Pub Date : 2024-09-27DOI: 10.1007/s10461-024-04510-z
Sylvia Shangani, Michael R Winter, Margaret Shea, Theresa W Kim, Kaku So-Armah, Kara M Magane, Scarlett L Bellamy, Richard Saitz, Michael D Stein
Poor mental health significantly impacts people with HIV (PWH) and those who drink alcohol. Limited data exist on the combined effects of social determinants of health (social vulnerability) on mental health in PWH with unhealthy substance use. We investigated the relationship between social vulnerability and poor mental health in PWH and whether this relationship differed by race/ethnicity. We conducted a cross-sectional analysis using data from the Boston ARCH Cohort among PWH with current or past unhealthy substance use. We created a 23-item social vulnerability index (SVI) using a deficit accumulation approach comprised of social determinants of health indicators. We estimated whether higher SVI score is associated with anxiety and depressive symptoms using logistic regression analysis. Among 251 participants with a mean age of 52 (SD = 10) years, 67.3% were male, 52% Black, 21% Hispanic, 19% White, and 73% unemployed. The SVI had a mean of 9.30 (SD = 3.4) with a 1.5-18 range. Nearly two in five persons reported past month heavy alcohol use and 35% illicit drug use. The prevalence of anxiety and depressive symptoms was 34.4% and 54.2% respectively. Higher SVI score was associated with anxiety symptoms (adjusted odds ratio [aOR] = 2.01, 95% confidence interval [CI] 1.46, 2.76, p ≤ 0.001), and depressive symptoms (aOR = 2.42, 95% CI 1.74, 3.36, p ≤ 0.001). Race/ethnicity did not moderate the relationship between SVI and each mental health outcome. SVI was significantly associated with poor mental health across racial/ethnicity groups in this cohort. Interventions that address social vulnerability may improve well-being and quality of life for PWH.
{"title":"Social Vulnerability and Mental Health Among People with HIV and Substance Use: The Role of Race.","authors":"Sylvia Shangani, Michael R Winter, Margaret Shea, Theresa W Kim, Kaku So-Armah, Kara M Magane, Scarlett L Bellamy, Richard Saitz, Michael D Stein","doi":"10.1007/s10461-024-04510-z","DOIUrl":"https://doi.org/10.1007/s10461-024-04510-z","url":null,"abstract":"<p><p>Poor mental health significantly impacts people with HIV (PWH) and those who drink alcohol. Limited data exist on the combined effects of social determinants of health (social vulnerability) on mental health in PWH with unhealthy substance use. We investigated the relationship between social vulnerability and poor mental health in PWH and whether this relationship differed by race/ethnicity. We conducted a cross-sectional analysis using data from the Boston ARCH Cohort among PWH with current or past unhealthy substance use. We created a 23-item social vulnerability index (SVI) using a deficit accumulation approach comprised of social determinants of health indicators. We estimated whether higher SVI score is associated with anxiety and depressive symptoms using logistic regression analysis. Among 251 participants with a mean age of 52 (SD = 10) years, 67.3% were male, 52% Black, 21% Hispanic, 19% White, and 73% unemployed. The SVI had a mean of 9.30 (SD = 3.4) with a 1.5-18 range. Nearly two in five persons reported past month heavy alcohol use and 35% illicit drug use. The prevalence of anxiety and depressive symptoms was 34.4% and 54.2% respectively. Higher SVI score was associated with anxiety symptoms (adjusted odds ratio [aOR] = 2.01, 95% confidence interval [CI] 1.46, 2.76, p ≤ 0.001), and depressive symptoms (aOR = 2.42, 95% CI 1.74, 3.36, p ≤ 0.001). Race/ethnicity did not moderate the relationship between SVI and each mental health outcome. SVI was significantly associated with poor mental health across racial/ethnicity groups in this cohort. Interventions that address social vulnerability may improve well-being and quality of life for PWH.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1007/s10461-024-04514-9
Joseph O Orinda, Victor Mudhune, Valarie Opollo, Calvin Mbeda, Ravindre Panchia, Erica Hamilton, Sufia Dadabhai, Doerieyah Reynolds, Theodorus G M Sandfort
Use of oral pre-exposure prophylaxis (O-PrEP) for HIV prevention has not been fully utilized in sub-Saharan Africa, especially among key populations with high HIV incidence and prevalence, including men who have sex with men (MSM) and transgender women (TGW). We examined correlates of interest in O-PrEP among participants in the HIV Prevention Trials Network (HPTN) Study 075, a prospective cohort study, conducted between 2015 and 2017, across 4 sites in Kenya, Malawi, and South Africa. The study included persons assigned male sex at birth, between 18 and 44 years of age, who reported anal intercourse with a man in the past 3 months. Interest in O-PrEP and potential correlates were assessed among 297 participants who were HIV negative. 52% of the participants reported being aware of PrEP and 73% indicated interest in PrEP once informed about it. PrEP interest was not significantly associated with any of the surveyed demographic or psychosocial variables except study site. Our findings suggest a broad and general interest in O-PrEP among MSM and TGW in sub-Saharan Africa, despite relatively low awareness. While the situation around PrEP will have changed in the included countries, major questions about successful implementation still need to be addressed.
{"title":"Interest in Oral Pre-exposure Prophylaxis Among Men Who Have Sex with Men and Transfeminine Persons in HPTN 075, a Multi-center HIV Prevention Study in Sub-Saharan Africa (2015-2017).","authors":"Joseph O Orinda, Victor Mudhune, Valarie Opollo, Calvin Mbeda, Ravindre Panchia, Erica Hamilton, Sufia Dadabhai, Doerieyah Reynolds, Theodorus G M Sandfort","doi":"10.1007/s10461-024-04514-9","DOIUrl":"https://doi.org/10.1007/s10461-024-04514-9","url":null,"abstract":"<p><p>Use of oral pre-exposure prophylaxis (O-PrEP) for HIV prevention has not been fully utilized in sub-Saharan Africa, especially among key populations with high HIV incidence and prevalence, including men who have sex with men (MSM) and transgender women (TGW). We examined correlates of interest in O-PrEP among participants in the HIV Prevention Trials Network (HPTN) Study 075, a prospective cohort study, conducted between 2015 and 2017, across 4 sites in Kenya, Malawi, and South Africa. The study included persons assigned male sex at birth, between 18 and 44 years of age, who reported anal intercourse with a man in the past 3 months. Interest in O-PrEP and potential correlates were assessed among 297 participants who were HIV negative. 52% of the participants reported being aware of PrEP and 73% indicated interest in PrEP once informed about it. PrEP interest was not significantly associated with any of the surveyed demographic or psychosocial variables except study site. Our findings suggest a broad and general interest in O-PrEP among MSM and TGW in sub-Saharan Africa, despite relatively low awareness. While the situation around PrEP will have changed in the included countries, major questions about successful implementation still need to be addressed.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-26DOI: 10.1007/s10461-024-04506-9
Jason M Lo Hog Tian, James R Watson, Lynne Cioppa, Michael Murphy, Anthony R Boni, Janet A Parsons, Robert G Maunder, Sean B Rourke
HIV stigma remains a barrier to good health and understanding how social support may reduce the negative impact of stigma on health may help with designing stigma interventions. This study aims to understand how different types of social support may moderate or change the nature of the relationship between stigma and mental health. We recruited 327 participants to complete the People Living with HIV Stigma Index at baseline (t1) between August 2018 and September 2019 and at follow-up (t2) between February 2021 and October 2021. Separate moderation models were created with different types of social support (emotional/informational, tangible, affectionate, positive social interaction) as moderators, baseline stigma (internalized, enacted, anticipated) as the antecedent, and mental health (t2) as the outcome. Emotional/informational support was a significant moderator for the relationship between enacted (b = -2.12, 95% CI: -3.73, -0.51), internalized (b = -1.72, 95% CI: -3.24, -0.20), and anticipated (b = -2.59, 95% CI: -4.59, -0.60) stigma at t1 and mental health at t2. Tangible support was a significant moderator for internalized stigma (b = -1.54, 95% CI: -2.74, -0.35). Lastly, positive social interaction was a significant moderator for internalized (b = -1.38, 95% CI: -2.71, -0.04) and anticipated stigma (b = -2.14, 95% CI: -3.93, -0.36). In general, the relationship between social support and better mental health was stronger for participants with low stigma. Intervention strategies aimed at both stigma reduction and boosting social supports with different functions may be important for improving the mental health of people living with HIV.
{"title":"The Role of Dimensions of Social Support in the Relationship Between Stigma and Mental Health: A Moderation Analysis.","authors":"Jason M Lo Hog Tian, James R Watson, Lynne Cioppa, Michael Murphy, Anthony R Boni, Janet A Parsons, Robert G Maunder, Sean B Rourke","doi":"10.1007/s10461-024-04506-9","DOIUrl":"https://doi.org/10.1007/s10461-024-04506-9","url":null,"abstract":"<p><p>HIV stigma remains a barrier to good health and understanding how social support may reduce the negative impact of stigma on health may help with designing stigma interventions. This study aims to understand how different types of social support may moderate or change the nature of the relationship between stigma and mental health. We recruited 327 participants to complete the People Living with HIV Stigma Index at baseline (t<sub>1</sub>) between August 2018 and September 2019 and at follow-up (t<sub>2</sub>) between February 2021 and October 2021. Separate moderation models were created with different types of social support (emotional/informational, tangible, affectionate, positive social interaction) as moderators, baseline stigma (internalized, enacted, anticipated) as the antecedent, and mental health (t<sub>2</sub>) as the outcome. Emotional/informational support was a significant moderator for the relationship between enacted (b = -2.12, 95% CI: -3.73, -0.51), internalized (b = -1.72, 95% CI: -3.24, -0.20), and anticipated (b = -2.59, 95% CI: -4.59, -0.60) stigma at t<sub>1</sub> and mental health at t<sub>2</sub>. Tangible support was a significant moderator for internalized stigma (b = -1.54, 95% CI: -2.74, -0.35). Lastly, positive social interaction was a significant moderator for internalized (b = -1.38, 95% CI: -2.71, -0.04) and anticipated stigma (b = -2.14, 95% CI: -3.93, -0.36). In general, the relationship between social support and better mental health was stronger for participants with low stigma. Intervention strategies aimed at both stigma reduction and boosting social supports with different functions may be important for improving the mental health of people living with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1007/s10461-024-04509-6
Christine Horvat Davey, Deepesh Duwadi, J Craig Phillips, Carol Dawson-Rose, Kathleen M Nokes, Joseph Perazzo, Allison R Webel
People with HIV (PWH) are at increased risk for metabolic disorders affecting body mass index (BMI), chronic symptoms, and impaired physical function and capacity. Although physical activity improves health and well-being, PWH often do not meet activity recommendations necessary to achieve these benefits. Despite the known impact of symptoms, physical activity, and physical function on health, little is known about the relationships and interactions between these variables and BMI and maximum oxygen consumption during exercise (VO2 max) in a multinational population of PWH. We examined the relationship of BMI with PROMIS-29 measures, physical activity, strength, flexibility, and VO2 max in a diverse sample of PWH. Additionally, we examined the relationship of VO2 max with PROMIS-29 measures. Data from 810 PWH who participated in a cross-sectional study conducted by the International Nursing Network for HIV Research (Study VII) were analyzed. Participants were recruited from 8 sites across the United States, Thailand, and South Africa. BMI was calculated from collected height and weight data. Physical function and symptoms were assessed using the PROMIS-29 measure. Physical activity was assessed using the 7-day Physical Activity Recall. VO2 max was calculated using sex at birth, age, BMI and the 6-minute Walk Test. Data were analyzed using descriptive, correlational, and regression statistical analyses. Participants had an average age of 49.1 (± 11.1) years, 44% were female, and the average BMI of the sample group was 27 kg/m2 (± 6.7). Increased BMI was associated with decreased 6-minute Walk Test (β=-2.18, p < 0.001), flexibility (β=-0.279, p < 0.001), and VO2 max (β=-0.598, p < 0.001), even after controlling for covariates (age, sex at birth, country, years living with HIV, and antiretroviral therapy status). BMI was not associated with self-reported physical activity. Increased VO2 max was associated with increased physical function (β = 0.069, p < 0.001), and decreased pain (β=-0.047, p < 0.006), even after controlling for covariates (country, years living with HIV, and antiretroviral therapy status). Future research should explore development of effective and sustainable symptom self-management interventions in PWH accounting for the potential impact of BMI and VO2 max.
{"title":"Impact of Body Mass Index and VO2 Max on Symptoms, Physical Activity, and Physical Function in a Multinational Sample of People with HIV.","authors":"Christine Horvat Davey, Deepesh Duwadi, J Craig Phillips, Carol Dawson-Rose, Kathleen M Nokes, Joseph Perazzo, Allison R Webel","doi":"10.1007/s10461-024-04509-6","DOIUrl":"https://doi.org/10.1007/s10461-024-04509-6","url":null,"abstract":"<p><p>People with HIV (PWH) are at increased risk for metabolic disorders affecting body mass index (BMI), chronic symptoms, and impaired physical function and capacity. Although physical activity improves health and well-being, PWH often do not meet activity recommendations necessary to achieve these benefits. Despite the known impact of symptoms, physical activity, and physical function on health, little is known about the relationships and interactions between these variables and BMI and maximum oxygen consumption during exercise (VO<sub>2</sub> max) in a multinational population of PWH. We examined the relationship of BMI with PROMIS-29 measures, physical activity, strength, flexibility, and VO<sub>2</sub> max in a diverse sample of PWH. Additionally, we examined the relationship of VO<sub>2</sub> max with PROMIS-29 measures. Data from 810 PWH who participated in a cross-sectional study conducted by the International Nursing Network for HIV Research (Study VII) were analyzed. Participants were recruited from 8 sites across the United States, Thailand, and South Africa. BMI was calculated from collected height and weight data. Physical function and symptoms were assessed using the PROMIS-29 measure. Physical activity was assessed using the 7-day Physical Activity Recall. VO<sub>2</sub> max was calculated using sex at birth, age, BMI and the 6-minute Walk Test. Data were analyzed using descriptive, correlational, and regression statistical analyses. Participants had an average age of 49.1 (± 11.1) years, 44% were female, and the average BMI of the sample group was 27 kg/m2 (± 6.7). Increased BMI was associated with decreased 6-minute Walk Test (β=-2.18, p < 0.001), flexibility (β=-0.279, p < 0.001), and VO<sub>2</sub> max (β=-0.598, p < 0.001), even after controlling for covariates (age, sex at birth, country, years living with HIV, and antiretroviral therapy status). BMI was not associated with self-reported physical activity. Increased VO<sub>2</sub> max was associated with increased physical function (β = 0.069, p < 0.001), and decreased pain (β=-0.047, p < 0.006), even after controlling for covariates (country, years living with HIV, and antiretroviral therapy status). Future research should explore development of effective and sustainable symptom self-management interventions in PWH accounting for the potential impact of BMI and VO<sub>2</sub> max.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1007/s10461-024-04482-0
Bankole Olatosi, Rena C. Patel, Xiaoming Li
The articles in this special issue of AIDS and Behavior focus on the collision between HIV/AIDS and COVID-19 as intersecting pandemics that profoundly impacted communities globally. This editorial highlights the complex interplay between these two public health crises. The pandemic disrupted access to HIV prevention, testing, and treatment services, potentially jeopardizing decades of progress. Mental health challenges and social vulnerability among people living with HIV (PWH) were exacerbated, with preexisting health disparities amplified, disproportionately affecting marginalized populations. However, despite these challenges, the pandemic also spurred innovation and adaptation in HIV prevention and care, with increased use of telehealth and other modalities. The enduring and actionable lessons learned from the collision of HIV and COVID-19 pandemics can prepare us for the next public health challenge with two calls for action. First, we call for integrated and equitable responses that address the multifaceted challenges faced by individuals and communities affected by HIV in the post-COVID-19 era. Second, we call for a strengthened commitment to building resilient health systems and community-engaged interventions that can withstand future challenges.
{"title":"When Pandemics Collide: Actionable Lessons in HIV Prevention, Treatment and Care During the Era of COVID-19","authors":"Bankole Olatosi, Rena C. Patel, Xiaoming Li","doi":"10.1007/s10461-024-04482-0","DOIUrl":"10.1007/s10461-024-04482-0","url":null,"abstract":"<div><p>The articles in this special issue of <i>AIDS and Behavior</i> focus on the collision between HIV/AIDS and COVID-19 as intersecting pandemics that profoundly impacted communities globally. This editorial highlights the complex interplay between these two public health crises. The pandemic disrupted access to HIV prevention, testing, and treatment services, potentially jeopardizing decades of progress. Mental health challenges and social vulnerability among people living with HIV (PWH) were exacerbated, with preexisting health disparities amplified, disproportionately affecting marginalized populations. However, despite these challenges, the pandemic also spurred innovation and adaptation in HIV prevention and care, with increased use of telehealth and other modalities. The enduring and actionable lessons learned from the collision of HIV and COVID-19 pandemics can prepare us for the next public health challenge with two calls for action. First, we call for integrated and equitable responses that address the multifaceted challenges faced by individuals and communities affected by HIV in the post-COVID-19 era. Second, we call for a strengthened commitment to building resilient health systems and community-engaged interventions that can withstand future challenges.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1007/s10461-024-04507-8
Casey Orozco-Poore, Amaya Perez-Brumer, Leyla Huerta, Ximena Salazar, Aron Nunez, Africa Nakamura, Rodrigo Aguayo-Romero, Alfonso Silva-Santisteban, Sari L. Reisner
{"title":"Correction: The “Cycle” of HIV: Limits of Personal Responsibility in HIV Vulnerability among Transgender Adolescents and Young Women in Lima, Peru","authors":"Casey Orozco-Poore, Amaya Perez-Brumer, Leyla Huerta, Ximena Salazar, Aron Nunez, Africa Nakamura, Rodrigo Aguayo-Romero, Alfonso Silva-Santisteban, Sari L. Reisner","doi":"10.1007/s10461-024-04507-8","DOIUrl":"10.1007/s10461-024-04507-8","url":null,"abstract":"","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-024-04507-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The introduction of the undetectable equals untransmittable (U = U) statement significantly reduces HIV stigma and provides an empirical basis for achieving "zero transmission." U = U messaging has gained increasing support and is well-developed in several countries. However, the current status of accurate knowledge of U = U and its associated factors among men who have sex with men (MSM) in China remians unclear. We conducted a cross-sectional survey among MSM recruited in Chengdu, China, from March to May 2022 to investigate the percentage of those who knew U = U accurately and to explore associations between sexual risk behaviors, HIV testing, socio-behavioral measures, and accurate knowledge of U = U. Of 497 MSM included in our study, 23.4% (116/497) had accurate knowledge of U = U. More than half of the participants (63.2%, 314/497) reported multiple sexual partnerships, 15.7% (78/497) used substance during sex, 37.4% (186/497) reported inconsistent condom use, and 76.1% (378/497) took HIV testing in the past six months. Factors associated with accurate knowledge of U = U among MSM included substance use during sex (multivariate odds ratios ORm = 1.96; 95%CI: 1.13-3.41), HIV status tested in the last six months (ORm = 2.07; 95%CI: 1.14-3.77), HIV-related literacy (ORm = 1.41; 95%CI: 1.14-1.74) and perceived higher risk of HIV infection (ORm = 1.11; 95%CI: 1.02-1.21). The findings indicate that great challenges need to be conquered for U = U achievement among the MSM population in Chengdu, China. Intervention strategies should be prioritized in health education on high-risk behaviors such as group sex and substance use, information provision and counseling of U = U in HIV testing services, and encouraging U = U knowledge sharing among MSM with their partners in China.
不可检测等于不可传播(U = U)声明的引入大大减少了对艾滋病毒的污名化,并为实现 "零传播 "提供了经验基础。U = U 信息已获得越来越多的支持,并在一些国家得到了很好的发展。然而,中国男男性行为者(MSM)对 U = U 及其相关因素的准确认知现状尚不清楚。我们于2022年3月至5月在中国成都招募的男男性行为者中进行了一项横断面调查,以调查准确了解U = U的比例,并探讨性危险行为、HIV检测、社会行为测量和对U = U的准确了解之间的关联。在我们研究的 497 名男男性行为者中,23.4%(116/497)准确了解 U = U。超过半数的参与者(63.2%,314/497)报告有多次性伴侣关系,15.7%(78/497)在性生活中使用药物,37.4%(186/497)报告不持续使用安全套,76.1%(378/497)在过去六个月中接受了 HIV 检测。与男男性行为者准确了解 U = U 相关的因素包括:性生活中使用药物(多变量赔率 ORm = 1.96;95%CI:1.13-3.41)、过去 6 个月中接受过 HIV 检测(ORm = 2.07;95%CI:1.14-3.77)、HIV 相关知识(ORm = 1.41;95%CI:1.14-1.74)以及认为感染 HIV 的风险较高(ORm = 1.11;95%CI:1.02-1.21)。研究结果表明,要在中国成都的男男性行为人群中实现 "U = U",还需要克服巨大的挑战。干预策略应优先考虑对高危行为(如群交和药物使用)进行健康教育,在艾滋病检测服务中提供有关U = U的信息和咨询,并鼓励中国的男男性行为者与其伴侣分享U = U知识。
{"title":"Low Level of Accurate Knowledge of Undetectable Equals Untransmittable (U = U) Among Men Who Have Sex with Men (MSM) Challenges U = U Achievement in Chengdu, Southwestern China.","authors":"Zhengli Shi, Jinghua Li, Hao Lin, Xiaodong Wang, Wangnan Cao, Yuhui Shi","doi":"10.1007/s10461-024-04502-z","DOIUrl":"https://doi.org/10.1007/s10461-024-04502-z","url":null,"abstract":"<p><p>The introduction of the undetectable equals untransmittable (U = U) statement significantly reduces HIV stigma and provides an empirical basis for achieving \"zero transmission.\" U = U messaging has gained increasing support and is well-developed in several countries. However, the current status of accurate knowledge of U = U and its associated factors among men who have sex with men (MSM) in China remians unclear. We conducted a cross-sectional survey among MSM recruited in Chengdu, China, from March to May 2022 to investigate the percentage of those who knew U = U accurately and to explore associations between sexual risk behaviors, HIV testing, socio-behavioral measures, and accurate knowledge of U = U. Of 497 MSM included in our study, 23.4% (116/497) had accurate knowledge of U = U. More than half of the participants (63.2%, 314/497) reported multiple sexual partnerships, 15.7% (78/497) used substance during sex, 37.4% (186/497) reported inconsistent condom use, and 76.1% (378/497) took HIV testing in the past six months. Factors associated with accurate knowledge of U = U among MSM included substance use during sex (multivariate odds ratios ORm = 1.96; 95%CI: 1.13-3.41), HIV status tested in the last six months (ORm = 2.07; 95%CI: 1.14-3.77), HIV-related literacy (ORm = 1.41; 95%CI: 1.14-1.74) and perceived higher risk of HIV infection (ORm = 1.11; 95%CI: 1.02-1.21). The findings indicate that great challenges need to be conquered for U = U achievement among the MSM population in Chengdu, China. Intervention strategies should be prioritized in health education on high-risk behaviors such as group sex and substance use, information provision and counseling of U = U in HIV testing services, and encouraging U = U knowledge sharing among MSM with their partners in China.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1007/s10461-024-04505-w
Alexis A Bender, David J Moore, Molly M Perkins, Riley Hunt, Regine Haardörfer
The National Institutes of Health Toolbox Emotion Battery (NIHTB-EB) was developed to provide researchers and clinicians with a concise tool for measuring emotional health. The NIHTB-EB has been validated and normed in English and Spanish-speaking populations in the United States. However, its application in certain groups, such as people living with HIV (PWH) and who may use methamphetamine has not been tested. This paper evaluates the factor structure in a sample of people without HIV and PWH who may or may not use methamphetamine. The sample included 773 adults ages 18 to 87. The factorial structure of the NIHTB-EB was examined using confirmatory factor analysis (CFA) in the full sample and among four subgroups based on HIV status and methamphetamine use. The CFA confirmed a three-factor structure that mirrors the previously validated structure with latent factors measuring negative affect, social relationships, and psychological well-being for three subgroups. While each latent factor was confirmed in all groups, we could not confirm, with confidence, the full battery in the smallest subgroup (HIV-seronegative participants who use methamphetamine). The three-factor NIHTB-EB is appropriate for use among PWH who may use methamphetamine, but further examination with larger samples is warranted.
美国国立卫生研究院工具箱情绪测试(NIHTB-EB)的开发旨在为研究人员和临床医生提供一种简明的情绪健康测量工具。NIHTB-EB 已在美国英语和西班牙语人群中得到验证和规范。然而,它在某些群体中的应用,如艾滋病病毒感染者(PWH)和可能吸食甲基苯丙胺的人群,尚未经过测试。本文评估了无 HIV 感染者和可能使用或不使用甲基苯丙胺的 PWH 样本的因子结构。样本包括 773 名年龄在 18 至 87 岁之间的成年人。 在全部样本中以及在基于 HIV 感染状况和甲基苯丙胺使用情况的四个分组中,使用确证因子分析(CFA)对 NIHTB-EB 的因子结构进行了研究。CFA 证实了三因素结构,该结构与之前验证的结构一致,三个亚组的潜在因素分别测量负面情绪、社会关系和心理健康。虽然每个潜因子在所有组别中都得到了证实,但我们无法确信在最小的子组别(使用甲基苯丙胺的 HIV 阴性参与者)中证实了整个电池组。三因素 NIHTB-EB 适合用于可能吸食甲基苯丙胺的感染者,但需要对更大样本进行进一步研究。
{"title":"A Confirmatory Factor Analysis of the NIH Emotions Toolbox Among People Living with HIV and Who May Use Methamphetamine.","authors":"Alexis A Bender, David J Moore, Molly M Perkins, Riley Hunt, Regine Haardörfer","doi":"10.1007/s10461-024-04505-w","DOIUrl":"10.1007/s10461-024-04505-w","url":null,"abstract":"<p><p>The National Institutes of Health Toolbox Emotion Battery (NIHTB-EB) was developed to provide researchers and clinicians with a concise tool for measuring emotional health. The NIHTB-EB has been validated and normed in English and Spanish-speaking populations in the United States. However, its application in certain groups, such as people living with HIV (PWH) and who may use methamphetamine has not been tested. This paper evaluates the factor structure in a sample of people without HIV and PWH who may or may not use methamphetamine. The sample included 773 adults ages 18 to 87. The factorial structure of the NIHTB-EB was examined using confirmatory factor analysis (CFA) in the full sample and among four subgroups based on HIV status and methamphetamine use. The CFA confirmed a three-factor structure that mirrors the previously validated structure with latent factors measuring negative affect, social relationships, and psychological well-being for three subgroups. While each latent factor was confirmed in all groups, we could not confirm, with confidence, the full battery in the smallest subgroup (HIV-seronegative participants who use methamphetamine). The three-factor NIHTB-EB is appropriate for use among PWH who may use methamphetamine, but further examination with larger samples is warranted.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1007/s10461-024-04456-2
Colleen Dockerty, Kate Shannon, Wendee Wechsberg, Colleen Thompson, Mary Kestler, Melissa Braschel, Kathleen Deering
Women living with HIV face high social and structural inequities that place them at heightened risk for gender-based violence and mental health conditions, alongside health services access inequities, with almost no research done to better understand access to mental health services. This study therefore examined social and structural factors associated with barriers to counselling or therapy amongst women living with HIV who experienced lifetime physical and/or sexual violence in Metro Vancouver, Canada. Bivariate and multivariable logistic regression using generalized estimating equations (GEE) were used and adjusted odds ratios (AOR) and 95% Confidence Intervals ([95%CIs] are reported). From Sept/15-Aug/21, 1695 observations were collected among 279 participants. In multivariable analysis, with all variables measured in the last six months, experiencing any barriers to counselling or therapy was significantly associated with having thoughts or attempts of suicide (AOR:1.64 [1.02–2.66]), lacking coverage for health care (AOR:1.60 [1.17–2.18]), and everyday discrimination (AOR:1.02 [1.00-1.04]) and anticipated (AOR:1.57 [1.04–2.36]), enacted (AOR:1.48 [1.02–2.16]) or internalized (AOR:1.53 [1.07–2.20]) HIV stigma. Access to interdisciplinary mental health care services should be improved. Social and structural interventions to reduce HIV stigma and discrimination are urgently needed.
{"title":"Stigma, Discrimination and Other Social-Structural Factors Associated with Barriers to Counselling or Therapy among Women Living with HIV Who have Experienced Violence in Metro Vancouver, Canada","authors":"Colleen Dockerty, Kate Shannon, Wendee Wechsberg, Colleen Thompson, Mary Kestler, Melissa Braschel, Kathleen Deering","doi":"10.1007/s10461-024-04456-2","DOIUrl":"10.1007/s10461-024-04456-2","url":null,"abstract":"<div><p>Women living with HIV face high social and structural inequities that place them at heightened risk for gender-based violence and mental health conditions, alongside health services access inequities, with almost no research done to better understand access to mental health services. This study therefore examined social and structural factors associated with barriers to counselling or therapy amongst women living with HIV who experienced lifetime physical and/or sexual violence in Metro Vancouver, Canada. Bivariate and multivariable logistic regression using generalized estimating equations (GEE) were used and adjusted odds ratios (AOR) and 95% Confidence Intervals ([95%CIs] are reported). From Sept/15-Aug/21, 1695 observations were collected among 279 participants. In multivariable analysis, with all variables measured in the last six months, experiencing any barriers to counselling or therapy was significantly associated with having thoughts or attempts of suicide (AOR:1.64 [1.02–2.66]), lacking coverage for health care (AOR:1.60 [1.17–2.18]), and everyday discrimination (AOR:1.02 [1.00-1.04]) and anticipated (AOR:1.57 [1.04–2.36]), enacted (AOR:1.48 [1.02–2.16]) or internalized (AOR:1.53 [1.07–2.20]) HIV stigma. Access to interdisciplinary mental health care services should be improved. Social and structural interventions to reduce HIV stigma and discrimination are urgently needed.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-20DOI: 10.1007/s10461-024-04513-w
Cathy J Reback, Demetria Cain, Joshua A Rusow, David Benkeser, Lindsey Schader, Bevin A Gwiazdowski, Simone J Skeen, Marissa Hannah, Marvin Belzer, Marne Castillo, Kenneth H Mayer, Mary E Paul, Jonathan Hill-Rorie, Nathan Dorcey Johnson, Julie McAvoy-Banerjea, Travis Sanchez, Lisa B Hightow-Weidman, Patrick S Sullivan, Keith J Horvath
TechStep was a technology-based trial, with a stepped care approach, to reduce sexual risks and increase PrEP uptake among transgender and gender expansive youth and young adults (15-24 years old). From October 2019 to September 2021, 254 participants were randomized into: 1) Text (n = 82), or 2) Webapp (n = 87), or 3) Control (n = 85). At the 3-month follow-up assessment, those randomized to Text and Webapp and did not demonstrate improvement on primary outcomes were re-randomized to receive virtual eCoaching (Text + or Webapp +), or to remain in their initial condition without eCoaching. Results showed no effect on condomless encounters at 6-month, the primary endpoint, when comparing the Webapp + (0.33 decrease; 95%CI: -0.01, 0.67, p-value = 0.057) or the Text + (0.27 decrease; 95%CI: -0.13, 0.68, p-value = 0.181) conditions to the Control condition. However, in secondary analyses, condomless encounters were significantly reduced for Text compared to Control. The rate of PrEP uptake was low for all study arms.Trial registration: Clinical Trials # NCT04000724 (registered June 26, 2019).
{"title":"Technology-Based Interventions, with a Stepped Care Approach, for Reducing Sexual Risk Behaviors and Increasing PrEP Initiation Among Transgender and Gender Expansive Youth and Young Adults.","authors":"Cathy J Reback, Demetria Cain, Joshua A Rusow, David Benkeser, Lindsey Schader, Bevin A Gwiazdowski, Simone J Skeen, Marissa Hannah, Marvin Belzer, Marne Castillo, Kenneth H Mayer, Mary E Paul, Jonathan Hill-Rorie, Nathan Dorcey Johnson, Julie McAvoy-Banerjea, Travis Sanchez, Lisa B Hightow-Weidman, Patrick S Sullivan, Keith J Horvath","doi":"10.1007/s10461-024-04513-w","DOIUrl":"https://doi.org/10.1007/s10461-024-04513-w","url":null,"abstract":"<p><p>TechStep was a technology-based trial, with a stepped care approach, to reduce sexual risks and increase PrEP uptake among transgender and gender expansive youth and young adults (15-24 years old). From October 2019 to September 2021, 254 participants were randomized into: 1) Text (n = 82), or 2) Webapp (n = 87), or 3) Control (n = 85). At the 3-month follow-up assessment, those randomized to Text and Webapp and did not demonstrate improvement on primary outcomes were re-randomized to receive virtual eCoaching (Text + or Webapp +), or to remain in their initial condition without eCoaching. Results showed no effect on condomless encounters at 6-month, the primary endpoint, when comparing the Webapp + (0.33 decrease; 95%CI: -0.01, 0.67, p-value = 0.057) or the Text + (0.27 decrease; 95%CI: -0.13, 0.68, p-value = 0.181) conditions to the Control condition. However, in secondary analyses, condomless encounters were significantly reduced for Text compared to Control. The rate of PrEP uptake was low for all study arms.Trial registration: Clinical Trials # NCT04000724 (registered June 26, 2019).</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}