited, if any, training and experience in RHT and LGBTQ patient care. Additionally, there was also an evident dichotomy between dentists who were offering RHT and dentists who were knowledgeable and well-versed in LGBTQ issues. Barriers to implementation included time constraints and minimal training and knowledge.Conclusions: While potential facilitators such as test kit reimbursement and patient referral sources could enable LGBTQ and RHT training and uptake, actual implementation in the oral health setting will likely require additional trainings, more involved collaboration with primary care providers, and an overall cultural change amongst the dental profession. [ABSTRACT FROM AUTHOR]

Background: Men who have sex with men (MSM) continue to be disproportionately impacted by human immunodeficiency virus (HIV) and syphilis in China. Little is known about HIV and syphilis infections among MSM in Xi'an, a developing city in Northwest China. A cross‐sectional study with recruitment via snowball sampling was conducted to collect HIV and syphilis infection status and risk factors among MSM in Xi'an between April 2013 to December 2016. Among the 5000 participants, the mean age was 29.0 years (SD 7.7) and the prevalence of HIV, syphilis, and coinfection was 6.5%, 2.2%, and 0.4%, respectively. There was no significant change in HIV prevalence from 2013 to 2016, while the prevalence of syphilis and coinfection showed a downward trend. Multiple logistic regression analyses found that being over 25 years old (OR = 1.647), junior high school/middle school education and below (OR = 3.085), with a sexual role of passive or versatile (OR = 3.300; OR = 2.337), rush poppers use during the last 6 months (OR = 1.660) and syphilis infection (OR = 2.235) were more likely to acquire HIV infection, whereas used condoms in the last episode of anal sex (OR = 0.572) and tested HIV antibody previously (OR = 0.252) were protective factors for HIV infection. HIV prevalence among MSM in Xi'an was stable, whereas the prevalence of syphilis and coinfection showed a downward trend. Interventions to promote HIV and sexually transmitted disease testing and condom use should be strengthened, especially for MSM with low education. Highlights: In conclusion, this study shows that HIV prevalence among MSM in Xi'an was stable, while the prevalence of syphilis and coinfection showed a downward trend. Evidence‐based interventions to promote HIV and STD testing and condom use should be strengthened, especially for MSM with low education, to help end HIV/AIDS in China. [ABSTRACT FROM AUTHOR]

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Context: India has the third-highest number of people living with human immunodeficiency virus (HIV) in the world. Early diagnosis can prevent HIV transmission and since a large proportion of the Indian population are likely to be seen in a dental setting, it may serve as an important site for early HIV diagnosis.Aims: The aim of this study was to investigate the knowledge of HIV, attitudes, and willingness to conduct HIV testing among Indian dentists.Settings: A cross-sectional survey of 503 Indian dentists was conducted in Delhi, Gandhinagar, Bhubaneswar, and Hyderabad (representing low, moderate, and high HIV prevalence areas).Subjects and Methods: HIV knowledge was measured using the HIV-KQ-18, and attitudes and willingness were examined.Statistical Analysis Used: Descriptive analysis and Chi-square test were performed using SPSS version 21.Results: A third of the respondents had a high HIV knowledge score. High knowledge scores were positively associated with age group, level of education, and dental specialty. Over 73% were willing to deliver HIV-positive test results. Almost 80% of the respondents felt that rapid HIV testing was needed in a dental setting. Attitudes and willingness were found to be significantly related to the survey site suggesting cultural difference as an important factor in taking up HIV testing.Conclusions: General awareness of HIV among this sample of Indian dentists appears to be low. The findings from this study however suggest that Indian dentists have expressed a need for rapid HIV testing in dental setting with a strong emphasis on the need for further education on HIV testing. [ABSTRACT FROM AUTHOR]

A strong nursing workforce is integral to quality healthcare. Nursing is an important aspect of healthcare outcomes and plays a critical role in patient safety. Nursing students are key to ensuring an adequate pipeline of nursing professionals. An exploratory cross-sectional online survey was conducted with a convenience sample of 158 students in nurse education programs leading to a Bachelor's Degree in New York State. The current study sought to identify the motivation to pursue a career in nursing, including a career as a Registered Nurse (RN). Personal motivators (primarily the desire to help others) ranked as the main reason for choosing the profession (60.1%). Employment motivators (including job, benefits and monetary reasons) ranked second (26.8%), and Lifestyle motivators (including hours and schedules) ranked third (13.1%). Statistical analysis revealed consistent priorities regarding primary motivators across subgroups of nursing students. Results also indicated that students who have their RN license while pursuing a Bachelor's Degree are a unique subset of students in nursing programs. Each of the following findings were significant at p < 0.001: Nursing students enrolled in a Bachelor's Degree program who already hold an RN license are more likely to; be over 30 years of age, attend school part-time, attend fully online classes (pre-pandemic mode), already have an Associate's Degree in Nursing and attend a public university. Understanding the motivations of students in nursing programs can inform both academia and employers to recruit and retain future nursing professionals. [ABSTRACT FROM AUTHOR]

Background: While hepatitis B virus (HBV) infection in children has declined dramatically in China due to the vaccination strategy for newborns, HBV infection in high-risk adults is receiving an increasing attention. The number of people who use drugs (PWUD) in China is huge, but their status of HBV infection and vaccination is less reported, especially from large samples. The related knowledge can help decision makers develop the further strategy of HBV prevention and control. Methods: A seroepidemiological survey was conducted in all four compulsory isolated detoxification centers (CIDCs) and all eight methadone maintenance treatment (MMT) clinics located in Xi'an, China. All PWUD who were undergoing detoxification or treatment in these settings were included. A questionnaire was designed to obtain the information of HBV vaccination history of participants, and sociodemographic and behavioral data of participants were obtained from the registration records of their respective CIDCs or MMT clinics. Results: A total of 4705 PWUD participated in the survey. Positive rates of HBsAg (current infection) and HBsAg or anti-HBc (current/past infection) were 5.50% and 58.02%, notably higher than those reported for the general adult population in the same province during the same period. As age increased, the anti-HBc positive rate increased with statistically significant trend. The all-negative for HBsAg, anti-HBc, and anti-HBs accounted for 28.82%. Only 18.49% were identified by the questionnaire as having received HBV vaccine. The logistic regression found that compared with identified vaccinated PWUD, those unsure if having been vaccinated and those identified non-vaccinated had a significantly higher HBV current/past infection rate, with an increasing trend. Conclusion: PWUD are a high-risk adult group of HBV infection in China. Of them, more than half have not received HBV vaccine, and a significant portion are susceptible to HBV. Catch-up vaccination is need for this population to prevent and control HBV transmission. [ABSTRACT FROM AUTHOR]