Spatial regression, Spatial data analysis, Spatial weight matrix, Spatial autocorrelation and heterogeneity, Spatial demographic analysis,

Introduction: This study evaluates the impact of the COVID-19 pandemic on testing for common sexually transmitted infections. Specifically, changes are measured in chlamydia and gonorrhea testing and case detection among patients aged 14−49 years during the COVID-19 pandemic.Methods: U.S. chlamydia and gonorrhea testing and positivity were analyzed on the basis of >18.6 million tests (13.6 million tests for female patients and 4.7 million tests for male patients) performed by a national reference clinical laboratory from January 2019 through June 2020.Results: Chlamydia and gonorrhea testing reached a nadir in early April 2020, with decreases (relative to the baseline level) of 59% for female patients and 63% for male patients. Declines in testing were strongly associated with increases in weekly positivity rates for chlamydia (R 2 =0.96) and gonorrhea (R 2 =0.85). From March 2020 through June 2020, an expected 27,659 (26.4%) chlamydia and 5,577 (16.5%) gonorrhea cases were potentially missed. Conclusions:The COVID-19 pandemic impacted routine sexually transmitted infection services, suggesting an increase in syndromic sexually transmitted infection testing and missed asymptomatic cases. Follow-up analyses will be needed to assess the long-term implications of missed screening opportunities. These findings should serve as a warning for the potential sexual and reproductive health implications that can be expected from the overall decline in testing and potential missed cases.

The effects of highways on transforming human society and promoting population change have been investigated in several disciplines, including geography, sociology, economics, and planning. Currently, the primary highway construction activity in the nation is highway expansion; however, this expansion has not been the focus of much of the existing literature. This research examines the role that highway expansion plays in the process of population change. Specifically, this research proposes an integrated spatial regression approach to study the impacts of highway expansion on population change in the 1980s and 1990s in Wisconsin at the minor civil division level. The integrated approach thoroughly considers the factors that influence population change, appropriately examines the spatial variations of their impacts, simultaneously incorporates spatial lag and spatial error dependence, and systematically selects the optimal neighborhood structure. The findings suggest that the impacts of highway expansion on population change differ across rural, suburban, and urban areas: There are only indirect effects in rural areas, both direct and indirect effects in suburban areas, and no statistically significant effects in urban areas. Overall, highway expansion serves as a facilitator of population change within the framework of growth pole theory and location theory.

No abstract