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PURPOSE Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the 2 most frequently reported notifiable sexually transmitted infections (STIs) in the United States, and Trichomonas vaginalis (TV), although not a notifiable disease, is the most common curable non-viral STI worldwide. Women bear a disproportionate burden of these infections and testing is necessary to identify infections. Although vaginal swabs are the recommended sample type, the specimen most often used among women is urine. The objective of this meta-analysis was to assess the diagnostic sensitivity of commercially available assays for vaginal swabs vs urine specimens from women. METHODS A systematic search of multiple databases from 1995 through 2021 identified studies that (1) evaluated commercially available assays, (2) presented data for women, (3) included data obtained from the same assay on both a urine specimen and a vaginal swab from the same patient, (4) used a reference standard, and (5) were published in English. We calculated pooled estimates for sensitivity and the corresponding 95% CIs for each pathogen as well as odds ratios for any difference in performance. RESULTS We identified 28 eligible articles with 30 comparisons for CT, 16 comparisons for NG, and 9 comparisons for TV. Pooled sensitivity estimates for vaginal swabs and urine, respectively, were 94.1% and 86.9% for CT, 96.5% and 90.7% for NG, and 98.0% and 95.1% for TV (all P values CONCLUSIONS Evidence from this analysis supports the Centers for Disease Control and Prevention's recommendation that vaginal swabs are the optimal sample type for women being tested for chlamydia, gonorrhea, and/or trichomoniasis. Key words: Chlamydia trachomatis; Neisseria gonorrhoeae; Trichomonas vaginalis; women's health https://doi.org/10.1370/afm.2942, INTRODUCTION Effective screening for sexually transmitted infections (STIs) and adherence to recommended laboratory testing practices is essential to STI surveillance, control, and prevention. Endocervical, vaginal, and urine specimens from women [...]

Background: Vaccine hesitancy continues to grow and as a result, rates of vaccine preventable diseases continue to increase. As vaccines to prevent sexually transmitted infections and cancer are currently under development, there is a need to understand determinants that could impact uptake. Barriers to HPV vaccine uptake include discomfort discussing the sexual transmission of the virus along with safety concerns. Therefore, similar opinions could impact uptake of future STI and cancer vaccines. This study explores beliefs about future STI and cancer vaccines to better understand factors that could impact uptake in both positive and negative ways. Methods: Six online focus groups consisting of 9 to 15 participants were conducted utilizing an electronic chat format from February to March 2022, using a national convenience sample in the United States. Participants were primary care givers to an adolescents aged 11-17 years. A content analysis approach was utilized to examine data. Results: Of the 64 participants, the majority were white (72%), female (84%), and the mean age was 47 years. Most expressed positive opinions about the need for vaccines that could prevent STIs and cancer. Regarding STI vaccines, one mentioned wanting to "protect [their] child, who may not always make the best decisions on their own and could be put at risk by someone without their knowledge or understanding." Cancer vaccines were seen as beneficial because "cancer is awful [and] vaccines would be better than suffering." Participants also raised safety and efficacy concerns regarding new vaccines stating they "would wait years until [they] could see the lasting effects" and new vaccines were "a huge experiment." Some expressed specific confusion about cancer vaccines, how they would be developed, and preference for a cancer cure instead of a vaccine. Conclusion: While participants had favorable opinions about STI and cancer vaccines, safety and efficacy concerns existed. To promote uptake, effective communication approaches will need to be developed to educate parents and adolescents about vaccine development and safety. This education should begin now to ensure that parents and adolescents have the necessary information in order to make informed decisions once vaccines are available. [ABSTRACT FROM AUTHOR]

Project: Assessing evidence-based interventions to promote human papillomavirus (HPV) vaccination starting at age 9. Issue: On-time HPV vaccination by the 13th birthday has proven to be effective in preventing HPV cancers and pre-cancers. However, HPV vaccination coverage rates in the United States (U.S.) continue to lag behind other routinely recommended vaccinations for adolescents. Endorsed by the American Academy of Pediatrics and American Cancer Society, starting HPV vaccination at age 9 could help improve coverage rates by allowing additional time to complete vaccination series by the 13th birthday and a more concentrated focus on cancer prevention messaging. However, the lack of empirically tested interventions to improve HPV vaccination initiation and completion among 9--10-year-olds present an opportunity to examine how existing evidence-based interventions can be adapted and tested to ensure they remain effective in promoting uptake at earlier ages. Results: The two most widely utilized repositories by program planners and practitioners, of evidencebased intervention for various cancer prevention and control programs are limited regarding HPV vaccination interventions. The National Cancer Institute Evidence-based Cancer Control Programs include six interventions. Most of these interventions focus on adolescent females, two include a focus on males, and none include 9--10-year-olds. The Guide to Community Preventive Services is a collection of the evidence-based strategies or approaches for general vaccination uptake, including enhancing access to vaccination services, increasing community demand for vaccinations, and provider- or system focused interventions. None of the strategies suggested are specific to HPV vaccination among 9-10-year-olds. Implementation science, with a specific focus on adapting interventions and strategies to improve uptake of healthcare services can provide the theoretical guidance to modify existing interventions and strategies for 9-10-year-olds while simultaneously documenting the key drivers for implementing interventions to be maximally effective. One such framework is the Framework for Reporting Adaptations and Modification (Expanded & Implementation Strategies). Lessons Learned: Starting HPV vaccination at age 9- years-old could help improve HPV vaccination coverage rates. However, current evidence-based interventions and strategies focus on older adolescents. Implementation science could be beneficial in adapting current interventions to meet the needs of 9-10-year-olds, ultimately improving vaccination coverage thereby contributing to cancer prevention efforts. [ABSTRACT FROM AUTHOR]

Background: Despite effective HIV prevention methods, such as pre-exposure prophylaxis, there were more than 30,000 new HIV diagnoses in 2020. People aged 13 to 34 years accounted for more than half (57%) of these cases and 51% of those newly diagnosed lived in the South, demonstrating how these infections disproportionately impact different communities and the need for additional prevention methods. HIV vaccines could be important additions to available primary prevention tools, especially as three mRNA HIV vaccines recently entered phase 1 clinical trials. Therefore, more needs to be known about facilitators of, and barriers to, acceptance. This study seeks to understand drivers of HIV vaccine acceptability among parents in Alabama. Methods: Semi-structured interviews were conducted with parents of adolescents aged 9 to 17 years in Alabama. Interviews explored participants opinions about a future HIV vaccine, including the need for a vaccine to be developed, acceptability, and desired vaccine characteristics, such as cost and booster doses. Interviews were recorded, transcribed, and analyzed using a thematic analysis approach. Results: All 21 participants expressed a need for an HIV vaccine to be developed: 10 said that if such a vaccine were available, they would get their child vaccinated, 10 were unsure, and one said they would refuse. Many participants expressed a need for an HIV vaccine because of the severity of HIV-associated diseases. This was especially salient for participants who remembered the peak of the HIV/AIDS epidemic and the number of deaths that occurred. However, many expressed concerns about a future HIV vaccine, including that those vaccinated would test positive for HIV due to the presence of antibodies and preference for behavioral interventions such as condom use and abstinence. Conclusion: As HIV vaccine development continues, it is imperative to understand the determinants that could impact uptake. Within this study, all participants expressed the need for an HIV vaccine to be developed. Half were willing to get their children vaccinated if one was available, suggesting more work is needed to promote uptake of a future HIV vaccine. Continuing to examine potential determinants that could impact uptake will be vital to promote vaccination once one is available. [ABSTRACT FROM AUTHOR]