JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Lessons Learned in Engaging Adolescents and Young Adults to End the US HIV Epidemic.","authors":"Kathryn Macapagal, Marie C D Stoner, Carly E Guss, Adam C Sukhija-Cohen, Corrina Moucheraud, Parya Saberi, Allysha C Maragh-Bass","doi":"10.1097/QAI.0000000000003616","DOIUrl":"10.1097/QAI.0000000000003616","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and young adults (AYA) in the United States are disproportionately affected by HIV. Few interventions are designed to reduce new HIV infections for AYA populations or take AYA's developmental state into consideration.</p><p><strong>Setting: </strong>Ending the HIV Epidemic in the US (EHE) priority areas in California, Florida, Illinois, Massachusetts, and North Carolina.</p><p><strong>Methods: </strong>Thematic synthesis of 5 EHE projects was completed. Methodologic commonalities were identified and summarized across projects to identify key lessons learned.</p><p><strong>Results: </strong>Engaging methods used by and accessible to AYA were central to study recruitment, and to the dissemination of health information for educational purposes. Lessons learned included use of social media and other creative methods for recruitment, retention, and dissemination of study activities; engaging AYA virtually and face-to-face; and ensuring equitable, timely monetary compensation and meaningful benefits to AYA participants.</p><p><strong>Conclusions: </strong>Researchers and public health officials should incorporate AYA developmental context and experiences throughout the research and implementation process. This necessitates community and AYA-engaged research, intervention development, implementation, and dissemination. Future directions include expanding these efforts to communities outside of EHE areas and outside the United States, and ensuring that HIV research and interventions focus not just on individual AYA, but also on the systems and people that bear on their health and well-being (eg, health care providers, supportive adults, schools, laws, and policies).</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"98 5S","pages":"e88-e97"},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Re-Engagement Into HIV Care Among Adults in the Swiss HIV Cohort Study.","authors":"Andreas D Haas, Katharina Kusejko, Matthias Cavassini, Huldrych Günthard, Marcel Stöckle, Alexandra Calmy, Enos Bernasconi, Patrick Schmid, Matthias Egger, Gilles Wandeler","doi":"10.1097/QAI.0000000000003597","DOIUrl":"10.1097/QAI.0000000000003597","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about the clinical status of persons with HIV who re-engage in care after an interruption. We evaluated the immunologic and clinical characteristics of individuals re-engaging in care within the Swiss HIV Cohort Study.</p><p><strong>Methods: </strong>Participants who re-engaged in care after an interruption >14 months with a viral load ≥100 copies/mL were classified as having interrupted antiretroviral therapy (ART). We defined late re-engagement as re-engaging with a CD4 cell count of <350 cells/µL or a new Centers for Disease Control and Prevention stage C disease. Linear and logistic regression models with restricted cubic splines were used to estimate the mean CD4 cell count at re-engagement and the probability of late re-engagement as a function of care interruption duration.</p><p><strong>Results: </strong>Of 14,864 participants with a median follow-up of 10.2 years (interquartile range 4.7-17.2 years), 2768 (18.6%) interrupted care, of whom 1489 (53.8%) re-engaged. Among those re-engaging, 62.3% had interrupted ART. For participants who interrupted ART, the mean CD4 count declined from 374 cells/µL [95% confidence interval (CI): 358 to 391 cells/µL] before the interruption to 250 cells/µL (95% CI: 221 to 281 cells/µL) among those re-engaging after 14 months, and to 185 cells/µL (95% CI: 160 to 212 cells/µL) among those re-engaging after 60 months. The estimated risk of late re-engagement in care was 68.6% (95% CI: 62.3% to 74.4%) for participants who interrupted ART for 14 months and 75.2% (95% CI: 68.9% to 80.6%) for those who interrupted ART for 60 months.</p><p><strong>Conclusions: </strong>Although HIV care interruptions are not very common in Switzerland, most persons with HIV re-engaging after interrupting ART return with late-stage HIV.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"491-500"},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generating Evidence for Effective HIV Implementation at Scale: The Value and Feasibility of a Network for Implementation Science in HIV.","authors":"Sheree Schwartz, Nanette Benbow, Russell A Brewer, Laura K Beres, Debbie L Humphries, Latesha E Elopre, Sung-Jae Lee, Maile Y Karris, Joseph G Rosen, Jessica Kassanits, Aadia Rana, Jill Blumenthal, Joyce L Jones, Robin Gaines Lanzi, Uyen Kao, Tequetta Valeriano, Alison Hamilton, Brian Mustanski, Sten H Vermund","doi":"10.1097/QAI.0000000000003627","DOIUrl":"10.1097/QAI.0000000000003627","url":null,"abstract":"<p><strong>Abstract: </strong>The Network for Implementation Science in HIV (NISH) was established to conduct multisite research to study real-world implementation of evidence-based HIV interventions across US contexts, and to generate generalizable knowledge around implementation strategies to support the achievement of Ending the HIV Epidemic goals. NISH sites represent diverse Ending the HIV Epidemic priority jurisdictions and include participation of multiple units within those sites (eg, multiple clinics and community-based organizations) and bring together research teams from multiple backgrounds within implementation science and the HIV service sector. We argue and provide examples of how NISH studies have and can contribute to the context versus generalizability debate, generate power in numbers, and synthesize, develop, and test implementation strategies that advance both effectiveness and equity. To date, the network has conducted observational studies exploring ongoing implementation and determinants across contexts, and the identification and codesign of strategies to be leveraged in future work. The next stage of network evolution is to leverage this infrastructure to test implementation strategies through nimble study designs built for fast-changing evidence and implementation environments. We argue that the initial successes of NISH warrant future investment to efficiently capitalize on developed infrastructure and optimize science that can effectively be scaled up to address our most critical questions to end the HIV epidemic and support communities most affected.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"98 5S","pages":"e59-e67"},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Implementation Science to End the HIV Epidemic in the United States: Progress and Opportunities for Federal Agencies.","authors":"Christopher Gordon, Linda J Koenig, Demetrios Psihopaidas, Eric Refsland, Rebecca Mandt","doi":"10.1097/QAI.0000000000003629","DOIUrl":"10.1097/QAI.0000000000003629","url":null,"abstract":"<p><strong>Abstract: </strong>Implementation science has emerged and matured as an essential field for HIV treatment and prevention, designed to bridge the gap between research and practice by identifying opportunities to overcome barriers to implementation of effective interventions, and to accelerate the replication and scale-up of HIV care innovations. In this article, we describe activities and collaborations among the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the National Institutes of Health to optimize the impact of national federal funding opportunities aimed at identifying effective and replicable HIV care and prevention interventions, improving HIV health outcomes, and reducing HIV incidence in the U.S. These activities are outlined in the context of the Ending the HIV Epidemic in the U.S. Initiative, which was enacted across U.S. Department of Health and Human Services agencies, providing new funding and outlining an operational plan to further guide federal agencies in their specific roles and funding areas.In describing these activities and opportunities, we aim to demonstrate how implementation science is being increasingly leveraged to accelerate progress towards ending HIV through scale-up and dissemination efforts. Continued collaboration through federal implementation science will be instrumental in reaching Ending the HIV Epidemic goals.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"98 5S","pages":"e10-e16"},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language Justice in Implementation Science: Experiences Working With Latinxs to End the HIV Epidemic.","authors":"Carlos E Rodriguez-Diaz, Jahn Jaramillo, Yaiomy Santiago-Rivera, Audrey Harkness, Valeria D Cantos, Albert Liu, Susan Buchbinder, Carlos S Saldana, Karina Gonzalez, Souhail M Malavé-Rivera, Nequiel Reyes, Janie Vinson, Jane Y Scott, Robin Gaines Lanzi, Bertha Hidalgo","doi":"10.1097/QAI.0000000000003630","DOIUrl":"10.1097/QAI.0000000000003630","url":null,"abstract":"<p><strong>Abstract: </strong>HIV continues to affect populations made socially vulnerable, including Latinx groups. For Spanish-speaking people, there are additional social factors that increase their vulnerability. How we communicate, mainly language, is fundamental to achieving expected outcomes when implementing health interventions. In this article, we address the issue of language justice and how it has been applied to meet the needs of Spanish-speaking Latinx populations in different locations in the United States when conducting HIV implementation science research. Language justice can inform HIV implementation science research to be inclusive, equitable, and reflective of the diverse populations aimed to serve, ultimately leading to a more just health care system and better health outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"98 5S","pages":"e104-e110"},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communities Started the End of the HIV Epidemic: Experiences With and Recommendations for Conducting Community-Engaged HIV Implementation Research.","authors":"Carlos E Rodriguez-Diaz, Mamaswatsi P Kopeka, Waimar Tun, Edda I Santiago-Rodriguez, José J Mulinelli Rodríguez, DeMarc A Hickson, Dana Watnick, Donaldson F Conserve","doi":"10.1097/QAI.0000000000003631","DOIUrl":"10.1097/QAI.0000000000003631","url":null,"abstract":"<p><strong>Abstract: </strong>Communities of people living with or impacted by HIV have been at the forefront of HIV research, from identifying the health priorities to advocating for the development and implementation of interventions that benefit affected populations and individuals. Community engagement is considered fundamental for successful implementation of science projects. However, researchers have acknowledged the limited guidance on community engagement for implementation science research. Some recommendations have been made for community engagement in implementation sciences, but conducting HIV implementation research must consider the unique challenges of addressing the stigma and disenfranchisement of the populations affected. Despite the specific difficulties for community-engaged implementation science research, there are successful experiences and lessons learned that could support future fruitful experiences. This publication aims to share recommendations for community-engaged HIV implementation research based on the expertise of community-academic partnerships. These recommendations include the perspectives of academic and community partners. Community engagement in HIV implementation research will be needed beyond ending the epidemic. The future of community engagement in research may lay in embracing the constant change and securing the mechanisms to respond to it.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"98 5S","pages":"e80-e87"},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not a Monolith: Regional HIV Implementation Science Lessons With Latino/a/x Populations.","authors":"Harita S Shah, Pedro Alonso Serrano, Carlos E Rodriguez-Diaz, Kathleen R Page, Jonathan Ross, Sarah M Wilson, Valeria D Cantos","doi":"10.1097/QAI.0000000000003611","DOIUrl":"10.1097/QAI.0000000000003611","url":null,"abstract":"<p><strong>Abstract: </strong>HIV incidence is increasing among Latino/a/x individuals in the United States, especially among young Latino/x gay, bisexual, and sexual minority men. Latino/a/x populations face heightened structural and social barriers to effective interventions for HIV prevention, including pre-exposure prophylaxis, and across the HIV care continuum. Implementation science provides a timely methodology for developing, testing, and scaling effective interventions into practice. Implementation science considers a specific population's priorities and environment, which is especially relevant given the diversity of Latino/a/x populations. In this article, we present lessons learned from our group's experiences leading HIV-related implementation research with various Latino/a/x populations in the United States and Puerto Rico. We highlight the importance of structural and social determinants of health, community-engaged research, and culturally tailored interventions to address HIV disparities. Implementation researchers and institutional leaders can leverage these lessons learned to drive the multilevel change needed to end the HIV epidemic among Latino/a/x populations.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"98 5S","pages":"e98-e103"},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the US Health Workforce to End the HIV Epidemic: Lessons Learned From 11 Ending the HIV Epidemic Jurisdictions.","authors":"Phillip L Marotta, Debbie Humphries, Daniel Escudero, David A Katz, Joseph G Rosen, Samantha Veronica Hill, Jennifer L Glick, Dennis H Li, Latosha Elopre, Fatemeh Ghadimi, Rinad S Beidas, Jose Bauermeister, Stephen Bonett, Drew B Cameron, LaRon E Nelson, Serena Rajabiun, Larry R Hearld, Mansoorah Kermani, Sarah Stoltman, Darjai Payne, Tobeya Ibitayo, Faiad Alam, Amanda Williams, Corilyn Ott, Emma Kay, Sarah Chrestman, Scott Batey, Laramie R Smith, Robin Gaines Lanzi, Karen Musgrove, Mayra Malagon, Jeannette Bailey-Webb, Florence Momplaisir, Robert Gross, Gregory Gross, Taylor Kaser, Tawnya Brown, Chelsey R Carter, Michael Mugavero, Tequetta Valeriano, Sarah Shaw, Anjuli D Wagner, Bakari Atiba, Russell A Brewer","doi":"10.1097/QAI.0000000000003625","DOIUrl":"10.1097/QAI.0000000000003625","url":null,"abstract":"<p><strong>Background: </strong>Supplements were awarded under the National Institutes of Health, ending the HIV epidemic (EHE) initiative to foster implementation science through community-engaged research. The objective of this study was to synthesize lessons learned, identify areas of research sufficiently studied, and present an agenda for future research on HIV health workforce development from a collaboration across 9 EHE projects in 11 jurisdictions in the United States.</p><p><strong>Methods: </strong>EHE supplement recipients completed a semistructured questionnaire to identify shared lessons learned about common themes of workforce development using the Consolidated Framework for Implementation Research and Expert Recommendation for Implementing Change frameworks. Data were synthesized to identify shared lessons learned, topic areas no longer in need of research, and next steps.</p><p><strong>Results: </strong>Project teams emphasized several strategies including clarifying roles and responsibilities, the need for dynamic training, and stigma mitigation as strategies to enhance the implementation of HIV prevention and treatment services. Strengthening organizational support through supportive supervision structures, ensuring sustainable funding, preventing turnover, addressing salary constraints, and establishing clear promotion and educational pathways were identified as useful workplace development strategies. Supplements identified lessons learned about deploying community engagement strategies to ensure communities were aware of HIV prevention and treatment services. Several areas sufficiently studied that can be deprioritized were identified and discussed.</p><p><strong>Conclusion: </strong>A research agenda for workplace development moving forward is discussed with several recommendations to improve the implementation of HIV prevention and treatment programs.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"98 5S","pages":"e181-e191"},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental cost of pre- and post-exposure prophylaxis service provision via an online pharmacy in Kenya.","authors":"Yilin Chen, Michalina A Montaño, Paulami Naik, Nicholas Thuo, Catherine Kiptinness, Maeve Rafferty, Andy Stergachis, Melissa Latigo Mugambi, Kenneth Ngure, Katrina F Ortblad, Monisha Sharma","doi":"10.1097/QAI.0000000000003680","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003680","url":null,"abstract":"<p><strong>Background: </strong>Online pharmacy HIV pre- and post-exposure prophylaxis (PrEP/PEP) provision is a novel strategy to expand HIV prevention coverage. In the ePrEP pilot study, we found online pharmacy PrEP/PEP was feasible and reached populations at HIV risk in Kenya. However, program costs data are lacking.</p><p><strong>Methods: </strong>We conducted a costing within the ePrEP pilot study in Nairobi from 11/01/2022-12/29/2023. We obtained costs from expense reports and conducted time-and-motion observations and staff interviews. We estimated total and unit costs in the first year of implementation, cost per client and per PrEP client-month (2023 US Dollars (USD)).</p><p><strong>Results: </strong>Overall, 229 clients initiated PrEP (507 months of PrEP coverage) and 1320 initiated PEP. Based on observed program volume, annual financial cost was $109,945 USD (PrEP: $19,456; PEP: $90,489). Cost per client was higher for PrEP than PEP ($85 vs $68.6), and cost per PrEP client-month was $38 (mean duration: 2.2 months). Main drivers of financial costs were courier-delivery of HIV testing kits and drugs (PrEP: 50.6%; PEP: 40.5%), demand generation (PrEP: 25.9%; PEP: 32.1%), and equipment, system development, and utilities (PrEP: 9.3%; PEP: 9.8%). Assuming a scaled-up client volume of 2500 (PrEP: 370; PEP: 2130) reduced per-client financial costs for PrEP ($65.5) and PEP ($56) and cost per PrEP client-month ($29.6).</p><p><strong>Conclusions: </strong>Costs of online PrEP/PEP provision is likely higher than clinic-based PrEP. Implementing cost sharing models including charging clients for HIV testing and optimizing courier delivery routes can increase program efficiencies. Our cost estimates can inform economic evaluations of online PrEP/PEP delivery.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in HIV preexposure prophylaxis use before and after launch of the Ending the HIV Epidemic in the U.S. initiative, 2016-2023.","authors":"Weiming Zhu, Ya-Lin A Huang, Athena P Kourtis, Robyn Neblett-Fanfair, Jonathan Mermin, Karen W Hoover","doi":"10.1097/QAI.0000000000003674","DOIUrl":"10.1097/QAI.0000000000003674","url":null,"abstract":"<p><strong>Introduction: </strong>The Ending the HIV Epidemic in the U.S. (EHE) initiative was launched by the U.S. Department of Health and Human Services in 2019 with the goal of decreasing new HIV infections 90% by 2030. Increasing the use of HIV preexposure prophylaxis (PrEP) is one of the EHE strategies. We assessed the impact of EHE activities on PrEP use.</p><p><strong>Methods: </strong>Using IQVIA Real-world longitudinal prescription data and the National HIV Surveillance System data, we calculated jurisdiction-level PrEP to diagnosis ratios (PDRs) in the United States from 2016-2023. We assessed impact of EHE with a difference-in-difference (DID) analysis.</p><p><strong>Results: </strong>The PDR increased from 3.0 to 14.7 in EHE Jurisdictions; from 1.2 to 7.2 in EHE states; and from 2.5 to 13.4 in non-EHE jurisdictions. On average, no additional increase in the PDR was found for EHE counties compared with matched non-EHE counties, (adjusted DID: 0.2, 95% confidence interval [CI]: -1.0∼1.3), or for EHE states (adjusted DID: 0.4, 95% CI: -1.6∼2.4).</p><p><strong>Conclusions: </strong>Overall PrEP use increased markedly, with some EHE jurisdictions achieving greater increases than non-EHE jurisdictions with similar PDRs in 2019. The uneven increase in PrEP use in EHE jurisdictions underscores the need for jurisdiction-specific PrEP implementation strategies designed for the needs of each community. It also underscores the need for sufficient funding to accomplish EHE goals.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}