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

{"title":"Barriers and Facilitators of Hypertension Care Among PLHIV at Yaoundé Central Hospital, Cameroon. Qualitative Research 2024.","authors":"Francis Duhamel Nang Nang, Liliane Kuate Mfeukeu, Rita Marie Ifoue, André Pascal Kengne, Paul Junior Cheubo, Jean Pierre Junior Tchitetchoun, François Anicet Onana, Fabrice Djouma Nembot, Anastase Dzudie, Siméon Pierre Choukem, Charles Kouanfack","doi":"10.1177/23259582251383981","DOIUrl":"10.1177/23259582251383981","url":null,"abstract":"<p><p>BackgroundIn Cameroon, people living with HIV (PLHIV) receiving antiretroviral therapy (ART) have a high prevalence of hypertension (HTN) and an increased risk of cardiovascular mortality. Managing HTN in this population is a major challenge. This qualitative study, conducted at the Yaoundé Central Hospital, Cameroon, in 2024, explored the barriers and facilitators to hypertension management in PLHIV.MethodsThe study involved 15 participants, including 9 PLHIV diagnosed with hypertension, 03 healthcare providers, and 03 psychosocial agents. A quota sampling approach was used to recruit participants. Data was collected through 12 in-depth interviews and a focus group with 3 psychosocial agents. Data collection took place over a period of 5 months, from January to May 2024. A semistructured interview guide was used to explore participants' perceptions of hypertension management. Data analysis was based on the COM-B model to interpret the results, using NVivo software.ResultsIdentified barriers included a lack of knowledge about hypertension, difficulties in accessing medications due to high costs, and psychosocial issues such as family stress affecting treatment adherence. Additionally, cultural and religious beliefs, such as a preference for traditional treatments and miraculous healings, limited engagement with conventional medicine. However, facilitators included regular visits for ART follow-up, which allowed for hypertension screening, and financial support from families that facilitated access to treatment. The proactive involvement of healthcare providers and continuous communication also contributed to treatment adherence.ConclusionThe study highlights the need for interventions that address socio-economic, cultural, and medical barriers to improve hypertension management in PLHIV, particularly through enhancing access to care and raising awareness.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251383981"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251757","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":"Ensuring Access to HIV Care for Everyone, Especially Those Who Need It Most: A Call for Action and Innovation.","authors":"Chris Duncombe, Wilson Gomez","doi":"10.1177/23259582251333584","DOIUrl":"https://doi.org/10.1177/23259582251333584","url":null,"abstract":"","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251333584"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016618","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":"High Prevalence of Asymptomatic STIs in MSM PWH in a Male HIV Clinic in Mexico City.","authors":"Juan Pablo Sánchez Navarro, Gustavo Barriga Angulo, José Antonio Mata Marín, Mara Rodríguez Evaristo, Paola Edith Padilla Noguera, Jesús Enrique Gaytán Martínez","doi":"10.1177/23259582251321039","DOIUrl":"10.1177/23259582251321039","url":null,"abstract":"<p><strong>Background: </strong>The incidence of sexually transmitted infections (STIs) remains high among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) (PWH). This study determined the prevalence of asymptomatic STIs in MSM PWH attending an HIV clinic in Mexico City.</p><p><strong>Methods: </strong>This cross-sectional study (May 2022-November 2023) included self-questionnaires on STI-related behaviors and symptoms, urethral samples for multiplex polymerase chain reaction (PCR), and serological tests for syphilis, HBV, and HCV.</p><p><strong>Results: </strong>Among 261 patients, 56.7% were receiving antiretroviral therapy, 41.8% had suppressed HIV-1 viral load, and 26.1% tested positive for at least one STI in urethral PCR. The most prevalent microorganisms were <i>Ureaplasma urealyticum</i> (14.9%), <i>Mycoplasma hominis</i> (6.9%), <i>Mycoplasma genitalium</i> (4.2%), and <i>Chlamydia trachomatis</i> (3.1%). Multiple infections were identified in 5.3% of cases. Seroprevalence rates for syphilis, HBV, and HCV were 17.6%, 6.5%, and 3.1%, respectively. Current smoking and insertive anal sex were the only statistically significant associated factors.</p><p><strong>Conclusions: </strong>This study underscores the high frequency of asymptomatic STIs and the importance of regular screening.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251321039"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449481","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":"Out-of-Catchment Area Antiretroviral Therapy Initiation and its Factors among HIV Positive People on Lifelong Therapy in Western Ethiopia: Implementation of Decentralized ART Services.","authors":"Lami Bayisa, Tesfaye Shibiru Keno, Gurmessa Enkosa Ayana, Tesfaye Abera, Adugna Olani Akuma","doi":"10.1177/23259582241307467","DOIUrl":"https://doi.org/10.1177/23259582241307467","url":null,"abstract":"<p><p><b>Background:</b> Decentralized human immunodeficiency virus (HIV) is a model adopted to improve access to antiretroviral therapy (ART) within communities and mitigate the burden of HIV treatment and care on health care facility. In Ethiopia, these services help HIV clients fully benefit from ART as they are able to access ART within their catchment areas. However, HIV clients still travel out of their catchment areas to commence the ART. Thus, this study aimed to assess the magnitude of out-of-catchment area ART initiation and its associated factors among people living with HIV (PLWHIV) in Western Ethiopia. <b>Methods:</b> This cross-sectional study was conducted among 423 PLWHIV from November 25 to December 30, 2025, at Nekemte Comprehensive Specialized Hospital. A systematic sampling method was used to recruit the study participants. Epi Data 3.1 and STATA 14.0 were used for data entry and analysis, respectively. Logistic regression analysis was computed to identify factors associated with out-of-catchment ART initiation among PLWHIV. Variables with a <i>P</i> value <.25 from the bivariable analysis were entered into the multivariable analysis. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and <i>P</i> value <.05 were used to determine a significant association. <b>Results:</b> A total of 423 PLHIV were included in the study. The mean age of study participants was 33.43 ± 9.79 years. One-fifth (22%) of the participants-initiated ART out of their catchment area with 95% (CI: 18.28-26.20). Participants who did not disclose their HIV (AOR = 4.39, 95% CI = 2.45-7.87), tested through voluntary counseling and testing (AOR = 3.99, 95% CI = 2.21-7.19), knowledgeable about HIV/AIDS (AOR = 2.15, 95% CI = 1.18-3.93), using traditional healing (AOR = 1.91, 95% CI = 1.03-3.55), being female (AOR = 2.42, 95% CI = 1.36-4.32), and perceived stigma (AOR = 3.41, 95% CI = 1.88-6.18) were significantly associated with out-of-catchment ART initiation. <b>Conclusion and Recommendation:</b> A substantial number of PLWHIV <i>in study area had</i> initiated ART outside their designated catchment areas. To address this, it is crucial to enhance HIV serostatus disclosure, combat discrimination associated with HIV/AIDS, and promote decentralized HIV care and ART services.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582241307467"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950362","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":"Stakeholder Perspectives on the Role of Peer Mentors in the Implementation of Long-Acting Antiretroviral Therapy for Use by Adolescents and Young People in Western Kenya: Findings from a Formative Study, KuwaFree! LiveFree!","authors":"Salim Bakari, Biegon Whitney, Munyoro Dennis, Shukri Hassan, Caitlin Bernard, Eunice Kaguiri, Mehar Maju, Edith Apondi, Edwin Were, Rena C Patel","doi":"10.1177/23259582241303579","DOIUrl":"10.1177/23259582241303579","url":null,"abstract":"<p><p>Long-acting antiretroviral treatment (LA ART) is a forthcoming option for adolescents and young people living with HIV (AYPLHIV), but perspectives on using peer mentors to implement LA ART for AYPLHIV are unknown. We conducted seven focus group discussions (<i>n</i> = 58 participants) from November 2021 to April 2022 in Kenya with four stakeholder groups, including AYPLHIV, healthcare providers, advocates, and policymakers. We used inductive coding and thematic analysis. Our stakeholders articulated peer mentors are crucial in the implementation of LA ART for AYPLHIV in leading communication, facilitating referrals, and providing empathy from lived experiences. Additionally, they can serve as early adopters, help navigate service points, and provide messaging on the benefits and drawbacks of LA ART. They emphasized the necessity of training peer mentors for the LA ART scale-up. Peer mentors are essential for linkage and referring of AYPLHIV to LA ART, and peer mentors' involvement should be integrated into a national implementation plan.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582241303579"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971576","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":"Trajectories to HIV Viral Suppression and Nonsuppression: Case Studies From Rural East African Adolescents and Young Adults in the SEARCH-Youth Trial.","authors":"Jason Johnson-Peretz, Anjeline Onyango, Cecilia Akatukwasa, Fredrick Atwine, Titus M O Arunga, Lawrence Owino, Florence Mwangwa, Marilyn Nyabuti, Jane Kabami, Laura B Balzer, Diane V Havlir, James Ayieko, Theodore Ruel, Elizabeth A Bukusi, Edwin D Charlebois, Moses Robert Kamya, Carol S Camlin","doi":"10.1177/23259582251337202","DOIUrl":"10.1177/23259582251337202","url":null,"abstract":"<p><p>BackgroundWhile research has identified many associations between socioeconomic factors and human immunodeficiency virus (HIV) nonsuppression, few qualitative studies have defined the mechanisms by which these factors interrelate and lead to HIV nonsuppression. The development of interventions to achieve universal virologic suppression and eliminate transmission will require a deeper understanding of the individual and social processes that drive antiretroviral therapy (ART) nonadherence and consequent viral nonsuppression.MethodsWe used a semistructured interview-based case-study approach to characterize changes across 3 time points in the lived contexts of 11 adolescents and young adults (aged 15-24 years) from intervention and control arms of a longitudinal HIV intervention trial in rural Kenyan and Ugandan communities. We sought to determine commonalities among those who never virally suppressed, those who became nonsuppressed, and those who moved from nonsuppression to viral suppression, exploring social and behavioral micro-processes or causal chains observed among individuals who share these trajectories.ResultsWe found that supportive family environments, high-quality service provision, and residential and partnership stability free of violence, or that permitted freedom to move and maintain extensive social ties both inside and outside one's immediate community, enabled ART adherence. We also found that several factors combine to have effects beyond each individual factor taken singly, for example, medication side effects were influenced by food insecurity; disclosure was most effective with individuals around whom one may potentially take medication, such as co-resident partners; and mobility compromised adherence when patients did not know how or where to access care in new places.RecommendationsOur findings suggest that to improve virologic suppression, clinical care and interventions should include assessment and strategies to address food insecurity, ART disclosure, and home-based violence from intimate partners or other family members. When such factors are present, we suggest referral for services, including violence prevention and protection services, and food provision for those patients who do not adhere because of medication side effects amplified by lack of food. We further recommend that clinics coordinate regionally to anticipate mobility, facilitate transfer of care to other areas, and ensure clients have access to information about care clinics elsewhere in the region.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251337202"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016697","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":"Meaningful Engagement as a Cornerstone for Implementing the Key Recommendations to Advance the Sexual and Reproductive Health and Rights of Women Living With HIV Across Policy, Practice, and Research in Canada.","authors":"Zoë Osborne, Muluba Habanyama, Brittany Cameron, Alexandra de Pokomandy, Brenda Gagnier, Elizabeth King, Jill Koebel, Mona Loutfy, Carrie Martin, Renée Masching, Manjulaa Narasimhan, Valerie Nicholson, Neora Pick, Stephanie Smith, Shelly Tognazzini, Wangari Tharao, Angela Kaida","doi":"10.1177/23259582241302773","DOIUrl":"10.1177/23259582241302773","url":null,"abstract":"<p><p>In 2022, a community-academic collaborative team published 5 key recommendations for developing a national action plan to advance the sexual and reproductive health and rights (SRHR) of women living with HIV in Canada. In 2023, a national gathering was convened to strategize implementation of the recommendations across policy, practice, and research settings. Discussions highlighted that meaningful engagement of women living with HIV (recommendation 1) is foundational to implementing the other recommendations. Meaningful engagement requires SRHR stakeholders to: actively dismantle power differentials; commit to engagement as an ongoing process; learn about regionally specific epidemiology and sociostructural forces that create and sustain vulnerability for HIV among women; invest in creating supportive infrastructure; and integrate Equity, Diversity, and Inclusion principles to call diverse groups into the conversation. This Canadian initiative demonstrates how global guidelines can be transformed into nationally tailored action plans to advance the SRHR of women living with HIV, grounded in meaningful engagement.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582241302773"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950447","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":"Moving Beyond Viral Suppression: Poor Patient-Provider Communication and Its Impact on Healthcare Outcomes Among People Living With HIV in the United States.","authors":"Bekana K Tadese, M Janelle Cambron-Mellott, Jean Marie Arduino, Bridget L Balkaran, Shakiba Eslamimehr, José M Zuniga","doi":"10.1177/23259582251359440","DOIUrl":"10.1177/23259582251359440","url":null,"abstract":"<p><p>BackgroundWhile advancement in treatment have turned HIV into a manageable chronic condition achieving viral suppression, it has become imperative to focus on overall health and improving health-related quality of life of people living with HIV (PLHIV) beyond viral suppression. This study aimed to describe how PLHIV perceive and manage their overall health, factors influencing patient-provider communication, and the impact of poor patient-provider communication on health outcomes.MethodsThis cross-sectional, online survey recruited HIV-positive adults in the United States between February 22 and June 2, 2022, via the Profiles Panel. Data on sociodemographic and health characteristics, and social determinants of health were collected. The study assessed how PLHIV view and manage their overall health by measuring self-rated overall health, Patient Activation Measure^® (PAM^®), general and HIV-specific health locus of control (HLOC). Multivariable analyses were used to identify the barriers and unmet needs in the patient-primary HIV clinician communication.ResultsOf the 781 PLHIV who completed the study, most participants were cisgender male (56.2%), non-Hispanic, White (51.5%), and <50 years old (67.0%). Over 90% of participants reported being virally suppressed or having an undetectable viral load. About one-third (31.5%) reported their overall health as either poor or fair. Participants were highly activated in managing their health with 58.0% at PAM level 3 and 33.3% at level 4 and had high scores across the dimensions of both general and HIV-specific HLOC. Overall, 18.2% of the participants reported suboptimal satisfaction and 16.8% reported facing difficulty in verbalizing their HIV-related health concerns with their primary HIV clinician. One-fourth of the participants reported \"sometimes\" or \"never/rarely\" discussing their HIV treatment medications with their primary HIV clinician. Furthermore, participants dissatisfied with their primary HIV clinician were twice as likely to self-report poor overall health (OR: 2.2, 95% CI: 1.38, 3.48).ConclusionThis study underscores the critical role of managing overall health by optimizing patient-provider relationships in influencing individual holistic well-being beyond viral suppression. Healthcare interventions should prioritize strategies to enhance patient communication and satisfaction, recognizing its profound impact on HIV and overall health outcomes.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251359440"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659529","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 Study of Risk Factors for Internalized Stigma among People with HIV in Washington, DC: Evaluating Modification by Gender.","authors":"Lauren F O'Connor, Jenna B Resnik, Morgan Byrne, Patricia E Houston, Sam Simmens, Amanda D Castel, Sohail Rana, Anne K Monroe","doi":"10.1177/23259582251370561","DOIUrl":"10.1177/23259582251370561","url":null,"abstract":"<p><p>ObjectivesThere is a high prevalence of internalized stigma among people with HIV (PWH) and it is possible that factors associated with stigma differ by gender. Therefore, we evaluated whether gender is an effect modifier of the association between covariates and internalized stigma among 694 PWH.MethodsLinear regression with interaction terms between covariates and gender was used to evaluate significant associations and test for interactions.ResultsWe found a 10-year increase in age was associated with lower stigma among women (β (95% CI): -0.20 (-0.30, -0.10)) but not among men (β = 0). Generalized anxiety disorder (GAD) was associated with higher stigma (GAD & GAD-squared β (95% CI): 0.12 (0.08, 0.187), -0.004 (-0.006, -0.001)) and an increased time since HIV diagnosis was associated with lower stigma (β (95% CI): -0.20 (-0.30, -0.10)).ConclusionsGender-specific interventions should be developed to account for the differences in the association between age and stigma across genders.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251370561"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958943","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 Fidelity of HIV/AIDS Care and Support Services for Orphan and Vulnerable Children in Gondar City, Northwest Ethiopia: A Mixed-Methods Evaluation.","authors":"Samuel Abebayehu, Endalkachew Mesfin Gebeyehu","doi":"10.1177/23259582251372458","DOIUrl":"10.1177/23259582251372458","url":null,"abstract":"<p><p>ObjectiveThis study evaluated the implementation fidelity (IF) of HIV/AIDS Care and Support (C&S) services for orphans and vulnerable children (OVC) at the African Network for Prevention and Protection Children against Neglect (ANPPCAN) Project, Gondar City, 2023.MethodA facility-based convergent parallel mixed-methods design was used to assess IF and identify factors influencing caregiver responsiveness. Quantitative data were collected from 424 OVC caregivers, 385 document reviews, 27 observations, and an inventory checklist. Qualitative data were obtained from five key informant interviews. Data were gathered concurrently, analyzed separately, and integrated during interpretation to provide a comprehensive view.ResultThe overall IF was 67.35%, with adherence at 81.5%, dosage at 45%, and caregiver responsiveness at 70.6%. Responsiveness was significantly associated with having separate waiting rooms, take-home materials, and friendly service delivery.ConclusionAlthough adherence was high, dosage was low and responsiveness moderate, indicating the need to strengthen service delivery components to improve implementation fidelity.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251372458"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958907","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}