Journal of the International Association of Providers of AIDS Care最新文献

{"title":"Exploring the HIV Epidemic in the Philippines: Initiatives and Challenges.","authors":"Dalmacito A Cordero","doi":"10.1177/23259582241312294","DOIUrl":"10.1177/23259582241312294","url":null,"abstract":"","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582241312294"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Even Though He Had Expressed Willingness to Take PrEP, He Declined When He Noticed the Drugs Were Packed in a Container Like That of ARVs\": Exploring Barriers to HIV/AIDS Risk Reduction Among Long-Distance Truckers in Kenya.","authors":"Cyrus Mutie, Kawira Kithuci, John Gachohi, Grace Mbuthia","doi":"10.1177/23259582251328814","DOIUrl":"10.1177/23259582251328814","url":null,"abstract":"<p><p>BackgroundDue to high-risk sexual networks along their transit routes, Long-distance truckers' (LDTs) risk of HIV is known to be high, as evidenced by prevalence rates of 14.34% in the region. Besides, the spaces in which LDTs operate are often marred with a multitude of barriers to HIV/AIDS risk reduction. However, there is limited evidence on the barriers encountered by LDTs in Kenya, hence the need for the current study.Methods and MethodologyWe used nine key informants and 18 in-depth interviews from purposively sampled participants, such as nurses and LDT peer educators at Kenya's Busia and Namanga international border points. We used semi-structured interview guides to collect data through audio records. Interviews were transcribed, coded, and thematically analysed using the QDA-Miner software to generate themes and sub-themes around barriers to HIV/AIDS risk reduction among LDTs.FindingsOverall, three themes, namely, health system, individual-level, and trucking career-related barriers emerged. The sub-themes under health system barriers included the location of healthcare facilities far from transit routes, long durations of hospital waiting time, and lack of targeted health facilities for LDTs, among several others. Under trucking career-related barriers, the sub-themes comprised tight work schedules, unfavourable trucking career policies, and insecurity along transit routes. For individual barriers, some of the sub-themes were language barriers and lack of awareness of current HIV/AIDS risk reduction services.ConclusionAlongside health system factors, individual level and trucking career-related factors were highlighted as the barriers to HIV/AIDS risk reduction among LDTs in Kenya. The existence of these barriers may complicate the fight against the pandemic in this hard-to-reach population, given their already known vulnerability to HIV infections.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251328814"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of an Antiviral Treatment Regimen for Immunological Nonresponders Through HIV-DNA Resistance Testing: A Case Report.","authors":"Kun He, Xiang Du, Qi Cao, Mingjun Li, Juan Qian, Min Liu","doi":"10.1177/23259582251340143","DOIUrl":"https://doi.org/10.1177/23259582251340143","url":null,"abstract":"<p><p>In August 2012, a 47-year-old male patient was diagnosed with human immunodeficiency virus (HIV) infection, with no other underlying disease or opportunistic infection. Baseline measurements revealed an HIV RNA count of 79 400 copies/mL and a CD4+ T-lymphocyte count of 8 cells/μL. Despite successful viral suppression with HIV RNA levels remaining below the detectable threshold for 9 consecutive years following the initiation of antiretroviral therapy, the patient's CD4+ T lymphocyte count persistently remained below 200 cells/μL. Resistance testing of the viral reservoir (HIV DNA) was conducted, which revealed proviral resistance. Based on these results, the antiviral treatment regimen was adjusted. One year later, the patient's immune function had significantly improved, with the CD4+ T lymphocyte count having increased to 319 cells/μL.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251340143"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a National Telephone Consultation Service for Clinicians in Mozambique.","authors":"Maria Ruano, Adelina Maiela, Margarida Khapesse, Célia Cumbi, Rosa Bene, Restano Uamir, Erin Branigan, Jeff Lane, Edy Nacarapa, Ferruccio Vio, Florindo Mudender","doi":"10.1177/23259582251320394","DOIUrl":"10.1177/23259582251320394","url":null,"abstract":"<p><p>The manuscript outlines the establishment of a remote consultation service for clinicians in Mozambique, highlighting best practices and lessons learned. It discusses the transition to full management by the Ministry of Health and the challenges of sustaining the service post-transition within the MoH Telehealth Program. The program evaluation results focus on the national telephone consultation service for HIV/AIDS care and treatment, which, between 2013 and 2019, received calls from a wide range of health facilities and cadres, including nonmedical prescribers, doctors, clinical assistants, and nurses. A 2017 clinician satisfaction survey indicated high satisfaction rates. Key implementation lessons emphasized the necessity of staffing the consultation line with highly trained clinicians, leveraging training to enhance service awareness and trust, supporting the public health system, maintaining operational flexibility, and strengthening pre-service clinical training.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251320394"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of COVID-19 Vaccine Uptake Among People Living with Human Immunodeficiency Virus.","authors":"Gaukhar Mergenova, Alissa Davis, Susan L Rosenthal, Assel Terlikbayeva, Sholpan Primbetova, Meruyert Darisheva, Assel Bukharbayeva, Alfiya Y Denebayeva, Jack DeHovitz","doi":"10.1177/23259582251328861","DOIUrl":"10.1177/23259582251328861","url":null,"abstract":"<p><p>BackgroundHuman immunodeficiency virus (HIV) cases are rising in Central Asia and Kazakhstan. People living with HIV (PLWH) in Kazakhstan are at heightened risk of severe COVID-19. We conducted a study to evaluate determinants of COVID-19 vaccine uptake among PLWH in Kazakhstan.MethodsIn this cross-sectional study, 196 PLWH were recruited from the Almaty City AIDS Center (July 2022-January 2023). We used logistic regression to evaluate how multilevel factors are associated with COVID-19 vaccine uptake among PLWH in Kazakhstan.ResultsCOVID-19 vaccine non-uptake was associated with higher HIV stigma scores (AOR = 1.08, 95%CI:1.02,1.16, P = 0.017), a lower level of education (AOR = 2.53, 95%CI: 1.04,6.17, P = 0.0412), and never receiving the flu vaccine (AOR = 15.64, 95%CI:3.66,66.89, P = 0.0002). Participants with at least mild anxiety symptoms (AOR = 0.15, 95%CI:0.03,0.64, P = 0.0107) and a positive attitude towards vaccination (AOR = 0.79, 95%CI: 0.73,0.86, P < 0.0001) were less likely to remain unvaccinated against COVID-19.ConclusionsCOVID-19 vaccination campaigns should be tailored for PLWH and incorporate stigma reduction interventions within healthcare settings.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251328861"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hardships and Perceived Barriers to Medical Care Among Newly Diagnosed People With HIV During the COVID-19 Pandemic.","authors":"Ethan Moitra, Julia Scheinbach, Michael Thompson","doi":"10.1177/23259582251331275","DOIUrl":"10.1177/23259582251331275","url":null,"abstract":"<p><p>Purpose of the researchA major consequence of the COVID-19 pandemic was a disruption of medical care in the United States. Using cross-sectional data from an ongoing randomized clinical trial, we examined severity of COVID-related hardships and other factors that might have influenced newly diagnosed people with HIV's (PWH's) receipt of care during the initial years of the pandemic (2020-22).Major findingsIn a sample of 29 newly diagnosed PWH presenting for care at three geographically diverse medical clinics in the United States, results showed that most patients (72.4%) reported that obtaining an HIV medical appointment during the pandemic was \"easy.\" Correlational analyses found that COVID-related hardships were significantly related to overall health and functioning, as well as experiences of discrimination.ConclusionsTaken together, these findings align with previous results to show that already vulnerable populations were particularly affected by service disruptions, but that many patients were able to access care despite the pandemic.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251331275"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk Factors of Zidovudine-Induced Anemia in Patients With HIV Infection Receiving Zidovudine-Containing Antiretroviral Therapy.","authors":"Lakkana Boonyagars, Peerawit Thinpangnga, Warangkana Munsakul","doi":"10.1177/23259582251321577","DOIUrl":"10.1177/23259582251321577","url":null,"abstract":"<p><strong>Background: </strong>Anemia is among the frequently observed conditions among people living with HIV (PLWH). Zidovudine (AZT) is the most common ART that causes anemia. This study aimed to identify the incidence and risk factors of AZT-induced anemia in PLWH receiving AZT-containing regimens.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on nonpregnant PLWH aged >18 years who received AZT-containing regimens for >6 months and had normal baseline hemoglobin levels. Data on medical history, clinical characteristics, and laboratory examination were collected. Cox proportional hazard regression analysis was performed to determine the risk factors of AZT-induced anemia.</p><p><strong>Results: </strong>A total of 401 individuals were included in the study. In total, 71 individuals presented with AZT-induced anemia. The incidence rate of anemia was 1.98 per 100 person-years of observations. Female sex, low-normal baseline hemoglobin level, low recent and low baseline CD4 cell count were independently associated with an increased risk of anemia. However, a higher body mass index was independently associated with a decreased risk of anemia.</p><p><strong>Conclusion: </strong>Routine screening, early detection, and treatment of anemia should be considered in PLWH receiving AZT-containing regimens.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251321577"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in People Living With HIV Attending Centre of Excellence in HIV Care at a Tertiary Level Teaching Hospital in North India-A Pilot Study.","authors":"Ragini Ram, Anuradha Subramanian, Rajeshwari K","doi":"10.1177/23259582241311912","DOIUrl":"10.1177/23259582241311912","url":null,"abstract":"&lt;p&gt;&lt;p&gt;With the availability of free antiretroviral therapy (ART) across India, HIV in adults has become a chronic disease with prolonged survival. The emergence of various non-communicable diseases in these prolonged survivors is a cause of concern. Metabolic dysfunction-associated steatotic liver disease (MASLD) in adults with HIV infection in India has not been explored to date. In this study, we attempted to assess the existence of MASLD in thirty adults registered at the Centre of Excellence in ART Care at a tertiary teaching hospital in New Delhi. This center provides free first-line, second-line, and third-line ART to patients as well as comprehensive HIV care including counseling, nutritional advice, and inpatient admissions for intercurrent illnesses. A total of 30 subjects were enrolled in the study to assess the occurrence of MASLD among people living with HIV (PLHIV) and its risk factors and to assess hepatic fibrosis in the subjects with MASLD using transient elastography and clinical fibrosis scores. The study population included 13 subjects on ART (43.3%) and 17 ART-naïve subjects (56.6%). All the study subjects underwent ultrasonography (USG) for the identification of the development of MASLD in them. Steatosis was identified as an increase in the echogenicity of the liver seen as an increase in the hepatorenal contrast and was further graded into the 3 grades of fatty liver. Out of the 30 subjects, 16.6% (5 out of 30) were found to have MASLD on USG, with grade 1 fatty changes seen in 4 (13.3%) and grade 2 fatty changes seen in 1 out of 30 subjects (3.3%). A majority (40%) of the subjects were underweight (body mass index [BMI] &lt; 18.5). 22.7% of the male subjects included in the study had MASLD whereas none of the females had fatty changes in the liver on USG. Out of the study subjects, MASLD was detected in 17.6% of ART-naïve subjects while it was detected in 15.4% of subjects on ART. Although no statistically significant association was seen with any of these parameters, a few important trends were observed. These might be statistically significant in a higher power study with a larger sample size. Higher BMI (mean difference [MD] = 3.25, &lt;i&gt;P&lt;/i&gt; = .09), waist circumference (MD = 3.84, &lt;i&gt;P&lt;/i&gt; = .15), hip circumference (MD = 4.36, &lt;i&gt;P&lt;/i&gt; = .14), and older age (MD = 6.56, &lt;i&gt;P&lt;/i&gt; = .07) were observed to be associated with MASLD in our study, whereas the biochemical parameters and HIV-related factors were not seen to have any particular trend of association in our study. However, a higher median CD4 count was associated with MASLD as compared to the group without fatty changes on USG. On FibroScan, all 5 subjects with fatty changes in our study were found to have liver stiffness less than 7 kPa which corresponds to F0-F1 stage of fibrosis. Using the nonalcoholic fatty liver disease score, 2 subjects had scores corresponding to F0-F2 stage of fibrosis (as per METAVIR score) while the rest (3 out of 5) had indeterminate values.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582241311912"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking Criminal Justice-Involved Individuals to HIV Preexposure Prophylaxis: A Qualitative Analysis of Multiple Stakeholder Perspectives.","authors":"Jessica Lee, Robin T Higashi, Timothy P Hogan, Julia L Marcus, Emily C Repasky, M Brynn Torres, Douglas Krakower, Ank E Nijhawan","doi":"10.1177/23259582251341940","DOIUrl":"https://doi.org/10.1177/23259582251341940","url":null,"abstract":"<p><p>ObjectiveAlthough incarcerated individuals are at disproportionately higher HIV risk compared to the general US population, few jails offer linkage to preexposure prophylaxis (PrEP). We explored stakeholder perspectives about barriers and facilitators to PrEP for justice-involved individuals.MethodsSemi-structured interviews were conducted with three stakeholder groups in Dallas County, Texas: justice-involved individuals (<i>n</i> = 8), County Jail staff (<i>n</i> = 9), and employees of local community organizations that provide PrEP services (<i>n</i> = 9). Transcripts were analyzed using a combined deductive and inductive approach.ResultsBarriers to PrEP linkage included: limited provider knowledge of and capacity for PrEP care, stigma around incarceration and PrEP, and mistrust in healthcare and criminal justice systems among justice-involved individuals. Perceived facilitators included addressing competing priorities, partnering with community organizations, and providers' cultural competency training.ConclusionFuture research should focus on adapting successful implementation strategies to the needs of justice-involved populations to improve HIV prevention and health outcomes in high-burden regions like the Southern USA.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251341940"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Like Someone Is Paying Attention to You, Listening to You, and Guiding You\": Acceptability of a Mental Health Chatbot Among Caregivers of Adolescents Living With HIV.","authors":"Neil Rupani, Diego H Vasquez, Carmen Contreras, Luis Menacho, Lenka Kolevic, Molly F Franke, Jerome T Galea","doi":"10.1177/23259582251327911","DOIUrl":"10.1177/23259582251327911","url":null,"abstract":"<p><p>BackgroundThis study assessed the acceptability, among caregivers, of a mental health chatbot designed for adolescents living with HIV aged 10 to 19 years.MethodsFifteen caregivers interacted with the mental health chatbot. Pre-post assessments and semistructured interviews evaluated acceptability. Data were analyzed using a Framework Analysis approach.ResultsCaregivers aged 31 to 70 years found the chatbot acceptable on individual, interpersonal, and environmental levels. They appreciated the educational content and self-help tools, feeling the chatbot would benefit them personally. Caregivers also saw potential in the chatbot to improve communication with their children, particularly during critical periods like HIV diagnosis. Despite concerns about data costs or internet access, most viewed the chatbot as an accessible supplement to traditional mental health services.ConclusionThis study suggests that a mental health chatbot for Peruvian adolescents living with HIV was acceptable to their caregivers, potentially benefiting caregivers' mental health, enhancing caregiver-adolescent interactions, and fostering better communication.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251327911"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}