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Article ; Online: "Do something with them!": developing "comfortable" engagement with Elders participating in an arts-based sexual health promotion and STBBI prevention workshop for Indigenous Youth in Labrador, Canada.

Landy, Rachel / Worthington, Catherine

International journal of circumpolar health

2021 Volume 80, Issue 1, Page(s) 1986250

Abstract: Although Indigenous Elders were traditionally involved in cross-generational health promotion and education, colonisation disrupted this role. Little research examines the role of Elders in contemporary health promotion for Indigenous youth and few ... ...

Abstract	Although Indigenous Elders were traditionally involved in cross-generational health promotion and education, colonisation disrupted this role. Little research examines the role of Elders in contemporary health promotion for Indigenous youth and few strategies have been identified to engage Elders in health promotion or sexual health education. We explored engagement of Elders through participatory filmmaking in a sexual health and HIV education workshop for youth. Eleven youth and five Elders participated in this 3.5-day workshop. During the workshop, Elders indicated they wanted to make a film and attend a sexual health and HIV education session. Four Elders were interviewed about their experiences. Interview transcripts and the Elders' film were analysed using content analysis. Although Elders initially felt hesitant to engage, the process of participatory filmmaking allowed Elders to co-create an environment for their "comfortable" workshop engagement. Elders' feelings of comfort were created by having control and sense of ownership over their engagement; the presence of youth; peer-based dialogue; inclusion of traditional items; and an Indigenous sexual health educator. Findings suggest participatory filmmaking is a promising approach for engaging and empowering Elders to reclaim traditional roles in sexual health education and health promotion with Indigenous youth.
MeSH term(s)	Adolescent ; Aged ; Canada ; Health Promotion ; Humans ; Newfoundland and Labrador ; Sexual Behavior ; Sexual Health
Language	English
Publishing date	2021-11-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2021.1986250
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Article ; Online: Perspectives on digital testing services for sexually transmitted and blood-borne infections from Two-Spirit, gay, bisexual, transgender, and other queer Black, Indigenous, people of colour living in Ontario, Canada.

Dulai, Joshun / Hassan, Abdi / Stewart, MacKenzie / Ryu, Heeho / Anand, Praney / Worthington, Catherine / Gilbert, Mark / Grace, Daniel

Ethnicity & health

2024 , Page(s) 1–20

Abstract: Objectives: Increased sexually transmitted and blood-borne infections (STBBI) testing can reduce the burden of disease among Two-Spirit, gay, bisexual, transgender, and other queer Black, Indigenous, people of colour (2SGBTQ+ BIPOC). However, this ... ...

Abstract	Objectives: Increased sexually transmitted and blood-borne infections (STBBI) testing can reduce the burden of disease among Two-Spirit, gay, bisexual, transgender, and other queer Black, Indigenous, people of colour (2SGBTQ+ BIPOC). However, this population encounters barriers, such as discrimination, when accessing in-person STBBI testing services. Digital STBBI testing, such as self-testing/collection kits ordered online and digital requisitions, may address some of these barriers. Our aim was to understand acceptability of free digital STBBI testing among 2SGBTQ+ BIPOC living in Ontario, Canada. Design: We approached this analysis using Implementation Science and Critical Race Theory. We conducted interviews and focus groups with 21 2SGBTQ + BIPOC individuals from 2020-2021. Participants were asked about their perceptions of the benefits and drawbacks of digital STBBI testing, populations that would benefit from using these services, and recommendations for how these services may be implemented in Ontario. Interviews and focus groups were transcribed verbatim and analyzed using reflexive thematic analysis. Results: Six themes emerged. Digital STBBI testing services: (1) May reduce oppression experienced by 2SGBTQ + BIPOC when testing in-person; (2) Should address the unique needs that 2SGBTQ + BIPOC experience due to other intersecting identities they possess; (3) Should adapt their services to suit the varying cultural contexts and living circumstances of 2SGBTQ + BIPOC; (4) Should be accessible to 2SGBTQ + BIPOC who hold diverse or no documentation; (5) Should be offered in multiple languages; (6) May be inaccessible to those without Internet access or devices. Conclusion: Digital STBBI testing is one strategy that may reduce discrimination experienced by 2SGBTQ + BIPOC when getting tested in-person. However, digital STBBI testing services may not address all the needs of 2SGBTQ + BIPOC. Racism and other forms of oppression embedded into in-person and digital testing services will need to be addressed to meet the needs of this diverse population.
Language	English
Publishing date	2024-04-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1497968-8
ISSN	1465-3419 ; 1355-7858
ISSN (online)	1465-3419
ISSN	1355-7858
DOI	10.1080/13557858.2024.2337623
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Zs.A 5110: Show issues

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Article ; Online: The Red River Cart Model: a Métis conceptualization of health and well-being in the context of HIV and other STBBI.

Atkinson, Danielle / Landy, Rachel / St Denys, Raye / Ogilvie, Kandace / Lund, Carrielynn / Worthington, Catherine

Canadian journal of public health = Revue canadienne de sante publique

2023 Volume 114, Issue 5, Page(s) 856–866

Abstract: Objectives: Métis people experience health inequities and often face discrimination when accessing health services. Métis-specific services are limited, and pan-Indigenous approaches to health services fail to acknowledge heterogenous identities and ... ...

Abstract	Objectives: Métis people experience health inequities and often face discrimination when accessing health services. Métis-specific services are limited, and pan-Indigenous approaches to health services fail to acknowledge heterogenous identities and distinct health needs of the Métis. This study explored a Métis response to HIV and other sexually transmitted and blood borne infections to inform public health services development for Métis people. Methods: As part of the DRUM & SASH Project, this study used a community-based research approach which privileged Métis knowledges and processes. Three gathering circles were held in Alberta, Canada, with self-identified Métis individuals who had lived experience or intimate knowledge of HIV/hepatitis C or worked in HIV/HCV service provision. The gathering circle process integrated Métis cultural practices in discussions about Métis understandings of health. Gathering circles transcripts were used to inform the description of the model emerging through the dialogue. Results: Twelve diverse Métis people participated in gathering circles. Participants identified 12 determinants of health and well-being grounded in Métis culture and imagery, including Métis medicine bag, fiddle, cart tarp, flag, Capote coat, sash, York boat, moccasins, grub box, weapons, tools, and stove. The Red River Cart Model, a Métis-specific model of health to guide service planning, was created from these discussions. Conclusion: The Red River Cart Model provides a holistic view of the determinants of Métis health and has potential as a collaborative client assessment resource for STBBI community health service providers. Additionally, this model may be helpful to other health service providers for developing Métis-specific/informed services and improving cultural safety for the Métis.
MeSH term(s)	Humans ; Concept Formation ; Alberta ; Sexual Behavior ; Community Health Services ; HIV Infections
Language	English
Publishing date	2023-04-18
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	417262-0
ISSN	1920-7476 ; 0008-4263
ISSN (online)	1920-7476
ISSN	0008-4263
DOI	10.17269/s41997-023-00771-8
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Zs.B 81: Show issues

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Article ; Online: Reach of GetCheckedOnline among gay, bisexual, transgender and queer men and Two-Spirit people and correlates of use 5 years after program launch in British Columbia, Canada.

Montiel, Andrés / Ablona, Aidan / Klassen, Ben / Card, Kiffer / Lachowsky, Nathan J / Brennan, David J / Grace, Daniel / Worthington, Catherine / Gilbert, Mark

Sexually transmitted infections

2024

Abstract: Objectives: Understanding who uses internet-based sexually transmitted and blood-borne infection (STBBI) services can inform programme implementation, particularly among those most impacted by STBBIs, including gender and sexual minority (GSM) men. ... ...

Abstract	Objectives: Understanding who uses internet-based sexually transmitted and blood-borne infection (STBBI) services can inform programme implementation, particularly among those most impacted by STBBIs, including gender and sexual minority (GSM) men. GetCheckedOnline, an internet-based STBBI testing service in British Columbia, Canada, launched in 2014. Our objectives were to assess reach, identify factors associated with use of GetCheckedOnline 5 years into implementation and describe reasons for using and not using GetCheckedOnline among GSM men. Methods: The Sex Now 2019 Survey was an online, cross-sectional survey of GSM men in Canada administered from November 2019 to February 2020. Participants were asked a subset of questions related to use of GetCheckedOnline. Multivariable binary logistic regression modelling was used to estimate associations between correlates and use of GetCheckedOnline. Results: Of 431 British Columbia (BC) participants aware of GetCheckedOnline, 27.6% had tested using the service. Lower odds of having used GetCheckedOnline were found among participants with non-white race/ethnicity (adjusted OR (aOR)=0.41 (95% CI 0.21 to 0.74)) and those living with HIV (aOR=0.23 (95% CI 0.05 to 0.76)). Those who usually tested at a walk-in clinic, relative to a sexual health clinic, had greater odds of using GetCheckedOnline (aOR=3.91 (95% CI 1.36 to 11.61)). The most commonly reported reason for using and not using GetCheckedOnline was convenience (78%) and only accessing the website to see how the service worked (48%), respectively. Conclusion: Over a quarter of GSM men in BC aware of GetCheckedOnline had used it. Findings demonstrate the importance of social/structural factors related to use of GetCheckedOnline. Service promotion strategies could highlight its convenience and privacy benefits to enhance uptake.
Language	English
Publishing date	2024-04-10
Publishing country	England
Document type	Journal Article
ZDB-ID	1420303-0
ISSN	1472-3263 ; 1368-4973
ISSN (online)	1472-3263
ISSN	1368-4973
DOI	10.1136/sextrans-2023-056007
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Article ; Online: Examining the Influence of Pre-HAART Experiences on Older, Self-Identifying Gay Men's Contemporary Constructions of Quality of Life (QOL).

Handlovsky, Ingrid / Amato, Anthony T / Ferlatte, Olivier / Kia, Hannah / Gagnon, Marilou / Worthington, Catherine

Journal of homosexuality

2023 Volume 71, Issue 8, Page(s) 1880–1899

Abstract: Some older gay men (50+) experience diminished quality of life (QOL) due to historical and ongoing discrimination in addition to living through a collective trauma-the pre-HAART era of the HIV/AIDS epidemic-characterized by the absence of treatment and ... ...

Abstract	Some older gay men (50+) experience diminished quality of life (QOL) due to historical and ongoing discrimination in addition to living through a collective trauma-the pre-HAART era of the HIV/AIDS epidemic-characterized by the absence of treatment and rampant discrimination targeting gay men. A growing body of literature, however, illustrates that older gay men demonstrate remarkable resilience but little is known about how QOL is conceptualized and how these conceptualizations are potentially shaped by pre-HAART experiences. The current study drew on constructivist grounded theory methods to examine how QOL is conceptualized in light of the sociohistorical relevance of pre-HAART. Twenty Canadian based gay men aged 50+ participated in semi-structured interviews via Zoom. Ultimately, QOL is understood as experiencing contentment, which is made possible by the development and implementation of three key processes: (1) developing and cultivating meaningful connections, (2) growing into and embracing identity, and (3) appreciating the capacity to do what brings joy. QOL for this group is greatly informed by a context of disadvantage, and the demonstrated resilience warrants further investigation to meaningfully support the overall well-being of older gay men.
MeSH term(s)	Humans ; Male ; Homosexuality, Male/psychology ; Quality of Life ; Middle Aged ; Aged ; HIV Infections ; Canada ; Antiretroviral Therapy, Highly Active ; Grounded Theory ; Self Concept ; Sexual and Gender Minorities/psychology
Language	English
Publishing date	2023-05-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	193138-6
ISSN	1540-3602 ; 0091-8369
ISSN (online)	1540-3602
ISSN	0091-8369
DOI	10.1080/00918369.2023.2212100
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Zs.A 1141: Show issues

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Article ; Online: Assessing the acceptability of dried blood spot testing for HIV and STBBI among Métis people in a community driven pilot project in Alberta, Canada.

Landy, Rachel / Atkinson, Danielle / Ogilvie, Kandace / St Denys, Raye / Lund, Carrielynn / Worthington, Catherine

BMC health services research

2022 Volume 22, Issue 1, Page(s) 1496

Abstract: Background: Little literature exists on culturally grounded approaches for addressing human immunodeficiency virus (HIV) and sexually transmitted and blood-borne infections (STBBI) among Métis people. The goal of this mixed-methods research was to ... ...

Abstract	Background: Little literature exists on culturally grounded approaches for addressing human immunodeficiency virus (HIV) and sexually transmitted and blood-borne infections (STBBI) among Métis people. The goal of this mixed-methods research was to explore the experiences of Métis community members participating in a dried blood spot testing (DBST) for HIV/STBBI pilot for Métis communities in Alberta, Canada, with the aim of assessing the acceptability of this testing method. Methods: Grounded in community-based and Indigenous research approaches and working in partnership with a Métis community-based organization, data collection included a survey and four gathering circles with Métis DBST recipients at one of two community events, and semi-structured interviews with three DBST providers. Results: Twenty-six of the 30 DBST recipients completed surveys, and 19 DBST recipients participated in gathering circles. Survey results suggest DBST is a highly acceptable STBBI testing method to Métis community members. Thematic analysis of gathering circle and interview transcripts revealed four broad themes related to the participants' experiences with DBST related to its acceptability (i. ease of DBST process, ii. overcoming logistical challenges associated with existing STBBI testing, iii. Reducing stigma through health role models and event-based, and iv. Métis-specific services). Conclusions: These findings illustrate the potential for DBST to be part of a culturally grounded, Métis-specific response to HIV and STBBI.
MeSH term(s)	Humans ; HIV ; Dried Blood Spot Testing ; Blood-Borne Infections ; Pilot Projects ; Alberta ; HIV Infections/diagnosis
Language	English
Publishing date	2022-12-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-022-08763-z
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Article ; Online: Universities without Walls: A Blended Delivery Approach to Training the Next Generation of HIV Researchers in Canada.

Ibáñez-Carrasco, Francisco / Worthington, Catherine / Rourke, Sean / Hastings, Colin

International journal of environmental research and public health

2020 Volume 17, Issue 12

Abstract: 1) Background: Although HIV has not diminished in importance in Canada, the field of HIV research remains small, and the graduate students who decide to pursue careers within it feel isolated and uncertain about their professional skills and ... ...

Abstract	(1) Background: Although HIV has not diminished in importance in Canada, the field of HIV research remains small, and the graduate students who decide to pursue careers within it feel isolated and uncertain about their professional skills and opportunities. Universities Without Walls (UWW) was created in 2009 to help redress these shortcomings. This paper presents a case study of UWW, a non-credit training program for emerging HIV researchers in Canada. In particular, we focus on the possibilities of experiential learning via online and blended delivery. UWW uses both online and in-person teaching modalities to teach engaged scholarship, interdisciplinarity, community-based research (CBR), intervention research, and ethics. (2) Methods: Using a case study, we elucidated the research question: "What are the factors that make Universities Without Walls a viable training environment in the contemporary HIV/AIDS field?" Focus groups were conducted with 13 UWW key stakeholders in 2012 during a program mid-point evaluation; in 2014, telephone or in-person interviews with the three directors were conducted by a UWW fellow (the 4th author of this paper), and in 2019 the authors analyzed the information and anecdotal evidence, which had been incorporated as thick description. In addition, fellows' self-assessments via portfolio and results from formal learning assessments were included. We also thematically analyzed 65 student self-reports (2009-2015). (3) Results and Discussion: Each UWW cohort lasted 9 months to one year and was comprised of: a) sustained mentorship from the co-directors (e.g., phone conversations, assistance with grant writing, letters of reference, etc.); b) fortnightly online webinars that aim to develop fellows' knowledge of community-based research (CBR), research ethics, intervention research, and interdisciplinary research; c) community service learning in the form of a "field mentoring placement"; d) face-to-face engagement with fellows and mentors, most notably at the week-long culminating learning institute; e) a stipend for fellows to carry out their training activities. The UWW pedagogical framework features experiential learning, critical pedagogy, and heutagogy made manifest in the field mentoring placements (community service learning), mentorship mediated by technologies, and in-person learning institutes. Our analysis showed that experiential learning was imparted by UWW's a) transparency about its "implicit curriculum", the attitudes, values, character, and professional identity imparted in the program as well as the overarching programmatic elements, such as commitment to diversity, the inclusion of those with lived experience, the flexible admissions policies and procedures, interdisciplinary faculty, flexible team, administrative structure, and valuing of technology in conducting research, learning, and teaching; b) curriculum co-designing and co-teaching, and c) sustaining a community of practice. The main results reported in our case study included significant "soft outcomes" for UWW fellows, such as developing a "social presence" as a precursor to lasting professional connections; learning to experience community-based research, intersectionality, and interdisciplinarity by interacting online with persons living with HIV, leaders in the field, and a variety of stakeholders (including nonprofit staff and policymakers). (4) Limitations: While fellows' self-evaluation data were collected by an independent assessor and anonymized to the extent this was possible, the co-authors inevitably bring their preconceptions and positive biases to UWW's assessment. As UWW was developed to function outside of traditional academic structures, it is unlikely that the UWW program could be transferred to a post-secondary environment in its entirety. UWW was also built for the socio-political environment of HIV health research. (5) Conclusions: The experiences of those involved with UWW demonstrate that explicit curricular components-such as interdisciplinarity, community-based research, intervention research, and applied ethics-can be learned through a blended delivery when combined with opportunities to apply the knowledge in ways, such as a field mentoring placement and a learning institute. Related to this outcome, our case study describes that implicit curricular components in the formation of a professional-the sense of self in the field as a researcher, student, and community member-can also be delivered through a blended model. However, the tools and activities need to be tailored to each student for their context, while pushing their disciplinarian and professional boundaries.
MeSH term(s)	Canada ; Curriculum ; HIV Infections ; Humans ; Research Personnel ; Universities
Language	English
Publishing date	2020-06-15
Publishing country	Switzerland
Document type	Journal Article
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17124265
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Article ; Online: Challenges to communicating the Undetectable equals Untransmittable (U=U) HIV prevention message: Healthcare provider perspectives.

Grace, Daniel / Stewart, Mackenzie / Blaque, Ezra / Ryu, Heeho / Anand, Praney / Gaspar, Mark / Worthington, Catherine / Gilbert, Mark

PloS one

2022 Volume 17, Issue 7, Page(s) e0271607

Abstract: Undetectable equals Untransmittable", or U=U, is a public health message designed to reduce HIV stigma and help communicate the scientific consensus that HIV cannot be sexually transmitted when a person living with HIV has an undetectable viral load. ... ...

Abstract	"Undetectable equals Untransmittable", or U=U, is a public health message designed to reduce HIV stigma and help communicate the scientific consensus that HIV cannot be sexually transmitted when a person living with HIV has an undetectable viral load. Between October 2020-February 2021 we conducted 11 in-depth interviews and 3 focus groups with diverse HIV/STI service providers (nurses, public health workers, physicians, frontline providers, and sexual health educators) in Ontario, Canada (n = 18). Our objective was to understand how U=U was communicated to sexual health service users in healthcare interactions. Interview questions were embedded in a larger study focused on improving access to HIV/STI testing. Transcripts were transcribed verbatim and analysed following grounded theory. Most providers emphasized the significance of U=U as a biomedical advancement in HIV prevention but had some challenges communicating U=U in everyday practice. We discovered four interrelated barriers when communicating the U=U message: (1) provider-perceived challenges with "zero risk" messaging (e.g., wanting to "leave a margin" of HIV risk); (2) service users not interested in receiving sexual health information (e.g., in order to provide "client centered care" some providers do not share U=U messages if service users are only interested in HIV/STI testing or if other discussions must be prioritized); (3) skepticism and HIV stigma from service users (e.g., providers explained how the hesitancy of some service users accepting the U=U message was shaped by a legacy of HIV prevention messages and persistent HIV stigma); and (4) need for more culturally appropriate resources (e.g., communities other than sexual and gender minority men; non-English speaking service users; that account for broader legal context). We discuss ways to overcome barriers to communicating the U=U message as well as the limitations and potential unintended consequences of U=U framings in the context of unequal access to HIV prevention and treatment.
MeSH term(s)	HIV Infections/prevention & control ; Health Personnel ; Humans ; Male ; Ontario ; Sexually Transmitted Diseases/prevention & control ; Viral Load
Language	English
Publishing date	2022-07-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0271607
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Article ; Online: Disruptions of sexually transmitted and blood borne infections testing services during the COVID-19 pandemic: accounts of service providers in Ontario, Canada.

Ryu, Heeho / Blaque, Ezra / Stewart, Mackenzie / Anand, Praney / Gómez-Ramírez, Oralia / MacKinnon, Kinnon R / Worthington, Catherine / Gilbert, Mark / Grace, Daniel

BMC health services research

2023 Volume 23, Issue 1, Page(s) 29

Abstract: Background: Since the onset of the COVID-19 pandemic in March 2020 in Canada, the availability of sexual health services including sexually transmitted and blood-borne infection (STBBI) testing has been negatively impacted in the province of Ontario due ...

Abstract	Background: Since the onset of the COVID-19 pandemic in March 2020 in Canada, the availability of sexual health services including sexually transmitted and blood-borne infection (STBBI) testing has been negatively impacted in the province of Ontario due to their designation as "non-essential" health services. As a result, many individuals wanting to access sexual healthcare continued to have unmet sexual health needs throughout the pandemic. In response to this, sexual health service providers have adopted alternative models of testing, such as virtual interventions and self-sampling/testing. Our objective was to investigate service providers' experiences of disruptions to STBBI testing during the COVID-19 pandemic in Ontario, Canada, and their acceptability of alternative testing services. Methods: Between October 2020-February 2021, we conducted semi-structured virtual focus groups (3) and in-depth interviews (11) with a diverse group of sexual health service providers (n = 18) including frontline workers, public health workers, sexual health nurses, physicians, and sexual health educators across Ontario. As part of a larger community-based research study, data collection and analysis were led by three Peer Researchers and a Community Advisory Board was consulted throughout the research process. Transcripts were transcribed verbatim and analysed with NVivo software following grounded theory. Results: Service providers identified the reallocation of public health resources and staff toward COVID-19 management, and closures, reduced hours, and lower in-person capacities at sexual health clinics as the causes for a sharp decline in access to sexual health testing services. Virtual and self-sampling interventions for STBBI testing were adopted to increase service capacity while reducing risks of COVID-19 transmission. Participants suggested that alternative models of testing were more convenient, accessible, safe, comfortable, cost-effective, and less onerous compared to traditional clinic-based models, and that they helped fill the gaps in testing caused by the pandemic. Conclusions: Acceptability of virtual and self-sampling interventions for STBBI testing was high among service providers, and their lived experiences of implementing such services demonstrated their feasibility in the context of Ontario. There is a need to approach sexual health services as an essential part of healthcare and to sustain sexual health services that meet the needs of diverse individuals.
MeSH term(s)	Humans ; Blood-Borne Infections ; COVID-19/diagnosis ; COVID-19/epidemiology ; Ontario/epidemiology ; Pandemics ; Sexual Behavior ; Sexual Health ; Community-Based Participatory Research ; Delivery of Health Care
Language	English
Publishing date	2023-01-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-09028-z
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Article ; Online: Evaluating the Impact of the COVID-19-Related Public Health Restrictions on Access to Digital Sexually Transmitted and Blood-Borne Infection Testing in British Columbia, Canada: An Interrupted Time Series Analysis.

Iyamu, Ihoghosa / Pedersen, Heather / Ablona, Aidan / Chang, Hsiu-Ju / Worthington, Catherine / Grace, Daniel / Grennan, Troy / Wong, Jason / Salmon, Amy / Koehoorn, Mieke / Gilbert, Mark

Sexually transmitted diseases

2023 Volume 50, Issue 9, Page(s) 595–602

Abstract: Background: Evidence of long-term impacts of COVID-19-related public health restrictions on digital sexually transmitted and blood-borne infection (STBBI) testing utilization is limited. We assessed these impacts on GetCheckedOnline (a digital testing ... ...

Abstract	Background: Evidence of long-term impacts of COVID-19-related public health restrictions on digital sexually transmitted and blood-borne infection (STBBI) testing utilization is limited. We assessed these impacts on GetCheckedOnline (a digital testing resource for STBBIs) relative to all STBBI tests in British Columbia (BC). Methods: Interrupted time series analyses were conducted using GetCheckedOnline program data comparing monthly test episodes (STBBI tests per requisition) among BC residents, stratified by BC region, and testers' sociodemographic and sexual risk profiles, for the prepandemic (March 2018-February 2020) and pandemic periods (March 2020-October 2021). Trends in GetCheckedOnline testing per 100 STBBI tests in BC regions with GetCheckedOnline were analyzed. Each outcome was modeled using segmented generalized least squared regression. Results: Overall, 17,215 and 22,646 test episodes were conducted in the prepandemic and pandemic periods. Monthly GetCheckedOnline test episodes reduced immediately after restrictions. By October 2021 (end of the pandemic period), monthly GetCheckedOnline testing increased by 21.24 test episodes per million BC residents (95% confidence interval, -11.88 to 54.84), and GetCheckedOnline tests per 100 tests in corresponding BC regions increased by 1.10 (95% confidence interval, 0.02 to 2.17) above baseline trends. After initial increases among users at higher STBBI risk (symptomatic testers/testers reporting sexual contacts with STBBIs), testing decreased below baseline trends later in the pandemic, whereas monthly GetCheckedOnline testing increased among people 40 years or older, men who have sex with men, racialized minorities, and first-time testers via GetCheckedOnline. Conclusions: Sustained increases in utilization of digital STBBI testing during the pandemic suggest fundamental changes in STBBI testing in BC, highlighting the need for accessible and appropriate digital testing, especially for those most affected by STBBIs.
MeSH term(s)	Humans ; Male ; Blood-Borne Infections/diagnosis ; Blood-Borne Infections/epidemiology ; British Columbia/epidemiology ; COVID-19/prevention & control ; Homosexuality, Male ; Interrupted Time Series Analysis ; Public Health ; Sexual and Gender Minorities ; Sexually Transmitted Diseases/diagnosis ; Sexually Transmitted Diseases/epidemiology ; Sexually Transmitted Diseases/prevention & control
Language	English
Publishing date	2023-05-16
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001833
Database	MEDical Literature Analysis and Retrieval System OnLINE

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