The_AT0 COVID-19_AJ0 pandemic_AJ0 disrupted_VVN our_DPS ability_NN1 to_TO0 provide_VVI comprehensive_AJ0 HIV_NP0 primary_AJ0 care_NN1 ,_PUN including_PRP sexual_AJ0 health_NN1 care_NN1 ,_PUN to_PRP those_DT0 persons_NN2 in_PRP greatest_AJS need_NN1 ._SENT Prior_AJ0 to_PRP the_AT0 COVID-19_AJ0 pandemic_AJ0 ,_PUN the_AT0 HIV_NP0 epidemic_NN1 in_PRP the_AT0 United_NP0 States_NP0 was_VBD experiencing_VVG modest_AJ0 downtrends_NN2 due_AJ0 in_PRP part_NN1 to_PRP successful_AJ0 harm_NN1 reduction_NN1 strategies_NN2 ,_PUN such_DT0 as_PRP HIV_NP0 pre-exposure_NN1 prophylaxis_NN1 (_PUL PrEP_NN1 )_PUR ,_PUN as_CJS well_AV0 as_CJS increasing_AJ0 testing_NN1 to_TO0 identify_VVI new_AJ0 cases_NN2 ,_PUN improving_VVG linkage_NN1 to_PRP care_NN1 ,_PUN and_CJC more_AV0 convenient_AJ0 and_CJC tolerable_AJ0 dosing_NN1 of_PRF antiretroviral_AJ0 (_PUL ART_NN1 )_PUR therapy_NN1 ._SENT Early_AJ0 COVID-19_AJ0 mitigation_NN1 strategies_NN2 affected_VVD our_DPS ability_NN1 to_TO0 provide_VVI prompt_AJ0 ,_PUN in-person_AJ0 care_NN1 ,_PUN leading_VVG to_PRP a_AT0 tremendous_AJ0 shift_NN1 to_PRP virtual_AJ0 medicine_NN1 platforms_NN2 ,_PUN including_PRP telephone_NN1 and_CJC video_NN1 telemedicine_NN1 ._SENT This_DT0 transition_NN1 allowed_VVN care_NN1 to_TO0 continue_VVI for_PRP many_DT0 ,_PUN highlighting_VVG a_AT0 new_AJ0 avenue_NN1 for_PRP ongoing_AJ0 care_NN1 ._SENT It_PNP also_AV0 accentuated_VVD the_AT0 inequities_NN2 and_CJC may_VM0 have_VHI worsened_VVN disparities_NN2 due_AJ0 to_PRP lack_NN1 of_PRF means_NN0 to_TO0 participate_VVI in_PRP virtual_AJ0 care_NN1 ,_PUN such_DT0 as_PRP a_AT0 capable_AJ0 device_NN1 ,_PUN internet_NN1 access_NN1 ,_PUN or_CJC technology_NN1 literacy_NN1 ._SENT Many_DT0 HIV_NP0 and_CJC sexual_AJ0 health_NN1 clinics_NN2 halted_VVD their_DPS in-person_AJ0 visits_NN2 ,_PUN interrupting_VVG the_AT0 care_NN1 continuum_NN1 for_PRP HIV_NP0 as_CJS well_AV0 as_CJS limiting_VVG access_NN1 to_PRP in-person_AJ0 sexual_AJ0 health_NN1 services_NN2 for_PRP STI_NP0 screening_NN1 and_CJC management_NN1 ._SENT The_AT0 abrupt_AJ0 shift_NN1 to_PRP telemedicine_NN1 allowed_VVN care_NN1 to_TO0 continue_VVI ,_PUN but_CJC there_EX0 were_VBD declines_NN2 in_PRP linkage_NN1 and_CJC retention_NN1 in_PRP HIV_NP0 care_NN1 ,_PUN antiretroviral_AJ0 starts_NN2 ,_PUN and_CJC viral_AJ0 suppression_NN1 rates_NN2 at_PRP HIV_NP0 clinics_NN2 in_PRP the_AT0 USA_NP0 and_CJC globally_AV0 ._SENT Equally_AV0 important_AJ0 ,_PUN reagents_NN2 needed_VVN for_PRP STI_NP0 diagnostic_AJ0 testing_NN1 were_VBD diverted_VVN to_PRP SARS-CoV-2_AJ0 assays_NN2 in_PRP this_DT0 public_AJ0 health_NN1 crisis_NN1 ,_PUN undermining_VVG availability_NN1 to_TO0 offer_VVI basic_AJ0 diagnostic_AJ0 tests_NN2 for_PRP chlamydia_NN1 and_CJC gonorrhea_NN1 ._SENT While_CJS it_PNP remains_VVZ to_TO0 be_VBI seen_VVN how_AVQ these_DT0 measures_NN2 affect_VVB the_AT0 HIV_NP0 and_CJC STI_NP0 epidemics_NN2 ,_PUN it_PNP is_VBZ quite_AV0 possible_AJ0 ,_PUN and_CJC even_AV0 likely_AJ0 ,_PUN that_CJT the_AT0 COVID-19_AJ0 pandemic_AJ0 will_VM0 reduce_VVI recent_AJ0 progress_NN1 made_VVN ._SENT 
Most_DT0 data_NN0 to_PRP date_NN1 show_VVB that_CJT persons_NN2 living_VVG with_PRP HIV_NP0 (_PUL PLWH_NP0 )_PUR do_VDB not_XX0 have_VHI significantly_AV0 increased_VVN susceptibility_NN1 to_PRP COVID-19_NN1 ._SENT Early_AJ0 case_NN1 series_NN0 and_CJC case-control_AJ0 studies_NN2 did_VDD not_XX0 show_VVI a_AT0 significant_AJ0 difference_NN1 in_PRP mortality_NN1 among_PRP PLWH_NP0 ,_PUN but_CJC more_AV0 recent_AJ0 data_NN0 from_PRP larger_AJC population-based_AJ0 cohorts_NN2 in_PRP the_AT0 USA_NP0 and_CJC Europe_NP0 has_VHZ shown_VVN trends_NN2 towards_PRP higher_AJC COVID-19_AJ0 mortality_NN1 among_PRP PLWH_NP0 ._SENT These_DT0 trends_NN2 are_VBB especially_AV0 notable_AJ0 among_PRP PLWH_NP0 who_PNQ also_AV0 have_VHB co-morbidities_NN2 that_CJT increase_VVB the_AT0 risk_NN1 for_PRP severe_AJ0 COVID-19_NN1 and_CJC among_PRP racial_AJ0 and_CJC ethnic_AJ0 minorities_NN2 ._SENT At_PRP this_DT0 time_NN1 ,_PUN data_NN0 are_VBB mixed_VVN to_TO0 truly_AV0 associate_VVI HIV_NP0 status_NN1 with_PRP adverse_AJ0 outcomes_NN2 due_AJ0 to_PRP COVID-19_NN1 ;_PUN rather_AV0 ,_PUN it_PNP is_VBZ much_AV0 more_AV0 evident_AJ0 that_CJT disparate_AJ0 COVID-19_AJ0 outcomes_NN2 are_VBB more_AV0 strongly_AV0 associated_VVN with_PRP cardiovascular_AJ0 and_CJC metabolic_AJ0 co-morbidities_NN2 and_CJC being_NN1 of_PRF racial_AJ0 or_CJC ethnic_AJ0 minority_NN1 status_NN1 ,_PUN which_DTQ are_VBB more_AV0 common_AJ0 among_PRP PLWH_NP0 ._SENT 
Harm_NN1 Reduction_NN1 in_PRP Principle_NN1 
Harm_NN1 reduction_NN1 ,_PUN broadly_AV0 defined_VVN ,_PUN prioritizes_VVZ minimizing_VVG the_AT0 harm_NN1 caused_VVN by_PRP an_AT0 action_NN1 or_CJC a_AT0 behavior_NN1 over_PRP stopping_VVG the_AT0 action_NN1 or_CJC behavior_NN1 ._SENT Critically_AV0 ,_PUN harm_NN1 reduction_NN1 recognizes_VVZ the_AT0 contribution_NN1 of_PRF stigma_NN1 related_VVN to_PRP a_AT0 behavior_NN1 and_CJC aims_VVZ to_TO0 reduce_VVI this_DT0 stigma_NN1 as_PRP a_AT0 barrier_NN1 to_PRP improving_VVG health_NN1 ._SENT This_DT0 approach_NN1 has_VHZ been_VBN applied_VVN most_AV0 commonly_AV0 to_PRP substance_NN1 use_NN1 ,_PUN such_DT0 as_PRP tobacco_NN1 use_NN1 ,_PUN alcohol_NN1 use_NN1 ,_PUN and_CJC injection_NN1 drug_NN1 use_NN1 ._SENT Recognizing_VVG that_CJT substance_NN1 abuse_NN1 behaviors_NN2 lead_VVB to_PRP adverse_AJ0 health_NN1 outcomes_NN2 ,_PUN the_AT0 primary_AJ0 goal_NN1 of_PRF harm_NN1 reduction_NN1 is_VBZ to_TO0 prevent_VVI or_CJC slow_VVI the_AT0 social_AJ0 and_CJC physical_AJ0 harms_NN2 associated_VVN ._SENT Harm_NN1 reductionists_NN2 often_AV0 apply_VVB these_DT0 principles_NN2 to_PRP halting_VVG the_AT0 spread_NN1 of_PRF a_AT0 pathogen_NN1 ._SENT Indeed_AV0 ,_PUN HIV_NP0 and_CJC other_AJ0 STI_NP0 management_NN1 have_VHB also_AV0 benefited_VVN from_PRP harm_NN1 reduction_NN1 strategies_NN2 ._SENT 
If_CJS SARS-CoV-2_NP0 acquisition_NN1 and_CJC subsequent_AJ0 COVID-19_AJ0 disease_NN1 is_VBZ the_AT0 adverse_AJ0 outcome_NN1 to_TO0 avoid_VVI ,_PUN then_AV0 what_DTQ is_VBZ the_AT0 behavior_NN1 or_CJC action_NN1 to_TO0 minimize_VVI to_TO0 reduce_VVI this_DT0 harm_NN1 ?_SENT Undoubtedly_AV0 ,_PUN this_DT0 a_AT0 difficult_AJ0 question_NN1 ._SENT Merely_AV0 being_VBG near_PRP other_AJ0 persons_NN2 can_VM0 lead_VVI to_PRP virus_NN1 transmission_NN1 through_PRP respiratory_AJ0 droplets_NN2 and_CJC even_AV0 possibly_AV0 airborne_AJ0 particles_NN2 ,_PUN but_CJC complete_AJ0 social_AJ0 isolation_NN1 is_VBZ not_XX0 only_AV0 impractical_AJ0 but_CJC almost_AV0 impossible_AJ0 ._SENT Identifying_VVG the_AT0 harms_NN2 to_TO0 minimize_VVI must_VM0 be_VBI considered_VVN in_PRP the_AT0 broader_AJC context_NN1 that_CJT recognizes_VVZ individual_AJ0 physical_AJ0 and_CJC mental_AJ0 health_NN1 ._SENT 
Harm_NN1 Reduction_NN1 Strategies_NN2 
Harm_NN1 reduction_NN1 strategies_NN2 for_PRP infectious_AJ0 diseases_NN2 are_VBB relatively_AV0 similar_AJ0 and_CJC can_VM0 correlate_VVI from_PRP pathogen_NN1 to_PRP pathogen_NN1 ._SENT Indeed_AV0 ,_PUN in_PRP the_AT0 case_NN1 of_PRF COVID-19_NN1 ,_PUN HIV_NP0 ,_PUN and_CJC STIs_NN1 ,_PUN many_DT0 of_PRF the_AT0 same_DT0 principles_NN2 for_PRP harm_NN1 reduction_NN1 can_VM0 be_VBI transposed_VVN ,_PUN although_CJS with_PRP different_AJ0 details_NN2 ._SENT 
Prevention_NN1 
Intuitively_AV0 ,_PUN preventing_VVG an_AT0 adverse_AJ0 outcome_NN1 is_VBZ ideal_AJ0 ._SENT Multiple_AJ0 biomedical_AJ0 and_CJC behavioral_AJ0 strategies_NN2 exist_VVB to_TO0 reduce_VVI harm_NN1 by_PRP either_AV0 stopping_VVG exposures_NN2 ,_PUN modifying_VVG exposures_NN2 ,_PUN or_CJC preventing_VVG acquisition_NN1 after_PRP exposure_NN1 ._SENT 
Barrier_NN1 Protection_NN1 
Condoms_NN2 reduce_VVB transmission_NN1 of_PRF HIV_NP0 and_CJC bacterial_AJ0 STIs_NN1 effectively_AV0 ,_PUN if_CJS used_VVN adequately_AV0 and_CJC consistently_AV0 ,_PUN but_CJC lack_NN1 of_PRF access_NN1 to_PRP condoms_NN2 or_CJC perhaps_AV0 even_AV0 personal_AJ0 preference_NN1 limits_VVZ their_DPS utility_NN1 ._SENT As_CJS a_AT0 correlate_NN1 to_PRP barrier_NN1 protection_NN1 ,_PUN masking_NN1 has_VHZ proven_VVN effective_AJ0 to_TO0 reduce_VVI the_AT0 expulsion_NN1 of_PRF SARS-CoV-2_AJ0 and_CJC other_AJ0 respiratory_AJ0 virus_NN1 droplets_NN2 ._SENT Early_AV0 in_PRP the_AT0 pandemic_AJ0 ,_PUN the_AT0 role_NN1 of_PRF masking_NN1 was_VBD not_XX0 certain_AJ0 ,_PUN and_CJC the_AT0 lack_NN1 of_PRF available_AJ0 personal_AJ0 protective_AJ0 equipment_NN1 (_PUL PPE_NP0 )_PUR reinforced_VVD tendencies_NN2 towards_PRP inadequate_AJ0 or_CJC no_AT0 masking_NN1 ._SENT Consistent_AJ0 masking_NN1 remains_VVZ one_CRD of_PRF the_AT0 most_AV0 effective_AJ0 ways_NN2 of_PRF reducing_VVG transmission_NN1 ,_PUN especially_AV0 in_PRP close_AJ0 contact_NN1 ,_PUN such_DT0 as_PRP hair_NN1 salons_NN2 and_CJC airplane_NN1 flights_NN2 ._SENT Multiple_AJ0 concentrated_AJ0 outbreaks_NN2 have_VHB been_VBN linked_VVN to_PRP activities_NN2 without_PRP mask_NN1 use_NN1 ,_PUN such_DT0 as_PRP choir_NN1 practice_NN1 ,_PUN playing_VVG close_AJ0 contact_NN1 sports_NN2 ,_PUN and_CJC children_NN2 's_POS summer_NN1 camp_NN1 without_PRP masks_NN2 ,_PUN highlighting_VVG the_AT0 relative_AJ0 ease_NN1 of_PRF transmission_NN1 without_PRP enforced_AJ0 masking_NN1 or_CJC distancing_NN1 ._SENT Although_CJS a_AT0 nationwide_AJ0 mask_NN1 mandate_NN1 in_PRP the_AT0 United_NP0 States_NP0 has_VHZ been_VBN implemented_VVN only_AV0 for_PRP certain_AJ0 circumstances_NN2 ,_PUN several_DT0 US_NP0 states_NN2 have_VHB adopted_VVN broader_AJC measures_NN2 ,_PUN which_DTQ have_VHB been_VBN associated_VVN with_PRP decreased_AJ0 spread_NN1 of_PRF SARS-CoV-2_NN1 and_CJC declines_VVZ in_PRP hospitalization_NN1 rates_NN2 among_PRP persons_NN2 aged_PRP 18_CRD –_PUN 64._CRD Among_PRP healthcare_NN1 workers_NN2 (_PUL HCWs_NP0 )_PUR in_PRP one_CRD US_NP0 healthcare_NN1 system_NN1 ,_PUN a_AT0 mask_NN1 mandate_NN1 significantly_AV0 reduced_VVN new_AJ0 virus_NN1 acquisition_NN1 after_PRP its_DPS implementation_NN1 ._SENT Additionally_AV0 ,_PUN concurrent_AJ0 social_AJ0 distancing_NN1 recommendations_NN2 to_TO0 stay_VVI at_PRP least_AV0 6_CRD ft._NN0 or_CJC 1_CRD m_NN0 apart_AV0 as_CJS well_AV0 as_CJS "_PUQ shelter-in-place_AJ0 "_PUQ orders_NN2 ,_PUN also_AV0 referred_VVN to_PRP as_PRP lockdowns_NN2 or_CJC shutdowns_NN2 ,_PUN have_VHB drastically_AV0 altered_VVN the_AT0 course_NN1 of_PRF the_AT0 pandemic_AJ0 in_PRP states_NN2 and_CJC countries_NN2 that_CJT have_VHB employed_VVN these_DT0 measures_NN2 ._SENT These_DT0 types_NN2 of_PRF "_PUQ shelter-in-place_AJ0 "_PUQ restrictions_NN2 do_VDB not_XX0 align_VVI with_PRP harm_NN1 reduction_NN1 truly_AV0 ,_PUN as_CJS the_AT0 defined_AJ0 harm_NN1 in_PRP COVID-19_NN1 is_VBZ exposure_NN1 to_PRP the_AT0 virus_NN1 via_PRP contact_NN1 with_PRP other_AJ0 persons_NN2 ._SENT Nevertheless_AV0 ,_PUN it_PNP remains_VVZ effective_AJ0 ,_PUN just_AV0 as_CJS abstinence_NN1 is_VBZ effective_AJ0 at_PRP preventing_VVG HIV_NP0 and_CJC STIs_NP0 ,_PUN but_CJC permanent_AJ0 abstinence_NN1 ,_PUN or_CJC long-lasting_AJ0 shutdowns_NN2 in_PRP the_AT0 case_NN1 of_PRF COVID-19_NN1 ,_PUN is_VBZ not_XX0 practical_AJ0 ,_PUN despite_PRP their_DPS clear_AJ0 short-term_AJ0 effectiveness_NN1 ._SENT 
Chemoprophylaxis_NN1 
Established_AJ0 biomedical_AJ0 HIV_NP0 prevention_NN1 strategies_NN2 ,_PUN such_DT0 as_PRP PrEP_NN1 and_CJC post-exposure_NN1 prophylaxis_NN1 (_PUL PEP_NN1 )_PUR ,_PUN have_VHB shown_VVN incredible_AJ0 ability_NN1 to_TO0 reduce_VVI HIV_NP0 acquisition_NN1 at_PRP the_AT0 individual_AJ0 level_NN1 as_CJS well_AV0 as_CJS some_DT0 protection_NN1 at_PRP the_AT0 population_NN1 level_NN1 to_TO0 reduce_VVI HIV_NP0 acquisition_NN1 ._SENT PrEP_NN1 with_PRP combination_NN1 oral_AJ0 tablets_NN2 ,_PUN emtricitabine_NN1 combined_VVN with_PRP either_DT0 tenofovir_NN1 disoproxil_NN1 fumarate_NN1 (_PUL F_NP0 /_PUN TDF_NP0 )_PUR or_CJC tenofovir_NN1 alafenamide_NN1 (_PUL F_NP0 /_PUN TAF_NP0 )_PUR ,_PUN as_CJS well_AV0 as_CJS newer_AJC agents_NN2 such_DT0 as_PRP long-acting_AJ0 cabotegravir_NN1 injections_NN2 effectively_AV0 reduce_VVB sexual_AJ0 HIV_NP0 acquisition_NN1 by_PRP nearly_AV0 100_CRD %_NN0 if_CJS taken_VVN adequately_AV0 ._SENT For_PRP SARS-CoV-2_NP0 ,_PUN multiple_AJ0 observational_AJ0 studies_NN2 and_CJC randomized_AJ0 ,_PUN controlled_AJ0 clinical_AJ0 trials_NN2 have_VHB shown_VVN no_AT0 benefit_NN1 to_PRP hydroxychloroquine_NN1 (_PUL HCQ_NP0 )_PUR as_PRP PrEP_NN1 or_CJC PEP_NN1 ._SENT Further_AV0 ,_PUN no_AT0 data_NN0 support_VVB the_AT0 use_NN1 of_PRF vitamin_NN1 C_ZZ0 ,_PUN vitamin_NN1 D_ZZ0 ,_PUN or_CJC zinc_NN1 as_PRP PrEP_NN1 for_PRP SARS-CoV-2_NP0 infection_NN1 ._SENT 
Vaccination_NN1 
While_CJS an_AT0 effective_AJ0 HIV_NP0 vaccine_NN1 remains_VVZ elusive_AJ0 ,_PUN multiple_AJ0 phase_NN1 3_CRD clinical_AJ0 trials_NN2 are_VBB ongoing_AJ0 to_TO0 evaluate_VVI SARS-CoV-2_AJ0 vaccines_NN2 ._SENT Similarly_AV0 ,_PUN vaccine_NN1 development_NN1 against_PRP Neisseria_NP0 gonorrhoeae_NN2 ,_PUN Chlamydia_NN1 trachomatis_NN1 ,_PUN and_CJC Treponema_NP0 pallidum_NN1 is_VBZ also_AV0 proceeding_VVG ._SENT Vaccination_NN1 for_PRP preventing_VVG HIV_NP0 and_CJC STIs_NP0 has_VHZ yet_AV0 to_TO0 demonstrate_VVI robust_AJ0 protection_NN1 against_PRP infection_NN1 ,_PUN but_CJC vaccination_NN1 against_PRP SARS-CoV-2_NP0 to_TO0 prevent_VVI COVID-19_NN1 looks_VVZ to_TO0 be_VBI the_AT0 most_AV0 promising_AJ0 route_NN1 for_PRP prevention_NN1 ._SENT Several_DT0 vaccine_NN1 candidates_NN2 have_VHB demonstrated_VVN considerable_AJ0 efficacy_NN1 ._SENT The_AT0 first_ORD two_CRD vaccine_NN1 candidates_NN2 ,_PUN BNT162b2_CRD and_CJC mRNA-1273_CRD ,_PUN use_VVB innovative_AJ0 messenger_NN1 ribonucleic_AJ0 acid_NN1 (_PUL mRNA_NN1 )_PUR platforms_NN2 ._SENT These_DT0 mRNA_NN1 vaccines_NN2 employ_VVB lipid_AJ0 nanoparticles_NN2 to_TO0 introduce_VVI mRNA_NN1 into_PRP host_NN1 cells_NN2 for_PRP the_AT0 host_NN1 ribosomes_NN2 to_TO0 then_AV0 create_VVI the_AT0 spike_NN1 protein_NN1 which_DTQ is_VBZ the_AT0 antigen_NN1 target_NN1 for_PRP the_AT0 adaptive_AJ0 immune_AJ0 response_NN1 ._SENT These_DT0 have_VHB demonstrated_VVN remarkable_AJ0 efficacy_NN1 at_PRP preventing_VVG severe_AJ0 COVID-19_AJ0 and_CJC good_AJ0 tolerability_NN1 ._SENT Administered_VVN in_PRP a_AT0 two-dose_AJ0 regimen_NN1 21_CRD days_NN2 apart_AV0 ,_PUN Pfizer_NP0 /_PUN BioNTech_NP0 's_POS BNT162b2_AJ0 vaccine_NN1 showed_VVD 95_CRD %_NN0 efficacy_NN1 to_TO0 protect_VVI against_PRP COVID-19_CRD among_PRP 36_CRD ,_PUN 523_CRD participants_NN2 with_PRP no_AT0 prior_AJ0 COVID-19_NN1 in_PRP a_AT0 large_AJ0 ,_PUN multinational_AJ0 clinical_AJ0 trial_NN1 ._SENT The_AT0 primary_AJ0 endpoint_NN1 was_VBD symptomatic_AJ0 COVID-19_NN1 confirmed_VVN by_PRP polymerase_NN1 chain_NN1 reaction_NN1 (_PUL PCR_NP0 )_PUR ._SENT No_AT0 severe_AJ0 COVID-19_AJ0 cases_NN2 were_VBD identified_VVN in_PRP the_AT0 vaccine_NN1 arm_NN1 ._SENT The_AT0 BNT162b2b_AJ0 vaccine_NN1 was_VBD very_AV0 safe_AJ0 and_CJC fairly_AV0 well_AV0 tolerated_VVN ._SENT Among_PRP the_AT0 BNT162b2_AJ0 recipients_NN2 ,_PUN 83_CRD %_NN0 reported_VVD a_AT0 local_AJ0 ,_PUN injection_NN1 site_NN1 reaction_NN1 after_PRP their_DPS first_ORD dose_NN1 ,_PUN and_CJC 78_CRD %_NN0 reported_VVD a_AT0 reaction_NN1 after_PRP the_AT0 second_ORD dose_NN1 ;_PUN most_DT0 were_VBD mild_AJ0 to_TO0 moderate_VVI and_CJC resolved_VVN within_PRP 1_CRD –_PUN 2_CRD days_NN2 ._SENT There_EX0 were_VBD few_DT0 serious_AJ0 adverse_AJ0 events_NN2 in_PRP either_DT0 arm_NN1 ,_PUN and_CJC there_EX0 were_VBD no_AT0 deaths_NN2 related_VVN to_PRP the_AT0 vaccine_NN1 ._SENT The_AT0 BNT162b2_AJ0 vaccine_NN1 requires_VVZ −80_CRD °_NN0 C_ZZ0 storage_NN1 ._SENT While_CJS large_AJ0 medical_AJ0 facilities_NN2 may_VM0 have_VHI the_AT0 resources_NN2 to_TO0 store_VVI this_DT0 vaccine_NN1 ,_PUN cold_AJ0 chain_NN1 transport_NN1 and_CJC need_VVB for_PRP expensive_AJ0 ,_PUN −80_AJ0 °_NN0 C_ZZ0 freezers_NN2 significantly_AV0 limits_VVZ its_DPS ability_NN1 to_TO0 be_VBI rolled_VVN out_AVP broadly_AV0 ._SENT The_AT0 other_AJ0 mRNA_NN1 vaccine_NN1 ,_PUN mRNA-1273_NP0 produced_VVD by_PRP Moderna_NP0 ,_PUN similarly_AV0 showed_VVD considerable_AJ0 efficacy_NN1 and_CJC safety_NN1 ._SENT Also_AV0 administered_VVN in_PRP a_AT0 two-dose_AJ0 regimen_NN1 ,_PUN although_CJS 28_CRD days_NN2 apart_AV0 ,_PUN the_AT0 mRNA-1273_AJ0 vaccine_NN1 showed_VVD 94.1_CRD %_NN0 efficacy_NN1 at_PRP preventing_VVG COVID-19_NN1 among_PRP 30_CRD ,_PUN 420_CRD participants_NN2 in_PRP a_AT0 large_AJ0 ,_PUN randomized_AJ0 clinical_AJ0 trial_NN1 in_PRP the_AT0 USA_NP0 ._SENT Also_AV0 ,_PUN there_EX0 were_VBD no_AT0 severe_AJ0 COVID-19_NN1 in_PRP the_AT0 vaccine_NN1 intervention_NN1 arm_NN1 ._SENT Similarly_AV0 ,_PUN mild_AJ0 to_TO0 moderate_VVI local_AJ0 and_CJC systemic_AJ0 reactogenic_AJ0 symptoms_NN2 were_VBD much_AV0 frequent_AJ0 in_PRP the_AT0 mRNA-1273_CRD participants_NN2 ,_PUN but_CJC the_AT0 serious_AJ0 adverse_AJ0 events_NN2 were_VBD rare_AJ0 ._SENT Unlike_PRP the_AT0 BNT162b2_AJ0 vaccine_NN1 ,_PUN the_AT0 mRNA-1273_AJ0 vaccine_NN1 does_VDZ not_XX0 require_VVI such_DT0 low_AJ0 temperatures_NN2 for_PRP freezing_VVG yet_AV0 still_AV0 requires_VVZ cold_AJ0 chain_NN1 transport_NN1 and_CJC subzero_NN1 freezers_NN2 for_PRP storage_NN1 ._SENT At_PRP the_AT0 time_NN1 of_PRF this_DT0 writing_NN1 ,_PUN these_DT0 two_CRD mRNA_NN1 vaccines_NN2 have_VHB been_VBN granted_VVN Emergency_NN1 Use_NN1 Authorization_NN1 (_PUL EUA_NP0 )_PUR by_PRP the_AT0 US_NP0 Federal_AJ0 Drug_NN1 Administration_NN1 (_PUL FDA_NP0 )_PUR ._SENT Other_AJ0 vaccine_NN1 candidates_NN2 ,_PUN which_DTQ are_VBB employing_VVG more_AV0 traditional_AJ0 ,_PUN although_CJS potent_AJ0 ,_PUN viral_AJ0 vectors_NN2 ,_PUN are_VBB currently_AV0 undergoing_VVG phase_NN1 3_CRD clinical_AJ0 trials_NN2 ._SENT Interim_AJ0 results_NN2 for_PRP three_CRD candidates_NN2 appear_VVB promising_AJ0 to_TO0 offer_VVI fairly_AV0 good_AJ0 efficacy_NN1 and_CJC tolerability_NN1 ._SENT In_PRP phase_NN1 1_CRD –_PUN 2a_NN1 trials_NN2 ,_PUN Janssen_NP0 's_POS replaced-dns_NP0 .S_NP0 vaccine_NN1 (_PUL or_CJC JNJ-78436735_CRD )_PUR against_PRP SARS-CoV-2_NP0 demonstrated_VVD high_AJ0 production_NN1 of_PRF neutralizing_AJ0 antibody_NN1 in_PRP over_AV0 90_CRD %_NN0 of_PRF participants_NN2 on_PRP day_NN1 29_CRD after_PRP the_AT0 first_ORD dose_NN1 and_CJC approached_VVD 100_CRD %_NN0 by_PRP day_NN1 57._CRD Early_AJ0 results_NN2 from_PRP the_AT0 phase_NN1 3_CRD ENSEMBLE_NN1 trial_NN1 report_NN1 72_CRD %_NN0 efficacy_NN1 in_PRP the_AT0 USA_NP0 and_CJC 66_CRD %_NN0 efficacy_NN1 overall_AJ0 in_PRP preventing_VVG moderate_AJ0 to_PRP severe_AJ0 COVID-19_NN1 28_CRD days_NN2 after_PRP a_AT0 single_AJ0 dose_NN1 of_PRF the_AT0 vaccine_NN1 as_CJS well_AV0 as_CJS 85_CRD %_NN0 efficacy_NN1 in_PRP preventing_VVG severe_AJ0 disease_NN1 across_PRP all_DT0 multinational_AJ0 study_NN1 sites_NN2 ._SENT Perhaps_AV0 the_AT0 most_AV0 promising_AJ0 aspect_NN1 of_PRF this_DT0 vaccine_NN1 candidate_NN1 is_VBZ that_CJT it_PNP is_VBZ administered_VVN as_PRP a_AT0 single_AJ0 dose_NN1 and_CJC can_VM0 be_VBI transported_VVN through_PRP standard_AJ0 vaccine_NN1 distribution_NN1 channels_NN2 ._SENT The_AT0 replaced-dns_NN2 .S_NN2 may_VM0 not_XX0 be_VBI as_AV0 effective_AJ0 as_CJS the_AT0 mRNA_NN1 vaccine_NN1 ,_PUN but_CJC it_PNP still_AV0 offers_VVZ protection_NN1 from_PRP severe_AJ0 COVID-19_NN1 while_CJS improving_VVG ease_NN1 of_PRF implementation_NN1 and_CJC roll-out_NN1 ._SENT In_PRP early_AJ0 ,_PUN interim_AJ0 analysis_NN1 ,_PUN Astra_NP0 Zeneca_NP0 's_POS ChAdOx1_AJ0 nCoV-19_NN1 (_PUL AZ1222_NP0 )_PUR ,_PUN another_DT0 two-dose_AJ0 regimen_NN1 dosed_VVN at_PRP least_AV0 4_CRD weeks_NN2 apart_AV0 (_PUL although_CJS up_AVP to_PRP 12_CRD weeks_NN2 )_PUR ,_PUN showed_VVD efficacy_NN1 in_PRP protecting_VVG against_PRP symptomatic_AJ0 COVID-19_NN1 by_PRP 66.7_CRD %_NN0 with_PRP no_AT0 severe_AJ0 COVID-19_AJ0 cases_NN2 in_PRP the_AT0 vaccine_NN1 arm_NN1 among_PRP participants_NN2 in_PRP Brazil_NP0 ,_PUN South_NP0 Africa_NP0 ,_PUN and_CJC the_AT0 United_NP0 Kingdom_NP0 ._SENT "_PUQ Sputnik_NP0 V_ZZ0 "_PUQ is_VBZ the_AT0 nicknamed_AJ0 adenovirus_NN1 vector_NN1 vaccine_NN1 ,_PUN Gam-COVID-Vac_NP0 ._SENT Interim_AJ0 results_NN2 from_PRP a_AT0 large_AJ0 phase_NN1 3_CRD trial_NN1 showed_VVD 91.6_CRD %_NN0 efficacy_NN1 in_PRP reducing_VVG PCR-confirmed_AJ0 COVID-19_NN1 after_PRP two_CRD doses_NN2 21_CRD days_NN2 apart_AV0 in_AVP among_PRP 21_CRD ,_PUN 977_CRD participants_NN2 in_PRP Russia_NP0 ._SENT 
As_CJS vaccination_NN1 efforts_NN2 increase_VVB in_PRP the_AT0 community_NN1 ,_PUN the_AT0 need_NN1 to_TO0 reach_VVI communities_NN2 of_PRF color_NN1 ,_PUN especially_AV0 Black_AJ0 /_PUN African_AJ0 American_AJ0 ,_PUN Hispanic_AJ0 /_PUN Latinx_NN1 ,_PUN and_CJC Native_AJ0 and_CJC Indigenous_AJ0 communities_NN2 ,_PUN demands_VVZ equitable_AJ0 implementation_NN1 ._SENT Analogous_AJ0 to_PRP HIV_NP0 PrEP_NN1 ,_PUN systemic_AJ0 and_CJC structural_AJ0 barriers_NN2 such_DT0 as_PRP few_DT0 vaccination_NN1 sites_NN2 ,_PUN requirement_NN1 for_PRP online_AJ0 registration_NN1 ,_PUN and_CJC vaccine_NN1 hesitancy_NN1 may_VM0 prevent_VVI at-risk_AJ0 persons_NN2 from_PRP being_VBG vaccinated_VVN ._SENT These_DT0 barriers_NN2 must_VM0 be_VBI addressed_VVN in_PRP all_DT0 implementation_NN1 plans_VVZ to_TO0 ensure_VVI that_CJT vaccine_NN1 access_NN1 is_VBZ fair_AJ0 and_CJC equitable_AJ0 to_PRP all_DT0 communities_NN2 ._SENT 
Detection_NN1 
Another_DT0 major_AJ0 tenet_NN1 of_PRF harm_NN1 reduction_NN1 in_PRP infectious_AJ0 diseases_NN2 is_VBZ early_AJ0 detection_NN1 ._SENT While_CJS early_AJ0 intervention_NN1 is_VBZ actually_AV0 the_AT0 key_NN1 in_PRP reducing_VVG adverse_AJ0 outcomes_NN2 ,_PUN detection_NN1 early_AJ0 in_PRP the_AT0 course_NN1 is_VBZ necessary_AJ0 in_PRP order_NN1 to_TO0 then_AV0 perform_VVI the_AT0 intervening_AJ0 treatment_NN1 ._SENT Laboratory_NN1 methods_NN2 for_PRP detecting_VVG HIV_NP0 ,_PUN STIs_NP0 ,_PUN and_CJC SARS-CoV-2_NP0 infection_NN1 are_VBB similar_AJ0 ,_PUN but_CJC there_EX0 are_VBB key_AJ0 differences_NN2 in_PRP understanding_VVG the_AT0 utility_NN1 of_PRF diagnostic_AJ0 methods_NN2 due_AJ0 to_PRP the_AT0 different_AJ0 syndromes_NN2 ,_PUN and_CJC different_AJ0 timelines_NN2 ,_PUN that_CJT each_DT0 of_PRF these_DT0 causes_NN2 ._SENT 
Nucleic_AJ0 Acid_NN1 Amplification_NN1 Test_NN1 
Nucleic_AJ0 acid_NN1 amplification_NN1 testing_NN1 (_PUL NAAT_NP0 )_PUR ,_PUN most_AV0 often_AV0 performed_VVN by_PRP reverse_AJ0 transcriptase_NN1 polymerase_NN1 chain_NN1 reaction_NN1 (_PUL RT-PCR_NP0 )_PUR ,_PUN detects_VVZ a_AT0 pathogen_NN1 's_POS presence_NN1 by_PRP identifying_VVG and_CJC amplifying_VVG unique_AJ0 nucleic_AJ0 acid_NN1 sequences_NN2 or_CJC genes_NN2 of_PRF a_AT0 particular_AJ0 pathogen_NN1 ._SENT Often_AV0 ,_PUN NAATs_NN2 are_VBB the_AT0 most_AV0 sensitive_AJ0 and_CJC specific_AJ0 tests_NN2 for_PRP identifying_VVG a_AT0 pathogen_NN1 ._SENT HIV_NP0 RNA_NN1 detection_NN1 in_PRP blood_NN1 ,_PUN termed_VVD viral_AJ0 load_NN1 ,_PUN is_VBZ not_XX0 the_AT0 sole_AJ0 means_NN0 of_PRF identifying_VVG infection_NN1 ,_PUN but_CJC it_PNP is_VBZ the_AT0 most_AV0 sensitive_AJ0 and_CJC specific_AJ0 ._SENT In_PRP fact_NN1 ,_PUN the_AT0 viral_AJ0 load_NN1 is_VBZ used_VVN to_TO0 monitor_VVI response_NN1 to_PRP ART_NN1 ._SENT Similarly_AV0 ,_PUN most_DT0 STIs_NN1 can_VM0 be_VBI diagnosed_VVN by_PRP performing_VVG a_AT0 NAAT_NN1 on_PRP a_AT0 specimen_NN1 obtained_VVN from_PRP the_AT0 site_NN1 of_PRF exposure_NN1 (_PUL oropharynx_NN1 ,_PUN urethra_NN1 ,_PUN cervix_NN1 ,_PUN vagina_NN1 ,_PUN or_CJC anus_NN1 )_PUR to_TO0 identify_VVI pathogens_NN2 such_DT0 as_PRP C_NP0 ._SENT trachomatis_NN1 ,_PUN N_NP0 ._SENT gonorrhoeae_NN2 ,_PUN Trichomonas_NP0 vaginalis_NN1 ,_PUN Mycoplasma_NP0 genitalium_NP0 ,_PUN and_CJC herpes_NN2 simplex_VVB virus_NN1 (_PUL HSV_NP0 )_PUR ._SENT 
