Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv最新文献

{"title":"Structural characteristics of alcohol venues are associated with testing positive for HIV in rural Kwazulu-Natal, South Africa.","authors":"Sarah Norton, Anthony P Moll, Neo Morojele, Gerald Friedland, Sheela V Shenoi","doi":"10.1080/09540121.2025.2534532","DOIUrl":"https://doi.org/10.1080/09540121.2025.2534532","url":null,"abstract":"<p><p>The HIV epidemic in South Africa is one of the largest globally, with a 20% prevalence among adults. The South African National Strategic Plan recognizes the need to address social and structural barriers to HIV prevention, as well as behavioral drivers, including alcohol abuse. Nested within a rural community-based HIV testing initiative, including at alcohol venues (AVs), we explored whether structural features of AVs were associated with HIV seropositivity. Of the 488 individuals tested at 46 AVs, 43 (8.8%) were seropositive. The majority of AVs were rural, unregistered, informal, lacked a liquor license, well-maintained, single rooms with lighting, make-shift seating, and adjacent outdoor space. Sound systems, bathrooms and preventative health signage were less common. In this cross-sectional analysis, community members were more likely to be identified as living with HIV at shebeens that were in town (<i>p</i> = 0.006), well-maintained (<i>p</i> = 0.008), had bathrooms (<i>p</i> = 0.004), and were monitored by security (<i>p</i> = 0.047). Multivariable regression analysis identified indoor bathrooms as an independent correlate of living with HIV (Adjusted Odds Ratio: 0.52, CI 95% 0.30-0.90). While many structural characteristics were static, several were potentially modifiable. Understanding how AV characteristics are associated with testing positive for HIV may inform community-based interventions that can address HIV risk.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-adherence to antiretroviral therapy in pregnant women with HIV in Brazil, 2014-2019: a spatial analysis.","authors":"Luana Andrade Simões, Tércia Moreira Ribeiro da Silva, Matheus Marchesotti Dutra Ferraz, Guilherme Augusto Veloso, Maria das Graças Braga","doi":"10.1080/09540121.2025.2534540","DOIUrl":"https://doi.org/10.1080/09540121.2025.2534540","url":null,"abstract":"<p><p>This ecological study analyzed spatial patterns of non-adherence to antiretroviral therapy (ART) among pregnant women initiating treatment in Brazil from 2014 to 2019. Data were obtained from national systems: SICLOM, SISCEL, and IBGE. Among 23,757 pregnant women aged 15-49, most were aged 20-29 (54%), identified as brown (37.7%), had 8-11 years of education (7.9%), and lacked a partner (36.7%). The non-adherence rate was 20% (n = 4,742). Higher non-adherence was associated with being aged 20-24 (29%, <i>p</i> < 0.005), brown skin color (39.8%, <i>p</i> < 0.005), low education (0-7 years, 27.2%, <i>p</i> < 0.005), no partner (38%, <i>p</i> < 0.005), and changes in ART regimens (19.9%, <i>p</i> < 0.005). Spatial analysis showed higher non-adherence rates in the North and Northeast and lower rates in the South and Central-West. These findings reveal that social vulnerabilities, particularly in less developed regions, hinder ART adherence. Strengthening social policies and improving health service distribution are crucial to ensuring equitable access and supporting pregnant women living with HIV, especially in rural and remote areas.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating HIV prevention into routine health obstetric and gynecologic care.","authors":"Sneha Thatipelli, Megan Grabill, Kayla Harrell, Nia Bhadra-Heintz, Sara Solomon, Shimrit Keddem, Florence Momplaisir","doi":"10.1080/09540121.2025.2534110","DOIUrl":"https://doi.org/10.1080/09540121.2025.2534110","url":null,"abstract":"<p><p>There is low uptake of PrEP for women. This study aims to understand the barriers and facilitators to improving PrEP uptake and integrating PrEP care into obstetric and gynecologic (OBGYN) care. We used the consolidated framework for implementation research (CFIR 2.0) to guide our approach. We conducted semi-structured interviews with OBGYN professionals, medical directors, and PrEP navigators. Participants were recruited via emails and purposeful sampling. Between May and December 2023, we completed 16 interviews. All participants heard of oral PrEP and felt that HIV prevention was within their scope of practice, but very few were prescribing PrEP. On a scale of 1-10 with 10 being most comfortable, the average comfort level identifying PrEP candidates was 6.96 (SD 1.91), but comfort prescribing PrEP was 6.11 (SD 2.51). Barriers to PrEP included insurance considerations, a lack of clinic infrastructure to support PrEP prescription and monitoring, and discomfort with prescribing PrEP (Individual). Key facilitators were PrEP stewards, professional and patient PrEP awareness and knowledge. Proposed strategies to increase PrEP uptake included PrEP education, workflow improvements, and utilizing the electronic medical record for HIV screening and PrEP care. Addressing multilevel barriers and facilitators can help increase PrEP uptake in the OBGYN setting.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-12"},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploratory mixed-methods questionnaire study investigating motivators for and reservations about clinical research participation in people living with HIV.","authors":"Claire Petersen, M Wood, F Dransfield, M Grundy-Bowers, G Clunie, A Winston","doi":"10.1080/09540121.2025.2534531","DOIUrl":"https://doi.org/10.1080/09540121.2025.2534531","url":null,"abstract":"<p><p>Clinical research in healthcare settings offers substantial benefits, including reduced mortality rates in research-active hospitals and access to novel treatments for participants. Despite these advantages, research often faces recruitment challenges, particularly under-representation of women and ethnic minorities. This study explores the views of people living with HIV regarding research participation. This mixed-methods study was conducted at a central London hospital's HIV outpatient clinic and Clinical Trials Centre from April 2018 to January 2019. Using the COM-B models as a theoretical framework, questionnaires were designed for individuals currently or previously involved in research, and for those with no prior research involvement. Questions included demographics, motivators and reservations about research participation, and the importance of information sources when deciding to participate in research. Quantitative data were analysed descriptively, and a framework analysis of qualitative data was completed. Of the 155 respondents, 50 were participating in research, and 105 were not. Key motivators included advancing medical knowledge, altruism and access to new treatments. Major barriers were time commitments and concerns about side effects. 80% of people participating in research, and 74% of those not participating rating rated discussions with regular clinicians to be very important when deciding to participate in research. Women faced similar barriers to the overall cohort, particularly related to time commitments and care-giving responsibilities. Research participation is influenced by the therapeutic relationship with, and input from regular clinicians. Addressing barriers such as time commitments through flexible scheduling, integrating research and clinical visits, and utilising remote visits could improve recruitment. Involving patients in research design via Patient and Public Involvement and Engagement (PPIE) ensures protocols are acceptable and tailored to participant needs. Effective collaboration between researchers and clinicians is essential to optimise research recruitment. Clear, empathetic communication and flexible study designs can address participant concerns, ultimately enhancing involvement in clinical research.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-13"},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived experiences and coping mechanisms among children and adolescents living with HIV after HIV disclosure in Eastern Uganda.","authors":"Joseph Kirabira, Naume Akello, Keng-Yen Huang, Madrine Nakawuki, Edith Wakida, Celestino Obua, Scholastic Ashaba, Brian C Zanoni, Godfrey Zari Rukundo","doi":"10.1080/09540121.2025.2534117","DOIUrl":"https://doi.org/10.1080/09540121.2025.2534117","url":null,"abstract":"<p><strong>Purpose: </strong>To understand the experiences and coping mechanisms of children and adolescents living with HIV (CALH) after HIV disclosure.</p><p><strong>Methods: </strong>We conducted a qualitative study among CALH after HIV disclosure receiving care from two referral hospitals in eastern Uganda. In-depth interviews were conducted using an interview guide during routine outpatient visits to HIV clinics until data saturation was achieved. All interviews were audiotaped, and the collected data were analyzed using an inductive thematic approach.</p><p><strong>Results: </strong>We conducted 23 interviews with CALH aged 11-17 years. Participants' experiences of disclosure were categorized into two major themes: (1) negative experiences, including HIV-related stigma, loss of social support and trust, and emotional and behavioral challenges, and (2) positive experiences, including improved self-efficacy and adherence. Coping mechanisms after disclosure were categorized into two themes (1) healthy (adherence to treatment, distraction, guidance and counseling, social support, and cognitive restructuring) and (2) non-healthy (alcohol and other substance use) coping mechanisms.</p><p><strong>Conclusion: </strong>The above experiences and coping mechanisms highlight the need to develop interventions that promote planned early disclosure of HIV status to children, supported by trained healthcare workers with rigorous counseling for better physical and mental health outcomes.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-13"},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating patient outcomes and stakeholder perspectives in a novel healthcare transition clinic for young people living with HIV: a mixed methods study.","authors":"Nina E Hill, Leslie Pierce, Hannah Chew, Ashley Sellers, David Schlundt, Neerav Desai, Aima A Ahonkhai","doi":"10.1080/09540121.2025.2534124","DOIUrl":"https://doi.org/10.1080/09540121.2025.2534124","url":null,"abstract":"<p><p>Patients transitioning from pediatric to adult HIV care have lower rates of retention in care and viral suppression. Health system interventions can improve outcomes in adolescents and young adults living with HIV (AYA-HIV). We designed and implemented an Adolescent Young Adult Healthcare Transition (AYAHCT) clinic in a U.S.-based healthcare system. We present a mixed-method (quantitative and qualitative) evaluation. The quantitative analysis included retrospective clinical outcomes between 2017-2023. Qualitative analysis included stakeholder interviews in pediatric, AYAHCT, and adult HIV clinics. The pilot cohort included 18 patients. Patients attended 4.4 visits/year, and retention in care was 100% in the first year in the AYAHCT clinic. However, only 70% of patients were virally suppressed. Seven patients (38.8%) transitioned to adult care, with 85.7% retention in care and 96.8% viral suppression. Stakeholders identified strengths including Ryan White funding, institutional support, and program adaptability. Stakeholders identified barriers, including HIV stigma and political climate in the Southern U.S., with resources needed for mental health, disclosure, and case management. We describe the initial outcomes of the AYAHCT cohort with a qualitative evaluation of clinical implementation. The pilot cohort demonstrated excellent retention across HIV care transitions but low viral suppression. Qualitative analysis revealed opportunities for program improvement.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-14"},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the digital connections: comprehensive HIV knowledge, awareness of antiretroviral therapy, and digital media use among adolescents and young adults in a middle-income country.","authors":"Xavier Javines Bilon","doi":"10.1080/09540121.2025.2534121","DOIUrl":"https://doi.org/10.1080/09540121.2025.2534121","url":null,"abstract":"<p><p>There remains a gap in identifying factors that influence HIV knowledge among younger people in middle-income countries who report higher Internet access and social media use. In this study, the association of use of two types of digital media - Internet media and social media - for information about sex with comprehensive HIV knowledge and ART awareness among youth aged 15-24 was measured. Data from the 2021 Young Adult Fertility and Sexuality Study in the Philippines (<i>n</i> = 10,949) were used, and the adolescent health literacy framework was adopted to obtain parsimonious weighted logistic regression models. Digital media use for information about sex yielded varied results concerning improved comprehensive HIV knowledge and ART awareness. Social media use was only associated with improved comprehensive HIV knowledge (adjusted odds ratio [aOR] = 1.265, <i>p</i> = .002), but not ART awareness (aOR = 1.244, <i>p</i> = .063). Meanwhile, the use of Internet media was not associated with improved comprehensive HIV knowledge (aOR = 1.105, <i>p</i> = .335) nor ART awareness (aOR = 1.025, <i>p</i> = .832). Recommendations on how public health initiatives could maximize the potential of digital media to enhance HIV awareness were discussed.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of recent hate-related violence and their association with mental and physical health among people living with HIV in Atlanta, Georgia.","authors":"Madelyn Carlson, Melvin Livingston, Ameeta S Kalokhe, Jessica M Sales","doi":"10.1080/09540121.2025.2532598","DOIUrl":"https://doi.org/10.1080/09540121.2025.2532598","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) are disproportionately affected by violence. The majority of violence research has focused on intimate partner violence, childhood abuse, gender-based violence, and sexual violence more generally. Less research has examined community violence among PWH. In this analysis, we test the association between hate crime experience and mental and HIV outcomes in a sample of adults with HIV, majority of whom are Black/African American, living in Atlanta, Georgia.</p><p><strong>Setting: </strong>PWH were recruited from HIV service settings (<i>N</i> = 285) to participate in a cross-sectional study.</p><p><strong>Methods: </strong>Primary association was tested using logistic regression models with the following outcomes: anxiety, depression, PTSD, ever virally suppressed, continuous viral suppression, and engagement in HIV care. A two-way interaction term examined gender as potential effect measure modifier of the association between hate crime experience and health outcomes.</p><p><strong>Results: </strong>Roughly half the sample (<i>N</i> = 125) experienced a hate crime in the past 12 months. In the multivariate model adjusted for covariates, hate crime survivors had 4.02 higher odds of experiencing PTSD symptoms over the last four weeks compared to persons who did not suffer hate violence (95% CI 2.06, 7.85).</p><p><strong>Conclusion: </strong>HIV treatment interventions and care practices treating PWH with hate violence experience should respond to PTSD symptoms.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of first-line antiretroviral therapy choice on adverse drug reactions in children with HIV infection: a retrospective cohort study in southwest China.","authors":"Qiuli Chen, Yanyan Liao, Peijiang Pan, Chunyan Lu, Chuanyi Ning, Hailong Wang, Junjun Jiang, Li Ye, Lijuan Zhou, Shanfang Qin, Hao Liang","doi":"10.1080/09540121.2025.2532601","DOIUrl":"https://doi.org/10.1080/09540121.2025.2532601","url":null,"abstract":"<p><p>Antiretroviral therapy (ART) is essential in managing children with human immunodeficiency virus (HIV) infection, but is often complicated by adverse drug reactions (ADRs), which can significantly impact therapeutic outcomes. This study investigates ADRs in 375 children with HIV receiving zidovudine (AZT)- or abacavir (ABC)-based ART regimens, using Kaplan-Meier, Cox regression analyses to evaluate ADR incidences, and propensity score matching (PSM) to address confounders. We found ADRs occurred in 21.9% of the cohort. Incidence was significantly higher with the ABC-based regimen (31.2%) versus the AZT-based regimen (17.2%). Most ADRs-primarily gastrointestinal-emerged within the first month of ART. Cox regression analysis confirmed ABC-based regimen nearly tripled the ADR risk (adjusted hazard ratio [aHR] = 2.987, <i>P</i> < 0.001). Notably, children at advanced WHO clinical stages (III-IV) on the ABC-based regimen faced even greater risk (aHR = 3.190, <i>P</i> = 0.005) compared to earlier stages (I-II). These results underscore the need for regimen customization based on disease severity to improve safety and efficacy in pediatric HIV treatment, informing optimized ART protocols and personalized strategies.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to integrated mental health and HIV care: administrator and provider perspectives.","authors":"Alexis A Bender, Kiera Chan, Riley Hunt, Kimberly B Sessions Hagen, Sophia Hussen, Samuel Chidi Ohiwerei Opara, Molly M Perkins","doi":"10.1080/09540121.2025.2534107","DOIUrl":"https://doi.org/10.1080/09540121.2025.2534107","url":null,"abstract":"<p><p>Since the 1980s when the HIV epidemic began, HIV and substance use have been intricately linked. A promising area for improving access to care and treatment for people living and aging with HIV and substance use is through integrated care (i.e., \"the systematic coordination of general and behavioral healthcare\"). There is a recognized need to increase collaboration and integration of mental health, substance use, and primary care providers, including infectious disease specialties. We conducted in-depth interviews with 15 administrators (e.g., clinic managers and care coordinators) and 21 providers (e.g., Physicians, Advanced Practice Providers (APPs), nurses) across Georgia between January 2021 and November 2022. Interviews explored administrator and provider perceptions of clinic integration and their desire to increase integration. Data were analyzed using inductive and deductive thematic analysis guided by the Consolidated Framework for Implementation Research. Overall, study participants in a variety of public, private, and community healthcare settings across the state recognized the benefits of integrated behavioral and physical healthcare and noted some facilitators. However, they reported significant individual-, organizational-, and community-level barriers to implementing it in practice. Our findings highlight opportunities for improvement at the provider, organization, and policy/system levels.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-10"},"PeriodicalIF":1.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}