Journal of the International AIDS Society最新文献

{"title":"Understanding Suicidality Among Young People Living With and Affected by HIV: A Systematic Review","authors":"Kirsty M. Sievwright, Bai Xi Jasmine Chan, Mei Tan, Micaela Ciambrone, Virginia F. Byron, Maite Barrenechea, Justin Knox, Chloe A. Teasdale, Lorraine Sherr, Claude A. Mellins, Phillip Kreniske","doi":"10.1002/jia2.70193","DOIUrl":"https://doi.org/10.1002/jia2.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Suicide is a leading cause of death among young people (ages 10–24), and suicidality—which encompasses suicidal ideation, planning and attempts—is a growing public health concern. Young people living with or affected by HIV may face heightened vulnerability to suicidality; however, evidence-based mental health interventions for this group remain scarce. This systematic review aims to characterize the prevalence of suicidality and identify its determinants among young people with HIV-related experiences to guide future research and intervention efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a systematic review of four online databases from 1 January 2008 to 14 August 2023 was completed. English-language, peer-reviewed studies of any design that satisfied the following criteria were included: (1) data primarily collected from 2008 onwards; (2) study sample with a mean/median age between 10 and 24 years; and (3) disaggregated findings reported on suicidality for those living with and/or affected by HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 3737 identified articles, 54 studies met the inclusion criteria. These studies spanned 19 countries, with 17 studies explicitly focused on suicidality and only six presenting data from young people affected by HIV. Reported prevalence varied widely: 23 studies documented suicidal ideation (range: 0%–36.4%), 13 studies reported on suicide attempts (range: 0.2%−30.4%) and 2 studies provided data on suicide deaths (0.17% and 2.8%). Among 12 studies that examined associated factors, depression was the factor most consistently linked to increased suicidality risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This review identified a wide prevalence range of suicidal ideation and suicide attempts among young people living with or affected by HIV. Yet, few of these studies explicitly focused on suicidality or assessed factors associated with suicidality. The consistent association between depression and suicidality suggests an urgent need for tailored mental health interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To address research gaps, future studies should move beyond cross-sectional designs, examine protective factors, recruit participants outside of healthcare settings, and specifically include young people affected by HIV. In settings with limite","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149369406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract Supplement HIV Glasgow 8–11 November 2026, Glasgow, UK/Virtual","authors":"","doi":"10.1002/jia2.70211","DOIUrl":"https://doi.org/10.1002/jia2.70211","url":null,"abstract":"<p>Commonly-Used Abbreviations 1</p><p>Oral Presentations</p><p>    PrEP Today and Tomorrow: Challenges, Advances and Equitable Access 3</p><p>    Novel Strategies and Treatment 5</p><p>    The Hepatitis Alphabet: What's the Latest? 7</p><p>    Cardiometabolic Complications 9</p><p>    Antiretroviral Treatment and Resistance 14</p><p>    Under-Served Populations 18</p><p>    Hot Topics 22</p><p>Poster Presentations</p><p>    ARV-Based Prevention: Vertical Transmission and PEP 28</p><p>    ARV-Based Prevention: PrEP 35</p><p>    Treatment Strategies: Novel Therapeutic Targets (Phase I and II) 61</p><p>    Treatment Strategies: RCTs—Oral and Injectable Therapy in First-Line and Suppressed Switch Populations 72</p><p>    Treatment Strategies: Real-World and Implementation Science Studies, Oral and Injectable Therapy 95</p><p>    Treatment Strategies: Treatment Experienced Adults (Second-Line and Multi-Drug Resistance Studies) 182</p><p>    Treatment Strategies: Models of Care for Ageing/Frail Populations Including Virological Failure and Switching 204</p><p>    Treatment Strategies: Rapid ART Initiation 213</p><p>    Treatment Strategies: Adherence 222</p><p>    Clinical Management Considerations: Women 232</p><p>    Clinical Management Considerations: Late Presenters 245</p><p>    Clinical Management Considerations: Transgender People 255</p><p>    Clinical Management Considerations: Other 261</p><p>    Cure/Post-Treatment Control 269</p><p>    Opportunistic Infections and AIDS-Defining Cancers 274</p><p>    Clinical Pharmacology 280</p><p>    Community-Based Treatment and Prevention Initiatives, Including Primary Care Screening 289</p><p>    Public Health Strategies and Options 303</p><p>    Cost and Cost-Effectiveness 340</p><p>    Models of Care: Evaluation of ARV Delivery and Coverage 348</p><p>    Co-Morbidities and Complications of Disease and/or Treatment: Ageing and Frailty 364</p><p>    Co-Morbidities and Complications of Disease and/or Treatment: CV/Metabolic Including Weight Gain 380</p><p>    Co-Morbidities and Complications of Disease and/or Treatment: Malignancies (Non-AIDS Defining) 433</p><p>    Co-Morbidities and Complications of Disease and/or Treatment: Neurological 440</p><p>    Co-Morbidities and Complications of Disease and/or Treatment: Mental Health Disorders 445</p><p>    Co-Morbidities and Complications of Disease and/or Treatment: Other 455</p><p>    People Living With HIV and Mpox Virus 481</p><p>    People Living With HIV and Sexually Transmitted Diseases 487</p><p>    People Living With HIV and Tuberculosis 494</p><p>    People Living With HIV and Viral Hepatitis 497</p><p>    People Living With HIV and Other Infections 508</p><p>Author Index 517</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaching Frontline Providers With Updated HIV Clinical Guidance at Scale Under Declining Training Support: WhatsApp Microlearning During Rollout of 6-Monthly ART Dispensing in South Africa","authors":"Briony Chisholm,&nbsp;Lynne Wilkinson","doi":"10.1002/jia2.70222","DOIUrl":"https://doi.org/10.1002/jia2.70222","url":null,"abstract":"&lt;p&gt;HIV management is guided by regularly updated clinical guidelines, and keeping frontline healthcare workers (HCWs) informed requires ongoing training. Traditional approaches—in-person workshops/longer virtual sessions—are costly, slow to reach providers and disrupt clinical services. These challenges are growing as implementing partner (IP) support for facility-level training declines due to global funding cuts.&lt;/p&gt;&lt;p&gt;In South Africa, with primary healthcare clinics spread across 1.2 million km&lt;sup&gt;2&lt;/sup&gt;, in-person training requires travel, accommodation and staff time away, while longer virtual sessions are often poorly attended due to duration, lack of protected time and limited promotion.&lt;/p&gt;&lt;p&gt;These challenges were acute for the phased rollout of facility-based 6-month multi-month dispensing (6MMD) of antiretroviral therapy from August 2025. The timeline was short; virtual training was limited to a once-off session for provincial stakeholders; and facility-level IP support was reduced.&lt;/p&gt;&lt;p&gt;Previous HIV service delivery changes, such as repeat prescription collection strategies, took several years to reach national scale. One challenge was ensuring guideline updates reached facility-level prescribers, with practical guidance on how to implement them. Rapid dissemination of revised guidance is, therefore, increasingly important.&lt;/p&gt;&lt;p&gt;Microlearning—bite-sized units of learning [&lt;span&gt;1&lt;/span&gt;]—offers a potentially cost-effective, scalable and accessible solution. Delivered via mobile messaging, it avoids centralized gatherings and minimizes clinical service disruption. It is underpinned by cognitive load theory [&lt;span&gt;1, 2&lt;/span&gt;] and has been used for continuing education across medical specialities [&lt;span&gt;3-6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;South Africa has near-universal mobile phone access and widespread WhatsApp use [&lt;span&gt;7&lt;/span&gt;]. WhatsApp Business, a free encrypted messaging platform, allows structured group communication and moderation. South African clinicians have used WhatsApp to discuss complicated HIV/TB cases and for continuing medical education [&lt;span&gt;8&lt;/span&gt;]. A cluster randomized controlled trial in South African primary healthcare clinics found that WhatsApp-based HIV microlearning significantly improved HCW knowledge and increased correct patient care by 21% in the year after training [&lt;span&gt;9, 10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The 6MMD microlearning curriculum was developed by a training consultant and a differentiated service delivery technical specialist, based on the updated 2025 national HIV guidelines and the content and questions arising from the National Department of Health (NDoH) virtual 6MMD training session. There was no formal co-design process.&lt;/p&gt;&lt;p&gt;The developers grouped two or three related learning points into each of 8 weekly lessons. Each 10- to 15-min session comprised approximately 20 sequential WhatsApp messages: text explanations, realistic case studies, polls requiring participants to apply guidance, explanatory feedback, o","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 10","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149258923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of HIV Pre-Exposure Prophylaxis on HIV Incidence and Hepatitis B Outcomes Among Sex Workers Living With Hepatitis B: A Modelling Analysis in Côte D'Ivoire","authors":"Amir M. Mohareb,&nbsp;Arthur Y. Kim,&nbsp;Menan Gérard Kouamé,&nbsp;Marcellin Nouaman,&nbsp;Patrick A. Coffie,&nbsp;Maya Hajny Fernandez,&nbsp;Virginia R. Talbot,&nbsp;Ruitian Xeno Hu,&nbsp;Anne M. Neilan,&nbsp;Anders Boyd,&nbsp;Kenneth A. Freedberg,&nbsp;Joseph Larmarange,&nbsp;Emily P. Hyle","doi":"10.1002/jia2.70217","DOIUrl":"https://doi.org/10.1002/jia2.70217","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Nearly 10% of sex workers in sub-Saharan Africa live with chronic hepatitis B virus (HBV). HIV pre-exposure prophylaxis (PrEP) using tenofovir/emtricitabine (TDF/FTC) has not been studied in this population, possibly due to concerns of hepatitis flares following TDF/FTC cessation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a microsimulation model of HIV and HBV disease and data from 2016 to 2024, we compared the clinical impact of <i>TDF/FTC</i> as PrEP versus <i>no TDF/FTC</i> among women who sell sex with HBV in Côte d'Ivoire. We incorporated the anti-HBV effects of TDF/FTC and the increased probability of hepatitis flares and HBV surface antigen (HBsAg) loss following TDF/FTC cessation. We estimated input parameters from published literature: HIV incidence (1.9–3.0 per 100 person-years), PrEP adherence (55%), disengagement from PrEP care (4% per month for the first 12 months, then 12.5% per month), hepatitis flare incidence (2.0−4.0 per 100 person-years) and rate of HBsAg loss (1.0 per 100 person-years), which both increase following TDF/FTC cessation. Model outcomes included cumulative HIV incidence, average hepatitis flares, HBsAg loss and survival over 2, 5 and 10 years. We conducted sensitivity analyses varying HIV incidence, PrEP adherence, disengagement from PrEP care and hepatitis flare rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with <i>no TDF/FTC</i>, <i>TDF/FTC</i> would reduce cumulative HIV incidence: 4.1% versus 5.6% at 2 years and 10.1% versus 12.7% at 5 years. <i>TDF/FTC</i> would result in more hepatitis flares (mean 0.76 vs. 0.19 per person) and more HBsAg loss (8.4% vs. 5.7%) than <i>no TDF/FTC</i> after 5 years. Two- and five-year survival would be similar between the two strategies, and <i>TDF/FTC</i> would improve survival over longer horizons. Improving adherence and reducing disengagement from care would increase clinical benefits. Even with high disengagement from care and high risk of hepatitis flares, <i>TDF/FTC</i> would reduce HIV acquisition and improve overall long-term survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Women who sell sex with HBV in Côte d'Ivoire would benefit from TDF/FTC as PrEP to avoid HIV acquisition. The increased risk of hepatitis flares, while challenging to manage in resource-limited settings, would be outweighed by the benefits of HIV prevention. Efforts should be made to scale up PrEP in sex workers, including women with chronic HBV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 10","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149259388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spilling the Tea on HIV Prevention: Co-Designing Sexual Health Education in Black-Owned Baltimore Beauty Spaces","authors":"Sierra Cary-Brown,&nbsp;Megan E. Mansfield,&nbsp;Meg Jordan,&nbsp;Stephen B. Thomas,&nbsp;Marie-Claude Lavoie,&nbsp;Natalie Spicyn","doi":"10.1002/jia2.70221","DOIUrl":"https://doi.org/10.1002/jia2.70221","url":null,"abstract":"&lt;p&gt;In the United States, Black women bear a disproportionate burden of new HIV acquisitions, accounting for 50% of HIV diagnoses but representing only 13% of the female population [&lt;span&gt;1&lt;/span&gt;]. Similarly, in Baltimore, 19% of new HIV diagnoses in 2023 were among women [&lt;span&gt;2&lt;/span&gt;]. Although pre-exposure prophylaxis (PrEP) is readily available, uptake among women is low [&lt;span&gt;3&lt;/span&gt;]. Multi-level factors contribute to low PrEP uptake among Black women, including lack of awareness, medical distrust, gendered racism and stigma [&lt;span&gt;4, 5&lt;/span&gt;]. New models of engagement are needed to better serve women, and we sought to explore novel methods for increasing PrEP awareness and engagement among Black women in Baltimore.&lt;/p&gt;&lt;p&gt;Beauty shops are intergenerational hubs for information exchange and peer support among Black women, making them trusted venues for community health promotion [&lt;span&gt;6&lt;/span&gt;]. However, there is limited research examining the implementation of HIV prevention promotion in beauty shops. To address this gap, we recruited six Black Baltimore-based beauty industry (hair and aesthetic) professionals to co-design a community-based HIV prevention intervention. These participants were identified through street outreach efforts and shop-owner referral. Inclusion criteria were (1) being the shop owner-operator, (2) having Black women comprise an estimated majority of clientele, and (3) shop location within Baltimore City or Baltimore County, Maryland. Although shop location cannot necessarily determine where clients reside, four of the six shops are in zip codes with a high HIV incidence rate [&lt;span&gt;2&lt;/span&gt;], where 59.2% of the population identify as Black or African American. As of 2024, 36.1% of people in Baltimore had a Bachelor's degree or higher, the median household income was $62,177 and 58.9% of people were employed [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We used a five-step human-centred design [&lt;span&gt;8&lt;/span&gt;] approach to co-develop the intervention (Table 1).&lt;/p&gt;&lt;p&gt;&lt;i&gt;Tea Talk&lt;/i&gt; was piloted (step 5) in six shops for 3 months (March−June 2025). During testing, participating beauty industry professionals met every 2 weeks in a community of practice to discuss their experiences implementing the programme. Learnings included the impact of different business structures (e.g. single owner vs. multiple partners) as well as clientele age impacting engagement. We used shop-specific QR codes to monitor client access to the &lt;i&gt;Tea Talk&lt;/i&gt; PrEP informational website, which was accessed by clientele a total of 62 times during the pilot period. Participants reported strong client interest in sharing educational and preventative materials with others. After the 3-month pilot, participants completed an interview to discuss their experiences with the co-design process, implementation, and suggestions for changes and future directions. Recommendations included incorporation of digital materials and adding mental health components to the interventi","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 10","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149258788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Acceptability of Delivering HIV Self-Testing and Oral PrEP Refills to Female Sex Workers Through Community Drug Shops in Kampala, Uganda: A Single-Arm Pilot Interventional Study","authors":"Catherine Nakaye,&nbsp;Denis Mawanda,&nbsp;Nelson Mukiza,&nbsp;Brenda Gati Mirembe,&nbsp;Rita Nakalega,&nbsp;Zubair Lukyamuzi,&nbsp;Hajira Kataike,&nbsp;Josephine Basirika,&nbsp;Clemensia Nakabiito,&nbsp;Mary Glenn Fowler,&nbsp;Renee Heffron","doi":"10.1002/jia2.70220","DOIUrl":"https://doi.org/10.1002/jia2.70220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Female sex workers (FSWs) in Uganda are disproportionately affected by HIV, with prevalence estimates reaching 37%. Decentralization of pre-exposure prophylaxis (PrEP) delivery, including community-based mechanisms, brings services closer to target populations. We assessed feasibility and acceptability of decentralized oral PrEP refill delivery with HIV self-testing (HIVST) through a drug shop-based model in Kampala, Uganda, among FSWs already using oral PrEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From October 2024 to June 2025, we conducted a single-arm pilot interventional study with 45 FSWs, aged≥18 years, receiving oral PrEP from a government facility for ≥ 1 month before enrolment. Participants were purposively linked to community drug shops convenient to their areas of residence for oral PrEP refills provision after HIVST at 1, 3 and 6 months. Feasibility was assessed by study participation rate, accrual and retention parameters. Structured questions using a 4-point Likert scale were used to collect acceptability data at 3 and 6 months. Persistence was assessed by measuring proportions of participants who continued in care, received HIVST and oral PrEP refills from community drug shops. Descriptive analysis was conducted to summarize feasibility, acceptability and persistence to PrEP refills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 45 FSWs (median age [IQR]: 29 [26–35] years) were enrolled. All participants (100%, 45/45) willingly took up the community drug shop–based PrEP delivery model at baseline. Participant retention was 95.6%, 100% and 95.6% at 1, 3 and 6 months, respectively, which aligned with PrEP refill rates. Over 95% of FSWs at 3 and 6 months visits felt very comfortable and preferred receiving PrEP refills from community drug shops, with 100% of participants acknowledging them as very accessible, offering very private service and comfort to discuss sexual health with attending staff. HIVST convenient usability for drug shop staff possibly contributed to model acceptability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Community drug shop–based HIVST and oral PrEP refill delivery was feasible, acceptable and demonstrated high persistence with oral PrEP refills among this small FSW cohort in Uganda. These results warrant further research to evaluate the oral PrEP refill decentralization impact of this model when it is scaled up to reach a larger number of FSWs and other population groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 10","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149258349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PrEP4Her: Evaluating the Reach, Adoption, Preliminary Effectiveness and Fidelity of a Multi-Component Hybrid Type 3 Trial Designed to Increase PrEP Prescriptions for Black Women Receiving Gynaecologic Care in a University-Affiliated Women's Health Setting in the United States South","authors":"Anais Mahone,&nbsp;Audra Williams,&nbsp;Dave Cleveland,&nbsp;Bernadette Johnson,&nbsp;Grace Watson,&nbsp;Mirjam-Colette Kempf,&nbsp;Lynn T. Matthews,&nbsp;Michael J. Mugavero,&nbsp;Latesha E. Elopre","doi":"10.1002/jia2.70208","DOIUrl":"https://doi.org/10.1002/jia2.70208","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To address suboptimal HIV pre-exposure prophylaxis (PrEP) uptake among Black women, we designed PrEP4Her, a multi-phase, multi-component implementation strategy aimed to increase PrEP prescriptions among women receiving routine health services at a university-affiliated gynaecology (GYN) clinic located in the Southeastern United States.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Informed by intervention mapping, PrEP4Her, a hybrid type 3 trial, was piloted over 8 months, January 2024–August 2024, and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) conceptual framework guided the evaluation of proximal implementation outcomes. In this manuscript, we present (1) &lt;i&gt;Reach&lt;/i&gt; (the number of Black women prescribed PrEP and the proportion of PrEP prescribed to women with an indication, having a sexually transmitted infection (STI) within 12 months and/or reporting &gt;1 sex partners collected from a universal health screener); (2) &lt;i&gt;Adoption&lt;/i&gt; (the number of PrEP prescribers); (3) &lt;i&gt;Preliminary Effectiveness&lt;/i&gt; (PrEP prescribed over time). Also, we measured the number of Black women who self-reported talking to a doctor about PrEP as a secondary outcome &lt;i&gt;(Fidelity)&lt;/i&gt;. We collected evaluative data from the electronic health record (EHR), sexual health screener and self-administered post-visit survey. Descriptive statistics were utilized to describe the sample, and chi-square tests examined the relationships between patient characteristics and talking to providers about PrEP. Analyses were completed in October 2025.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;EHR data indicate there were 1274 unique first clinic visits. Most women identified as Black race (58%) and, on average, were 34 (±11.3) years old. Ten PrEP prescriptions were written by seven prescribers (i.e. adoption). Among women prescribed PrEP, nine identified as Black women and none had a recent STI (i.e. reach). PrEP was prescribed once before the pilot, eight times during the pilot and once in the month after the pilot. However, PrEP was not prescribed to women with PrEP indications (&lt;i&gt;N&lt;/i&gt; = 85) (i.e. preliminary effectiveness). Nearly half (43%) of surveyed women reported talking to a provider about PrEP (i.e. fidelity); most (49%) identified as Black race. Chi-square tests show significant differences by race (&lt;i&gt;p&lt;/i&gt; = 0.02).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We observed an increase in PrEP prescriptions from before to during the pilot period; however, 85 women with PrEP indications we","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149125781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Strategies to Enhance the Provision of Holistic Services Across Three Community-Based Organizations in King County, Washington, United States","authors":"Sarah A. Shaw,&nbsp;Anjuli Wagner,&nbsp;Alejandra Grillo Roa,&nbsp; Enoch,&nbsp;Martha Zuniga,&nbsp;Steven Sawyer,&nbsp;Richard Williams,&nbsp;Taylor Brown,&nbsp;Francis Slaughter,&nbsp;Taylor Rapson,&nbsp;David A. Katz","doi":"10.1002/jia2.70147","DOIUrl":"https://doi.org/10.1002/jia2.70147","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Addressing social determinants of health within HIV services is essential to achieve HIV epidemic control in the United States. Community-based organizations (CBOs) are uniquely positioned to implement integrated services, particularly for under-resourced and marginalized communities. However, effective strategies to support integrated services are needed for these settings. In a community-academic partnership, we applied implementation science tools to identify, prioritize and characterize strategies supporting three CBOs’ goals to enhance integrated services and reduce health inequities in King County, Washington, United States.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;From November 2021 to June 2022, we facilitated nominal group technique methods with each CBO to generate strategies aligned with conditions CBOs deemed necessary for successful integration. Staff evaluated strategies’ feasibility and effectiveness using 5-point Likert scales (Feasibility: 1 = Very hard to do with current resources to 5 = Very easy; Effectiveness: 1 = Large negative to 5 = Large positive impact). Go-Zone plots comparing strategies’ feasibility and effectiveness scores were generated to inform implementation prioritization. We mapped strategies to Expert Recommendations for Implementing Change (ERIC) thematic clusters and Consolidated Framework for Implementation Research (CFIR) constructs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This participatory process generated 118 strategies perceived as highly impactful (mean = 4.7, range = 4.6−5.0) and with mixed feasibility (mean = 3.3, range = 3.2−4.6). Strategies most frequently aimed to improve organizational structural characteristics, staff access to knowledge/information, communications, implementer and community engagement, reflecting and evaluating, and teaming. All nine ERIC thematic clusters were represented, most commonly change infrastructure, train/educate relevant groups, develop interrelationships, use evaluative and iterative strategies, and engage consumers. Highly feasible and impactful strategies often addressed knowledge access and engagement, while fewer addressed structural characteristics and teaming. We observed patterns in barrier-strategy mapping (CFIR-ERIC) and in strategy feasibility and impact when reviewing construct combinations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Implementing integrated services requires systems-level approaches that strengthen organizational infrastructure and respond to community priorities. Despite diverse","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149125859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation Outcomes and Lessons From a Health-Department-Driven Quality-Based Financing Approach to HIV Prevention Programmes in New York City, United States: A Mixed Methods Analysis","authors":"Sarit A. Golub,&nbsp;Ariel M. de Roche,&nbsp;Lila Starbuck,&nbsp;Imani K. Hall,&nbsp;Brittany C. Wilbourn","doi":"10.1002/jia2.70194","DOIUrl":"https://doi.org/10.1002/jia2.70194","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In 2021, the New York City Health Department (NYCHD) became one of the first jurisdictions in the United States to adopt a quality-based financing (QBF) approach to HIV prevention programming, shifting away from the traditional fee-for-service model. NYCHD used a multi-level approach that defined quality through three programme-level implementation strategies (PLS): universal screening; holistic care provision; and sex-positive, “risk-free” HIV prevention conversations. By focusing their QBF programme on implementation strategies in addition to service delivery outcomes, NYCHD held agencies accountable for both &lt;i&gt;what&lt;/i&gt; was provided and &lt;i&gt;how&lt;/i&gt; services were delivered.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Project PACE is a CDC-funded implementation science (IS) partnership between a public university and the NYCHD designed to document and evaluate their QBF approach. Data collected May 2023–September 2024 include: (1) thematic coding of qualitative interviews with agency staff (&lt;i&gt;n&lt;/i&gt; = 29); (2) quantitative analysis of staff survey data (&lt;i&gt;n&lt;/i&gt; = 69); and (3) thematic coding of technical assistance meeting minutes/programme monitoring data (document &lt;i&gt;n&lt;/i&gt; = 771). This paper presents an analysis of the impact of the strategy on 19 funded agencies, focusing on implementation outcomes and applying the Consolidated Framework for Implementation Research (CFIR) to examine barriers and facilitators to the implementation process.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The quality-focused implementation strategies were rated as highly acceptable, feasible and appropriate. Agencies reported multiple relative advantages of quality-focused implementation: more holistic care, increased access to services, integration of mental health and sexually transmitted infection testing into HIV prevention, reduced stigma and improved client rapport. Acceptability and feasibility ratings were strongly associated with both adoption and sustainment. Implementation barriers were clustered in the inner setting, individual and innovation CFIR domains, and focused on available resources, innovation recipients and innovation design constructs. The biggest challenges to feasibility were related to constraints in the overall care delivery system, including time pressure, service delivery limitations, restricted resources and competing demands.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Analyses indicate that health departments can develop quality-based PLS that are acceptable, appropriate, and feasible ","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149125782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Workflow Modelling of HIV Status-Neutral Care Implementation in Six High-Burden Jurisdictions in the United States: A Qualitative Study","authors":"Tongying Zhao,&nbsp;Laura K. Beres,&nbsp;Elena P. Rosenberg-Carlson,&nbsp;Joseph Kenny,&nbsp;Wilson Gomez,&nbsp;Alithia Zamantakis,&nbsp;Cathleen E. Willging,&nbsp;Russell A. Brewer,&nbsp;Jill S. Blumenthal,&nbsp;Joyce L. Jones,&nbsp;Uyen Kao,&nbsp;Tequetta Valeriano,&nbsp;Aadia I. Rana,&nbsp;Sung-Jae Lee,&nbsp;Maile Y. Karris,&nbsp;Ana M. Pachicano,&nbsp;Jessica Kassanits,&nbsp;Alison B. Hamilton,&nbsp;Robin G. Lanzi,&nbsp;LaRon E. Nelson,&nbsp;Lipin Lukose,&nbsp;Donna J. Smith,&nbsp;Nanette D. Benbow,&nbsp;Sheree R. Schwartz,&nbsp;Joseph G. Rosen,&nbsp;the NISH 001 Study Team","doi":"10.1002/jia2.70158","DOIUrl":"https://doi.org/10.1002/jia2.70158","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Status-neutral approaches to HIV treatment and prevention, which link all individuals to tailored, comprehensive services following HIV testing, are promising strategies for reducing HIV service delivery inequities and improving clinical outcomes. However, transferable, feasible models of status-neutral service delivery are poorly understood, particularly in the United States, where implementation contexts are geographically and institutionally disparate. To guide expanded implementation, we identified difference-making attributes of status-neutral implementation workflows in a diverse sample of public sector-funded HIV clinical organizations in U.S. jurisdictions prioritized in the Ending the HIV Epidemic (EHE) Initiative.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In March−June 2024, we invited frontline HIV service providers across six EHE jurisdictions (Alabama, Baltimore, Chicago, Dallas, Los Angeles, San Diego) to participate in virtual focus group discussions (FGDs), segmented by ongoing or planned status-neutral implementation. We depicted an HIV status-neutral workflow and elicited discussants’ perspectives on (in)consistencies between the illustration and their implementation practices. Applying comparative workflow modelling, we re-illustrated status-neutral implementation pathways and identified workstream features distinguishing service delivery across clinical organizations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We facilitated eight FGDs with 56 providers across 20 organizations. Status-neutral implementation processes varied substantially across clinical organizations—distinguished by the roles and responsibilities of clinical (i.e. physicians, nurses) and non-clinical (i.e. navigators, case managers) staff as well as by the sequence and timing of activities within workflows. We identified four workflow attributes that distinguished clinical organizations: (1) the timing of health insurance review (whether insurance assessments and navigation occurred earlier vs. later in the implementation pathway); (2) the magnitude of activity integration (whether services were delivered concurrently vs. sequentially); (3) the presence of implementation partnerships (whether HIV testing was conducted in-house vs. externally); and (4) the extent of workforce task-shifting (whether services were primarily delivered by clinical vs. non-clinical staff).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Workflow heterogeneities reflected jurisdictional and organizational differences in funding, staff","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149125776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}