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Introduction: While research has examined the connections between sleep quality, smartphone addiction, and depressive symptoms in general, no studies focused on undergraduate medical students in Nepal have specifically tested the complex relationship between these factors. Therefore, this study aimed to investigate the interaction between smartphone addiction, sleep quality, and depressive symptoms among undergraduate medical students of Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Methods: A cross-sectional study was conducted among 212 undergraduate medical students at Maharajgunj Medical Campus, Tribhuvan University, Nepal. Sleep quality, smartphone addiction, and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index, Smartphone Addiction Scale Short Version, and Patient Health Questionnaire-9. Data were analyzed using IBM SPSS version 26 via the bootstrap model approach. Results: Out of the total participants, 67.9% were male. Males showed higher scores in smartphone addiction and depressive symptoms than females (b = 5.3, Bca 95% CI:1.2, 9.1, p < 0.05). The unadjusted model indicated that the presence of smartphone addiction explained 36.5% of the indirect impact of sleep quality on depressive symptoms. However, in the adjusted model, after introducing socio-demographic, behavioral, and educational variables as covariates, this percentage decreased to 33.02%. Conclusion: This study highlights the significant role of both smartphone addiction and sleep quality in mediating the indirect effect on depressive symptoms among undergraduate medical students. Smartphone addiction emerged as a key mediator of depressive symptoms, indicating a potentially important factor in mental health. Investigating this relationship further through longitudinal studies will be crucial for developing effective preventative and therapeutic approaches. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention strategy that remarkably reduces HIV transmission risk. Although PrEP has been available in Nepal since 2019, very little is known about PrEP use among MSM in Nepal. This study aimed to examine PrEP awareness and its use among Nepali MSM and the factors influencing its adoption. A cross-sectional survey was conducted among MSM in Nepal between October and December 2022 (N = 250). Bivariate analysis and logistic regression were performed to determine factors associated with awareness and use of PrEP. In the study population, 59.6% of participants were aware of PrEP, however, only 30.4% of them had utilized it. The odds of PrEP awareness were higher among participants who had completed high school or above (aOR = 4.1; 95% CI = 1.8–9.6), those with health insurance coverage (aOR = 6.9; 95% CI = 2.1–22.3) and had tested for HIV (aOR = 21.2; 95% CI = 8.3–53.9). Similarly, participants who identified as gay (aOR = 3.4; 95% CI = 1.4–8.4), had visited a doctor within the past 6 months (aOR = 2.9; 95% CI = 1.2–6.5), had previously tested for HIV (aOR = 12.3; 95% CI = 3.4–44.7), and had been diagnosed with sexually transmitted infections (aOR = 7.0; 95% CI = 2.5–19.5) were more likely to have used PrEP. Our results highlight the critical importance of healthcare providers engaging in providing care for MSM, including facilitating as well as discussions about PrEP. In addition, there is a pressing need for innovative strategies (e.g., peer educators, social media, online facilitating technologies) to disseminate PrEP knowledge and reduce stigma surrounding PrEP. [ABSTRACT FROM AUTHOR]