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Time since first engaging in oral or anal sex with another man may act as a marker of engagement in sexual behaviors associated with sexually transmitted infection/HIV transmission among men who have sex with men. Background: Men who have sex with men (MSM) are disproportionately impacted by HIV and other sexually transmitted infections, with sexual behaviors acting as a primary predictor of disease acquisition. Predictors of engagement in specific sexual behaviors may act as key targets for preventive strategies. We hypothesized that time since first engaging in oral or anal sex with another man, or one's "gay age," is associated with sexual behavior among MSM. Methods: We examined 5280 MSM aged 18 to 40 years who were recruited from social and sexual connection Web sites. We used modified Poisson regression to examine associations between gay age and 4 sexual behaviors (enema use, group sex, receptive anal intercourse, insertive anal intercourse). We used time-varying effect models to examine how the prevalence of these behaviors varies across gay age. Results: In total, 76% of participants reported receptive anal intercourse in the past year, and 76% reported insertive anal intercourse. Group sex and enema use in the past year were reported by 39% and 36%, respectively. Modified Poisson and time-varying effect model analyses indicated that the prevalence of enema use, group sex, and insertive anal intercourse significantly increased with increasing gay age. Conclusions: Gay age may serve as an important marker of engagement in sexual behaviors associated with sexually transmitted infection/HIV acquisition among MSM. [ABSTRACT FROM AUTHOR]

There is limited research regarding interpretation services training and its benefit in contact tracing programs. This study seeks to assess the impact of optional formal interpretation services training on contact tracers and identify specific barriers tracers face when contacting patients with limited English proficiency, who have been disproportionately impacted by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Compared to their cisgender counterparts, genderqueer adults have significantly higher rates of sexually transmitted infections (STIs). Screening guidelines suggest that sexually active genderqueer adults should be screened for STIs annually, yet those living in rural or under resourced areas may be less likely to do so. Methods: Using social media, 438 genderqueer adults were recruited from a five-state region in the mid-Atlantic United States. To participate, adults were required to be 18+ and identify as transgender, genderqueer, nonbinary, or as a gender different than their assigned sex at birth. Via an online survey in REDCap, participants were asked about their history of STI testing and access to routine healthcare. Using log binomial regression, we evaluated the relationship between access to routine healthcare and STI testing. Results: Among participants who had ever had sex (n=354), 50% lived in a rural county, the majority (84%) were aged 18-34, 74% identified as White, and 21% identified as Black. 39% reported being tested for STIs in the past year. 14% reported having no routine care provider, 8% reported having to travel 50+ miles to receive routine care, 13% reported travelling 25-49 miles, and 49% reported < 25 miles. Unadjusted and adjusted log binomial regression revealed that those without a routine care provider were significantly less likely to report STI testing compared to those who travel less than 25 miles. However, those who travel further (25-49,50+ miles) were not significantly different than those reporting a < 25-mile distance. Conclusion: Only participants who reported not having a routine healthcare provider were significantly less likely to have been tested for STIs, while distance to provider was not a significant predictor. These findings suggest that connecting genderqueer populations to routine healthcare providers is of critical importance, regardless of distance. Given the shortage of healthcare providers cognizant of transgender-specific needs in many areas, immediate efforts can be made to ensure that genderqueer adults are connected to healthcare in neighboring communities and regions. [ABSTRACT FROM AUTHOR]

Background: Poverty and rural residency status have long been associated with higher rates of sexually transmitted infections (STI) due to fewer sexual health and medical resources. The continuing increase in STIs across the nation requires nuanced understanding of interacting or compounding roles of these disparities. Persistent poverty counties, those counties who have had >20% of the population at or below the national poverty level for at least 30 consecutive years, are predominately rural, and have higher rates of poor outcomes from other health conditions such as cancer. Despite this evidence, no published literature exists that examines the association between these persistent poverty counties and STI rates in the US. Methods: Drawing on data from the National Electronic Database Surveillance System (NEDSS), American Community Survey (ACS), and County Health Rankings we conducted unadjusted and adjusted binomial regressions, including generalized estimating equations, to examine potential relationships between persistent poverty, as defined by the U.S. Department of Agriculture Economic Research, and STI rates. Results: Of the 3,143 counties or county-level equivalents in the US, 353 (11.2%) are designated as persistent poverty, of which 63.5% are rural. Positive relationships between persistent poverty and gonorrhea (p=0.0023) and chlamydia (p< 0.001) incidence at the county level were observed. When controlling for rurality, sex education policies, and other factors, persistent poverty remained positively associated with STI incidence. Conclusion: These findings provide a more nuanced understanding of the growing literature surrounding the relationship between poverty and negative sexual health outcomes by demonstrating a positive relationship between county-level persistent poverty status with gonorrhea and chlamydia incidence. Negative social determinants may be exacerbated within these communities, which warrants further exploration to help inform community-based interventions. [ABSTRACT FROM AUTHOR]

Abstract: Direct-to-consumer test services have gained popularity for sexually transmitted infections in recent years, with substantially increased use as a result of the SARS-CoV-2 (CoVID-19) global pandemic. This method of access has been variously known as "self-testing," "home testing," and "direct access testing." Although these online services may be offered through different mechanisms, here we focus on those that are consumer-driven and require self-collected samples, and sample shipment to a centralized laboratory without involvement of health care providers and/or local health departments. We provide the American Sexually Transmitted Diseases Association's position on utilization of these services and recommendations for both consumers and health care providers. [ABSTRACT FROM AUTHOR]