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

{"title":"Negative Lifestyle Factors Specific to Aging Persons Living with HIV and Multimorbidity.","authors":"William Pastor Smith","doi":"10.1177/23259582241245228","DOIUrl":"10.1177/23259582241245228","url":null,"abstract":"<p><p>The primary goal of medical care during the pre-antiretroviral therapy (ART) era was to keep persons living with human immunodeficiency virus (HIV) alive, whereas since the advent of ART, the treatment objective has shifted to decreasing viral loads and infectiousness while increasing CD4+ T-cell counts and longevity. The health crisis, however, is in preventing and managing multimorbidity (ie, type 2 diabetes), which develops at a more accelerated or accentuated pace among aging persons living with HIV. Relative to the general population and age-matched uninfected adults, it may be more difficult for aging HIV-positive persons who also suffer from multimorbidity to improve negative lifestyle factors to the extent that their behaviors could support the prevention and management of diseases. With recommendations and a viable solution, this article explores the impact of negative lifestyle factors (ie, poor mental health, suboptimal nutrition, physical inactivity, alcohol use) on the health of aging individuals living with HIV.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241245228"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759494","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":"Predictors of Mothers Living with HIV Uptake of HIV Early Infant Diagnosis Services in Iringa District, Tanzania.","authors":"Happy Alfayo Kyando, Novatus Tesha, Emmy Metta","doi":"10.1177/23259582241272007","DOIUrl":"10.1177/23259582241272007","url":null,"abstract":"<p><strong>Background: </strong>Uptake of HIV early infant diagnosis (HEID) among HIV-exposed infants is the key to timely initiation of Antiretroviral Treatment (ART). However, despite the availability of HEID services in Tanzania, its uptake is low. We aimed to determine predictors of mothers living with HIV' with HIV-exposed infants' uptake of HEID services in Iringa District, Tanzania<b>.</b></p><p><strong>Methods: </strong>A health facility-based cross-sectional study was conducted in Iringa District from May to June 2023. Mothers with HIV-exposed infants were recruited in the study through a multistage sampling technique and interviewed using pre-tested structured questions. Logistic regression analysis was employed to determine potential predictors of HEID uptake.</p><p><strong>Results: </strong>A total of 309 mothers with HIV-exposed infants participated in the study. About 78.3% of the HIV-exposed infants had initial DNA PCR for HEID within 6 weeks of age and 86.1% within 8 weeks. Most mothers had high perceived benefits on uptake of HEID with a mean score of 4.3, high perceived self-efficacy with a mean score of 3.8 and 2.7 perceived risk of HIV infection on their HIV-exposed infants on the 5 scale Likert scale with 5 showing the highest perceived benefit, self-efficacy and risk. High perceived self-efficacy and being a businesswoman were the predictors of uptake of HEID. The odds of self-efficacy on the uptake of HEID by 2.4 times (aOR 2.4 95% CI 1.6-3.2) within 6 weeks of age and 1.9 (aOR 1.9 95% CI 1.3-2.7) within 8 weeks. The odds of being a businesswoman were 0.4 for 6 weeks and 0.3 for 8 weeks (aOR 0.4 95% CI 0.2-0.8) and (aOR 0.3 95% CI 0.1-0.8) respectively.</p><p><strong>Conclusion: </strong>Over three-quarters of the HIV-exposed infants had initial DNA PCR for HEID testing as recommended. Perceived self-efficacy was the main factor influencing HEID uptake. These findings highlight the need for strengthening HIV-positive mother's self-efficacy for improved uptake of HEID services.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241272007"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126083","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":"U = U: A Catalyst for Ending AIDS as a Public Health Threat.","authors":"José M Zuniga","doi":"10.1177/23259582241282561","DOIUrl":"10.1177/23259582241282561","url":null,"abstract":"","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241282561"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289970","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":"Multilevel Factors Impacting PrEP Engagement Among Young Gay Men and Young Transgender Women in Thailand: A Qualitative Analysis.","authors":"Peter A Newman,&nbsp;Suchon Tepjan,&nbsp;Kangwan Fongkaew,&nbsp;Pakorn Akkakanjanasupar,&nbsp;Jan Willem de Lind van Wijngaarden,&nbsp;Nuttapon Chonwanarat","doi":"10.1177/23259582231188221","DOIUrl":"https://doi.org/10.1177/23259582231188221","url":null,"abstract":"<p><p>Half of new HIV infections in Thailand are among young people, the majority of whom are young gay and other men who have sex with men (YMSM) and young transgender women (YTGW). Amid low pre-exposure prophylaxis (PrEP) coverage, we explored practice-based factors that impact PrEP engagement among YMSM and YTGW. In 2018, we conducted 4 focus group discussions with 20 YMSM and 5 YTGW, and 22 in-depth interviews (5 in 2022) with healthcare providers (HCPs), community-based organization (CBO)/nongovernmental organization (NGO) staff, and peer educators. The inclusion of PrEP in universal healthcare coverage, including YMSM and YTGW, is a substantial facilitator of PrEP use; however, systemic barriers at microsocial (lack of communication about PrEP from HCPs, teachers, parents), mesosocial (healthcare-service fragmentation, lack of PrEP-competent HCPs), and macrosocial levels (annual quotas on free HIV-testing, HIV- and sexual-stigma) constrain and disincentivize adolescents' engagement with PrEP. National scale-up of youth-friendly and LGBT-affirmative CBO/NGO clinics, HCP training, and tailored programs to support adolescents' adherence may promote PrEP engagement among YMSM and YTGW in Thailand.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"22 ","pages":"23259582231188221"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9850062","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":"Sex Differences in the Cognitive Performance of a South African Cohort of People With HIV and Comorbid Major Depressive Disorder.","authors":"Anna J Dreyer, Sam Nightingale, Lena S Andersen, Jasper S Lee, Hetta Gouse, Steven A Safren, Conall O'Cleirigh, Kevin G F Thomas, John A Joska","doi":"10.1177/23259582231203192","DOIUrl":"10.1177/23259582231203192","url":null,"abstract":"<p><p>Women with HIV (WWH) may be more vulnerable to cognitive impairment than men with HIV (MWH), which may be explained by the direct effects of HIV or by sociodemographic and psychiatric characteristics. We recruited 105 people with HIV (PWH; 76 women) with incomplete antiretroviral therapy adherence, comorbid major depressive disorder, and socioeconomically disadvantaged backgrounds. Participants completed neuropsychological testing and measures gathering sociodemographic, medical, and psychiatric information. We compared WWH and MWH cognitive performance using unadjusted and adjusted regressions, and within each respective group, we explored predictors of cognitive performance. Results showed no significant between-sex differences in cognitive performance, both globally and within domains. Fewer years of education (<i>β</i> = 0.94), illiteracy (<i>β</i> = 4.55), and greater food insecurity (<i>β </i>= -0.28) predicted lower cognitive performance in WWH but not MWH. We conclude that sex differences in PWH are likely due to sample characteristics representing broader inequalities, rather than true biological differences.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"22 ","pages":"23259582231203192"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/7a/10.1177_23259582231203192.PMC10548808.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134915","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 Model for Accelerating Access to Care and Treatment for Children and Adolescents Living with HIV in Nigeria, Tanzania, Uganda, and Zambia: The Faith-Based Action for Scaling-Up Testing and Treatment for the Epidemic Response (FASTER) Initiative.","authors":"Daniel Oliver, David Mabirizi, Marisa Hast, Mary Grace Alwano, Chalilwe Chungu, Alphonce Kelemani, Chizoba Mbanefo, Jessica Gross, KaeAnne Parris, Stephanie Dowling, Adele Clark, Amanda Williams, Lauren Simao, Carolyn Amole, Kanchana Suggu, Jibrin Kama, Felton Mpasela, Leah Mtui, Vennie Nabitaka, Renée Saunders, Dhelia Williamson, Emilia D Rivadeneira, Susan Hrapcak, Sophie Nantume, Esther Nazziwa, Megumi Itoh, Edward Machage, Chibuzor Onyenuobi, Gloria Munthali, Anath Rwebembera, Mwiya Mwiya, Cordelia Katureebe, Akudo Ikpeazu, Thomas Fenn","doi":"10.1177/23259582231186701","DOIUrl":"10.1177/23259582231186701","url":null,"abstract":"<p><p>The number of children newly infected with HIV dropped by 50%, from 320 000 in 2010 to 160 000 in 2021. Despite progress, ongoing gaps persist in diagnosis, continuity of care, and treatment optimization. In response, the United States President's Emergency Plan for AIDS Relief created the Faith-based Action for Scaling-Up Testing and Treatment for Epidemic Response (FASTER). Faith-based Action for Scaling-Up Testing and Treatment for Epidemic Response addressed gaps in countries with the highest unmet need by working with government to operationalize innovative interventions and ensure alignment with national priorities and with communities living with HIV to ensure the change was community-led. Between 2019 and 2021, FASTER's interventions were incorporated into national policies, absorbed by Ministries of Health, and taken up in subsequent awards and country operating plans. Continued effort is needed to sustain gains made during the FASTER initiative and to continue scaling evidence-based interventions to ensure that children and adolescents are not left behind in the global HIV response.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"22 ","pages":"23259582231186701"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/02/10.1177_23259582231186701.PMC10388624.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9909796","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":"Factors Associated With Changes in Alcohol Use During Pregnancy and the Postpartum Transition Among People With HIV in South Africa and Uganda.","authors":"Amelia M Stanton,&nbsp;Benjamin D Hornstein,&nbsp;Nicholas Musinguzi,&nbsp;Brett Dolotina,&nbsp;Catherine Orrell,&nbsp;Gideon Amanyire,&nbsp;Stephen Asiimwe,&nbsp;Anna Cross,&nbsp;Christina Psaros,&nbsp;David Bangsberg,&nbsp;Judith A Hahn,&nbsp;Jessica E Haberer,&nbsp;Lynn T Matthews","doi":"10.1177/23259582231161029","DOIUrl":"https://doi.org/10.1177/23259582231161029","url":null,"abstract":"<p><p>Identifying factors associated with alcohol use changes during pregnancy is important for developing interventions for people with HIV (PWH). Pregnant PWH (n = 202) initiating antiretroviral therapy in Uganda and South Africa completed two assessments, 6 months apart (T1, T2). Categories were derived based on AUDIT-C scores: \"no use\" (AUDIT-C = 0 at T1 and T2), \"new use\" (AUDIT-C = 0 at T1, >0 at T2), \"quit\" (AUDIT-C > 0 at T1, =0 at T2), and \"continued use\" (AUDIT-C > 0, T1 and T2). Factors associated with these categories were assessed. Most participants had \"no use\" (68%), followed by \"continued use\" (12%), \"quit\" (11%), and \"new use\" (9%). Cohabitating with a partner was associated with lower relative risk of \"continued use.\" Borderline significant associations between food insecurity and higher risk of \"new use\" and between stigma and reduced likelihood of \"quitting\" also emerged. Alcohol use interventions that address partnership, food security, and stigma could benefit pregnant and postpartum PWH.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"22 ","pages":"23259582231161029"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10034296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9587331","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-Related Stigma Shapes Research Participation for Youth Living With HIV in Kenya.","authors":"Emma Gillette,&nbsp;Violet Naanyu,&nbsp;Winstone Nyandiko,&nbsp;Ashley Chory,&nbsp;Michael Scanlon,&nbsp;Josephine Aluoch,&nbsp;Hillary Koros,&nbsp;Celestine Ashimosi,&nbsp;Whitney Beigon,&nbsp;Dennis Munyoro,&nbsp;Janet Lidweye,&nbsp;Jack Nyagaya,&nbsp;Allison DeLong,&nbsp;Rami Kantor,&nbsp;Rachel Vreeman","doi":"10.1177/23259582231170732","DOIUrl":"https://doi.org/10.1177/23259582231170732","url":null,"abstract":"<p><p><b>Introduction:</b> HIV stigma affects medication adherence, psychosocial outcomes, and clinical management for youth living with HIV (YLWH). We explored the impact of HIV stigma on research participation, to inform the ethical engagement of this vulnerable group. <b>Methods:</b> We interviewed 40 YLWH, 20 caregivers, and 39 subject matter experts (SMEs); transcripts were analyzed by HK and EG, with emerging themes confirmed by JA and AC. <b>Results:</b> All categories of participants identified the impacts of stigma on YLWH research participation, suggesting implementing privacy protections, considering recruitment locations carefully, and developing supportive relationships with YLWH. SMEs suggested that YLWH experience uniquely high risks from stigma due to the compounding effects of developmental challenges and transitionary life period. Accidental HIV disclosure and subsequent stigma were identified as a risk of research participation; some viewed the creation of community through research as a benefit. <b>Conclusion:</b> Participants provided insights into stigma-related considerations for research with YLWH, which may guide engagement protocols.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"22 ","pages":"23259582231170732"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/4c/10.1177_23259582231170732.PMC10141251.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10061692","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 Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program.","authors":"Pupe Sudsila, Sirinya Teeraananchai, Sasisopin Kiertiburanakul, Cheewanan Lertpiriyasuwat, Rattaphon Triamwichanon, Sivaporn Gatechompol, Opass Putcharoen, Ploenchan Chetchotisakd, Anchalee Avihingsanon, Stephen J Kerr, Kiat Ruxrungtham","doi":"10.1177/23259582231220513","DOIUrl":"10.1177/23259582231220513","url":null,"abstract":"<p><p>This study aimed to assess second-line antiretroviral therapy (ART) outcomes in a National HIV Treatment program. People living with HIV aged ≥18 years initiating first-line ART who switched to second-line protease inhibitor-based regimens from January 2008 to May 2019, with a minimum of 1-year follow-up were studied. The primary outcome was second-line treatment failure (two consecutive virological failure episodes (viral load ≥1000 copies/mL)). Of 318,506 PLH initiating ART, 29,015 (9.1%) switched to second-line regimens after a median (IQR) ART duration of 1.63 (0.60-3.59) years. Lost to follow-up (LTFU) occurred in 5316 (18.3%) of whom 1376 (5%) remained LTFU and alive; 4606 (15.9%) died. Cumulative second-line failure incidence was 9.8% at 6 years, more common in females, younger PLH those with lower switch CD4 cell counts. Multidisciplinary, innovative support systems are needed to improve second-line treatment outcomes, particularly those relating to modifiable risk factors.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"22 ","pages":"23259582231220513"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10734336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138804463","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":"<i>\"Pharmacies are Everywhere, and You can get it at any Time\"</i>: Experiences With Pharmacy-Based PrEP Delivery Among Adolescent Girls and Young Women in Kisumu, Kenya.","authors":"Melissa Vera, Elizabeth Bukusi, Pauline Achieng, Helen Aketch, Evelyne Araka, Jared M Baeten, Kristin Beima-Sofie, Grace John-Stewart, Pamela K Kohler, Melissa L Mugambi, Bernard Nyerere, Josephine Odoyo, Caroline Omom, Christine Omondi, Katrina F Ortblad, Jillian Pintye","doi":"10.1177/23259582231215882","DOIUrl":"10.1177/23259582231215882","url":null,"abstract":"<p><strong>Introduction: </strong>Many Kenyan adolescent girls and young women (AGYW) with behaviors associated with HIV acquisition access contraception at retail pharmacies. Offering oral pre-exposure prophylaxis (PrEP) in pharmacies could help reach AGYW with PrEP services.</p><p><strong>Methods: </strong>We piloted PrEP delivery at 3 retail pharmacies in Kisumu, Kenya. AGYW purchasing contraception were offered PrEP by nurses with remote prescriber oversight. AGYW who accepted were provided with a free 1-month supply. We conducted in-depth interviews with AGYW 30 days postobtaining PrEP. Transcripts were analyzed to explore experiences of AGYW accessing PrEP at pharmacies.</p><p><strong>Results: </strong>We conducted 41 interviews. AGYW preferred pharmacies for accessing PrEP and they were willing to pay for PrEP even if available for free at clinics. Reasons for this preference included accessibility, lack of queues, and medication stockouts, privacy, anonymity, autonomy, and high-quality counseling from our study nurses.</p><p><strong>Conclusions: </strong>Pharmacies may be an important PrEP access option for this population.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"22 ","pages":"23259582231215882"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299420","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}