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

{"title":"Psychological and Emotional Challenges Faced by Female HIV Counselors in Kashmir-A Phenomenological Study.","authors":"Khalid Bashir, Inaamul Haq, Mariya Amin Qurieshi, S Muhammad Salim Khan","doi":"10.1177/23259582251321035","DOIUrl":"10.1177/23259582251321035","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) counselors play a crucial, albeit challenging, role in preventing and controlling HIV. People living with HIV (PLHIV) need emotional support in addition to clinical treatment. Counseling is more difficult for female counselors, considering the psychological and emotional aspects of HIV counseling.</p><p><strong>Methodology: </strong>A qualitative study design was used to understand the complexity of the challenges faced by female HIV counselors. Interpretative phenomenological analysis (IPA) was employed as the research design. A small, homogeneous sample was purposively selected, comprising all 11 female HIV counselors in the Kashmir province and one female counselor in Leh (Ladakh). The IPA methodology was utilized, which emphasizes meaning-making and understanding the counselor's perspectives. The study was conducted from December 2022 to January 2023, with data collected through in-depth interviews at the counselors' workplaces and via Zoom for the Leh participant. Data were analyzed thematically using the IPA approach, revealing the counselors' real-life experiences, perceptions, and challenges.</p><p><strong>Results: </strong>The analysis generated two superordinate themes with multiple overarching themes and sub-themes: Intrusive emotional and psychological experiences: Counselors experienced significant emotional strain, including emotional exhaustion, burnout, and stigma. Inadequate skills for effective counseling of people who inject drugs (PWID): Limited training hindered effective counseling for substance users and PWID, highlighting the need for specialized training.</p><p><strong>Conclusion: </strong>Female HIV counselors in Kashmir face numerous psychological and emotional challenges, including emotional exhaustion, burnout, and stigma. Additionally, there is a lack of adequate training for counseling substance users. Addressing these issues through specialized training, stigma reduction initiatives, and mental health support is crucial for improving HIV counseling services and the overall HIV/AIDS response in the region.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251321035"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449483","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":"People Living with HIV's Worry That the COVID-19 Health Crisis Could Impact Long-Term HIV Care: Lessons From the French Context for Future Disease Epidemics.","authors":"M Salcedo, T Alain, C Lacoux, J C Jones, C Della Vecchia, N Charpentier, R Mabire-Yon, L Vallet, X Mabire, D Ferraz, D Michels, M Préau","doi":"10.1177/23259582251320127","DOIUrl":"10.1177/23259582251320127","url":null,"abstract":"<p><p><b>Background:</b> In 2020, people living with HIV (PLHIV) in France were worried that the COVID-19 health crisis would lead to long-term changes in their HIV care. Using data from the anonymous, online, cross-sectional survey ACOVIH, which was completed by PLHIV between July and September 2020, this study explored factors associated with worry about long-term changes to HIV care after the end of the first lockdown (17 March-11 May 2020). <b>Methods:</b> Using multivariate logistic regression, we compared participants who declared they were worried about long-term changes with those who did not, in terms of their demographic, behavioral, and socioeconomic characteristics, as well as their experience of the COVID-19 crisis and access to care. <b>Results:</b> Among the 249 respondents, 61.5% (n = 153) declared having worries about long-term changes to HIV care. Specifically, after adjustment for gender and age, PLHIV born outside of France (adjusted odds ratios (aOR) [95%CI] = 2.57[1.44;6.76]), those whose financial situation deteriorated since the beginning of the pandemic (4.87[1.97;13.20]), those with a history of HIV opportunistic infections (3.27[1.53;7.32]), and respondents who took psychotropic drugs (3.21[1.50;7.22]) were all more likely to declare having worries. In terms of related determinants, a deterioration in communication with their HIV medical team (3.47[1.61;7.94]), having worries about COVID-19 (1.36[1.14;1.62]), and believing that HIV treatment increased the risk of COVID-19 infection (1.52[1.15;2.03]), were all significantly associated with having worries about long-term changes to HIV care. <b>Conclusion:</b> In the context of future disease epidemics, taking into account the profiles of individual PLHIV, and providing clearer, targeted information on HIV care, could help reduce worry in this population about the continuity of HIV care and could foster efficient communication with care providers.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251320127"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537372","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":"Uncompromising Scientific Integrity.","authors":"José M Zuniga, Chris Duncombe","doi":"10.1177/23259582251333581","DOIUrl":"https://doi.org/10.1177/23259582251333581","url":null,"abstract":"","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251333581"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001439","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 Preexposure Prophylaxis Service Delivery Models for Emergency Departments: A Qualitative Study.","authors":"Ethan Cowan, Susie Hoffman, Laurie J Bauman, Yvette Calderon, Tatiana Gonzalez-Argoti, Christine T Rael, Jonathan Porter, Joanne E Mantell","doi":"10.1177/23259582251342842","DOIUrl":"10.1177/23259582251342842","url":null,"abstract":"<p><p>BackgroundOral preexposure prophylaxis (PrEP) effectively prevents HIV but is underutilized in the United States, particularly among populations with higher incidence of HIV. Emergency departments (EDs), which often care for medically underserved individuals, could play a key role in expanding PrEP access. However, integrating PrEP into ED workflows presents challenges.MethodsThis qualitative study involved interviews with 22 stakeholders from 15 EDs and 4 sexual health clinics across the United States. Participants included ED leaders, providers, and navigators. The data were analyzed using a PrEP care cascade model, focusing on provider buy-in, patient identification, education, PrEP initiation, and linkage to care.ResultsKey barriers included limited provider knowledge, ED priorities focused on acute care, and the reliance on grant funding without long-term plans for sustainability. Successful programs relied on ED champions to advocate for PrEP and improve staff engagement. Some EDs offered same-day PrEP prescriptions or starter packs, which improved uptake, but most relied on referrals and had low follow-up rates. Patient identification strategies, such as using navigators or risk scores, varied across sites. Education was often led by ancillary staff, as ED providers had limited time and training. Sustainability remained a major challenge, as most programs were dependent on short-term funding.ConclusionsTo expand PrEP access in EDs, it is essential to address systemic barriers, improve provider training and establish sustainable funding models. Streamlined workflows, dedicated staff, and targeted interventions can help EDs play a more active role in HIV prevention.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251342842"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150915","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 Longitudinal Investigation of Chemsex and Its Relationship with Depressive Symptoms Among Gay, Bisexual Men and Other Men Who Have Sex with Men in Taiwan.","authors":"Shih-Chun Hua, Stephane Wen-Wei Ku, PoYao Huang, Nai-Ying Ko, Chia-Wen Li, Adam Bourne, Carol Strong","doi":"10.1177/23259582251339906","DOIUrl":"10.1177/23259582251339906","url":null,"abstract":"<p><p>BackgroundThis study examines chemsex patterns among gay, bisexual, and other men who have sex with men (GBMSM) and their link to depression using a longitudinal approach. Recognizing and addressing chemsex is crucial for human immunodeficiency virus (HIV) care providers, as it supports harm reduction and effective HIV prevention and treatment for GBMSM.MethodsFrom 2017 to 2021, GBMSM at two sexual health clinics completed follow-up questionnaires. We identified chemsex trajectories using group-based modeling and assessed their association with depressive symptoms over two years using multivariable logistic models.ResultsAmong 256 GBMSM, three chemsex patterns were found: \"never or rarely engaged\" (87.4%), \"consistently engaged\" (8.8%), and \"high, decreasing and reinitiated\" (3.8%). There were no significant differences in depressive symptoms between the \"never or rarely engaged\" group and the other patterns.ConclusionsThe study reveals diverse chemsex behaviors but does not provide clear evidence linking these patterns to differences in depressive symptoms among GBMSM.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251339906"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027214","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":"Healthcare Providers' Perspective on HIV Testing and Hypothetical mHealth-connected Linkage to Care Among Men who have Sex with Men (MSM) in South Carolina.","authors":"Tony Brown, Prince Nii Ossah Addo, Monique J Brown, Xiaoming Li, Oluwafemi Adeagbo","doi":"10.1177/23259582251343669","DOIUrl":"10.1177/23259582251343669","url":null,"abstract":"<p><p>BackgroundHIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers' willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers' perceptions of HIV testing and treatment uptake among MSM, and providers' willingness to use mHealth technology to address barriers to HIV testing and treatment in SC.MethodsBetween August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on their experience (2-11 years of service) providing HIV-related services to MSM in peri-urban (<i>n</i> = 7) and rural (<i>n</i> = 3) SC. The interviews were audio recorded, lasted 40-70 min, and were transcribed verbatim. The interview transcripts were analyzed inductively.ResultsFive themes emerged from the analysis: (a) challenges to HIV testing services; (b) concerns about HIV knowledge and status in the MSM community; (c) mixed feelings about HIV self-testing; (d) providers' perception of HIV treatment uptake and retention; and (e) potential of mHealth technology for the delivery of HIV care. Overall, participants reported limited resources, homophobia, medical mistrust, distance, medical costs, and HIV-related stigma as major barriers to HIV testing and treatment uptake in their localities (especially in rural areas). Particularly, they reported that MSM experience significant stigma associated with their sexual orientation and HIV.ConclusionsGiven barriers to care such as stigma and lack of access to care still impede MSM from receiving appropriate HIV services, mHealth-connected approaches could potentially address the barriers to HIV testing and care among MSM and improve their health outcomes. This is key to ending the HIV epidemic in SC and the United States by 2030.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251343669"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150911","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":"Epidemiology of Antiretroviral Therapy Related Adverse Drug Reactions and its Predictors Among Patients with Human Immunodeficiency Virus/AIDS in Ethiopia: A Systematic Review and Meta-analysis.","authors":"Woretaw S Zewdu, Samuel B Dagnew, Mulugeta M Zeleke, Yared A Ferede, Achenef B Kassie, Tilay A Moges, Muluken A Alemu","doi":"10.1177/23259582251358929","DOIUrl":"10.1177/23259582251358929","url":null,"abstract":"<p><p>ObjectiveAdverse drug reactions (ADRs) induce iatrogenic harm in antiretroviral therapy (ART) care continuum. However, there is a dearth of concrete evidence in a resource-limited setting. Thus, this study was designed to consolidate existing knowledge, thereby informing policy and clinical care to improve patient safety.DesignSystematic review and meta-analysis.Data sourcesPubMed, CINAHL, Web of Science, and EMBASE databases were searched.Eligibility criteriaEmploying the condition, context, and population framework, observational primary studies were included.Data extraction and synthesisIndependent reviewers undertook data extraction and synthesis. This meta-analysis employed the random-effects restricted maximum likelihood (REML) method, with its protocol preregistered on the International Register of Systematic Reviews (CRD42024546390).ResultsThe pooled prevalence of ADRs was 36.7% [95% CI: 26.6-46.9, <i>I</i>² = 99.64%].ConclusionAltogether, this study revealed that ART-related ADRs in Ethiopia was 36.7%, underscoring rigorous monitoring. Giving special emphasis to patients with female gender, advanced disease, comorbidities, malnutrition, TB treatment, and poor adherence is a prudent decision.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251358929"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642863","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":"Clinical Outcomes of a Nurse-Delivered, Technology-Enabled HIV Outpatient Model.","authors":"Sara Day, Rebecca Wilkins, Andrew Murungi, Christina Antoniadi, Yodit Fissahaye-Yimer, Samuel Ohene-Adomako, David Asboe, Caroline Rae","doi":"10.1177/23259582241274304","DOIUrl":"10.1177/23259582241274304","url":null,"abstract":"<p><p>We evaluated Klick, a nurse-led, digitally enabled model of HIV outpatient care, launched in 2020. Klick's smartphone app offers online booking, remote nurse-led consultations, and results. An audit of Klick nurse-led consultations was conducted against BHIVA monitoring guidelines, and nurses were interviewed about their experience. Of 40 Klick patients audited, 4 of 5 BHIVA standards were met: 100% had documented co-medications, smoking history, blood pressure, and viral load data, and 89% received a cardiovascular risk calculation (Targets 97%-90%-90%-90%-90%). Compared to national BHIVA audit findings, Klick performed better across 22 of 24 comparable measures. Nurses safely managed a cohort comprising some complexity (eg, co-morbidities, polypharmacy); no cases were escalated off the pathway, and all were virologically suppressed. Using a digitally supported model, nurses effectively provided safe care to HIV-positive patients with predominantly stable health, enabling consultants to focus on more complex caseloads. Care was comprehensive and person-centered and obtained better outcomes compared to previous national audits.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241274304"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289968","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":"Application of the UNAIDS Incidence Patterns Model to Determine the Distribution of New HIV Infection in Lagos State, Nigeria.","authors":"Toriola Femi-Adebayo, Monsurat Adeleke, Bisola Adebayo, Temitope Fadiya, Bukola Popoola, Opeyemi Ogundimu, Funmilade O Adepoju, Ayotomiwa Salawu, Oladipupo Fisher, Olusegun Ogboye, Leopold Zekeng","doi":"10.1177/23259582241238653","DOIUrl":"10.1177/23259582241238653","url":null,"abstract":"<p><strong>Background: </strong>Identifying patterns in the distribution of new HIV infections in the population is critical for HIV programmatic interventions. This study aimed to determine the distribution of New HIV infection by applying the incidence patterns mathematical model to data from Lagos state.</p><p><strong>Methods: </strong>The incidence patterns model (IPM) software is a mathematical model developed by UNAIDS to estimate the demographic and epidemic patterns of HIV infections. This model was adapted in Lagos state to predict the distribution of new HIV infections among specified risk groups in the next 12 months.</p><p><strong>Results: </strong>The IPM predicted a total HIV incidence of 37 cases per 100 000 individuals (3979 new infections) will occur among the 15 to 49 subpopulations. The results also showed that sero-concordant HIV-negative couples with external partners (29%), female sex workers (26%), men-having-sex-with-men (18%), and previously married females (6%) accounted for the majority of the estimated new HIV infections. Overall, key populations constitute almost half (48%) of the estimated number of new HIV infections.</p><p><strong>Conclusion: </strong>The study helped to identify the population groups contributing significantly to new HIV infections. Therefore, priority interventions should be focused on these groups.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241238653"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175173","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 of Frailty Phenotypes in Older People Living with HIV: A Cross-Sectional Study from Brazil.","authors":"Susana Lilian Wiechmann, Alexandre Mestre Tejo, Manuel Victor Silva Inácio, Arthur Eumann Mesas, Marcos Aparecido Sarria Cabrera","doi":"10.1177/23259582241241169","DOIUrl":"10.1177/23259582241241169","url":null,"abstract":"<p><strong>Background: </strong>Frailty may affect people living with HIV (PLHIV) prematurely. Fried's frailty phenotype, composed of 5 criteria, is one of the most used instruments for its assessment. This study aimed to determine the prevalence of these criteria among PLHIV classified as prefrail and frail in Brazil.</p><p><strong>Methods: </strong>A cross-sectional study analyzed the prevalence of the Frailty Phenotype in Brazil with 670 individuals aged ≥ 50 years and undetectable viral load.</p><p><strong>Results: </strong>The prevalence of prefrail and frail individuals was 50.7% and 13.6%, respectively. A low level of physical activity was the most prevalent criterion (50.9%). Except for unintentional weight loss, all other criteria were more prevalent among individuals with lower education levels. All criteria were more prevalent among individuals of lower socioeconomic status than among those of moderate or high status (<i>P</i> < .05).</p><p><strong>Conclusions: </strong>A low level of physical activity was the component that most contributed to PLHIV being considered prefrail or frail.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241241169"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876726","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}