Augmenting Care
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STI Stigma and Screening: Challenges to Clinical Change View Digital Media
Paper Presentation in a Themed Session Michael Perini
Stigmas associated with STIs often produce screening obstacles that interfere with proper care. This was especially true during the COVID pandemic. Howard University recently participated in a three-year SPNS (Special Projects of National Significance) study (2018-2021) that sought to implement needs-based training, clinical, and non-clinical interventions. The hope was that the interventions would improve screening, testing, and treatment of common bacterial STIs among people with HIV or at risk for HIV who are served by HRSA’s Ryan White HIV/AIDS Program (RWHAP) and/or Bureau of Primary Health Care (BPHC) funded clinics or health centers. Howard University was one of nine clinical demonstration sites in three United States (U.S.) jurisdictions, Florida, Louisiana, and Washington, D.C., selected to participate in this pilot demonstration project because of higher than national average incidences of GC, CT, syphilis, and HIV. Ethnic, gender and racial stigmas, exacerbated by the COVID-19 pandemic, generated significant issues related to the deployment of the interventions. This paper employs qualitative and quantitative data and assessments to highlight the challenges facing the DC convener site, Howard University, and details the solutions that the administrators and clinicians created to address and overcome these concerns.
Knowledge and Practices Regarding Antimicrobial Use and Resistance among Health Seekers in Two Tertiary Hospitals: An Observational Study View Digital Media
Paper Presentation in a Themed Session Evans Otieku
The objective is to evaluate antimicrobial resistance (AMR) knowledge and find out how health value judgment (HVJ) and economic value judgment (EVJ) behaviors affect antibiotic use; and understand if access to information on AMR implications may influence perceived AMR mitigation strategies. We conducted an observational study comprising 1,600 adult health seekers in two of Ghana’s top-tier public teaching hospitals. Outcome measures include 1) the levels of knowledge of the health and economic implications of AMR; 2) HVJ and EVJ behaviors influencing antibiotic use; and 3) differences in perceived AMR mitigation strategy between participants with and without exposure to the intervention. Results: Participants had a general knowledge of the health and economic implications of antibiotic use and resistance. However, more than half of them disagree that AMR could lead to reduced productivity/indirect cost 71% [95%CI: 66% – 76%], increased provider cost 87% [95%CI: 84% – 91%], and cost borne by carers of AMR patients/societal costs 59% [95%CI: 53% – 64%]. Both HVJ and EVJ behaviors influence participants to use antibiotics, but the latter was a better predictor (reliability co-efficient >0.87). Participants exposed to the intervention were more likely to recommend restrictive access to antibiotics (p<0.01) and pay slightly more for a health treatment strategy that reduces their risk of AMR in the medium to long term (p<0.01) than those not given the information. Access to AMR information at the point of care could be a powerful intervention to mitigate the prevalence of AMR and its associated health and economic implications.
