Stacey B. Griner

Background: Chlamydia infection rates are high among young adults (YA, ages 18-24). Fortunately, vaccines are being developed to target this pathogen, but chlamydia vaccine acceptability has remained largely unaddressed. The purpose of this descriptive study was to assess the acceptability of a prospective chlamydia vaccine and perceived barriers to receiving such a vaccine among YA. Methods: Sexually active YAs in the United States were recruited for an online survey in May 2022. Participants were asked to indicate their likelihood of being vaccinated for chlamydia, receiving the vaccine if recommended by a doctor, researching the vaccine, and asking their provider about the vaccine (5-point Likert scale). Barriers were listed and participants indicated if each barrier would discourage them. Demographic information was collected, and descriptive analyses were conducted in SAS. Results: Approximately 49% of participants were likely to get a chlamydia vaccine (184/379); this increased to 56% if the vaccine was recommended by a physician (211/379). Only 14% were likely to ask their provider about a chlamydia vaccine (42/295) and 16% were likely to seek additional information about the vaccine (50/320). Barriers with a strong influence included vaccine effectiveness (72%, 273/379), cost (68%, 256/379), and for contracting chlamydia because of the vaccine (66%, 251/379). Discussion: Nearly half of YA are accepting of a chlamydia vaccine, with physician influence likely to increase acceptance. Before implementation, studies should identify effective strategies to educate physicians about their role in vaccine uptake and inform the general population on the safety and effectiveness of the chlamydia vaccine.

Background: Social isolation and loneliness are increasingly recognized as public health concerns for aging populations, yet the experiences of older Asian Indian immigrants in the United States (US) remain understudied. This qualitative study explored how immigration, acculturation, and changes in social networks shape isolation, loneliness, and resilience among older Asian Indian immigrants. Methods: In‐depth interviews were conducted with 29 Asian Indian immigrants aged 50 years and older in the Dallas–Fort Worth metroplex. Participants were recruited through purposive sampling with support from local cultural and faith‐based organizations. A semi‐structured interview guide examined social networks, isolation, loneliness, acculturation, cultural identity, and coping. Interviews were audio‐recorded, transcribed verbatim, translated when necessary, and analyzed using inductive thematic analysis. Descriptive statistics summarized participant characteristics. Results: Participants described substantial disruption of social networks after immigration, including fewer close friendships, reduced spontaneous social interactions, and limited nearby family support. These changes contributed to loneliness and emotional strain, particularly in an individualistic social environment that contrasted with communal norms in India. Participants also described acculturative stress related to preserving Indian cultural identity while adapting to US society, especially in intergenerational family contexts. Despite these challenges, many used resilience strategies such as staying active, lifelong learning, maintaining optimism, and seeking supportive social circles. Conclusion: Social isolation among older Asian Indian immigrants reflects a public health challenge shaped by migration, cultural adaptation, family dispersion, and limited culturally relevant supports. Community‐based, culturally tailored interventions are needed to strengthen social connection, reduce loneliness, and promote healthy aging in immigrant communities.

Background: Expedited partner therapy (EPT) is a critical strategy to treat and reduce the transmission of chlamydia. U.S. college health centers (CHCs) serve students nationwide and are uniquely positioned to reach a major segment of young adults, a group at disproportionate risk for sexually transmitted infections. This study examined the provision of EPT at CHCs and if institutional characteristics are associated with EPT provision. Methods: We analyzed data from the 2023 American College Health Association Sexual Health Services Survey (N=115 CHCs). We conducted descriptive analyses for EPT provision and investigated associations with institutional characteristics, including locale, enrollment number, geographic region, public/private, Carnegie classification, Minority Serving Institution status, and CHC chlamydia positivity rate. We also used conventional qualitative content analysis to identify themes from an open-ended question about challenges CHCs face with EPT provision. Results: Almost 70% of CHCs offered EPT in some capacity. EPT provision differed significantly by institutional type (private versus public) and chlamydia positivity rate. No other institutional characteristics were significant. Six qualitative themes were found regarding challenges to provision. Providing EPT for non-students and healthcare providers being required or preferring to interact with partners directly were most commonly endorsed. Conclusions: Although most responding CHCs offered EPT to some degree, EPT remains underutilized, with few differences based on institutional characteristics. Addressing the identified challenges could improve EPT uptake, benefiting young adults’ sexual health outcomes.

Objectives: The demand for point-of-care testing (POCT) increased exponentially during the COVID-19 pandemic, providing a convenient and accessible method of virus detection outside of traditional laboratory settings. As high rates of sexually transmitted infections (STIs) remain a prominent public health concern, POCT for STI detection may offer an option that reduces key barriers to care such as stigma and limited clinic hours. The aim of this narrative review is to identify key facilitators, barriers and gaps related to the acceptability and implementation of STI POCT from patient perspectives in non-traditional settings. Methods: To conduct this narrative review, a comprehensive literature search was conducted using PubMed, Embase and Scopus to identify relevant studies published between 1 January 2015 and May 2025, focusing on patient perspectives and contextual determinants of POCT implementation for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Search terms included free-text keywords (such as “point of care”) and indexed terms (such as Point-of-Care Testing (MeSH)). Findings were contextualised based on patient perspective data and implementation into non-traditional settings. Results: 40 studies were included in the narrative review, reflecting geographical regions where POCT implementation has been prioritised. Study designs and implementation environments varied. POCT for CT/NG screening generally reported high diagnostic accuracy and reliability as well as increased uptake and high acceptability across settings. Availability, perceived convenience and increased autonomy significantly influenced POCT uptake and implementation among patients. Implementation facilitators included ease of device usage, minimal training and improved quality of care. Implementation barriers primarily focused on logistics, workflow and cost. Conclusions: Community-engaged approaches to designing and implementing STI POC tests in non-traditional settings are necessary to better understand specific needs. High patient satisfaction, device acceptability and improved health outcomes place STI POCT as a promising avenue for strengthening public health efforts against the STI epidemic.

Professional organizations’ syphilis screening guidelines are updated to align with evidence and need. Guideline awareness, current guideline dissemination sources, and future preferred sources were investigated among prenatal providers (n = 225). Some providers lacked awareness of screening guidelines, and primary sources of guideline information were practice bulletins, professional organizations, and continuing education courses.

Sexually transmitted infections (STIs) during pregnancy are associated with adverse pregnancy and neonatal outcomes, and evidence‐based guidelines recommend STI screening during pregnancy by prenatal providers. Guideline dissemination is a key component influencing implementation into care, but limited information exists regarding preferred dissemination sources. This cross‐sectional study assessed prenatal STI screening guideline awareness, preferred dissemination sources, and differences in guideline knowledge and dissemination sources by practice characteristics. Prenatal providers (MD/DO; n = 225) were recruited via an online survey platform. We assessed provider awareness about prenatal STI guidelines, the dissemination source of current knowledge, the preferred dissemination source for future guidelines, and provider and clinic characteristics like practice setting and years in practice. Descriptive univariate statistics and bivariate analyses were conducted. Over 12% ( n = 28) of providers lacked awareness of STI screening guidelines. There were significant differences ( p = 0.024) in awareness by practice setting, with 83.3% ( n = 120) in private practice reporting guideline awareness compared to 95.1% ( n = 39) in outpatient hospitals and 97.3% ( n = 39) in community clinics. Also, those affiliated with an academic institution had significantly more awareness of guidelines compared to those who were not affiliated (93.4% and 84.0%, p = 0.034). For future dissemination, preferred sources across the sample included practice bulletin (73%, n = 27), professional organization (59.5%, n = 22), and continuing education (CE) (37.8%, n = 14). Overall, guideline awareness among prenatal care providers was low, with differences across practice settings, suggesting a need for targeted dissemination strategies for providers based on setting. Preferred sources included practice bulletins, professional organizations, and CE, all of which should be tested and examined systematically for effectiveness in future work. Additional studies may examine the content of the guidelines prior to dissemination to facilitate adoption into clinical practice.

Background: Chlamydia infections during pregnancy are associated with adverse outcomes such as preterm birth, low birth weight, perinatal death, and miscarriage. Many professional organizations have evidence-based guidelines recommending chlamydia screening during pregnancy, but little is known regarding the factors influencing the adoption of these guidelines into practice. This study assessed the awareness, adoption, and acceptability of prenatal chlamydia screening guidelines among physicians. Methods: Prenatal providers in the United States (MD/DO; n = 201) were recruited via an online survey platform. Items assessed provider awareness about prenatal chlamydia and STI screening guidelines, current practice behaviors, and risk factors considered when screening pregnant patients for STIs. Guideline characteristics including acceptability, feasibility, relative advantage, and evidence source were assessed. Descriptive and bivariate comparisons were analyzed using SAS v9.4. Results: Over 12% of providers were unaware of prenatal STI screening recommendations from their professional organizations, and almost 8% were unaware of chlamydia screening guidelines. Most providers reported using the prenatal chlamydia screening guideline from the American College of Obstetricians and Gynecologists (70%). Those selecting this guideline were significantly more likely to describe this guideline as clear ( P = 0.004) and report that guideline source was important ( P = 0.006) compared to other organization guidelines. Conclusions: Awareness of professional organization guidelines about prenatal chlamydia screening guidelines was high among providers. However, women are not screened adequately during their pregnancies suggesting that there are other factors contributing to the underutilization of screening. Future studies should focus on how these organizations can improve guideline dissemination to increase implementation of chlamydia screening during pregnancy.