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Background: Since oral pre-exposure prophylaxis (PrEP) was approved for HIV prevention in 2012, 78 countries have begun offering PrEP in some form. Measuring progress against global targets and sharing strategies across countries are critical to driving impact. Since 2014, AVAC has collected data from PrEP programs to track and generate insights on PrEP implementation. Methods: The Global PrEP Tracker is a comprehensive database of PrEP projects and national programs. Data are collected through a quarterly survey to 253 programs, and include PrEP initiation numbers, geography, and other indicators. This analysis examined data from Quarter 3 (Q3) 2016 to Q2 2020 to highlight global and regional PrEP initiation trends. Results: Global PrEP uptake has increased six-fold in approximately four years, from 102,446 initiations in 2016 to 651,586 in 2020. Annual growth has slowed over time, from 104% from 2017 to 2018, to 55% from 2018 to 2019, to 18% from 2019 to 2020. At the regional level, Oceania has the highest rate of change, with total PrEP initiations increasing from 318 to 29,093, driven largely by Australia. Sub-Saharan Africa has substantially expanded PrEP access, from 4154 initiations in 2016 to 290,981 by mid-2020, comprising 44% of the global total. South Africa and Kenya have led this growth, counting 69,876 and 63,000 cumulative initiations, respectively. Brazil is leading PrEP uptake in Latin America and the Caribbean, accounting for two-thirds of initiations, and Thailand comprises 51% of initiations in Asia. The United States has the most cumulative initiations at 203,837, about one-third of the global total, but has comparatively modest growth rates. Shared traits in many of these settings are early adoption, national commitment to scale-up, and programs tailored to populations at high risk offering rights-based services and linkages to social support. Conclusions: While PrEP initiations have grown exponentially in several countries, global uptake falls far short of UNAIDS' target of 3 million users, indicating a need for sustained demand creation where PrEP programs exist, and scale-up where PrEP is provided via demonstration projects with limited reach. Countries should replicate successful approaches, including service delivery models that meet end users' needs, to achieve notable reductions in new HIV infections., OA11.01 K. Segal (1); L. Fitch (2); F. Riaz (2); J. Rodrigues (2) and M. Warren (2) (1) AVAC, Product Introduction and Access, Washington, DC, United States, (2) AVAC, New [...]

Purpose: Cancer treatment can have consequences for individuals which may have profound impact on daily living. Accessing assistance can be problematic. This study explores associations between income and concerns, help-seeking, and unmet needs related to physical changes following cancer treatment., Method: A national survey was conducted with cancer survivors about experiences with follow-up care one to three years after treatment. We report a trend analysis describing associations between income and cancer survivors' concerns, help-seeking, and unmet needs related to physical changes after treatment., Results: In total 5,283 cancer survivors between 18 and 64 years responded, of which 4,264 (80.7%) indicated annual household income. The majority of respondents were survivors of breast (34.4%), colorectal (15.0%), and prostate (14.0%) cancers. Over 90% wrote about experiencing physical changes following cancer treatment. Survivors with low annual household incomes of less than $25,000 (CAN) reported the highest levels of concern about multiple physical changes and were more likely to seek help to address them., Conclusions: Cancer survivors can experience various physical challenges and unmet needs following cancer treatment and difficulty obtaining relevant help across all income levels. Those with low income are more severely affected. Financial assessment and tailored follow-up are recommended., Competing Interests: Competing Interests: None declared., (© Canadian Physiotherapy Association, 2023.)

Objective: Globally, the number of older adults surviving cancer is anticipated to grow rapidly over the next decades. Cancer and its treatment can leave survivors with a myriad of challenges including physical changes which impact independence and quality of life. This project explored the relationship of income level with concerns and help-seeking for physical changes following treatment in older Canadian survivors of cancer., Methods: A Canada-wide survey of community-dwelling survivors of cancer explored their experiences with survivorship care one to three years following completion of treatment. A secondary trend analysis examined the relationship of income with older adults' level of concern and help-seeking experiences regarding physical consequences they attributed to their cancer treatment., Results: In total, 7,975 people aged 65 years and older who survived cancer responded to the survey, of whom 5,891 (73.9%) indicated annual household income. Prostate (31.3%), colorectal (22.7%) and breast (21.8%) cancer accounted for the majority of respondents. Of those who reported household income data, over 90% wrote about the impact of physical changes following treatment, their concerns about the changes, and whether they sought help for their concerns. The most frequently identified physical challenge was fatigue (63.7%). Older survivors with low annual household incomes of less than $CA25,000 reported the highest levels of concern about multiple physical symptoms. 25% or more of the survey respondents across all income levels reported difficulty finding assistance for their concerns about the physical challenges, especially in their local communities., Conclusion: Older survivors of cancer can experience a range of physical changes, amenable to intervention by physical therapy, yet experience challenges obtaining relevant help. Those with low income are more severely affected, even within a universal healthcare system. Financial assessment and tailored follow-up are recommended., (© 2023. The Author(s).)

Introduction: Individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) face significant health disparities and barriers to accessing care. Patients have reported provider lack of knowledge as one of the key barriers to culturally responsive, clinically competent care. Many US and Canadian medical schools still offer few curricular hours dedicated to LGBTQ-related topics, and medical students continue to feel unprepared to care for LGBTQ patients., Methods: We developed a 10-hour LGBTQ health curriculum for preclinical medical and physician assistant students. The curriculum included lectures and case-based small-group discussions covering LGBTQ terminology, inclusive sexual history taking, primary care and health maintenance, and transition-related care. It also included a panel discussion with LGBTQ community members and a small-group practice session with standardized patients. Students were surveyed before and after completing the curriculum to assess for increases in confidence and knowledge related to LGBTQ-specific care., Results: Forty first- and second-year medical students completed the sessions and provided valid responses on pre- and postcourse surveys. Nearly all students initially felt unprepared to sensitively elicit information, summarize special health needs and primary care recommendations, and identify community resources for LGBTQ individuals. There was significant improvement in students' confidence in meeting these objectives after completion of the five sessions. Knowledge of LGBTQ health issues increased minimally, but there was a significant increase in knowledge of LGBTQ-related terminology., Discussion: Our 10-hour LGBTQ health curriculum was effective at improving medical students' self-confidence in working with LGBTQ patients but was less effective at increasing LGBTQ-related medical knowledge., (© 2021 Minturn et al.)