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

{"title":"Stress and Coping During an HIV Cure-Related Trial with an Analytical Treatment Interruption: A Qualitative Assessment of the Experiences of Young Women in Durban, South Africa.","authors":"Ali Ahmed, Miranda Hill, Krista L Dong, Mzwakhe Wiseman Ngcobo, Ayanda Zulu, Ntombifuthi Langa, Luyanda Maphalala, Vanessa Pillay, Maud Mthembu, Whitney Tran, Rachel Lau, Jamila K Stockman, Thumbi Ndung'u, Karine Dubé","doi":"10.1177/23259582261423985","DOIUrl":"10.1177/23259582261423985","url":null,"abstract":"<p><p>IntroductionYoung women in sub-Saharan Africa bear a disproportionate HIV burden yet rarely participate in cure-related studies. Analytical treatment interruptions (ATI), used to assess sustained control off therapy, raise clinical, ethical, and psychosocial concerns.MethodsWe conducted a longitudinal qualitative study within a Phase 2A ATI trial (NCT05281510) at the FRESH site in Durban, South Africa. Nineteen women living with HIV (median age 26) completed in-depth interviews at 4 timepoints. We applied framework analysis informed by the Lazarus-Folkman stress and coping model.ResultsParticipants enrolled to contribute to science, reduce pill burden, and due to trust in the clinical team. They anticipated viral rebound, resistance, stigma, and partner transmission. Over time, many reported improved emotional well-being, using meaning-based strategies (pride in contribution) and problem-focused strategies (self-monitoring, condom negotiation). Burdens included stigma, selective disclosure, partner resistance, frequent visits, and blood draws. Benefits included increased HIV literacy, self-management, and comfort with procedures.ConclusionATI-inclusive clinical trials can be acceptable when designs include clear and ongoing education, strong confidentiality protections, mental health and peer support, partner-inclusive risk reductions, and flexible scheduling with practical supports to minimize participation burden and potential psychosocial harms.Clinical trial registrationNCT05281510.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261423985"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180656","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":"Depressive Symptoms and Clinical and Nutritional Outcomes among Adults Living with HIV Initiating Antiretroviral Therapy in Dar es Salaam, Tanzania.","authors":"Kynza Khimani, Alfa Muhihi, Wafaie W Fawzi, Nzovu Ulenga, Christopher R Sudfeld","doi":"10.1177/23259582261442282","DOIUrl":"10.1177/23259582261442282","url":null,"abstract":"<p><p>BackgroundDepression is highly prevalent among people living with HIV (PLWH). However, few studies have examined its relationship with clinical and nutritional outcomes in sub-Saharan Africa.MethodsWe conducted a cohort study of 3996 PLWH in Tanzania. Depressive symptoms were measured at antiretroviral therapy (ART) initiation with the Hopkins Symptom Checklist-25 (HSCL-25). Symptoms consistent with depression were defined using the conventional HSCL-25 (score >1.75) and Tanzania-adapted (score >1.06) cutoffs. We evaluated the association of depression defined by both cut-offs and tertiles of HSCL-25 scores with clinical and nutritional outcomes using regression models.ResultsUsing the conventional HSCL-25 cutoff, men with symptoms consistent with depression had increased risk of all-cause mortality (hazard ratio (HR): 1.68; 95% CI: 1.17-2.39) and HIV disease progression (HR: 1.59; 95% CI: 1.15-2.19). Women in the highest tertile of depressive symptom scores had increased risk of >10% weight loss (HR: 1.27; 1.05-1.55) and incident pulmonary TB (HR: 1.93, 95% CI: 1.19-3.12).ConclusionsDepressive symptoms at ART initiation were associated with poor clinical and nutritional outcomes; however, the risks appear to differ by gender and depression severity.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261442282"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633942","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":"Family Relationships, Resilience, and Quality of Life in People Living with HIV and Their Family Members: An Actor-Partner Interdependence Mediation Model.","authors":"Cuihong Huang, Fanghui Shi, Xueying Yang, Shuaifeng Liu, Yuejiao Zhou, Xiaoming Li","doi":"10.1177/23259582261440323","DOIUrl":"10.1177/23259582261440323","url":null,"abstract":"<p><p>ObjectivesTo explore the association between family relationships and quality of life (QoL), and the mediating role of resilience among people living with HIV (PLWH) and their family members (FMs).MethodsBaseline data were drawn from an ongoing study in Guangxi, China, including 783 PLWH-FM dyads. The actor-partner interdependence mediation model examined how individuals' family relationships/cohesion affect their own (actor effects) and their partners' QoL (partner effects), and the mediating role of resilience.ResultsA significant actor-direct effect was observed for FMs' family relationships on their own mental QoL (<i>β</i> = 0.136, <i>P</i> < 0.001), while no such effect was found for PLWH. Resilience functioned as a mediator between PLWH's family cohesion and PLWH's QoL (physical: <i>β</i> = 0.109, mental: <i>β</i> = 0.089, <i>P</i> < 0.001) and between FMs' family relationships and FMs' QoL (physical: <i>β</i> = 0.062, mental: <i>β</i> = 0.075, <i>P</i> < 0.001). Regarding partner effects, FMs' resilience mediated the association between PLWH's family cohesion and FMs' QoL (physical: <i>β</i> = 0.036, mental: <i>β</i> = 0.044, <i>P</i> < 0.01).ConclusionFindings underscore that future interventions should target the family as a unit to strengthen family ties and improve the cross-dyadic role of resilience, particularly that of FMs.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261440323"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628114","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":"A Cross-Sectional Analysis of Randomized Survey Modality to Assess Impact of Survey Modality on Demographic, Behavioral, and Psychosocial Measures among Men Who Have Sex with Men in Kenya.","authors":"Joseph Nzioka, Patriciah Wambua, Fredrick Otieno, Joshua Kimani, Rhoda Kabuti, Felix Ochieng, Richard Gichuki, Mary Wanjiru, Monica Okumu, Lyle McKinnon, Supriya D Mehta","doi":"10.1177/23259582261434295","DOIUrl":"10.1177/23259582261434295","url":null,"abstract":"<p><p>ObjectivesWe assessed whether survey mode influenced reporting of sexual behaviors and psychosocial factors among men who have sex with men (MSM) in Kenya.MethodsIn cross-sectional analysis of baseline data from 493 MSM in Kisumu and Nairobi enrolled in a prospective cohort study, participants were randomized 1:1 to Computer-Assisted Personal Interview (CAPI) or Audio Computer-Assisted Self-Interview (ACASI). We compared responses across survey modes using Poisson regression with robust variance, adjusting for socio-demographics.ResultsIn both sites, CAPI users more frequently reported sex with a female partner. In Kisumu, CAPI users were less likely to report receptive anal intercourse. In Nairobi, CAPI users were less likely to report food insecurity, transactional sex, and STI symptoms.ConclusionWhile most responses were similar across modes, ACASI prompted higher reporting of sensitive behaviors, highlighting added value for capturing stigmatized and sensitive information. Offering both methods may enhance data quality and respect participant preferences.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261434295"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816767","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":"Health Literacy, Knowledge of HIV/AIDS, and Public Stigma Among General Citizens of Japan: An Online Cross-Sectional Survey.","authors":"Taisuke Togari, Yoji Inoue, Sakurako Abe","doi":"10.1177/23259582251414562","DOIUrl":"10.1177/23259582251414562","url":null,"abstract":"<p><p>BackgroundThis study aimed to examine how health literacy, knowledge of HIV/AIDS, and public stigma are associated with social distance toward people living with HIV/AIDS (PLWH), as a behavioral manifestation of stigma, among the general Japanese population.MethodsWe conducted an online cross-sectional survey targeting adults (age range: 20-60 s) from among the 2.2 million registrants in Rakuten Insight from September 20 to 25, 2019. Stratified randomized sampling was performed according to the region, sex, and age. The study participants were 2268 eligible for analysis (effective response rate: 90.7%).ResultsModels were examined using hierarchical multiple regression analysis. The results indicated that low-level knowledge of HIV/AIDS affected social distance to PLWH (B = 3.77, (95% CI, 1.30 to 6.24)). 'Access,' 'understand,' 'appraise' and 'use' of European health literacy survey questionnaire affected social distance to PLWH (B = .03, (-.07 to .13); - B = .15, (-.27 to -.04); B = .06, (-.04 to .17); B = -.07, (-.19 to .05)). Public stigma of HIV/AIDS affected social distance to PLWH (B = .97, (.92 to 1.01)).ConclusionsThese findings indicate that health literacy not only maintains and promotes individual health but also has the potential to reduce social distance toward PLWH.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582251414562"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064372","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 Predictors of Loss to Follow-Up Among ART Patients on Follow-Up at Public Health Facilities in Southwest Ethiopia. A Time-to-Event Analysis.","authors":"Oftana Daba, Dereje Tsegaye, Mohammed Reshad","doi":"10.1177/23259582261426232","DOIUrl":"10.1177/23259582261426232","url":null,"abstract":"<p><p>BackgroundLoss to follow-up (LTFU) remains a major challenge to successful antiretroviral therapy (ART), contributing to increased morbidity, mortality, and drug resistance, particularly in Sub-Saharan Africa. Evidence on the timing and predictors of LTFU in rural Ethiopia is limited. This study aimed to determine the time to LTFU and its predictors among adults on ART in selected health facilities of Ilu Aba Bor Zone, Southwest Ethiopia.MethodsA retrospective cohort study was conducted among 372 adults living with human immune virus (HIV) on ART at 4 public health facilities from October 2018 to November 2022. Data were extracted from standardized ART forms and patient charts. Kaplan-Meier survival analysis estimated survival probabilities, and Cox proportional hazards regression identified predictors of LTFU, reporting adjusted hazard ratios with 95% confidence intervals (CI). Proportional hazards assumptions were checked using Schoenfeld residuals and log-log plots.ResultsOver 6993 person-months of follow-up (median: 19 months), 70 participants (18.8%) were LTFU, mostly within the first year (34.3% in the first 6 months; 32.9% in the second 6 months). Independent predictors included absence of a registered phone number, World Health Organization clinical stage III/IV, noninitiation of cotrimoxazole preventive therapy, nondisclosure of HIV status, and poor or fair adherence.ConclusionLTFU was common during early antiretroviral. Strengthening patient tracing, promoting disclosure, initiating preventive therapy, and improving adherence support may enhance retention and contribute to achieving human Immune deficiency virus epidemic control targets.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261426232"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317527","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":"Prevalence and Factors Associated With Hyperglycemia Among Patients on Dolutegravir-Based Antiretroviral Therapy: A Cross-Sectional Study From Central Uganda.","authors":"Charles Nkubi Bagenda, Carol Nantongo, Michael Junior Mugisa, Elastus Ssemwanga, Sylivia Achieng Lumumba, Edward Kikabi, Ritah Kiconco, Simon Peter Rugera","doi":"10.1177/23259582261426447","DOIUrl":"10.1177/23259582261426447","url":null,"abstract":"<p><p>BackgroundThe use of dolutegravir (DTG)-based antiretroviral therapy (ART) has been associated with the development of hyperglycemia. This study determined the prevalence and factors associated with hyperglycemia among people living with HIV (PLWH) on DTG-based ART in Uganda.MethodsWe conducted a cross-sectional study among 219 systematically recruited PLWH on DTG-based ART for ≥1 year at a Health Centre IV in Central Uganda. Data were collected using a structured questionnaire, anthropometric measurements, and laboratory investigations. Logistic regression was performed to identify factors associated with hyperglycemia.ResultsOut of 219 participants, 45 had fasting glucose ≥110 mg/dL, giving a hyperglycemia prevalence of 20.55% (95% confidence interval [CI]: 15.68%-26.45%). Overweight (aOR 8.11, 95% CI: 2.76-23.85, <i>P</i> < .001) and abnormal waist-to-hip ratio (aOR 4.36, 95% CI: 1.23-15.37, <i>P</i> = .022) were significantly associated with hyperglycemia.ConclusionsHyperglycemia is prevalent among PLWH on DTG-based ART and is potentially associated with overweight and abnormal waist-to-hip ratio.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261426447"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276191","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":"Predisposition to Pre-Exposure Prophylaxis and Associated Factors Among Men who Have Sex with Men in Brazil: A Cross-Sectional Study.","authors":"Yndiara Kássia da Cunha Soares, Álvaro Francisco Lopes de Sousa, Ana Paula Morais Fernandes, Lariane Angel Cepas, Talita Morais Fernandes, Aires Garcia Dos Santos Junior, Wínola Dafny Douglas de Oliveira, Chrystiany Plácido de Brito Vieira, Lidya Tolstenko Nogueira, Rosilane de Lima Brito Magalhães, Paulo de Tarso Moura Borges, Telma Maria Evangelista de Araújo","doi":"10.1177/23259582251407470","DOIUrl":"10.1177/23259582251407470","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the predisposition to use pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) and associated factors among men who have sex with men (MSM). <b>Method:</b> Cross-sectional, analytical study, developed at the Testing and Counseling Center and social locations of the target population, in Teresina, Piauí, Brazil, with a sample composed of 320 MSM, recruited by the snowball sampling technique. Data collection was performed in two consecutive stages, the first being HIV testing and counseling. The second stage consisted of the application of instruments to characterize the sample regarding sociodemographic aspects, sexual behavior, knowledge, and acceptability of PrEP for HIV and an HIV Risk Perception Scale. For the descriptive analysis, measures of position and dispersion were used. In the univariate analysis, Simple Logistic Regression was used, with selection by the Wald test at the 20% level. In the multivariate analysis, Multiple Logistic Regression with a Bayesian approach was used. <b>Results:</b> MSM in the age group between 20 and 39 years were predominant 290 (90.6%), income greater than four minimum wages 103 (32.2%) and complete higher education 219 (68.4%). The expressive majority 297 (92.8%) reported predisposition to use PrEP for HIV, which was associated with MSM with complete higher education (OR = 5.56; 95% CI = 1.03-30.44; P = 0.046), having presented signs/symptoms of STI in the last 12 months (OR = 3.08; 95%CI = 1.05-9.09; P = 0.041) and satisfactory knowledge about PrEP (OR = 1.69; 95%CI = 1.01-2.83; P = 0.045). <b>Conclusion:</b> A high predisposition to use PrEP was found among MSM in the sample, despite the unsatisfactory knowledge about PrEP and unsatisfactory perception of risk regarding HIV. Understanding the risk factors and protective factors for the use of this important prevention method is essential for its expansion and consequent effectiveness in controlling the HIV epidemic.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582251407470"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12894643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165600","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":"Validation of a Risk Prediction Nomogram for Virologic Failure Among Patients on First-Line ART After ONE-J Program Implementation in Northwest Ethiopia.","authors":"Bekalu Bewket, Etsubdink Dessalew Abawa, Zelalem Alamrew Anteneh","doi":"10.1177/23259582261428509","DOIUrl":"10.1177/23259582261428509","url":null,"abstract":"<p><p>IntroductionVirological failure is defined as a plasma viral load >1000 copies/mL on 2 consecutive tests after 3 months of adherence support and 6 months of ART. In Ethiopia, limited studies have developed risk prediction models, though such models are vital for guiding patient-specific interventions and improving HIV treatment outcomes.ObjectiveThis study aims to determine the incidence and prognostic factors of virologic failure among HIV patients on first-line HAART following the one-J program at Felege Hiwot Hospital, Northwest Ethiopia, in 2025.MethodsA retrospective cohort study was conducted using patient records from Felegehiwot Comprehensive Specialized Hospital. Data were analyzed with STATA 17 and R 4.5.0. Descriptive statistics and multivariable logistic regression (via LASSO-selected predictors) were applied to develop a simplified nomogram. Model performance was evaluated using discrimination, calibration, and decision curve analysis to assess clinical utility.ResultThe incidence of virologic failure was 20.2% (95% CI: 17.9-22.6). Key predictors included TB-HIV co-infection, INH prophylaxis, CPT, adverse drug reactions, disclosure, alcohol use, smoking, and CD4 level. The model showed good performance (AUC = 0.817; reduced AUC = 0.810), strong calibration (Brier = 0.117), and superior clinical benefit in decision curve analysis.ConclusionA nomogram integrating 8 predictors TB-HIV co-infection, INH prophylaxis, CPT, adverse drug reaction history, disclosure status, alcohol use, smoking status, and CD4 count showed excellent discrimination (AUC = 0.817) and good calibration, indicating strong potential for individualized risk prediction in HIV patient management.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261428509"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317444","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":"Health Worker Experiences and Perspectives on the Integration of Long-Acting Injectable Antiretroviral Therapy into a Safety-Net HIV Clinic in the Southeastern United States.","authors":"Hanna E Huffstetler, Christopher Lopez, Harsh Agarwal, Odai A Mansour, Vivian F Go, Claire E Farel, Sonia Napravnik, Sarah E Rutstein","doi":"10.1177/23259582261426448","DOIUrl":"10.1177/23259582261426448","url":null,"abstract":"<p><p>BackgroundFollowing its approval by the US Food and Drug Administration in January 2021, clinics have moved to implement the first long-acting antiretroviral regimen (cabotegravir [CAB] and rilpivirine [RPV]) into routine care.MethodsIn this qualitative implementation study, we characterize health worker experiences with the introduction of CAB/RPV into a safety net HIV clinic in the Southeastern US during the first 10 months of service integration. Interviews were analyzed using directed content analysis and results were synthesized using the updated Consolidated Framework for Implementation Research.ResultsHealth workers described both successes and challenges. Successes included strong awareness of and enthusiasm for CAB/RPV and the integration of supportive resources over time. Challenges included inconsistent communication about logistics, perceived pressures on human resources, and concerns about structural barriers affecting patient access to care.ConclusionsFindings highlight the resource demands of implementing CAB/RPV, and the complex array of factors that shape successful implementation.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261426448"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12932877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284246","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}