Suchergebnisse

Introduction: Hard-to-reach and minority groups are often at higher risk for adverse sexual health outcomes. While such groups are therefore of
interest to sexual health researchers, it can be difficult to locate and recruit sufficient sample sizes using probability sampling methods. This study
aims to establish whether web-panel surveys can provide a viable less resource intensive means of boosting sample sizes of two hard-to-reach
groups (people of Black African ethnicity, and gay men) for a sexual health survey, and the extent of any bias.
Methods: Results from a national probability sample survey (Natsal-3, administered using a computer-assisted personal interview (CAPI) and selfinterview
(CASI) with 15,162 participants), which included 211 black African participants and 83 gay men, were compared with results from a webpanel
survey (using identical questions) of 529 black Africans and 592 gay men. Web-panel survey results for socio-demographics were
compared with external benchmarks, and for sexual behaviours and attitudes reported in Natsal-3. Odds ratios (ORs) were used to examine
differences between variables and the average absolute OR, along with the number of estimates for which the web-panel survey differed
significantly from the benchmarks, were used to summarise survey performance.
Results: At least 18% of estimates differed significantly between surveys for gay and black African men, and 28% for black African women. For
black African women average absolute ORs were: 1.6 for attitudinal questions asked in CAPI, 1.5 for attitudinal CASI questions, 3.2 for behaviour
questions asked in CAPI and for 1.7 for behaviour CASI. For black African men average absolute ORs were: 1.5 for attitudinal questions asked in
CAPI, 1.8 for attitudinal CASI questions, 2.5 for behavioural questions asked in CAPI and 1.6 for behavioural questions asked in CASI=1.6. For
gay men, average absolute ORs were: 2.2 for attitudinal questions asked in CAPI, 2.8 for attitudinal CASI questions, 1.8 for behavioural questions
asked in CAPI to 1.6 for behavioural questions asked in CASI.
Discussion: Web-panel surveys may be able to sample hard-to-reach groups but may not be able to replace probability-sample surveys where
accurate population-level estimates of sensitive sexual behaviours are required. Differences between web and CASI responses, where mode
effects may be similar, suggest web-panel survey selection bias.

BACKGROUND: Anogenital warts are the second most common sexually transmitted infection diagnosed in sexual health services in England. About 90% of genital warts are caused by human papillomavirus (HPV) types 6 or 11, and half of episodes diagnosed are recurrences. The best and most cost-effective treatment for patients with anogenital warts is unknown. The commonly used treatments are self-administered topical agents, podophyllotoxin (0.15% cream) or imiquimod (5% cream), or cryotherapy with liquid nitrogen. Quadrivalent HPV (qHPV) vaccination is effective in preventing infection, and disease, but whether it has any therapeutic effect is not known. METHODS AND DESIGN: To investigate the efficacy of clearance and prevention of recurrence of external anogenital warts by topical treatments, podophyllotoxin 0.15% cream or imiquimod 5% cream, in combination with a three-dose regimen of qHPV or control vaccination. 500 adult patients presenting with external anogenital warts with either a first or subsequent episode of anogenital warts will be entered into this randomised, controlled partially blinded 2 × 2 factorial trial. DISCUSSION: The trial is expected to provide the first high-quality evidence of the comparative efficacy and cost-effectiveness of the two topical treatments in current use, as well as investigate the potential benefit of HPV vaccination, in the management of anogenital warts. TRIAL REGISTRATION: The trial was registered prior to starting recruitment under the following reference numbers: International Standard Randomized Controlled Trial Number (ISRCTN) Registry - ISRCTN32729817 (registered 25 July 2014); European Union Clinical Trials Register (EudraCT) - 2013-002951-14 (registered 26 June 2013).

Abstract
Purpose
The COVID-19 pandemic and lockdown restrictions introduced personal and relationship stressors that potentially increased the risk of intimate partner violence (IPV) for some. We estimated the population prevalence and correlates of fearing a partner in the first year of the pandemic in Britain.

Method
We used data from Natsal-COVID Wave 2—a web-panel survey undertaken one year after the initial British lockdown from 23 March 2020. Quotas and weighting were used to achieve a quasi-representative sample of the general population. Participants were asked about fearing a partner, which is a simple and valid screening tool to identify IPV experiences.

Results
In our sample (unweighted n = 6302, aged 18–59), 9.0% of women and 8.7% of men reported fearing a partner in the first year of the pandemic. Women (73.3%) were more likely than men (49.9%) to indicate that fearing a partner made them feel anxious or depressed; men were more likely to report increased substance use (30.8% vs. 18.4%) and affected work/studies (30.0% vs. 20.0%). For both women and men, fearing a partner during the first year of the pandemic was associated with established health and wellbeing outcomes like anxiety/depression, alcohol use, accessing sexual/reproductive health services, and relationship dissolution as well as feeling that the "pandemic made things worse" across various life domains.

Conclusions
Population-level estimates of IPV during the COVID-19 pandemic highlight harmful experiences that occurred alongside other wide-ranging hardships, and the associations presented identify key populations with potential ongoing need. We make recommendations for primary, secondary, and tertiary prevention of IPV.

AbstractIntroductionMigrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe.MethodsA cross‐sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV‐positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign‐born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men.ResultsA total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post‐migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three‐quarters of people on antiretrovirals had an HIV viral load <50 copies/mL.ConclusionsMigrants access healthcare in Europe and while many migrants had previously tested for HIV, that they went on to test positive at a later date suggests that opportunities for HIV prevention are being missed. Expansion of testing beyond sexual health and antenatal settings is still required and testing opportunities should be linked with combination prevention measures such as access to PrEP and treatment as prevention.