Aids Education and Prevention最新文献

HIV prevention research on sexual minority men focuses predominantly on risk factors, yet there is potential for enhancing HIV risk reduction by also examining resilience factors. We used mixed methods to explore HIV-related resilience pathways among 20 HIV-negative sexual minority men reporting HIV syndemic risks (childhood sexual abuse, partner abuse, mental health problems, substance abuse). Using grounded theory, we found that stress-related growth after mental health problems and/or unwanted sexual experiences can trigger development/use of HIV prevention resilience resources that, in turn, help sexual minority men cope and enhance HIV prevention behavior. We identified 23 HIV resilience resources at individual, interpersonal, community, health system, and structural levels. These findings informed a preliminary Theory of HIV Prevention Resilience for Sexual Minority Men. Our findings identified resilience resources to be nurtured through public health or mental health/substance use-focused interventions at broader levels to better address the HIV epidemic.

PrEP campaigns often promote a "private" frame emphasizing personal HIV risk management. We explore how a "public" frame emphasizing community-managed sexual health is relevant among men who have sex with men (MSM) and can advance HIV prevention. We sampled MSM from the United States (N = 311 in 2015) and the Netherlands (N = 222 in 2020) soon after each country's official PrEP introduction to study the early adoption of PrEP frames. Using regressions and machine learning, we quantified support for different PrEP frames, person-level correlates, and relationships to personal PrEP disclosure. Respondents were generally neutral about PrEP framing (U.S.: 44%, Netherlands: 48%), yet many held private (U.S.: 23%, Netherlands: 28%) and public (U.S.: 33%, Netherlands: 24%) frames. Public and neutral frames were associated with PrEP users and disclosure comfort. PrEP messaging and uptake could improve by understanding how and when MSM frame their PrEP use as a public or private matter.

Couples HIV testing and counseling (CHTC) emerged as an early HIV prevention intervention for male couples in the US. Understanding how couples speak to a testing counselor may enhance CHTC training and delivery. Raters analyzed CHTC sessions involving 66 adult cisgender male couples and noted three distinct styles. When co-speaking, partners collaborated in the construction of a shared response, often using plural pronouns. Parallel speaking involved partners sharing individual perspectives in turn, often using singular pronouns. The spokesperson style was typified by one partner consistently speaking first and saying more. Most (65.1%) couples adopted a consistent style. The majority of these were co-speaking (72.1%). Fewer had a consistent spokesperson (18.6%) or parallel speaking style (9.3%). Where observed, style changes often accompanied shifts in topic or in the CHTC counselor's attention. A couple's communication style may provide CHTC counselors with information about partners' familiarity with each other's perspectives as well as relationship power. Implications for rapport building and engagement are discussed.

In sub-Saharan Africa, HIV is the leading cause of death among 15-24-year-olds. Tanzanian youth rank fifth in HIV prevalence, yet testing rates are low. Dissemination of oral HIV self-implemented tests (Oral-SIT) may improve access if tests are coupled with graphic instructions to address low literacy. This study analyzed how a graphic instruction book (GIB) alone, compared to a GIB combined with an instructional video (GIB-video), affected comprehension of the Oral-SIT kit procedures. In a randomized experiment (N = 257; 14-19 yrs), we analyzed misunderstandings of testing procedures across the two study arms. Participants in the GIB-only condition reported more misunderstandings (59%) than in the GIB-video condition (41%). Fifty-eight percent of misunderstandings contained major errors, though most centered on a few graphics. Fewer than 6% of participants had four or more misunderstandings. Overall, the GIB was comprehended well and with modifications, could enhance Oral-SIT fidelity in low-literacy settings.

This mixed-methods study explored resilience-enabling behaviors and practices exhibited by young Latino sexual minority men (YLSMM) to cope with stigmatizing experiences attributed to their multiple minoritized identities and reduce their HIV risk. Guided by a positive deviance approach, we identified and interviewed 15 YLSMM (aged 18 to 24) with a history of regular HIV testing and lived experiences of intersectional stigma. Thematic analysis reveals multilevel strategies used by participants to mitigate the adverse effects of stigma on mental health and HIV preventive behaviors. Strategies included using positive self-talk and self-expression, having an immediate network of supportive friends and families, and engaging in community-based support groups and events. In turn, these strategies motivated participants to exercise self-care, accept their minoritized identities, especially their sexual orientation, seek emotional and informational support, and connect with other Latino sexual minority men and the larger Latine community.

In China, pre-exposure prophylaxis (PrEP) uptake among men who have sex with men (MSM) and HIV-serodiscordant couples is low. We offered differentiated PrEP options tailored to MSM in a community-based organization (CBO) setting, and to HIV-serodiscordant couples attempting conception in a specialized HIV care clinic. The CBO facilitated PrEP by linkage with a telemedicine platform for virtual consultation; additional online follow-up on social media was conducted by peers. PrEP was taken properly in 88.7% of visits. Retention was 82.4% at Month 6. MSM having HIV-infected partners over the past 6 months were more likely to adhere to PrEP; ≥ 50 years old and daily oral PrEP were significant predictors for failing in retention. Five pregnancies were reported in the clinic. A peer-led and social media, telemedicine-assisted PrEP model within a CBO is a feasible approach to roll out PrEP among MSM. Integrated PrEP in specialized HIV clinics is appropriate for serodiscordant couples attempting conception.

Adolescents with intellectual disability (ID) are often deficient in knowledge about HIV/AIDS. This pilot study evaluated the impact and acceptability of an HIV education intervention for adolescents with mild-to-moderate ID delivered in a peri-urban setting in Uganda. This quasi-experimental study involved 60 adolescents with mild to moderate ID evenly split between the intervention and control groups. Data were collected using a questionnaire that included sociodemographic information, HIV knowledge and attitudes, and acceptability measures, administered at baseline, immediately postintervention, and 3 months later. Approximately 53.3% of the participants were male, and 50% had mild ID. Immediately post-intervention, the intervention group reported a significantly higher increase in HIV knowledge (8.5 vs. -0.2, p < .001) and attitudes (3.9 vs. 0.1, p < .001) than the control group. A similar significant increase was maintained at 3 months post-intervention. These findings show that tailored education programs can improve HIV knowledge and attitudes in adolescents with ID.

Young Black gay, bisexual, and other men who have sex with men who are living with HIV are at an increased risk of experiencing poor mental health due to their exposures to intersectional stigma and discrimination, but often do not seek traditional mental health care. We qualitatively explored conceptualizations of mental health through interviews with 40 participants and analyzed our data using a phenomenology-informed approach. Participants conceptualized mental health as having inward-facing (cultivation of a healthy relationship with oneself, maintaining a peaceful state of mind, lack of depressed mood) and outward-facing components (goal-oriented behavior, resilient coping mechanisms). Some participants espoused an internal locus of control over one's mental state, while others focused on structural or environmental factors as key drivers of mental health. Our findings suggest that provider trainings and service integration, consistent with a more holistic conception of mental health, could help providers support well-being among this population.

Of 1.2 million Americans who would benefit from pre-exposure prophylaxis (PrEP), only 36% were prescribed PrEP in 2023. Project HOMES is an ongoing study that evaluates recovery residences for individuals in medication-assisted recovery from opioid use disorder across five Texas cities. Behavioral and psychosocial survey data and biomarkers were collected with a focus on the history of HIV testing, PrEP awareness, and willingness to engage in preventive treatments from a subsample of participants. Preliminary results demonstrated varying levels of HIV testing (83%), PrEP awareness (51%), and willingness to use PrEP (44%) among residents. Willingness to use PrEP was further differentiated by the method of administration, including the preference for pills (40%) and injections (40%). The findings underscore the critical role that recovery residences could play in PrEP access and addressing health care disparities among people with a history of injecting drugs.

HIV pre-exposure prophylaxis (PrEP) is a cornerstone of the Ending the HIV Epidemic plan. We evaluated sociodemographic factors associated with PrEP use in jurisdictions with high HIV diagnosis rates between the initial years of PrEP rollout in the U.S. Data were abstracted from AIDSVu, U.S. Census Bureau, and Massachusetts Institute of Technology Election Lab data for years 2012-2019. Linear mixed methods modeling was used to correlate county-level PrEP rates and correlational analysis for state-level PrEP rates (PrEP use per 100,000 persons) with year, HIV diagnoses, income, insurance coverage, proportion of Democratic votes for president in 2020, race, and geographic location. Sociodemographic factors such as income, race, and political affiliation were significantly associated with county- and state-level PrEP use. Further research to understand policy differences that lead to inequitable provision of PrEP is needed.