BackgroundAcross sub-Saharan Africa, men's levels of HIV-testing remain inadequate relative to women’s. Men are less likely to access anti-retroviral therapy and experience higher levels of morbidity and mortality once initiated on treatment. More frequent HIV-testing by men at continued risk of HIV-infection is required to facilitate earlier diagnosis. This study explored the frequency of HIV-testing among a rural population of men and the factors associated with more frequent HIV-testing.MethodsWe conducted a secondary analysis of a population-based survey in three rural district in Zambia, from February-November, 2013. Households (N = 300) in randomly selected squares from 42 study sites, defined as a health facility and its catchment area, were invited to participate. Individuals in eligible households were invited to complete questionnaires regarding demographics and HIV-testing behaviours. Men were defined as multiple HIV-testers if they reported more than one lifetime test. Upon questionnaire completion, individuals were offered rapid home-based HIV-testing.ResultsOf the 2376 men, more than half (61 %) reported having ever-tested for HIV. The median number of lifetime tests was 2 (interquartile range = 1-3). Just over half (n = 834; 57 %) of ever-testers were defined as multiple-testers. Relative to never-testers, multiple-testers had higher levels of education and were more likely to report an occupation. Among the 719 men linked to a spouse, multiple-testing was higher among men whose spouse reported ever-testing (adjusted prevalence ratio = 3.02 95 % CI: 1.37-4.66). Multiple-testing was higher in study sites where anti-retroviral therapy was available at the health facility on the day of a health facility audit. Among ever-testers, education and occupation were positively associated with multiple-testing relative to reporting one lifetime HIV-test. Almost half (49 %) of ever-testers accepted the offer of home-based HIV-testing.DiscussionReported HIV-testing increased among this population of men since a 2011/12 survey. Yet, only 35 % of all men reported multiple lifetime HIV-tests. The factors associated with multiple HIV-testing were similar to factors associated with ever-testing for HIV. Men living with HIV were less likely to report multiple HIV-tests and employment and education were associated with multiple-testing. The offer of home-based HIV-testing increased the frequency of HIV-testing among men.ConclusionAlthough men's levels of ever-testing for HIV have increased, strategies need to increase the lifetime frequency of HIV-testing among men at continued risk of HIV-infection.

Mental health concerns are common among university and college students. Digital mental health resources and support are offered through university websites. However, the content and type of mental health activities of these institutions have not been analyzed. The aim of this study was to conduct a content analysis of mental health commitment and practices listed on Canadian postsecondary institutional websites. A 27-variable codebook was developed to map the content of all Canadian postsecondary institutions (n = 90). Descriptive statistics were applied to provide a broad snapshot of current institutional wellbeing activities. Nearly all institutions offered crisis response options, and multiple mental health supports through various modalities. However, few institutions had a wellbeing framework (34%), engaged in recent campuswide anti-stigma campaigns (33%), tracked campus wellness activities (13%), monitored student mental health outcomes (13%), and solicited feedback through the wellness center webpages (14%). These outcomes were similar across all geographic regions but statistically significantly different between small, medium, and large institutions. Findings suggest institutions need to address these gaps, provide smaller institutions with greater governmental support for building mental health capacity, and work towards developing a centralized hub for mental health that is accessible, navigable, and considers student needs and preferences.

There have been increased calls to address the growing mental health concerns of postsecondary students in Canada. Health promotion focuses on prevention and is needed as part of a comprehensive approach to student mental health support, with an emphasis on not just the individual but also the sociocultural environment of postsecondary institutions. The aim was to conduct a scoping review of the literature pertaining to the associations between postsecondary institutional factors and student wellbeing. The review included a comprehensive search strategy, relevance screening and confirmation, and data charting. Overall, 33 relevant studies were identified. Major findings provide evidence that institutional attitudes, institutional (in)action, perceived campus safety, and campus climate are associated with mental wellbeing, suggesting that campus-wide interventions can benefit from continued monitoring and targeting these measures among student populations. Due to the large variability in reporting and measurement of outcomes, the development of standardized measures for measuring institutional-level factors are needed. Furthermore, institutional participation and scaling up established population-level assessments in Canada that can help systematically collect, evaluate, and compare findings across institutions and detect changes in relevant mental health outcomes through time.

No abstract

To establish a public-sector "see and treat" cervical cancer prevention program in Zambia by linking services to an HIV care and treatment infrastructure.