Michael Schwandt

Context: In Canada, there is currently no universal (federal or provincial) public health policy for systematic COVID-19 screening for those living in congregate housing.Understanding feasibility of rapid testing in congregate living setting provides critical data to reduce the risk of outbreaks in these settings. Objective: Use rapid antigen screening to detect SARS-CoV-2 in an asymptomatic group of university students and staff. Design: Cross-sectional study where we used rapid antigen testing from February to April, 2021. A survey was administered during the last three weeks of the study. Setting: University of British Columbia, Vancouver, Canada. Participants: Asymptomatic students and staff living or working in UBC owned and operated student residences. It was also open to asymptomatic students living on campus in privately owned housing and varsity athletes. Outcome Measures: Use of BD Veritor rapid antigen test and asymptomatic participants’ experiences with rapid testing for SARS-CoV-2. Results: A total of 3536 BD Veritor tests were completed in 1141 unique individuals. The BD Veritor sensitivity in a sample of 136 was 100% with a specificity of 93%. The positive predictive value was 76% and negative predictive value was 100%. One third of participants completed between two to four tests and 21% were screened five or more times. The mean number of tests completed per person was three. The mean length of time between those who had more than one test was seven days. There were eight false positives and 25 PCR confirmed COVID-19 positive individuals identified through this work. All individuals reported having no symptoms that they attributed to COVID-19. Almost all (n=22, 88%) COVID-19 positive cases were found in male participants. A total of 86 additional students from multiple different student residences (n=9) were asked to self-isolate while they waited for their COVID-19 diagnostic test results. An average of seven additional students positive for COVID-19 living in congregate housing were identified through contact tracing by finding one positive case. Almost all (98%) of survey participants found rapid testing acceptable/very acceptable. Two-thirds reported reasons for returning included easy access, quick, painless and results given the day of testing. Conclusion: Rapid testing as a screening tool is accurate in detecting active COVID-19 infection, relatively inexpensive and operationally feasible in identifying asymptomatic individuals.

Learning objectives: On completion of this presentation, participant should be able to: Understand the feasibility of RAT for SARS-CoV-2 screening in primary care Understand the role of RAT for SARS-CoV-2 screening in prevention of COVID-19 transmission in community Context: The COVID-19 pandemic has paralyzed human interactions worldwide. At least half of COVID-19 transmissions could originate from asymptomatic individuals. Rapid Antigen Testing (RAT) with nasal sampling at the point of care is inexpensive, fast and less invasive than PCR testing. Objective: The overall study objective was to examine the feasibility of point-of-care RAT for detecting SARS-CoV-2 amongst an asymptomatic population living in congregate housing. Design: Cross-sectional survey. Setting: This study was conducted at the University of British Columbia (UBC). Approximately 1500 undergraduate student were at the study site during February-April 2021. Population: Students living in UBC housing and staff working in the UBC housing sites were eligible. People testing positive for COVID-19 in the prior 90 days were excluded from the study. Intervention: The BD Veritor testing kit was used to test bilateral nasal specimens. Results were ready by the small BD Veritor reader. Outcome measures: Experiences of surveyed participants completing RAT. The survey was conducted during the last three weeks the site was open. Results: A total of 223 participants consisting of 134 (60%) females and 89 (40%) males completed the survey for a 37% response rate. Participants were mainly of European descent (45%), though there were East Asians (18%), African/ Caribbean (5%) and Indigenous (3%) people who also completed the survey. Almost all (98%) reported that RAT was acceptable/very acceptable and 97% would take another test. Participants believed they would test negative given their careful observation of public health measures such as hand washing, mask wearing and restricting contacts to their small “bubble”. Their expectation of testing negative was based on having no or minimal interactions with any person who had tested positive. More than two thirds of participants reported RAT provide them peace of mind and reduced anxiety levels. Participants found the RAT to be safe, easy, accessible and rapid. Conclusions: Rapid antigen testing for detecting COVID-19 is well accepted and could support the detection of infection at an early stage amongst asymptomatic individuals while easing their worries

The purpose of this systematic review and meta-analysis was to address disparities related to sexual health among students by examining the effectiveness of sexually transmitted infection (STI) preventive interventions in educational settings. PubMed, Medline, Cochrane Library, Public Health Database, and EMBASE databases were used to conduct searches. Information relating to studies, programs, participants, and quantitative outcome variables were extracted. Risk of bias was assessed and meta-analysis was conducted. This systematic review included 16 articles. The outcomes were classified into behavioral and psychosocial categories. The behavioral category included sexual partners, sexual activity, condom use, STI/HIV testing, and alcohol/drug use before sex. The psychosocial category consisted of knowledge, motivational factors, and skills. Interventions had a significantly positive impact on both behavioral (OR, 1.28; 95% CI, 1.17–1.39) and psychosocial (OR, 1.92; 95% CI, 1.36–2.72) outcomes. Among the psychosocial outcomes, the interventions were most effective at promoting knowledge (OR, 3.17; 95% CI, 2.13–4.72), followed by enhancing motivational factors (OR, 1.69; 95% CI, 1.04–2.75) and increasing behavioral skills (OR, 1.43; 95% CI, 1.13–1.81). The results of this systematic review provide empirical evidence for public health professionals and policy makers regarding planning, implementation, evaluation, and modification of STI preventive intervention programs in educational settings.

Background Population health approaches are visible among multidisciplinary methods used in urban design and planning, but attention to health equity is not always an explicit focus. Population and...

Saskatoon has nearly half of the diagnoses of HIV in Saskatchewan, Canada, with an incidence rate among Indigenous populations within inner-city contexts that is 3 times higher than national rates. Previous research does not adequately explore the relations between HIV vulnerabilities within these contexts and the experiences of illness disclosure that are informed by identity transformations, experiences of stigma, and social support. From an intersectionality framework and a constructivist grounded theory approach, this research involved in-depth, semistructured interviews with 21 Indigenous people living with HIV and/or AIDS in Saskatoon, both male and female. In this article, we present the key themes that emerged from the interviews relating to experiences of HIV disclosure, including experiences of and barriers to the disclosure process. In the end, we highlight the important identity transformation and role of being and becoming a “helper” in the community and how it can be seen as a potential support for effective community health interventions.

Background: HIV point-of-care testing (POCT) was approved for use in Canada in 2005 and provides important public health benefits by providing rapid screening results rather than sending a blood sample to a laboratory and waiting on test results. Access to test results soon after testing (or during the same visit) is believed to increase the likelihood that individuals will receive their results, and improve access to confirmatory testing and linkages to care. This paper reviews the literature on the utilization of HIV POCT across Canadian provinces. Methods: We searched OVID Medline, Embase, EBM Reviews, PsycINFO, CINAHL and 20 electronic grey literature databases. All empirical studies investigating HIV POCT programs in Canada published in French or English were included. Results: Searches of academic databases identified a total of 6091 records. After removing duplicates and screening for eligibility, 27 records were included. Ten studies are peer-reviewed articles and 17 are grey literature reports. HIV POCT in Canada is both feasible and accepted by Canadians. It is preferred to conventional HIV testing (ranging from 81.1% to 97%) and users are highly satisfied with the testing process (ranging between 96% and 100%). Conclusions: The majority of studies demonstrate that HIV POCT is feasible, preferred and accepted by diverse populations in Canada. Loss to follow-up and linkage rates are also good. However, more research is needed to understand how best to scale up HIV POCT in contexts that currently have very limited or no access to testing.

In response to the growing evidence supporting healthy built environments as a means of promoting health, several checklist-based knowledge translation tools have been designed for public health practitioners, urban planners and policy-makers. These tools have increased, but to date no comparison has been done of the quality or value of these tools to users for evaluating city plans for healthy built environment features. A search of both peer-reviewed literature and grey literature yielded 10 checklist-based tools from North America and Australia that were evidence-informed. The checklist criteria in each tool were evaluated using a thematic analysis. Themes were further classified into six settings. Tools were compared based on the breadth of settings assessed and usability for evaluating city plans. Our analysis identified that tools varied widely in the breadth of content with several tools addressing less than half the settings. Overall more recently published tools scored as more useful and in-depth. Transportation, urban design and open spaces were most addressed both within tools and across all tools. There is significant variation in quality and concepts covered across tools and no single tool is best used across all settings.

Restaurant inspection frequency: The RestoFreq Study

SummaryCommercial sex work is one of the driving forces of the HIV epidemic across the world. In Vietnam, although female sex workers (FSWs) carry a disproportionate burden of HIV, little is known about the risk profile and associated factors for HIV infection among this population. There is a need for large-scale research to obtain reliable and representative estimates of the measures of association. This study involved secondary data analysis of the ‘HIV/STI Integrated Biological and Behavioral Surveillance’ study in Vietnam in 2009–2010 to examine the correlates of HIV among FSWs. Data collected from 5298 FSWs, including 2530 street-based sex workers and 2768 venue-based sex workers from 10 provinces in Vietnam, were analyzed using descriptive statistics and bivariate and multivariate logistic regression analyses. HIV prevalence among the overall FSW population was 8.6% (n = 453). However, when stratified by FSW subpopulations, HIV prevalence was 10.6% (n = 267) for street-based sex workers and 6.7% (n = 186) for venue-based sex workers. Factors independently associated with HIV infection in the multivariate analysis, regardless of sex work types, were injecting drug use, high self-perceived HIV risk, and age ≥ 25 years. Additional factors independently associated with HIV risk within each FSW subpopulation included having ever been married among street-based sex workers and inconsistent condom use with clients and having sex partners who injected drugs among venue-based sex workers. Apart from strategies addressing modifiable risk behaviours among all FSWs, targeted strategies to address specific risk behaviours within each FSW subpopulation should be adopted.

Toxoplasma gondii and Toxocara spp. are zoonotic parasites with potentially severe long-term consequences for those infected. We estimated incidence and investigated distribution, risk factors, and costs associated with these parasites by examining hospital discharge abstracts submitted to the Canadian Institute for Health Information (2002–2011). Annual incidence of serious toxoplasmosis and toxocariasis was 0.257 (95% confidence interval [CI]: 0.254–0.260) and 0.010 (95% CI: 0.007–0.014) cases per 100,000 persons, respectively. Median annual health-care costs per serious case of congenital, adult-acquired, and human immunodeficiency virus (HIV)–associated toxoplasmosis were $1,971, $763, and $5,744, respectively, with an overall cost of C$1,686,860 annually (2015 Canadian dollars). However, the total economic burden of toxoplasmosis is likely much higher than these direct health-care cost estimates. HIV was reported as a comorbidity in 40% of toxoplasmosis cases and accounted for over half of direct health-care costs associated with clinical toxoplasmosis. A One Health approach, integrating physician and veterinary input, is recommended for increasing public awareness and decreasing the economic burden of these preventable zoonoses.