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

{"title":"Risk Perception and Its Influence on Pre-Exposure Prophylaxis (PrEP) Uptake and Adherence Among Pharmacy-Based PrEP Users in South Africa: A Qualitative Study.","authors":"Hugo Ferrero, Kelechi Elizabeth Oladimeji, Mara Aileen Yerkes, Athini Nyatela, Cheryl Hendrickson, Angela Tembo, Samanta Tresha Lalla-Edward","doi":"10.1177/23259582261447318","DOIUrl":"10.1177/23259582261447318","url":null,"abstract":"<p><p>BackgroundPre-exposure prophylaxis (PrEP) is highly effective in preventing human immunodeficiency virus (HIV) transmission, particularly for individuals at increased risk. However, uptake and long-term adherence remain challenging, with limited data on pharmacies beyond pilot studies. This study explored how psychological, social, and structural factors shape perceptions of HIV risk and influence PrEP adherence, using the Tripartite Risk Perception (TRIRISK) model, Protection Motivation Theory, and the Theory of Planned Behavior.MethodsA qualitative design using in-depth interviews (IDIs) was conducted pre-implementation (May 2023) and during implementation (April-July 2024) of pharmacy-based PrEP services. Participants were adults (18+years) accessing pharmacy-based PrEP services in Gauteng and the Western Cape, South Africa. Data were analyzed thematically using Excel and MAXQDA, guided by the integrated behavioral frameworks.ResultsA total of 99 IDIs were conducted, 30 in 2023, 69 in 2024. Through the TRIRISK model, this study found that decisions to start or continue PrEP were shaped by perceived vulnerability to HIV, awareness of risky sexual behaviors, mistrust of partners, and emotional experiences like fear and trauma. The PMT further highlighted how emotional triggers, along with perceived severity and coping efficacy, affected motivation to initiate or continue PrEP. The TPB helped explain how subjective norms, such as stigma and social judgment, and perceived behavioral control, shaped by access, convenience, and privacy, impacted adherence.ConclusionIntegrated behavioral frameworks offer critical insights into PrEP-related decision making. Interventions, including pharmacy-based PrEP models, should address emotional barriers, such as stigma-sensitive messaging, strengthening social support, and reducing structural inequalities.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261447318"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205287","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":"Evaluating Equity-Centered Capacity-Building Programs to Strengthen Implementation Leadership in Southern U.S. HIV Service Organizations.","authors":"Katie A McCormick, Megan C Stanton, Katyayani Strohl, Samira B Ali","doi":"10.1177/23259582261470700","DOIUrl":"10.1177/23259582261470700","url":null,"abstract":"<p><p>BackgroundIn the United States, Southern HIV service organizations (SHSOs) are well-positioned to deliver evidence-based interventions for people living with HIV. However, SHSO leaders often lack the necessary implementation leadership skills. This exploratory study evaluates changes in SHSO leaders' implementation leadership skills after participation in a capacity-building program.MethodsData were collected as part of the pre-/post-program evaluation from SHSO leaders who participated in a capacity-building program.ResultsParticipant data (n=98) were analyzed using two-way repeated measures ANOVA to examine changes in Implementation Leadership Scale (ILS) scores pre-/post-program participation. Within-subjects effects showed an overall significant difference in ILS scores between pre/post. Between-subjects effects showed no significant differences between programs on ILS scores. Within-subjects effects showed a significant interaction between time and program type on ILS scores. Results of the multivariate Wilks' lambda test also showed a significant time-by-program interaction on ILS scores.ConclusionFindings underscore the significance of <i>equity-centered</i> capacity-building efforts in bolstering the implementation leadership skills of organizational leaders and the need for continued investment in SHSOs.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261470700"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520523","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":"Virologic and Immunological Failure and Associated Factors Among Adults Living With HIV on HAART at Jimma Medical Center, Southwest Ethiopia.","authors":"Rahel Tamrat Teshome, Mulatu Gashaw, Aster Wakjira Garedo, Tesfaye Deme, Wondimagegn Adissu, Daniel Yilma, Zeleke Mekonnen, Lealem Gedefaw Bimerew","doi":"10.1177/23259582261453642","DOIUrl":"10.1177/23259582261453642","url":null,"abstract":"<p><p>BackgroundAntiretroviral therapy reduces HIV morbidity, mortality, viral replication, and transmission, and viral load testing is the preferred method for monitoring effectiveness. This study assessed virologic and immunologic failure and associated factors among adults living with HIV on HAART at Jimma Medical Center, southwest Ethiopia.MethodsAn institution-based cross-sectional study was conducted from February to March 2019 among 272 adults on HAART. Data were collected from medical records and structured interviews. CD4+ T-cell counts and plasma viral loads were measured using standard laboratory procedures. Data were analyzed using SPSS version 24. Descriptive statistics summarized the data, and bivariate and multivariate logistic regression analyses were performed to identify associated factors. Multicollinearity was assessed before the final model. Adjusted odds ratios (AORs) with 95% confidence intervals were reported, and a <i>P</i>-value <.05 was considered statistically significant.ResultsOf the participants, 60.7% were female, with a mean age of 36.6 years and a median ART duration of 96 months. Immunologic failure occurred in 8.1% and virologic failure in 10.3%. Immunologic failure was associated with tuberculosis co-infection and poor ART adherence. Virologic failure was associated with poor adherence, baseline viral load ≥1000 copies/mL, and CD4+ count <250 cells/mm³.ConclusionAdherence support remains essential for viral suppression.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261453642"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13230656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150186","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":"HIV Care for Adolescents and Young Adults: A Cross-Sectional Comparison of Nurse Practitioner and Physician Roles in Engagement in Care, Trust, and Clinical Outcomes.","authors":"Emily Anne Barr, Suzanne E Courtwright, Sheryl Malone-Thomas, Lori Silveira, Deborah Kacanek, Paul Cook, Sean M Reed, Hillary Dunlevy","doi":"10.1177/23259582261485418","DOIUrl":"https://doi.org/10.1177/23259582261485418","url":null,"abstract":"<p><p>BackgroundNurse practitioners (NPs) may help address HIV workforce shortages, but evidence comparing health outcomes in youth remains limited. This study compared clinical and patient-reported outcomes among adolescents and young adults with HIV (AYA-WH) receiving NP versus physician care.MethodsIn this cross-sectional study, health record and survey data from AYA-WH (N=109) receiving care in Colorado, USA (June 2019-November 2020) were analyzed. Outcomes included viral suppression, care engagement, telehealth use, trust, adherence, and HIV stigma.ResultsViral suppression and engagement in care were comparable between NP and physician groups. Youth receiving NP care had more visits, greater telehealth use, higher CD4 counts, and were more likely to report higher patient-provider trust. Adherence and stigma did not differ by provider type.ConclusionsNPs are well-positioned to expand access to youth-focused HIV care while maintaining outcomes comparable to physician providers.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261485418"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pragmatic Strategies for Sustaining HIV Care: 25-Year Outcomes from an Independent Practice in India.","authors":"Murali K Yanamadala","doi":"10.1177/23259582261444528","DOIUrl":"10.1177/23259582261444528","url":null,"abstract":"<p><p>BackgroundLong-term evidence from resource-limited settings spanning transitions in HIV care is scarce. We describe 25-year outcomes from a pragmatic Indian cohort employing simplified regimens and strategic drug sequencing.MethodsTreatment-naïve adults initiated dual-nucleoside reverse transcriptase inhibitor therapy (2000-2025), reserving protease and integrase inhibitors for later lines (\"class preservation\"). Primary outcomes were survival and treatment durability.ResultsAmong 971 patients retained in care (12,438 patient-years), Kaplan-Meier survival was 95.8% at 5 years and 88.3% at 25 years. Median first-line durability was 8.3 years. Overall, 85% achieved ≥95% adherence. Opportunistic infection incidence declined from 451.5 to 69.7 per 1000 patient-years. Clinically driven monitoring saved US$7578 per patient.ConclusionsFor patients retained in continuous care, strategic sequencing, intensive adherence support, and provider continuity sustained durable outcomes over 25 years. These findings characterize outcomes achievable under sustained engagement rather than population-level results.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261444528"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775151","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":"Treatment Outcome, Medication Adherence, and Associated Factors After the Introduction of Dolutegravir-Based Antiretroviral Therapy (ART) Regimen Among HIV/AIDS Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.","authors":"Zenebe Negash, Yonatan Fekadu, Mengistu Girma Tirore, Zelalem Tilahun Tesfaye, Malede Berihun Yismaw","doi":"10.1177/23259582261446464","DOIUrl":"10.1177/23259582261446464","url":null,"abstract":"<p><p>BackgroundThis study assessed treatment outcomes, medication adherence, and associated factors among human immunodeficiency virus (HIV) patients receiving dolutegravir-based antiretroviral therapy (ART) at Tikur Anbessa Specialized Hospital, Ethiopia.MethodsA hospital-based retrospective study was conducted from February to May 2024 using medical records of patients treated between 2018 and 2020. A total of 425 records were selected through random sampling. Sociodemographic, clinical, and treatment-related data were collected using a structured tool and analyzed with SPSS.ResultsAmong participants, 58.8% were female, and 76.0% were aged 31 to 60 years. Overall, medication adherence was 85.7%, and viral load suppression was achieved in 99.8% of patients. All patients were screened for tuberculosis, and 60% received isoniazid preventive therapy. Adherence was significantly associated with World Health Organization clinical stage, follow-up status, advanced HIV disease, and antiretroviral dose days.ConclusionDolutegravir-based ART showed excellent virologic outcomes and high adherence levels, highlighting key factors influencing treatment success.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261446464"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775157","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":"National Trends in Sexual Behavior, Substance Use and HIV Testing Among United States Men Who Have Sex With Men Recruited Online, 2017 Through 2024.","authors":"Michael Smith, Cristian Acero-Martinez, Irah L Lucas, Mariah Valentine-Graves, Stefan Baral, Sarah M Murray, Patrick S Sullivan, Travis Sanchez","doi":"10.1177/23259582261497550","DOIUrl":"https://doi.org/10.1177/23259582261497550","url":null,"abstract":"<p><p>BackgroundGay men and other men who have sex with men are disproportionately impacted by HIV and other sexual transmitted infections. Thus, monitoring changes to HIV-related risk and prevention behaviors are relevant to contextualizing public health programming. The American Men's Internet Survey (AMIS) is conducted annually for gay men and other men who have sex with men (MSM), aged 15 and older to describe recent trends in key behaviors relevant to HIV prevention.MethodsData from 62,125 analysis-eligible MSM participants in 7 AMIS cross-sectional cycles conducted from July 2017 through October 2024 were analyzed to identify temporal trends in the annual prevalence of sexual behaviors, substance use, and testing behaviors, stratified by participants' self-reported HIV status. Age interactions with behavior trends were also examined.ResultsMSM who reported a negative or unknown HIV status had significant increases in the prevalence of condomless anal intercourse with male partners (CAI) and use of illicit drugs other than marijuana. STI testing and diagnosis prevalence among MSM decreased in 2020 and rebounded starting in 2021. HIV testing prevalence increased among MSM HIV negative/unknown status MSM aged 15-24; MSM in other age groups experienced a reduction in HIV testing in 2020 and a rebound starting in 2021. MSM living with HIV had significant increases in the prevalence of CAI and illicit drug use, including marijuana. STI testing and diagnosis prevalence among MSM living with HIV decreased in 2020 and rebounded starting in 2021.ConclusionsConsistent increases in behaviors that may increase HIV and STI acquisition/transmission risk occurred during a time when HIV and STI testing was significantly impacted by the COVID-19 pandemic followed by a rebound. The complexity of these trends highlights a need for ongoing monitoring of prevention and care behaviors, prevention strategies targeted at reducing risky behaviors and substance use, and expanded access to HIV/STI testing, particularly during times when traditional in-person services may be curtailed.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261497550"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-Based Analysis of Synergistic Effects of Functional Disability and Comorbidities on Retention in HIV Care Among People With HIV.","authors":"Modupe Olajumoke Onigbogi, Osaro Mgbere, Paul Rowan, Ruosha Li, Charles Darkoh","doi":"10.1177/23259582251411352","DOIUrl":"10.1177/23259582251411352","url":null,"abstract":"<p><p>ObjectiveThis cross-sectional study examined how types of disability and comorbidities influence retention in care (RIC) among people with HIV (PWH) in Houston/Harris County, Texas, USA.MethodsData from 1142 participants in the Houston Medical Monitoring Project (2015-2021) were analyzed. Descriptive statistics, bivariate analyses, and multivariable logistic regression were used to evaluate factors associated with RIC.ResultsApproximately 74.9% of participants were retained in care. Compared to PWH without specific comorbidities, those with dyslipidemia and kidney disease had higher odds of RIC (AOR: 2.66; 95% CI: 1.40-5.03 and AOR: 14.08; 95% CI: 1.44-138.12, respectively). PWH reporting only mobility disability had increased odds of RIC (AOR: 3.40; 95% CI: 1.33-8.71), while those reporting only visual disability had reduced odds of RIC (AOR: 0.38; 95% CI: 0.16-0.87). Durable viral suppression was strongly associated with greater RIC (AOR: 7.96; 95% CI: 5.28-11.99).ConclusionComorbidities and disability types significantly influence retention in HIV care. Tailored interventions are needed to improve RIC among PWH, particularly those with visual disabilities.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582251411352"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105938","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":"Crowdsourcing is Acceptable to Develop Pre-Exposure Prophylaxis Promotions in Alabama: A Qualitative Study with Sexual Minority Men and Sexual Health Providers.","authors":"Kevin M Joseph, Latesha Elopre, Lynn T Matthews, Barbara Van Der Pol, Joseph D Tucker, Ronnie M Gravett","doi":"10.1177/23259582251410273","DOIUrl":"10.1177/23259582251410273","url":null,"abstract":"<p><p>IntroductionCrowdsourcing engages the community to create and share solutions; this participatory method could be used to create effective pre-exposure prophylaxis (PrEP) promotions. We explored acceptability of using crowdsourcing to develop PrEP promotions among sexual minority men (SMM) and sexual health providers in Alabama.MethodsWe conducted focus group discussions (FGDs) with SMM and interviews with sexual health providers with guides grounded in the Theoretical Framework of Acceptability. We employed thematic analysis through deductive and inductive coding.ResultsTen SMM (60% Black, 50% younger than 30 years) participated in FGDs, and six providers completed interviews. We found four themes: 1) Personal identity and background inform the participation and products of crowdsourcing, 2) SMM and providers are motivated to participate in crowdsourcing, 3) Crowdsourcing participants require resources to effectively engage, and 4) Logistic and social factors are barriers to crowdsourcing participation.DiscussionCrowdsourcing as a strategy to create PrEP promotions in the Southern United states would be acceptable and feasible in the correct context. These formative, yet novel, findings demonstrate that SMM and sexual health providers would be willing to participate in crowdsourcing events and also provide key insight to design crowdsourcing events.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582251410273"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959717","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":"Initial Antiretroviral Third-Drug Class and Time to Loss of Virologic Suppression: A Real-World Colombian Cohort Study.","authors":"Juan Carlos Alzate-Ángel, Otto Sussmann, Javier Andrade, Beatriz Hernández, Héctor Mueses-Marín, Ximena Galindo, Sandra Liliana Valderrama-Beltrán, William Lenis, Leonardo Montero, Mónica Mantilla, Leonardo Arévalo, Diana Alzamora, Eric Delgado, Martha García, Ernesto Martínez-Buitrago","doi":"10.1177/23259582261436966","DOIUrl":"10.1177/23259582261436966","url":null,"abstract":"<p><p>BackgroundReal-world comparisons of initial antiretroviral third-drug classes are limited in middle-income settings. We evaluated whether the initial third-drug class predicts time to loss of virologic suppression in Colombia.MethodsHistorical cohort of 609 ART-naïve adults (2016-2020). Outcome: first HIV RNA ≥200 copies/mL. We compared NNRTI, PI, and INSTI regimens using adjusted and IPTW-weighted Cox models.ResultsRegimens were NNRTI (72%), PI (20%), and INSTI (8%); 19.9% lost suppression. Compared with NNRTI, PIs showed higher but nonsignificant hazards (aHR 1.50, 95% CI 0.98-2.27). For INSTIs, we did not detect significant differences (aHR 1.22, 95% CI 0.64-2.31). Diagnosis-to-ART delays and treatment interruptions were associated with loss of suppression.ConclusionsTreatment continuity and timely initiation predicted sustained suppression better than drug class. Low INSTI usage limits statistical power to detect differences. Structural barriers to continuity may limit the real-world benefit of newer regimens.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261436966"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521358","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}