Improving uptake of COVID-19 testing and vaccination in a homeless population: mixed-methods evaluation of community health worker-led education in a shelter.

Objectives: Access to healthcare and accurate health information is a persistent issue for people experiencing homelessness (PEH), one heightened by the COVID-19 pandemic and exacerbated by issues of health literacy and mistrust. Strategies involving community health workers (CHWs) have the potential to improve education and service delivery for PEH. The objective of this study is to assess PEH knowledge, attitudes and barriers to COVID-19 testing and vaccination, and the impact of CHW-led education within a homeless shelter in Indiana.

Stakeholder-engaged development of a rapid test for detection of acute HIV infection.

Background/objective: The utilization of rapid HIV tests has been effective at reducing transmission rates in high-risk populations by allowing individuals to receive diagnosis in as little as one minute and begin treatment. However, no current rapid tests can detect HIV immediately after infection in the acute HIV infection (AHI) phase, when the virus is at its most infectious, and instead require a waiting period of up to 90 days after exposure. Rapid HIV tests to detect AHI are currently under development.

Human-centered design of a smartphone-based self-test for HIV viral load monitoring.

Background/objective: HIV viral load self-testing could enable people living with HIV (PLHIV) to monitor their viral suppression status more easily, potentially facilitating medication adherence and safe behavior decision-making. Smartphone-based viral load testing innovations have the potential to reach resource-limited and vulnerable communities to address inequities in access to HIV care. However, successful development and translation of these tests requires meaningful investigation of end-user contexts and incorporation of those context-specific needs early in the design process.

Feasibility and anticipated acceptability of community health worker-facilitated HPV self-sampling for cervical cancer screening around Lake County, Indiana.

Background/objective: In light of calls to engage community health workers (CHWs) in the delivery of cervical cancer screening innovations, this study explores CHW perspectives on i) barriers to cervical cancer screening in a predominantly Hispanic community in Lake County, Indiana, the county with the highest cervical mortality in the state; and ii) the acceptability and feasibility of CHW-facilitated human papillomavirus (HPV) self-sampling as a means of reducing screening disparities.

Methods: In 2021, in-depth interviews were conducted with 15 CHWs employed by Lake County community-based organizations including clinics, schools, and faith-based organizations.

Results: Harnessing CHWs' voices as insiders with knowledge of their communities' health landscape, our analysis identified multilevel barriers to screening that spanned individual, interpersonal, and community levels of the socio-ecological model.

Leveraging COVID-era innovation for cervical cancer screening: Clinician awareness and attitudes toward self-sampling and rapid testing for HPV detection.

Cervical cancer screening rates are declining in the US, with persistent disparities among vulnerable populations. Strategies to better reach under-screened communities are needed. The COVID pandemic sparked major shifts in healthcare delivery, including the accelerated development and adoption of rapid diagnostic testing, broadened access to remote care, and growing consumer demand for self-testing, which could be leveraged for cervical cancer.