Introduction: In recent years, there have been many studies focusing on determinants of “hooking up” among college students. A hookup is defined as a noncommittal sexual encounter outside of a relationship. Hooking up is more frequent and becoming increasingly normative within the college student population. This represents a marked shift in openness and acceptance of uncommitted sexual behavior. However, this new exploration may also be linked to new stressors or anxieties in college students that may lead to depression. Less research has examined the role depression and anxiety may play in the behavior of hooking up. Method: Data is currently being collected using four surveys and will continue to be collected in the fall of 2023. We expect a sample size of approximately 300 college students. The Hook-up Motives Questionnaire (HMQ) has been administered to learn social motivating factors for hook-up behavior. The PHQ-9 & GAD-7 surveys have been administered to assess depression and anxiety. Additionally, the survey includes self-reported sexual behaviors and influencing factors for hooking-up. Data will be analyzed using appropriate statistical techniques. Results: The collected data will inform the relationship between anxiety, depression, and the behavior of hooking up. Conclusion: We expect that the results will inform the public health community regarding the incidence of generalized anxiety, depression, and their relationship to sexual behavior. It is expected that the information will provide a deeper context to the behavior of hooking up when compared to current published research among college students.

Objective: Research reveals that people living with scarcity, especially in areas are not only at a greater risk for infectious diseases but also are at increased threat for NCDs including reproductive- age women. The study aimed to identify NCD risks among women from Pregnancy to postpartum in the resource-limited populations in Bangladesh.

Methods: This study is part of an observational pregnancy cohort conducted in Bangladesh, over 1 consecutive year. A total of 387 women were recruited within 24-36 weeks of pregnancy, and 364 women were followed over at 6 months post-pregnancy. Data on blood pressure, blood glucose and/or glycosylated hemoglobin, and hemoglobin level were collected during pregnancy and after 6 months of post-pregnancy.

Results: The pregnant women's mean (sd) age was 24.4 (5.0) years. Ninety-three percent of women gave live birth. At baseline, the incidence of pregnancy-induced hypertension (PIH) (SBP >140 mmHg & DBP >90 mmHg) was 8.8%, and elevated PIH (SBP >130-139 mmHg & DBP >80-89 mmHg) was 28.5%. At post-pregnancy follow-up, the incidence of elevated high blood pressure (HBP) was 12.8% and 3.05% had HBP. At baseline, the prevalence of gestational diabetes was 4.5% (HbA1c>6.4%) and glycemic intolerance (GI) 40.6% (HbA1C=5.4%-6.4%) using WHO criteria. At follow-up, the diabetic prevalence was 11% and GI was 46% (HbA1C=5.7%-6.4%). Five women died due to birth complications i.e. excessive bleeding or prolonged labor.

Conclusion:

Pregnancy-induced non-communicable diseases are an emerging problem in rural Bangladeshi women. The study findings advocate appropriate interventions for NCDs that linger from pregnancy in resource-limited contexts.

The Flint Water Crisis increased awareness of the health dangers associated with lead water contamination. Maternal elevated blood lead levels are associated with increased incidence of spontaneous abortion and infant mortality. The effectiveness of a randomized-controlled trial was assessed in increasing knowledge and reported skills that promote safe water drinking among women of reproductive. Females of reproductive age who would like to become pregnant in the next 2 years were randomly assigned to one of two groups. The intervention group received an educational class on healthy pregnancy (i.e. regular exercise, healthy diet, and folic acid use), history of lead contamination, overview of water contaminants, research/official information on the effects of water contaminants especially lead on the mother and baby, and demonstrations of water testing and installation of lead water filters. The control group received an educational pamphlet on lead-contaminated water. The majority of the 42 participants were non-Hispanic White/Caucasian and single. Most participants in the intervention group answered correctly many of the true/false and multiple-choice answer questions at follow-up. Only 32.2% of the control group participants rated themselves as confident/very confident to install a lead water filter on a kitchen faucet in comparison to 100% of the intervention participants at follow-up. Overall, at follow-up, there were higher knowledge and reported skills related to safe water drinking in the intervention than in the control group. The results and lessons learnt can be used to propose larger-scale interventions in universities, health departments, physician offices, and Women, Infant, and Children programs.

Background: The implementation of restrictive healthcare policies and legislation can further existing inequalities in access to care. In Texas, there has been an increase in state-level policies and directives restricting access to reproductive healthcare, criminalizing healthcare providers or limiting the scope of practice among healthcare providers. These have created a unique context for Texas clinicians and therefore, this study broadly explored how policy changes within Texas affected prenatal providers care for their pregnant patients.

Methods: Texas prenatal providers (n=17; OB/GYNs,/CNMs,/ARNPs/PAs) were recruited from a variety of practice settings to participate in hour-long interviews, guided by the Consolidated Framework for Implementation Research. As part of the Outer Setting domain, clinicians were asked how recent policy changes in Texas impacted the care of their patients. Interviews were audio-recorded, transcribed, and thematically coded.

Findings: Two policy themes emerged in this analysis: prenatal COVID vaccines and access to abortion care. Clinicians described pushback in their patient population in receiving the COVID vaccine based on Texas’ COVID response and recommendations. Clinicians emphasized that the laws in Texas suppressed patient access to abortion care, particularly receiving care within the six-week timeframe. Clinicians described how these policies increased documentation and supervision around miscarriage and abortion care, such as seeking ethical approval from leadership prior to providing care.

Implications: Findings indicate that prenatal providers perceived that new policies in Texas created various obstacles in their delivery of reproductive healthcare. Future studies should focus on how providers adapt to new policies in their care for patients.

Background and Objective: Cardiometabolic risk has increased among reproductive-age women, especially Black women, which poses a risk for later perinatal and cardiovascular health. The objective is to understand factors associated with receipt of recommended heart health screenings among reproductive-age Black women.

Methods: 267 Black women of reproductive age (18-49 years) with current US residency and no personal history of stroke, heart attack or permanent sterilization completed a cross-sectional web-based survey in January-March 2023. Chi-square tests were used to examine differences in receipt of recommended screenings/services by family and personal health history, insurance status, provider race/ethnicity, and workplace characteristics.

Results: Respondents were US-born (89.5%), average age (#), cisgender women (92.1%), had some college or more (70.4%), and had health insurance (85%). Respondents reported family history of pregnancy-related complications (13%) and chronic health conditions (23%). Most respondents (85%) did not know the recommended age for women to begin routine heart screenings. Respondents reported receipt of recommended screenings: annual physical (65%), blood panel test (55%), blood pressure check (61.8%), electrocardiogram (18%), hormone test (17%), and cardiac stress test (6.4%). Family history (heart attack, stroke) and personal history of cardiometabolic risk was associated with receipt of recommended screenings (all, p<.001). Employment in settings that provided free/discounted wellness programs and a primary provider of African descent was associated with receipt of recommended screenings (all, p<.001).

Conclusions: Personal/family history, provider race concordance, and workplace health culture may promote early screening to optimize later perinatal and cardiovascular health.

Background: The federal Title X program provides affordable and accessible family planning and sexual health services. In 2022, non-profit Converge: Partners in Access became the sole Mississippi Title X grantee. Converge developed a strategic evaluation plan to ensure efficient utilization and high-quality provision of Title X-related care.

Objectives: The objective of this study is to determine the implementation climate of Title X clinic network, including opportunities and challenges related to service utilization and quality improvement.

Methods: The study utilized a theory-based, mixed method approach via survey data collected from clinic staff and in-depth, semi-structured phone and in person interviews with clinic staff, administration, providers and patients.

Results: Preliminary results reveal areas for strategic improvement. For Title X clinics, this includes navigating the role of a new Title X grantee, provision of contraceptives, health care provider trainings (e.g., Nexplanon insertion and colposcopy courses), and Title X-specific trainings and job aids, including abortion referral and pregnancy options counseling, particularly in a post-Dobbs environment. Further, results indicate perception of barriers and opportunities varies by constituent group, with providers and administrators identifying different practice priorities regarding evidence-based strategies.

Conclusions: Results from this study can inform strategies to improve service utilization and quality of care for Title X networks in Mississippi and serve as an evaluation model for grantees nationwide, particularly in the context of a rapidly evolving policy and administrative environment. Improving delivery of care and service utilization can ultimately better meet the reproductive and sexual health needs of Title X patients.

Background: WISH aims to increase access to family planning (FP) and sexual and reproductive health (SRH) across Africa and Asia. Options has supported governments to strengthen their structures and processes for quality improvement of these services.

Methods: Government stewardship over SRH/FP was assessed by government and non-government actors using an innovative QI questionnaire. This assessed the extent to which supportive policies were in place; processes were adhered to and actions were taken to improve services and outcomes.

Results: Assessments in Pakistan, Zambia, Uganda and Madagascar, show an increase in quality improvement systems and processes (from a mean of 13% in 2019 to 64% in 2021/22) and actions and improvements in quality (from a mean of 22% in 2019 to 53% in 2021/22). Key actions taken in response to these insights included agreeing standards and guidelines, assigning responsible focal persons and teams for the implementation of initiatives, establishing mechanisms for the review, validation and discussion of SRH/FP data and ensuring that data feeds back into planning and budgeting meetings.

Conclusions: Use of the tool identified gaps and enabled development of evidence-informed action plans. This helped focus investments of resources and technical assistance to strengthen national stewardship for QI of SRH/FP services.

The Centers for Disease Control (CDC) reported that 73 % of African American adults and adolescents diagnosed with HIV were men. Sixty percent of the men were gay and bisexual (CDC, 2020). Notably, newly infected cases of HIV in the Southern US, (Georgia, Alabama, Mississippi, Tennessee, and South Carolina) are the highest in the nation. Roye (2017) asserted that the HIV crisis is most severe in the Southern States, where 37% of the country’s population is located. Additionally, newly diagnosed infections are highest among African American males living in the South. Self-identifying as gay as well as being black in the Southern U.S. act as major social barriers to immersing in better sexual health practices (Pichon et al., 2022). MSMs find it difficult to identify as gay because of potential discrimination resulting from conservative southern cultural norms.

This qualitative study explored how multiple levels of culture influence sexual health practices, particularly PrEP uptake of African American MSMs living in the Southern region of the United States. Presenters will discuss the implications of study findings for public health outreach in the Southern US. Addressing the social and political challenges faced by African American MSMs living in the southern region is essential for local, state, and national initiatives focused on eliminating the HIV epidemic—stakeholders must be prepared, proactive, and prevention-focused (3Ps).

While PrEP has the potential to prevent new infections, it is unclear how state-specific laws governing sexual and reproductive health (SRH) services impact access for cisgender women.

20 states with the highest HIV incidence among women in the US were included. We conducted a search using the following words: [“Pre-exposure prophylaxis OR PrEP”] AND [“Policy” OR “Strategies” OR “Guidelines”] AND [“Women” OR “Girls”]. Medicaid expansion status, PrEP pre-authorization requirements, pharmacist prescribing laws, financial support programs, and Traditional Medicaid coverage of PrEP, HIV testing, emergency contraception and coverage status without a prescription, were compiled.

Nearly half of included states did not expand Medicaid at the state level. Emergency contraception was covered under traditional Medicaid for almost all states included in this analysis; Georgia and Mississippi do not cover these services, and data on Arkansas and Puerto Rico remain unclear. Of the 16 states that covered emergency contraception, seven have additional requirements that limit access. Although PrEP is covered under all traditional Medicaid plans, six states require pre-authorization. HIV testing was covered by traditional Medicaid in all states, except for Florida, which has additional requirements for service acquisition. Only three states had HIV testing mandates and only four allow pharmacists to prescribe PrEP. Among financial support programs, only six states have established programs to cover the cost of PrEP.

We identified barriers to SRH access, including limited Medicaid expansion coverage, pre-authorization requirements, and limitations on pharmacist prescribing abilities. Medicaid expansion remains a strong approach in expanding access to SRH services.