Confidential, accessible point-of-care sexual health services to support the participation of key populations in biobehavioural surveys: lessons for Papua New Guinea and other settings where reach of key populations is limited

To achieve the UNAIDS 90-90-90 targets at a national level, many countries must accelerate service coverage among key populations. To do this, key population programs have adopted methods similar to those used in respondent-driven sampling (RDS) to expand reach. A deeper understanding of factors from RDS surveys that enhance health service engagement can improve key population programs. To understand the in-depth lives of key populations, acceptance of expanded point-of-care biological testing and determine drivers of participation in RDS surveys, we conducted semi-structured interviews with 111 key population participants (12–65 years) were purposefully selected from six biobehavioral surveys (BBS) in three cities in Papua New Guinea. Key populations were female sex workers, men who have sex with men, and transgender women. Four reasons motivated individuals to participate in the BBS: peer referrals; private, confidential, and stigma-free study facilities; "one-stop shop" services that provided multiple tests and with same-day results, sexually transmitted infection treatment, and referrals; and the desire to know ones’ health status. Biobehavioral surveys, and programs offering key population services can incorporate the approach we used to facilitate key population engagement in the HIV cascade

A socio-ecological analysis of factors influencing HIV treatment initiation and adherence among key populations in Papua New Guinea

Background: In Papua New Guinea (PNG) members of key populations, including female sex workers (FSW), men who have sex with men (MSM) and transgender women (TGW), have higher rates of HIV compared to the general adult population and low engagement in HIV care. This paper examines the socio-ecological factors that encourage or hinder HIV treatment initiation and adherence among HIV positive members of key populations in PNG. Methods: As part of a larger biobehavioural survey of key populations in PNG, 111 semi-structured interviews were conducted with FSW, MSM and TGW, of whom 28 identified as living with HIV. Interviews from 28 HIV positive participants are used in this analysis of the influences that enabled or inhibited HIV treatment initiation and treatment adherence. Results: Enablers included awareness of the biomedical benefits of treatment; experiences of the social, familial and health benefits of early treatment initiation and adherence; support provided by family and friends; and nonjudgmental and supportive HIV service provision. Factors that inhibited treatment initiation and adherence included perception of good health and denial of HIV diagnosis; poor family support following positive diagnosis; and anonymity and stigma concerns in HIV care services. Conclusion: Exploring health promotion messages that highlight the positive health impacts of early treatment initiation and adherence; providing client-friendly services and community-based treatment initiation and supply; and rolling out HIV viral load testing across the country could improve health outcomes for these key populations

The polarization observables T, P, and H and their impact on γp→pπ0\gamma p \to p\pi^0 multipoles

Data on the polarization observables T, P, and H for the reaction $\gamma p\to p\pi^0$ are reported. Compared to earlier data from other experiments, our data are more precise and extend the covered range in energy and angle substantially. The results were extracted from azimuthal asymmetries measured using a transversely polarized target and linearly polarized photons. The data were taken at the Bonn electron stretcher accelerator ELSA with the CBELSA/TAPS detector. Within the Bonn-Gatchina partial wave analysis, the new polarization data lead to a significant narrowing of the error band for the multipoles for neutral-pion photoproduction

The N(1520) 3/2- helicity amplitudes from an energy-independent multipole analysis based on new polarization data on photoproduction of neutral pions

New data on the polarization observables T, P, and H for the reaction $\gamma p \to p\pi^0$ are reported. The results are extracted from azimuthal asymmetries when a transversely polarized butanol target and a linearly polarized photon beam are used. The data were taken at the Bonn electron stretcher accelerator ELSA using the CBELSA/TAPS detector. These and earlier data are used to perform a truncated energy-independent partial wave analysis in sliced-energy bins. This energy-independent analysis is compared to the results from energy-dependent partial wave analyses

Cycling behaviour in 17 countries across 6 continents : levels of cycling, who cycles, for what purpose, and how far?

International comparisons of cycling behaviour have typically been limited to high-income countries and often limited to the prevalence of cycling, with lack of discussions on demographic and trip characteristics. We used a combination of city, regional, and national travel surveys from 17 countries across the six continents, ranging from years 2009 through 2019. We present a descriptive analysis of cycling behaviour including level of cycling, trip purpose and distance, and user demographics, at the city-level for 35 major cities (>1 million population) and in urbanised areas nationwide for 11 countries. The Netherlands, Japan and Germany are among the highest cycling countries and their cities among the highest cycling cities. In cities and countries with high cycling levels, cycling rates tend to be more equal between work and non-work trips, whereas in geographies with low cycling levels, cycling to work is higher than cycling for other trips. In terms of cycling distance, patterns in high- and low-cycling geographies are more similar. We found a strong positive association between the level of cycling and women’s representation among cyclists. In almost all geographies with cycling mode share greater than 7% women made as many cycle trips as men, and sometimes even greater. The share of cycling trips by women is much lower in geographies with cycling mode shares less than 7%. Among the geographies with higher levels of cycling, children (60 years) remain underrepresented in all geographies but have relatively better representation where levels of cycling are high. In low-cycling settings, females are underrepresented across all the age groups, and more so when older than 16 years. With increasing level of cycling, representation of females improves across all the age groups, and most significantly among children and older adults. Clustering the cities and countries into homogeneous cycling typologies reveals that high cycling levels always coincide with high representation of females and good representations of all age groups. In low-cycling settings, it is the reverse. We recommend that evaluations of cycling policies include usage by gender and age groups as benchmarks in addition to overall use. To achieve representation across different age and gender groups, making neighbourhoods cycling friendly and developing safer routes to school, should be equally high on the agenda as cycling corridors that often cater to commuting traffic

New data on γ⃗p⃗→ηp\vec{\gamma} \vec{p}\rightarrow \eta p with polarized photons and protons and their implications for N∗→NηN^* \to N\eta decays

The polarization observables $T, E, P, H$, and $G$ in photoproduction of $\eta$ mesons off protons are measured for photon energies from threshold to $W=2400\,$MeV ($T$), 2280 MeV ($E$), 1620 MeV ($P, H$), or 1820 MeV ($G$), covering nearly the full solid angle. The data are compared to predictions from the SAID, MAID, J\"uBo, and BnGa partial-wave analyses. A refit within the BnGa approach including further data yields precise branching ratios for the $N\eta$ decay of nucleon resonances. A $N\eta$-branching ratio of $0.33\pm 0.04$ for $N(1650)1/2^-$ is found, which reduces the large and controversially discussed $N\eta$-branching ratio difference of the two lowest mass $J^P=1/2^-$-resonances significantly.Comment: 10 pages, 11 figure

"Now we are in a different time; various bad diseases have come." understanding men's acceptability of male circumcision for HIV prevention in a moderate prevalence setting

Background: Adult male surgical circumcision (MC) has been shown to reduce HIV acquisition in men and is recommended by the WHO for inclusion in comprehensive national HIV prevention programs in high prevalence settings. Only limited research to date has been conducted in countries experiencing moderate burden epidemics, where the acceptability, operational feasibility and potential epidemiological impact of MC remain unclear. Methods. A multi-method qualitative research study was conducted at four sites in Papua New Guinea (PNG), with 24 focus group discussions and 65 in-depth interviews carried out among 276 men. Results: The majority of men were in favour of MC being introduced for HIV prevention in PNG and considered improved genital hygiene, enhanced sexual pleasure and culturally appropriateness key factors in the acceptability of a future intervention. A minority of men were against the introduction of MC, primarily due to concerns regarding sexual risk compensation and that the intervention went against prevailing cultural and religious beliefs. Conclusion: This is one of the first community-based MC acceptability studies conducted in a moderate prevalence setting outside of Africa. Research findings from this study suggest that a future MC program for HIV prevention would be widely accepted by men in PNG