AIDS and Behavior最新文献

Suicide Risk (SR) and the COVID-19 pandemic affected People with HIV (PWH) disproportionately in comparison with the general population, but little information on SR during and after the COVID-19 lockdown on the Latino PWH has been described, therefore, this study aimed to describe SR in PWH attended the HIV clinic before (2018-2019), during (2020), and after (2021-2022) the COVID-19 lockdown, the trend of SR, and the factors associated. Three standardized questions from the "Columbia-Suicide Severity Rating Scale" (C-SSRS) were routinely applied as screening for suicide risk to all PWH attending their clinical visits during 2018-2022. We estimated suicidality risk and rate. We compared sociodemographic characteristics in those with and without SR. We evaluated the potential association of SR with the calendar year before, during, and after the COVID-19 lockdown using a mixed-effects logistic regression. A total of 2330 patients were seen during the study period; 2157 (93%) were evaluated for suicidality at least once, of those, 75 (3.5%) had SR. Those with SR compared with non-SR were more frequently women (20% vs 10%) and with a heterosexual HIV transmission route (29% vs 23%). SR rates per 1000 patients-day among those evaluated were 0.03 in 2018, 0.25 in 2019, 3.16 in 2020, 7.0 in 2021 and 11.98 in 2022. Throughout the model, independently of covariables, a significant increase in the OR of SR was observed in these years compared to 2018: 1.07 in 2019; 2.74 in 2021; and 4.82 in 2022, except in 2020, OR = 0.18.

The emergency department (ED) is an important setting to identify people at increased risk of HIV infection who may benefit from HIV pre-exposure prophylaxis (PrEP). However, prescribing or referral for PrEP in the ED is not widespread. The purpose of this study is to evaluate the use of an off-site HIV PrEP patient navigator to facilitate PrEP access for patients who seek care for sexually transmitted infections (STIs) in the ED. Between January 1, 2023 and June 30, 2023, patients who tested positive for a bacterial STI in the ED were eligible for outreach by an off-site PrEP patient navigator. Interested patients were scheduled for telehealth appointments for PrEP. Demographic, clinical information and outcomes were obtained. During the study period, there were 160 patients eligible for PrEP outreach. Outreach was completed in 75 (47%) of patients, with 46/75 (61%) agreeable to scheduling a PrEP appointment. Of these 46 patients, median age was 30 years old [IQR 23, 35], 25 (54%) were male, 40 (87%) were Black/African American and 6 (13%) identified as men who have sex with men (MSM). Forty three of 46 interested patients (93%) scheduled an appointment and 35/46 (76%) completed an appointment. Thirteen of 35 (37%) patients who completed an appointment were prescribed PrEP, with 6/13 (46%) and 2/13 (15%) remaining on PrEP at 3 and 6 months, respectively. Use of an off-site patient navigator can facilitate referrals for HIV PrEP for patients who are diagnosed with bacterial STIs in the ED.

Expanding HIV cluster detection using molecular HIV surveillance (MHS) raises ethical and social concerns, which may impede HIV outbreak detection and response as well as deter people living with HIV from seeking care. This underscores the need for effective communication strategies. We examined two methods for explaining MHS among men who have sex with men (MSM) living with HIV and at-risk without HIV in the United States. Participants recruited during the 2021 American Men's Internet Survey (AMIS) were randomized to view a brief video (N = 822) or text (N = 1701) explaining MHS. Respondents with high video engagement were less likely to be concerned about MHS. In the text group, discomfort with MHS decreased as awareness of different public health activities increased. Overall, information about MHS and increased awareness of it improved its acceptability. Effective communication is an essential prerequisite for meaningfully engaging stakeholders regarding MHS implementation in HIV prevention and control efforts.

HIV incidence among transgender women remains high and disproportionately impacts young, Black, and Latina transgender women. Data on preferred PrEP modalities among this population are limited. Participants in The LITE Cohort completed a survey module on PrEP modality preferences during 24-month study visits. We summarized ranked preferences based on an exhaustive set of 10 head-to-head comparisons of 5 PrEP modalities (pill, injection, implantable device, topical gel, and intravenous antibodies) and conducted in-depth interviews to contextualize findings. Between 2020 and 2022, 789 participants completed the PrEP modality survey module. The most preferred PrEP modality was the implant (ranked first among 45% of respondents), followed by pill (21%), injection (19%), gel (10%), and intravenous antibodies (4%). The implant ranked highest among Latina transgender women (36%), young adult transgender women (ages 18-24 years; 41%), those living in the South (47%), and those with PrEP indication(s) (45%), while injection was the top-ranked modality among Black transgender women (30%). Qualitative analysis of in-depth interviews (n = 45) revealed that PrEP modality preferences were individualized, context-dependent, considered gender-related factors (e.g. gender-affirming hormone injections), and informed by prior healthcare experiences, personal values, and anticipated modality-specific facilitators and barriers. Our findings suggest high interest in long-acting PrEP options, including implants and injections, and daily pills among transgender women.

Reliable and valid assessment tools are crucial for measuring alcohol use expectancies (AUE) among youth living with HIV (YLHIV). In this paper, we assess the psychometric properties of the original 17-item East Africa Alcohol Expectancy Scale (AFEXS) among Ugandan YLHIV-a scale developed and validated by Woolf-King et al. for use among Uganda adults living with HIV. Specifically, we applied the measure to a sample of 100 Ugandan YLHIV enrolled in a substance use intervention. To analyze the psychometric properties, we conducted exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and convergent validity analyses. The resulting 15-item youth AFEXS scale differed from the 11-item adult version. The 15-item Youth AFEXS demonstrated high internal consistency (α = 0.85), aligning with theoretical expectations of a three-factor structure related to sexual expectancies (7 items; α = 0.89), negative expectancies (4 items; α = 0.72), and release of inhibition expectancies (4 items; α = 0.77). The global scale and sub-scales demonstrated satisfactory convergent validity through positive correlations measures of frequency of alcohol consumption in the past 12 months: global AFEXS (r = 0.617; p = 0.000), sexual expectancies (r = 0.583; p = 0.000), negative expectancies (r = 0.618; p = 0.000), and release expectancies (r = 0.596; p = 0.000). The study confirms the youth AFEXS as a reliable and valid tool for assessing AUE among Ugandan YLHIV.

In the realm of HIV care, support groups play a pivotal role by bringing together individuals living with HIV to share experiences and receive guidance from healthcare professionals. These groups are renowned for their substantial benefits, including improving emotional well-being, enhancing treatment adherence, and fostering a strong sense of community. However, despite these advantages, there is a notable gap in Ethiopia regarding concrete evidence of their impact on key treatment outcomes. This study aims to bridge this gap by exploring how support group care influences viral suppression rates among HIV patients. The study was conducted among 259 HIV-positive individuals on ART using the EPHIA survey, employing a two-stage, stratified sampling design across urban areas in nine regions and two city administrations. Data analysis was performed using STATA version 17, and multicollinearity was assessed (VIF = 1.07). A multivariate logistic regression model was fitted, with a p-value of ≤ 0.05 considered statistically significant. Results showed that 25.12% of participants utilized HIV support groups. Those who participated in support groups were 3.14 times more likely to achieve viral load suppression compared to non-participants (AOR = 3.14, 95% CI: 1.35-6.30). This study highlights that HIV support groups significantly boost viral suppression rates, underscoring the importance of integrating these groups into standard treatment protocols. These findings underline the need for continued research to assess long-term outcomes and further optimize the effectiveness of support group care in enhancing HIV treatment outcomes.

Studies among men who have sex with men (MSM) in sub-Saharan Africa (SSA) focus mainly on HIV epidemiology, revealing little about the diversity within this population. We utilized data from the HIV Prevention Trials Network (HPTN) 075 study, to explore demographic and psychosexual characteristics of MSM in SSA who also have sex with women. Persons included in the analyses were aged 18-44 years and assigned male sex at birth and identified as male, reported anal sex with a man in the past 3 months, and had enrolled at one of four study sites (Kisumu, Kenya; Blantyre, Malawi; Cape Town and Soweto, South Africa). Nearly a quarter of the participants had recently engaged in sex with both men and women (MSMW). These men differed in terms of demographic and psychosexual characteristics, and sexual behavior from men who only had had sex with men (MSME). Compared to the latter, MSMW were more likely to prefer the insertive sexual role, reported more sexual partners in the past three months, and had more instances of condomless insertive anal intercourse with a man. These findings suggest that men who have sex with both men and women have specific characteristics and need tailored interventions that take their specific needs into account.

Sexual and gender minority youth (SGMY) are vulnerable to acquiring HIV and need HIV prevention and health services, but may have competing needs. A prior analysis found that PrEP use reports increased in a combination intervention study arm with coaching, peer support, and automated text-messages. This paper examines ancillary support and healthcare services utilization as secondary intervention objectives. SGMY (N = 895, 40% Black, 29% Latino) in Los Angeles and New Orleans were recruited from May, 2017 to August, 2019 and randomized to four intervention conditions: (a) automated text-messaging and monitoring intervention (AMMI), (b) AMMI plus peer support online (AMMI+PS), (c) AMMI plus strengths-based coaching by near-peer paraprofessionals (AMMI+C), or (d) all three (AMMI+PS+C). Intent-to-treat multivariate regression analyses evaluated the interventions' efficacy on past 4-month reports of ancillary support services use, having a regular healthcare provider, receiving care from doctor's office or clinic and mental health specialists, and participation in mental health support groups and HIV prevention programs. Ancillary services utilization reports declined from 40% of youth reporting an average of 4.4 services at baseline to 22.6% reporting 2.5 services by 24 months. Food, housing, transportation, and other basic services were utilized most frequently. Youth in the two coaching interventions maintained higher reports of services use over time compared to AMMI-only (both OR 1.23, 95%CI 1.12-1.35) and to AMMI+PS (both OR 1.20 95%CI 1.08-1.33). Our coaching intervention may support SGMY to stay engaged in support services. Results may be limited by self-report biases. It is unclear if these services are related to better long-term outcomes.

The reliance on replacement blood donors in developing countries has led to an increased prevalence of transfusion-transmitted infections (TTIs), including HIV. This systematic review and meta-analysis aimed to assess the seroprevalence of HIV among blood donors in South Asian countries and disseminate the findings in choropleth maps. In addition, gender-specific prevalence or the yearly trend of HIV prevalence among blood donors was also investigated. Following the PRISMA guidelines, we searched PubMed, Scopus, CAB abstracts, CINAHL, and Google Scholar for articles published between January 2000 and December 2022. The DerSimonian-Laird effect model was used due to the high heterogeneity of the data. Data analysis was performed using R Studio version 4.1.0, ArcGIS, and GraphPad Prism 7.0. The pooled seroprevalence of HIV among blood donors in South Asian countries was found to be 0.13%, with the highest prevalence of 0.19% in India and the lowest prevalence of 0.02% in Bangladesh and Bhutan. Female blood donors had a higher seroprevalence than their male counterparts (0.24%, vs. 0.17%). In contrast to voluntary blood donors with an HIV seroprevalence of 0.13%, replacement blood donors have a higher HIV prevalence of 0.26%. The observed high heterogeneity was attributed to variations in country, gender, type of blood donors, and study year. This study demonstrates a significant burden of HIV among blood donors in South Asia, emphasizing the need for enhanced donor screening protocols, targeted interventions and educational campaigns to ensure the safety of blood transfusion services. Future research should explore additional risk factors and focus on expanding screening methods, particularly in resource-limited settings.