HIV Research & Clinical Practice最新文献

{"title":"An HIV long-term survivor and activist's perspective on HIV cure-related research - Nelson vergel.","authors":"Nelson Vergel","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2328408"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140193686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to HIV rapid start among New Jersey providers.","authors":"Debbie Y Mohammed, Russell Brewer, Jason Leider, Eugene Martin, Sunny Choe","doi":"10.1080/25787489.2024.2402140","DOIUrl":"10.1080/25787489.2024.2402140","url":null,"abstract":"<p><strong>Background: </strong>Rapid Start ensures that persons with HIV initiate antiretroviral therapy in less than seven days after diagnosis. Benefits of Rapid Start include timely linkage to medical care, viral suppression in a shorter time and improved retention to medical care. Despite these benefits, there is a slow uptake of Rapid Start, in New Jersey.</p><p><strong>Objective: </strong>Identify barriers to Rapid Start among New Jersey providers.</p><p><strong>Methods: </strong>An electronic survey, consisting of 28 questions, with the following domains was administered to New Jersey providers, using Qualtrics: provider and practice characteristics (10), knowledge (1), barriers (8) and attitudes to diverse patient types (9). The results were analyzed using descriptive statistics due to small numbers over strata. Approval to conduct the survey was obtained from the William Paterson University Institutional Review Board.</p><p><strong>Results: </strong>There were 69 responses to the survey. Providers were at least 45 years old (48%), female (44/60, 73%), nurse practitioners or physician assistants (41/59, 69%). Overall, 44/63 (70%) providers did not correctly identify that integrase inhibitors had the lowest prevalence of transmitted drug resistance. Newly diagnosed patients were referred for medical care in 37 (65%) of the medical sites. Only providers from Ryan White (federally funded clinics for persons with HIV) (64%) and non-Ryan White (73%) public sites reported co-located HIV testing sites. Seventy percent of medical sites offered same-day medical appointments. However, a lower proportion of private (62%), public Ryan White (55%), and other medical sites (36%) offered same-day appointments compared to public non-Ryan White sites (82%). Despite having staff available 40 h per week (91%), only 55% of Ryan White sites offered extended office hours in the early morning, evenings, or on Saturdays. When compared to providers in public non-Ryan White sites, a lower proportion of providers in Ryan White sites were comfortable doing Rapid Start either on the day of or within one week of diagnosis, 82% and 72%, respectively, or starting antiretroviral therapy before genotype results were available, 55% and 46%, respectively. Overall, providers were not comfortable with Rapid Start for persons engaging in condomless sex (60%).</p><p><strong>Conclusions: </strong>Policy and administrative decisions are needed to eliminate barriers at the clinic level. An HIV clinical scholar program, to increase providers knowledge, may increase uptake of Rapid Start.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2402140"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing the IDCaRe team: an integrated and culturally-affirming approach to improving health engagement for HIV-positive veterans.","authors":"James Michael Brennan, Madison B Bailey, William Hua","doi":"10.1080/25787489.2024.2404333","DOIUrl":"10.1080/25787489.2024.2404333","url":null,"abstract":"<p><strong>Background: </strong>Veterans Health Administration (VHA) has been at the forefront of offering integrated and patient-centered care to address the complex needs of more than 30,000 Veterans with HIV in the United States of America. These Veterans present with diverse cultural identities, personal values, and goals pertinent to their care, and they are often managing multiple comorbid chronic conditions, mental health diagnoses, and psychosocial stressors alongside HIV. The quality of their care has often been affected by stigma, minority stress, and the quality of the patient-provider relationship and associated collaborations over treatment approaches and goals, which has a direct effect on outcomes.</p><p><strong>Objective: </strong>At San Francisco VA Health Care System, the Infectious Disease Care and Resilience (IDCaRe) team was established to improve outcomes for Veterans with acute needs or persistent difficulties in care delivery and efficacy.</p><p><strong>Method: </strong>A five-step model to address complex needs in HIV care was adapted from existing literature and evidence base, combined with a culturally-aligned, interdisciplinary care orientation. This model was implemented with patients determined to be at high-risk for poor health engagement. A representative composite case study demonstrates the process.</p><p><strong>Results: </strong>Three Veterans underwent the intervention with results presented. Lessons learned and future discussions are also discussed.</p><p><strong>Conclusion: </strong>The IDCaRe model has promise as an integrated, patient-centered, behaviorally-grounded intervention for improving HIV-related care outcomes for Veterans with complex needs.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2404333"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors driving decisions in the use of HIV pre-exposure prophylaxis: a real-world study in the United States.","authors":"Yohance Whiteside, Abigail McMillan, Fritha Hennessy, Phoebe Salmon, Tim Holbrook, Bekana K Tadese","doi":"10.1080/25787489.2024.2382552","DOIUrl":"10.1080/25787489.2024.2382552","url":null,"abstract":"<p><p><b>Background:</b> Uptake of pre-exposure prophylaxis (PrEP) in the United States (US) remains below target, despite reported high efficacy in prevention of HIV infection and being considered as a strategy for ending new HIV transmissions. Here, we sought to investigate drivers for PrEP use and barriers to increased uptake using real-world data. <b>Methods:</b> Data were drawn from the Adelphi PrEP Disease Specific Programme^™, a cross-sectional survey of PrEP users and PrEP non-users at risk for HIV and their physicians in the US between August 2021 and March 2022. Physicians reported demographic data, clinical characteristics, and motivations for prescribing PrEP. PrEP users and non-users reported reasons for or against PrEP use, respectively. Bivariate analyses were performed to compare characteris tics of users and non-users. <b>Results:</b> In total, 61 physicians reported data on 480 PrEP users and 121 non-users. Mean ± standard deviation of age of users and non-users was 35.3 ± 10.8 and 32.5 ± 10.8 years, respectively. Majority were male and men who have sex with men. Overall, 90.0% of users were taking PrEP daily and reported fear of contracting HIV (79.0%) and having at-risk behaviors as the main drivers of PrEP usage. About half of non-users (49.0%) were reported by physicians as choosing not to start PrEP due to not wanting long-term medication. PrEP stigma was a concern for both users (50.0%) and non-users (65.0%). More than half felt that remembering to take PrEP (57.0%) and the required level of monitoring (63.0%) were burdensome. <b>Conclusions:</b> Almost half of people at risk for HIV were not taking PrEP due to not wanting long-term daily medication and about half of current PrEP users were not completely adherent. The most common reason for suboptimal adherence was forgetting to take medication. This study highlighted drivers for PrEP uptake from physician, PrEP user, and non-user perspectives as well as the attributes needed in PrEP products to aid increased PrEP uptake.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2382552"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenting with HIV: a patient's view on updated infant feeding guidelines in the US.","authors":"Ciarra Covin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2357871"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the lived experience research priorities for improving health-related quality of life in people living with HIV with cognitive impairment.","authors":"Kate Alford, Jaime H Vera, John Hammond, Stephanie Daley","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>People living with HIV experience higher rates of cognitive impairment (CI), and at younger ages, than the general population. These individuals report poor health-related quality of life (HRQL), however, interventions aimed at assisting people living with HIV to live well with CI do not currently exist and represent an important un-met need in this population.</p><p><strong>Objective: </strong>This study aimed to identify the lived experience research priorities for improving HRQL and identify interventions to support priority areas.</p><p><strong>Methods: </strong>A Research Advisory Group was established with 15 lived experience, academic, healthcare, and third sector professionals. Additionally, two semi-structured focus groups were undertaken, with health and third sector professionals and people living with HIV with CI. Participants were asked to rank factors impacting HRQL, identified in prior research, in terms of priority and intervention development. Findings were analysed using a combination of conventional and summative content analysis. Study findings were feedback to our Research Advisory Group.</p><p><strong>Results: </strong>Five people living with HIV with CI, recruited through third sector agencies [Male 80%; median age 59 (range 56-78); White British 60%; homosexual 60%], and three healthcare and third sector participants (66% third sector professionals from two local HIV charities; 33% HIV-specific clinical psychologist) took part in two focus groups and ranked interventions targeting improvement in physical function, social connectedness, cognition and perceived control over cognitive health as priority areas. Findings were then fed back to the Research Advisory Group who recommended the development of an illness-specific cognitive rehabilitation programme and improved information provision as important avenues for intervention development.</p><p><strong>Conclusion: </strong>Given the absence of meaningful patient and public involvement, intervention, and support guidelines for people living with HIV with CI, this provides a roadmap for future research in this important and growing area of HIV clinical care.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2358724"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond community engagement: perspectives on the meaningful involvement of people with HIV and affected communities (MIPA) in HIV cure research in The Netherlands.","authors":"Tamika A Marcos, Kai J Jonas, Maaike A J Noorman, Chantal den Daas, John B F de Wit, Sarah E Stutterheim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Meaningful involvement of people with HIV and affected communities in HIV cure research is essential to ensuring that cure research efforts are conducted transparently, socially justly, and ethically. This study set out to investigate how people with HIV and affected communities are involved in cure research in the Netherlands and explore what can be done to optimize involvement and engagement.</p><p><strong>Methods: </strong>Eighty-five semi-structured online, telephone, and face-to-face interviews were conducted with people with HIV (<i>N</i> = 30), key populations (<i>N</i> = 35), and key informants (KI; <i>N</i> = 20) in the field of HIV. The interviews were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Awareness of the meaningful involvement of people with HIV (MIPA) efforts was low among people with HIV and key populations, which contrasted with KI, who exhibited greater awareness. People with HIV and KI emphasized the importance of MIPA in ensuring the representation of lived experiences in HIV cure research and fostering trust between communities and researchers. Practical implementations of MIPA were unclear, ultimately resulting in difficulties defining MIPA beyond clinical trial participation. People with HIV and key populations also doubted their skills and self-efficacy to make meaningful contributions when confronted with involvement beyond participating in research and clinical trials.</p><p><strong>Conclusions: </strong>MIPA is crucial for improving the quality, transparency, and ethical conduct of HIV cure research. It emphasizes the need for increased awareness and funding, standardized guidelines to ensure meaningful involvement, and combat tokenism and misconceptions.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2335454"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised control trial of BIC/F/TAF vs DRV/c/F/TAF in context of HIV test-and-treat, BicTnT.","authors":"Gary Whitlock, Sarah Fidler, Amanda Clarke, Sujin Kang, Arnold Xhikola, Ana Milinkovic, Alfredo Soler-Carracedo, Merle Henderson, Tanya Adams, Ishrat Jahan, Akif Khawaja, Graham Taylor, Marta Boffito","doi":"10.1080/25787489.2024.2400453","DOIUrl":"10.1080/25787489.2024.2400453","url":null,"abstract":"<p><strong>Background: </strong>Head-to-head data for bictegravir/emtricitabine/tenofovir alafenamide (BIC/F/TAF; B) and darunavir/cobicistat/emtricitabine/tenofovir alafenamide (DRV/c/F/TAF; D) are lacking in the context of rapid antiretroviral therapy (ART) initiation. This study, BIC-T&T, evaluates the efficacy and tolerability of B vs D in a UK test-and-treat setting.</p><p><strong>Setting: </strong>BIC-T&T was a randomised, open-label, multi-centre, study in which participants initiated ART within 14 days after confirmed HIV-1 diagnosis before baseline laboratory.</p><p><strong>Methods: </strong>The primary endpoint is the virological response (HIV RNA < 50copies/mL) at week 12 by time-weighted average change in log₁₀ HIV RNA recorded in viral load assays from treatment initiation to week 12, using two-sample Wilcoxon rank-sum test.</p><p><strong>Results: </strong>36 participants were randomised: 94% were male, 53% white; mean (SD) age was 35 years (11.8). Baseline mean (±SD) log₁₀ HIV-RNA was 4.79 (± 0.87) log₁₀ copies/mL and CD4 505 (±253) cells/mm³. The mean (±SD) time from confirmed HIV diagnosis to ART initiation was 7.9 (± 3.7) days. The time-weighted mean decrease in log₁₀ HIV RNA from treatment initiation to week 12 was significantly greater in B in comparison to D (3.1 vs. 2.6 log₁₀ copies/mL, <i>p</i> < 0.001). Both regimens demonstrated good tolerability with infrequent laboratory abnormalities and no grade 3 or 4 adverse events.</p><p><strong>Conclusion: </strong>In this first head-to-head study in the context of ART initiation, HIV RNA decline from baseline to week 12 was significantly more rapid for BIC/F/TAF compared with DRV/c/F/TAF.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2400453"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare worker perspectives on HIV status sharing intervention components for partnered, Black sexual minority men in South Africa.","authors":"Michael P Barry, Remco P H Peters, Sarah Portle, Cikizwa Bongo, Dawie Nel, Helen E Struthers, Joseph Daniels","doi":"10.1080/25787489.2024.2424040","DOIUrl":"10.1080/25787489.2024.2424040","url":null,"abstract":"<p><strong>Background: </strong>Globally, there is suboptimal coverage of antiretroviral treatment to treat and prevent HIV. It is crucial for individuals to know their partner's HIV status so they may use all appropriate and available prevention tools. For sexual minority men in South Africa, a population known to face intersecting forms of marginalization including a disparate burden of HIV incidence, there are challenges to status sharing.</p><p><strong>Objective: </strong>We explore perspectives of healthcare workers (HCW) with expertise providing services to sexual minority men to identify strategies to support HIV status sharing.</p><p><strong>Methods: </strong>As part of a larger study designed to improve HIV-related health outcomes for sexual minority men, we conducted one focus group discussion (participant <i>n</i> = 4) and two in-depth-interviews with HCW. We used thematic analysis to synthesize qualitative themes and identify corresponding implications for interventions.</p><p><strong>Results: </strong>HCW each had 5-23 years of experience. We identified three implementation considerations to support sharing of HIV status: (1) ensuring partner support for sharing status while circumventing risk of personal harms, (2) facilitating concordant couple-based peer support and belonging, and (3) leveraging the strengths of mass media as educational tools.</p><p><strong>Conclusion: </strong>HCW highlighted that sharing that one is living with HIV is a sensitive and potentially dangerous process that can be managed by involving both partners in the process. This process may be supported by incorporating HIV status sharing narratives in popular media.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2424040"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening person-centered care through quality improvement: a mixed-methods study examining implementation of the Person-Centered Care Assessment Tool in Zambian health facilities.","authors":"Amy Casella, Adamson Paxon Ndhlovu, Jessica E Posner, Lackeby Kawanga, Peteria Chan, Malia Duffy, Caitlin Madevu-Matson, Jemmy M Musangulule","doi":"10.1080/25787489.2024.2378585","DOIUrl":"10.1080/25787489.2024.2378585","url":null,"abstract":"<p><strong>Introduction: </strong>Person-centered care (PCC) is considered a fundamental approach to address clients' needs. There is a dearth of data on specific actions that HIV treatment providers identify as priorities to strengthen PCC.</p><p><strong>Objective: </strong>This study team developed the Person-Centered Care Assessment Tool (PCC-AT), which measures PCC service delivery within HIV treatment settings. The PCC-AT, including subsequent group action planning, was implemented across 29 facilities in Zambia among 173 HIV treatment providers. Mixed-methods study objectives included: (1) identify types of PCC-strengthening activities prioritized based upon low and high PCC-AT scores; (2) identify common themes in PCC implementation challenges and action plan activities by low and high PCC-AT score; and (3) determine differences in priority actions by facility ART clinic volume or geographic type.</p><p><strong>Methods: </strong>The study team conducted thematic analysis of action plan data and cross-tabulation queries to observe patterns across themes, PCC-AT scores, and key study variables.</p><p><strong>Results: </strong>The qualitative analysis identified 39 themes across 29 action plans. A higher proportion of rural compared to urban facilities identified actions related to stigma and clients' rights training; accessibility of educational materials and gender-based violence training. A higher proportion of urban and peri-urban compared to rural facilities identified actions related to community-led monitoring.</p><p><strong>Discussion: </strong>Findings provide a basis to understand common PCC weaknesses and activities providers perceive as opportunities to strengthen experiences in care.</p><p><strong>Conclusion: </strong>To effectively support clients across the care continuum, systematic assessment of PCC services, action planning, continuous quality improvement interventions and re-measurements may be an important approach.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2378585"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}