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Introduction:In Belgium, the provision of pre-exposure prophylaxis (PrEP) for HIV prevention is centralized in specialized HIV clinics. Engaging family physicians in PrEP care could help scale-up its delivery and reach underserved populations. The objective of this study was to gain insight into family physicians' self-perceived roles in providing PrEP.MethodsWe conducted 16 online group discussions with a total of 105 Flemish family physicians, between November 2020 and February 2021. A brief online questionnaire assessed their socio-demographics and experience with sexual health. We analyzed verbatim transcribed data using a grounded theory approach.ResultsDespite limited awareness and experience, participants reported a high willingness to be more actively involved in PrEP care. Four potential roles for the family physician in PrEP care were identified: acting as low-threshold entry point for advice; opportunistic case finding of PrEP candidates; initiating appropriate care for PrEP-eligible clients; and ensuring high-quality follow-up care for PrEP users. Participants framed each of these roles within their current activities and responsibilities as primary care providers. Yet, participants differed in their views on the concrete operationalization of these roles, and in the extent of their involvement in PrEP. Particular challenges were a lack of experience with antiretrovirals, perceived limited exposure to clients at high HIV risk, and a lack of expertise and resources to conduct time-intensive risk assessments and counseling related to PrEP.ConclusionBelgian family physicians demonstrated a keen willingness to be involved in PrEP care, but had differing views on the practical implementation into their practices. Providing tailored training on sexual health and PrEP, and investing in collaboration between primary and secondary care, could optimize the integration of PrEP in the primary care practice.

Additional file 6: Survey Questionnaire.

Additional file 4: Participants’ attitudes towards dengue fever.

Additional file 2: Participant’s knowledge on signs and symptoms of dengue fever.

Additional file 5: Participants’ preventive and control measures against dengue fever.

Additional file 1: Thresholds and methods used for scoring people’s knowledge, attitude and practice (KAP).

Additional file 3: Participants knowledge on dengue virus transmission and vector.

Additional file 1: Table S1. COVID-19 related knowledge deficit and fear of SARS-COV2 infection Mixed effect logistic regression (regression coefficient used for COVID-19 related knowledge). Table S2. COVID-19 related knowledge deficit and fear of Severe COVID-19 illness Mixed effect logistic regression (regression coefficient used for COVID-19 related knowledge). Figure S1. Directed acyclic graph - association between COVID-19 related knowledge deficit and fear of acquiring SARS-COV2 infection. Figure S2. Directed acyclic graph - association between COVID-19 related knowledge deficit and fear of acquiring Severe COVID-19. Figure S3. Exploring the missing data pattern of missingness and percentage of missingness (R output). Figure S4. Exploring Missing data (R output). Figure S5. Respondents field of study by country. Figure S6. COVID-19 related knowledge by country.

Additional file 1.

Background The surge of COVID-19 infections has prompted many countries to take unprecedented policy measures. In Belgium, the authorities implemented a nation-wide stay-at-home order for several months. Evidence of the mental health effect of such measures is scarce. A recent review by Brooks et al. has compiled a defined list of stressors affecting people’s mental health under quarantine during previous epidemic settings. This study aims to test the association between these stressors and the mental health of students attending higher education during the stay-at-home order in Belgium. Methods In this cross-sectional study, 18,301 students from 13 higher education institutions (HEI) participated in an online survey between 26 April and 11 May 2020. We assessed the association between potential stressors and depressive symptoms severity scores and structural equation modeling was used to assess how stressors may mediate the association between duration of exposure and depressive symptoms severity. Results The stressors proposed by Brooks et al. were found to be associated with depressive symptoms severity. The stressors ‘perceived academic stress’, ‘institutional dissatisfaction’ and ‘fear of being infected’ were associated with substantially higher depressive symptoms severity scores. The association between duration of exposure and depressive symptoms severity was mediated by ‘academic stress’. Being in a steady relationship and living together with others were both associated with a lower depressive symptoms severity. Conclusion Findings underline the need for a student-centered approach and mental health prevention. Authorities and HEIs should consider whether and if so, how a stay-at-home order should be implemented.

The COVID-19 pandemic most likely had a negative impact on mental health. Sexual minorities are at higher risk for adverse mental outcomes such as depression, anxiety and suicidal ideation. Such mental health disparities may have exacerbated during the COVID-19 pandemic, due to restricted real-life social contact. The study aim was to examine changes in depression, anxiety and suicidal ideation among Belgian sexual minority adults between the periods before and during the first COVID-19 lockdown. We conducted an online survey, which was disseminated by community organizations throughout Belgium in April 2020. The questionnaire included two-item Generalized-Anxiety-Disorder (GAD-2) and Patient-Health-Questionnaire (PHQ-2) measures. To assess how such symptoms and other factors (e.g., loneliness) had changed, we asked to what extent these occurred before and since the lockdown. We included 965 fully completed questionnaires in the analysis. The proportions of participants screening positive for depression and anxiety were significantly higher during the lockdown than before the lockdown, based on their reported symptoms for these periods: 29.3%% vs. 13.5% (p < 0.001), and 37.1% vs. 25.7% (p < 0.001) respectively. Lonely and young participants were more likely to acquire depression. About one in five participants reported suicidal ideation. Our findings suggest that the COVID-19 pandemic has exacerbated already existing mental health disparities between sexual minority adults and the general population. These exacerbations may be the result of increased loneliness and social isolation. The results highlight the need for stimulating and strengthening social connectedness within the LGBTQI community during and in the aftermath of the COVID-19 pandemic, and the need for maintaining mental health services for such groups during pandemic restrictions.

Introduction: Hypertension (HTN) is a leading cause of cardio-vascular diseases (CVD) and deaths globally. The hypertension prevalence in Cambodia was high at 23.5% in 2016 among adults aged 40 to 69 years old. To respond to this high prevalence, innovative interventions have been established by government, donors as well as by private sectors to improve access to screening, care and treatment. Given the multitude of existing interventions for hypertension care, there is a need to assess the outcomes of these interventions as well as inequities of the health care through the cascade of hypertension care. Methods: We performed a population-based survey (5000 individuals aged over 40 and over) to generate a cascade of care for HTN in Cambodia. The cascade shows the patients’ flow in the health system and where they are lost (dropped out of) along all steps of the cascade from (i) prevalence, (ii) screening, (iii) diagnosis, (iv) treatment in the last 12 months, (v) treatment in the last 3 months, and (vi) being under control. The cascade is built with conditional approach and multivariate logistic regression was also used to determine the profile of the people dropping out from each bar of the cascade.Results: The prevalence of hypertension (i) among study participants was 35.16%, of which 81.91% have their blood pressure measured in the last three years (ii). Over 63% of those received screening were diagnosed by health care professional as hypertensive patients (iii). Among these hypertensive patients, 56.19% have received treatment in the last 12 months (iv) and 54.26% have received the follow-up treatment in the last 3 months (v). The results showed that only 1 out of 3 people (35.8%) with HTN (and under treatment) had their blood pressure under control (vi). Those who are female, aged over 50 years old and has higher level in wealth quintile has higher odds to receive screening, diagnosis, and treatment. While greater odds in having their blood pressure under-control was found in people with female gender, medium wealth quintile, having hypertension more than 5 years and receive treatment at private facility.Conclusions: Overall, people with hypertension are lost along the cascade and people with male gender, younger age, from poor households, and visiting private facility are more likely to drop out. Efforts to improve the quality of services and community-based intervention are needed to prevent inequitable drops along the cascade of care. Implications for applicability/transferability: Cascade of care approach provides information on the outcome along the continuum of care. Our study provides a complete overview of cascade of HTN care with a profile of people dropping out. This will help policy-maker to implement the appropriate intervention to ensure equitable assess to care in the health system.

Supplemental material, sj-pdf-1-sjp-10.1177_1403494820981186 for The COVID-19 International Student Well-being Study by Sarah Van de Velde, Veerle Buffel, Piet Bracke, Guido Van Hal, Nikolett M. Somogyi, Barbara Willems and Edwin Wouters in Scandinavian Journal of Public Health

Additional file 1. Contextualisation of COVID-19 stressors.

Additional file 2.