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Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the diseases it causes remain a public health threat. Data describing health education campaigns for COVID-19 on university and college campuses are lacking, however. Purpose: This study explored college students' experiences of a USA campus COVID-19 campaign encouraging masking, social distancing and handwashing. Methods: We conducted in-depth interviews with 33 demographically diverse students. Questions focused on students' experiences during COVID-19, actions and beliefs, and reactions to the university's COVID-19 prevention campaign. Thematic analysis was used to evaluate responses to the campaign and identify suggestions for future interventions. Results: Students identified three areas of concern -- lack of enforcement for nonadherence, inequities and inconsistencies in messaging and failure to connect messages to students' daily experiences -- as problematic. Participants also said the campaign did not address their primary COVID-19 concerns, outlining four thematic content areas needing more attention -- learning in quarantine, missing the 'college experience', difficult social relationships and chaos and uncertainty. Discussion: COVID-19 prevention campaigns on campus may be best served by a holistic ecological model engaging with needed forms of support on multiple levels. Conclusion: Health education and promotion campaigns that speak to individual, relational, community and policy aspects of disease such as COVID-19 are more promising than campaigns that promote single prevention actions.

The widespread availability of health information and treatment for HIV in Southern Africa does not reach all populations. Few programs and materials are developed with middle-aged and older rural individuals living with HIV as the target audience, despite this being a growing population. This vacuum inevitably exacerbates the disjuncture between clinical and experiential knowledge. This study uses in-depth interviews from 2018 with middle-aged and older rural South Africans who self-report medication adherence to ART in order to explore experiences of living with HIV and beliefs about anti-retroviral treatment (ART). Participants revealed a general sense of vulnerability as a major motivation for HIV medication adherence. A majority of the participants believed that death was imminent if they defaulted on ART at any point in time. Although the availability of ART brought hope to many, HIV was still perceived as a death sentence, particularly if ART adherence was imperfect. The study findings suggest a need to examine the psychosocial component of community programs for middle-aged and older people living with HIV. For this growing population that experienced the full course of the epidemic, more research is needed on the burden of psychological and mental health issues emerging from the need for long-term HIV medication adherence. [ABSTRACT FROM AUTHOR]

The global health crisis precipitated by the COVID-19 pandemic underscored the necessity of swift vaccine development and distribution to curb virus transmission. However, discussions on vaccine acceptance and hesitancy have predominantly focused on pre-vaccination attitudes, often overlooking the significance of post-vaccination experiences in shaping individual and communal attitudes toward vaccines. This oversight is particularly critical among healthcare workers in low- and middle-income countries (LMICs), who play a dual role in combating the pandemic and influencing public vaccine sentiment. Using the theory of planned behavior, this study explores the post-vaccination experiences of healthcare workers in Sierra Leone and assesses how these experiences influence their attitudes toward vaccine safety, efficacy and their advocacy for vaccine uptake within their communities. Employing a qualitative design, the study interviewed 24 healthcare workers, 21 of whom were vaccinated against COVID-19. Semi-structured interviews, conducted in English or Krio, were audio recorded, transcribed verbatim and analyzed using thematic analysis to identify key themes. Three themes were identified: positive vaccination experiences exceeding initial expectations, strong belief in the vaccine's protective benefits and active roles in vaccine advocacy. Despite initial hesitations due to concerns over potential adverse effects, participants reported no significant issues post-vaccination, fostering trust in vaccine safety and effectiveness. Healthcare workers' positive post-vaccination experiences significantly bolster their vaccine advocacy, influencing their recommendations to patients, friends, families, colleagues and community members. This study highlights the importance of understanding and leveraging healthcare workers' experiences to enhance public trust and vaccine uptake, crucial for pandemic response efforts in LMICs. [ABSTRACT FROM AUTHOR]

Migration to South Africa is motivated by the pursuit of employment, safety, and improved living conditions. However, immigrants encounter significant challenges, such as restricted access to essential services, which were exacerbated by the COVID-19 pandemic. This paper investigates the impact of the COVID-19 pandemic on Malawian immigrants in South Africa, addressing the lack of attention given to this immigrant population by highlighting their vulnerabilities. Using a qualitative exploratory and descriptive approach, in-depth interviews were conducted with 24 Malawi immigrants who were over 18 years old and had established residency in South Africa before the onset of the COVID-19 pandemic. Five key stakeholders were also interviewed for additional perspectives and to ensure triangulation and improve data reliability. The interviews were transcribed verbatim and analyzed using thematic analysis strategies and coding with Nvivo12 software. The study highlighted the exacerbated struggles of Malawian immigrants in South Africa amid the COVID-19 pandemic, uncovering systemic discrimination in healthcare, marked by longer wait times and reluctance from health workers to treat undocumented immigrants. The study also revealed a dire security situation, with immigrants living in high-crime areas and feeling particularly targeted due to their foreign status, a situation worsened by the pandemic's economic effects. Additionally, the economic downturn induced by COVID-19 significantly impacted employment opportunities, with many immigrants facing prolonged unemployment and job losses, especially in sectors where they traditionally found work. The detailed accounts of participants highlight not only the multifaceted challenges imposed by the pandemic but also the critical need for inclusive policies and support systems that ensure healthcare access, safety, and economic resilience for immigrants, particularly during global health emergencies. Future research should focus on effective interventions for socioeconomic integration and well-being, particularly for immigrants from other African countries. [ABSTRACT FROM AUTHOR]

International migrants, particularly those migrating between and among developing countries (South-South migration), continue to experience increased vulnerabilities as social services in host countries are inadequate. Using the Person in Environment (PiE) framework, the study explored coping strategies adopted by Malawian migrants living in South Africa during the Covid-19 pandemic. Data were collected through in-depth interviews with Malawian migrants (n = 24), and key stakeholders (n = 5). Data were audio-recorded, transcribed verbatim, and analyzed thematically using NVivo12. Migrants expressed reliance on self-help attitudes by remaining focused on their goals and staying positive. Participants used social support through informal networks (family, friends, and neighbors) including Malawian migrant social groups. Migrants also expressed dependence on the church and international aid organizations for informational support and to leverage national-level resources. Most importantly, the Ubuntu cultural philosophy provided them with the strength to stick together and support one another in the face of adversaries. These findings underscored the need for national policies that support underserved populations with resources to build networks of communities of coping that can reduce the risk of health threats during pandemics. Further research, on the provision of social services, and with a more diverse population of South-South migrants living in South Africa, is needed. [ABSTRACT FROM AUTHOR]

While COVID-19 affected all segments of the population, vulnerable social groups, including international students, were disproportionately affected. The primary objective of this study was to explore COVID-19-related experiences of African international graduate students (AIGS). Qualitative data were collected through in-depth interviews with 15 AIGS. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Participants reported experiencing fear of the virus and anxiety about their health and their family members (individual), feelings of isolation and depression because of reduced social engagement and lack of familial support (interactional), dealing with workrestrictive student visas, and loss of work opportunities (environmental/structural). The person-in-environment (PIE) and Ubuntu philosophy were useful lenses to understand the findings in the context of COVID-19 given its sociocultural connection to AIGS. Understanding the experiences of AIGS can help inform better approaches, including institutional and national policy changes, to support not only AIGS but also vulnerable international students during pandemics. [ABSTRACT FROM AUTHOR]

Canada and the USA are often compared for their markedly different approaches to health care despite cultural similarities and sharing the world’s longest international boundary. The period between the onset of the COVID-19 pandemic in January 2020 and the availability of a vaccine in December 2020 offers an ideal opportunity to compare subnational Canadian and American pandemic mortality. Preventing the spread of COVID-19 was through compliance with health orders and best practices; treatment was only available to those admitted to hospitals and whose lives were at risk. Using publicly available data from the Johns Hopkins University 2019 Novel Coronavirus Visual Dashboard, we seek to uncover if there were any similarities in Canadian provinces’ and American states’ monthly COVID-19 mortality per 100,000 people, building on a broader scientific push towards understanding the successes and failures of different health systems in the pandemic. The similar province and state cumulative COVID-19 mortality rate trajectories identified in our analyses do not amount to intuitive comparative jurisdictions which suggests the importance of identifying localized pandemic responses. [ABSTRACT FROM AUTHOR]

During disasters, vulnerable populations are disproportionately affected. COVID-19 disproportionately affected African American (AA) families, increasing their risk for COVID-19 morbidity and mortality. The pandemic also exacerbated existing negative milieu such as economic opportunity and access to social and healthcare services. We explored AA families' experiences of indirect pandemic effects. Data were collected through semi-structured in-depth telephone interviews with 11 AA parent/grandparents of school-aged child (5–17 years). Line-by-line coding and thematic analysis were used to analyze and interpret the data. Three emergent themes highlighted the salient indirect effects of COVID-19 pandemic on AA families: (i) access to healthcare, (ii) access to food, and (iii) disaster unpreparedness. Participants expressed frustration with virtual healthcare services and inability to schedule in-person hospital appointments for health conditions unrelated to COVID-19. Lack of food products in stores and limited financial resources due to pandemic-related job layoffs were important food insecurity factors discussed. Unpreparedness on the part of institutions, state, and the nation, created heightened perceptions of vulnerability. Given the social vulnerability spectrum in the U.S., pandemic planning approaches that promote equity are critical if public officials are to develop effective adaptation, mitigation, response, and recovery plans that mobilize and serve diverse populations. [ABSTRACT FROM AUTHOR]

Objective: As HIV shifts from "death sentence" to "chronic condition," disclosure of HIV status to intimate partners and family is a significant component of both prevention and treatment adherence. While disclosure is closely considered in many studies, few examine middle-aged and older persons' (age 40+) perspectives or practices. We trace older rural South Africans' views on HIV disclosure to their partners and family members in a high prevalence community over a period of extensive antiretroviral treatment (ART) rollout. Methods: Community focus group discussions (FGD) conducted in 2013 and 2018 show shifts in older persons' thinking about HIV disclosure. Findings: Our FGD participants saw fewer negative consequences of disclosure in 2018 than in 2013, and highlighted positive outcomes including building trust (partners) as well as greater support for medication collection and adherence (family). Discussion: Particularly as the epidemic ages in South Africa and globally, tracing changes in older persons' views on disclosure is an important step in developing messaging that could enhance treatment as prevention and ART adherence. [ABSTRACT FROM AUTHOR]