Prevention of adverse sexual health outcomes (PASHO), such as unplanned pregnancies, sexually transmitted diseases and infections, and sexual violence, in the US military is a complicated matter. Challenges like multiple focus areas spread across a complex organization with disconnected efforts complicate the military’s actions to address the issue.

The objective of the study was to identify the current strategies in place to address PASHO in the US military. A qualitative case study was designed and included semi-structured interviews with US military staff representing a variety of PASHO work throughout the organization. Study participants were recruited using respondent-driven sampling and represented military programs in health promotion, sexual assault prevention, research, and clinical services. Interviews were transcribed and transcripts were coded for thematic data analysis. Seven types of activities were identified in the military’s strategy execution efforts to address PASHO, including training and education, clinical services, engagement, and resource sharing. Additionally, although not a specific focus of current PASHO activities, participants noted the criticality of collaboration as an opportunity to amend fragmented efforts for the prevention of adverse sexual health outcomes among service members.

There are limited studies identifying the types of PASHO activities in the US military. More research is needed to continue identifying PASHO strategies in the armed forces and to understand their effectiveness in building the evidence base of practice for public health work in military populations.

Background: Adolescents experience high rates of sexually transmitted infections (STIs) and unintended pregnancies. We developed two effective national scale entertainment-education programs using intensive formative research with adolescents to improve sexual and reproductive health (SRH) outcomes. These interventions varied in format from a brief video to a 47-episode soap opera.

Methods: Plan A is a 23-minute video developed in 2016 for young women of color in the U.S. It was evaluated in a 5-year randomized controlled trial with 1,770 participants attending SRH clinics in California. Vencer el Miedo (VEM) is a soap opera that aired on prime-time television in Mexico in 2020 with 3.5 million viewers per night. VEM was evaluated in a cross-sectional survey (street-intercept and phone) with adolescents (n=1,640) and parents of adolescents (n=820) in the five most populated areas of Mexico.

Results: Plan A viewers had increased discussion of SRH topics with providers and sustained improvements in SRH knowledge, risk perception, HIV/STI testing, and condom use. Adolescent VEM viewers had higher likelihood of seeking information about contraception and healthy romantic relationships, using a contraceptive method other that condoms, and using dual methods in the last three months. Among parents, watching VEM was positively associated with talking with their adolescent child about SRH topics in the last three months.

Conclusions: Collaboratively-planned entertainment-education programs with different formats can be effective at improving adolescent SRH outcomes. Plan A has been scaled across the U.S. and VEM aired in multiple Latin American countries and the U.S. on Spanish-language television.

Background: Human papillomavirus (HPV) infection is a significant public health problem, with nearly 2,900 cases of HPV-related cancers reported in New York State (NYS) each year. Despite ongoing statewide effects to improve vaccination rates, rates remain below the 2030 Healthy People target coverage goal of 80 percent. Given little is known about unvaccinated adolescents in counties with low levels of immunization, this study aims to identify barriers, facilitators, and targeted interventions to improve vaccine uptake and address health equity. Methods: We conducted qualitative, semi-structured interviews with key informants in 15 NYS counties within the lowest quartile of HPV vaccine coverage among 13-year-old adolescents. Public health representatives were identified through snowball and purposive sampling; informants included Immunization Quality Improvement for Providers (IQIP) consultants, vaccine coordinators, medical directors, and primary care providers. Interviews focused on vaccination coverage knowledge, barriers, facilitating factors, and strategy recommendation for improvement in vaccine uptake. All conversations were audio-recorded, transcribed, and analyzed using ATLAS.ti. Results: Forty-four interviews were conducted with key informants. Identified barriers to HPV vaccination included lack of knowledge, vaccine misinformation, and absence of a school vaccination requirement. Key informants asserted major barriers could be primarily addressed through education efforts, increased awareness of vaccine benefits, direct parent-doctor conversations, and additional provider education . Conclusions: Addressing identified barriers through targeted education efforts and improved provider communication strategies may help improve NYS HPV vaccination rates and address health equity. These findings will be crucial in guiding future initiatives for improved vaccine uptake in communities with significant barriers to vaccination.

Background: Condoms serve as contraception, as well as prevention for sexually-transmitted infections. Due to being high-priced, many males choose not to use the preventative devices. Governmental health insurance (HI), such as New York State Medicaid, however, often provides condom coverage (CC). Thus, I questioned the familiarity that individuals have regarding the CC policy associated with their HI. I also investigated the likelihood that individuals would take advantage of a policy that provides CC.

Methods: To study the knowledge and practices of individuals, I surveyed 564 random males in English and Spanish throughout the various public settings of the NYC boroughs of Manhattan and the Bronx. Chi-square testing was conducted for statistical analysis.

Results: Overall, I reconfirmed that minorities are more likely to utilize Medicaid, while non-minorities participate in private HI plans. Regardless of the HI utilized, the majority of the sample was unfamiliar with the CC policy associated with their plan. Minority Medicaid recipients were more likely than non-minority Medicaid recipients to be familiar with the CC policy. Age had a statistically significant impact on awareness, inasmuch as older Medicaid recipients were more likely to be aware of CC. Finally, the majority of participants stated that if they had access to a prescription that provided free condoms, they would make a request.

Conclusion: The provision of CC by all HIs and honoring of CC by clinicians will impact prevention and be a benefit to society at large.