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

{"title":"Structural and psychosocial determinants of condom nonuse among people living with HIV: a qualitative approach.","authors":"Tello-Bello María Amanda Julieta, Rosas-Santiago Francisco Javier, Rodríguez-Pérez Víctor, Sánchez-Alemán Miguel Ángel","doi":"10.1080/09540121.2025.2562241","DOIUrl":"https://doi.org/10.1080/09540121.2025.2562241","url":null,"abstract":"<p><p>This descriptive qualitative study analyzed the meanings attributed to condom use and nonuse among adults living with HIV who are receiving antiretroviral treatment in Mexico. Through in-depth interviews with forty-four adults, the narratives were situated from an ecological perspective, considering individual, relational, community, structural, and epidemiological factors. The findings show that the decision not to use condoms is mainly driven by subjective processes related to pleasure, perceptions of a partner's health, normalization of risk, and resignation in the face of the diagnosis. Among women, gender mandates hinder the negotiation of sexual care, while among men, a narrative of autonomy linked to desire prevails. Social and sexual networks reinforce patterns that discourage protection, especially in contexts involving substance use or economic exchange. Public policy discourses - such as those promoting preventive medications or emphasizing an undetectable viral load - are often interpreted subjectively, weakening risk perception and self-care. Structural factors such as exclusion, precariousness, and gaps in access to information and services further complicate the situation. The study underscores the need for interventions that integrate biomedical and psychosocial perspectives, incorporating the meanings that shape sexual decision-making and addressing the sociocultural conditions that sustain them.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-13"},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193486","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":"Lessons from the field: a systematic review of global and continental prevalence and challenges of People Living with HIV (COVID-19).","authors":"Mahmood Reza Masoudi, Reza Sadeghi, Saeed Salehi, Esmail Reza Pour, Manizheh Zeidabadi Nezhad, Saeedeh Kazemi, Alireza Rafati","doi":"10.1080/09540121.2025.2562562","DOIUrl":"https://doi.org/10.1080/09540121.2025.2562562","url":null,"abstract":"<p><p><b>ABSTRACT</b>COVID-19, caused by SARS-CoV-2, accounts for 186 million infections and more than 4 million deaths globally. This systematic review concentrates on the epidemiological profiling of HIV/AIDS, along with the unique challenges posed by COVID-19 in delivering health services across different regions of the world. This review includes 16 studies and documents from various world regions that show the negative effects of the pandemic on HIV treatment and services. A reduction in medication compliance, missing appointments, and interruption of both clinical and non-clinical HIV-related services has been reported. Additional barriers to obtaining HIV care include fear of infection, lack of transportation and poverty. The review calls for formal agreements between governments, health systems and public health expert communities to make health systems more responsive to the needs of PLWH during and after the COVID-19 pandemic.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193563","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":"Awareness, acceptance, and impact of undetectable equals untransmittable (U = U) among people living with HIV across Canada.","authors":"Alex Tran, James R Watson, Jason M Lo Hog Tian, Kristin McBain, Arthur D Miller, Anthony R Boni, Lynne Cioppa, Michael Murphy, Deborah Norris, Kim Samson, Danita Wahpoosewyan, Jennifer Demchuk, Catherine M L Pearl, Gayle Restall, Jared Star, Wangari Tharao, Adrian Betts, Jacqueline Gahagan, Justine Aman, Darren Lauscher, Josephine Pui-Hing Wong, Bruce Richman, Randy Davis, Breklyn Bertozzi, Christian Hui, Daniel Grace, Gordon Arbess, Sean B Rourke","doi":"10.1080/09540121.2025.2562238","DOIUrl":"https://doi.org/10.1080/09540121.2025.2562238","url":null,"abstract":"<p><p>Undetectable equals Untransmittable (U = U) is a pivotal tool for HIV prevention, stigma reduction, and improving quality of life for people living with HIV. This study examined awareness, acceptance, and impact of U = U among people living with HIV across Canada, and explored differences across sociodemographic characteristics. From 2018-2024, 1,083 participants were recruited in-person and online using snowball sampling. Peer researchers conducted interviews, initially in person and later mostly online due to COVID-19. Demographic data and U = U outcomes were collected and analyzed using multivariate logistic regression. Overall, 72% of participants had heard of U = U, 67% strongly accepted it, and 51% had discussed it with a healthcare provider. Awareness and acceptance were lower among heterosexual and bisexual participants. Cis-women and participants who were unemployed were less likely to report positive impacts from U = U. Black-identifying participants were more likely to report benefits, while Indigenous participants were more likely to believe U = U could reduce stigma and shift public opinion. Older participants were less likely to discuss U = U with a healthcare provider. Findings highlight U = U's potential to reduce stigma, but gaps remain in awareness, acceptance, and provider communication. Tailored strategies are needed to engage diverse communities and support healthcare providers in confidently sharing the zero-risk message.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-12"},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193537","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":"Psychosocial syndemics and quality of life among Australian people living with HIV.","authors":"Yiu Leung, Toby Newton-John, Dion Alperstein, Kim Begley, Ruth Hennessy, Shiraze Bulsara","doi":"10.1080/09540121.2025.2562237","DOIUrl":"https://doi.org/10.1080/09540121.2025.2562237","url":null,"abstract":"<p><p><b>Objective:</b> Advances in treatment have transformed HIV into a manageable chronic illness, yet people living with HIV (PLHIV) continue to face psychosocial challenges that reduce quality of life (QoL). These factors often co-occur and interact, creating syndemic effects that worsen outcomes. <b>Method:</b> This study examined relationships between HIV-related stigma, mental health difficulties, and social disconnection in predicting QoL. Participants were 213 PLHIV (184 male, 21 female, eight transgender/other/undisclosed) attending Albion, an urban tertiary HIV clinic in Sydney, Australia. They completed questionnaires assessing stigma, mental health, social support, and QoL. <b>Results:</b> HIV-related stigma, mental health difficulties, and social disconnection each independently predicted poorer QoL. A syndemic effect was found between stigma and social disconnection, with QoL lowest when both were high. <b>Conclusions:</b> Psychosocial comorbidities significantly impact QoL in PLHIV. Findings underscore the value of a syndemic framework to guide clinical research and highlight the need for holistic interventions addressing stigma, social support, and mental health.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-19"},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201696","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":"Optimizing implementation of an evidence-based self-help intervention program for people living with HIV (PLWH) with depressive symptoms in Botswana.","authors":"Boitumelo Vavani, Nadia Garnefski, Philip Spinhoven, Kennedy Amone-P'Olak, Tshephiso Teseletso, Vivian Kraaij","doi":"10.1080/09540121.2025.2565425","DOIUrl":"https://doi.org/10.1080/09540121.2025.2565425","url":null,"abstract":"<p><p>An evidence-based self-help program in booklet format has been developed to reduce depressive symptoms among people living with HIV (PLWH) in Botswana. Its effectiveness was evaluated in a Randomized Controlled Trial (RCT), with a sample of 72 PLWH. The program was shown to be effective in reducing depressive symptoms (<i>d</i> = 0.76). Good implementation is an important step. This paper aims to present an evidence-based implementation strategy for the booklet self-help intervention. A reflexive methodology was adopted. An implementation model based on the stepwise approach of Versluis et al. ([2020]. SERIES: eHealth in primary care. Part 4: Addressing the challenges of implementation. European Journal of General Practice, 26(1), 140-145.) was applied to the present study. Barriers were identified and deductively coded based on the Consolidated Framework for Implementation Research (CFIR) categories. The Expert Recommendations for Implementing Change (ERIC) framework was used to develop implementation strategies to address the identified barriers. Barriers encountered during implementation included costs, lack of screening, lack of trained professionals, etc., with the most important and changeable barrier being the lack of screening and referral into the self-help program. The most important implementation strategies include good collaboration with stakeholders and training of staff and coaches. Standard screening for depressive symptoms is critical to accessing the intervention. A coordinated strategy including stakeholder engagement and ongoing training and support, and structural support is necessary.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-10"},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201722","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":"Exploring the complexities of infant feeding decisions for immigrant pregnant people living with HIV in Ontario, Canada: a qualitative study.","authors":"Tomisin John, Thivia Jegathesan, Mark H Yudin, Douglas M Campbell","doi":"10.1080/09540121.2025.2562239","DOIUrl":"https://doi.org/10.1080/09540121.2025.2562239","url":null,"abstract":"<p><p>North American societies recommend that Pregnant People Living with Human Immunodeficiency Virus (PLWHIV) use formula to feed their infants to eliminate the risk of perinatal HIV transmission. However, many Canadian PLWHIV have migrated from HIV-endemic countries, where the World Health Organization recommends exclusive breastfeeding. These opposing recommendations, along with the complex interplay of social, cultural, and personal factors, create tension when making decisions regarding infant feeding. This study describes the experiences of PLWHIV in making decisions to inform healthcare providers and enhance guidelines for the use of breast milk. In-depth interviews were conducted with patients (<i>n</i> = 10) from a tertiary hospital in Toronto, Ontario. All participants were immigrants to Canada, with the majority (<i>n</i> = 8) self-identifying as African or Caribbean. Regarding their most recent pregnancy, 6 exclusively formula-fed, three exclusively used breast milk, and one used a combination of both feeding methods. The thematic analysis revealed four key themes: values and facilitators in the decision-making process, challenges experienced with infant feeding choices, reflections on these decisions, and recommendations for enhanced care. The findings highlight the need for socially and culturally inclusive evidence-based counseling, a safe environment, multidisciplinary care, and access to information that supports the best possible outcomes for both mothers and babies through informed decision-making.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-14"},"PeriodicalIF":1.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186997","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":"Socioeconomic marginalization, social exclusion, and engagement in transactional sex among transgender women living with HIV: the role of multidimensional gender affirmation.","authors":"Raymond Van Huizen, Margot Annequin, Marion Mora, Aissatou Faye, Marion Fiorentino, Michel Bourrelly, Gwenaëlle Maradan, Cyril Berenger, Florence Michard, Yazdan Yazdanpanah, Anaenza Freire Maresca, Elisabeth Rouveix, Lou Cuenot, Liam Balhan, Marie Costa, David Michels, Laszlo Blanquart, Giovanna Rincon, Christel Protiere, Bruno Spire","doi":"10.1080/09540121.2025.2560094","DOIUrl":"https://doi.org/10.1080/09540121.2025.2560094","url":null,"abstract":"<p><p>Gender affirmation (GAF) is a multidimensional (psychological, social, medical, administrative) social determinant of health for transgender individuals. Transactional sex (TS) is prevalent among transgender women living with HIV (TWLH), who face intersectional discrimination. GAF's relationship with TS is understudied. ANRS-Trans&HIV(2020-2022) was a French cross-sectional, community-based, life-event study of TWLH. We used clustering analyses to identify patterns of GAF among TWLH and compared TS engagement across clusters. 331/506 (65%) were currently engaged in TS. Most reported income <1000€/month. Three clusters were identified: \"Sparse engagement with medical and administrative dimensions\" (s-MA) - less likely to report lifetime feminizing hormone-use, gender-affirming surgery, or a gender-concordant identity document, \"Past and predominant engagement with medical dimension\" (p-M) - lifetime but not current feminizing hormone use, and feminizing-but-not-genital surgery, and \"Current and comprehensive engagement with all dimensions\" (c-MAPS) - current feminizing hormone use & genital surgery, gender-concordant identity documents, infrequent misgendering, and less frequently envisioning gender-affirming care. S-MA (aPR = 1.60, CI = 1.15-2.22) and p-M (aPR = 1.60, CI = 1.17-2.20) had higher TS engagement than c-MAPS. We identified diverse GAF experiences, though some may forego hormone use or genital surgery because they interfere with TS (e.g., erectile dysfunction). Findings underscore improving access to formal employment, reducing socioeconomic marginalization, and offering person-centered care.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT04849767.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-18"},"PeriodicalIF":1.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193511","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":"High prevalence of pain and mental health conditions amongst people well-established in HIV care: results of a cross-sectional survey in Lima, Peru.","authors":"Patrick Lasowski, Deanna Tollefson, Luis Menacho, Jonathan DePierro, Ann Duerr","doi":"10.1080/09540121.2025.2562242","DOIUrl":"https://doi.org/10.1080/09540121.2025.2562242","url":null,"abstract":"<p><p>People living with HIV (PLWH) are at risk for mental health (MH) disorders and pain, but this burden is largely unknown in low/middle-income countries. From February-October 2023, we conducted a cross-sectional survey at a large HIV clinic in Lima, Peru to quantify the prevalence of MH disorders and pain amongst PLWH established in care and to explore relationships between MH and well-managed HIV. At clinic visits, PLWH were invited to complete validated measures for depression, post-traumatic stress disorder (PTSD), alcohol use disorder (AUD), and pain (PHQ-8, PCL5, AUDIT-C, and BPISF). We abstracted data on treatment and viral suppression from medical charts. We calculated the prevalence of depression (PHQ8 ≥ 10), PTSD (PCL-5 ≥ 30), AUD (AUDIT-C ≥ 4 for men, ≥ 3 for women), and pain severity/interference (none, mild, moderate, or severe). We conducted logistic regression analyses to determine associations between MH/pain and viral suppression. Among 397 participants, 32% (95% CI: 27-37%) reported AUD, 21% (17-26%) reported depression, and 13% (9.5-16%) reported PTSD; 14% (11-18%) and 12% (9.3-16%) reported moderate/severe pain intensity and interference, respectively. There were no associations between MH/pain and viral suppression. High levels of MH disorders and pain among PLWH established in care suggest screening is needed for all PLWH, even those with well-controlled HIV.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-10"},"PeriodicalIF":1.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187115","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 educational intervention improves HIV competence of secondary school staff in Uganda: a stepped wedge cluster randomized trial.","authors":"Emmanuel Kimera, Mari Armstrong-Hough, Linda Grace Alanyo, Samuel Ouma, David Kyadondo, Joan Nangendo, Moses R Kamya","doi":"10.1080/09540121.2025.2564198","DOIUrl":"https://doi.org/10.1080/09540121.2025.2564198","url":null,"abstract":"<p><p>HIV competence, encompassing knowledge, skills, attitudes, and practices to prevent, manage, and reduce HIV impact, is critical for meeting young people's HIV prevention and care needs. This study evaluated the effect of the Community of Practice on HIV (CoP-HIV) educational intervention on staff HIV competence and prevention knowledge in Ugandan schools, where HIV prevalence is rising among youth. Using a stepped-wedge cluster randomized trial, the intervention was implemented across six schools in western Uganda (March-September 2023). It included two eight-hour workshops and a handbook on HIV prevention and care, delivered over one month per school. Data were collected from 174 randomly selected staff (mean age 34.9 years, 49.9% female) at four points: baseline, T1, T2, and T3. Linear mixed-effects modeling showed significant improvements in HIV competence (20-point increase; <i>β</i> = 19.87, SE = 1.02, <i>p</i> < 0.05) and prevention knowledge (5.5-point increase; <i>β</i> = 5.5, SE = 0.97, <i>p</i> < 0.05). Competence varied by school and time, while prevention knowledge improved consistently. The CoP-HIV intervention enhanced staff capacity, demonstrating potential for broader school-based HIV control. Despite pragmatic design strengths, short follow-up and reliance on self-reported data were limitations. Longer-term studies should examine effects on students' preventive behaviors and well-being.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186964","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":"The moderation effect of chemsex on the association between sexual sensation seeking and self-esteem in men with HIV who have sex with men.","authors":"Cristian Alcocer-Bruno, Nicolás Ruiz-Robledillo, Rosario Ferrer-Cascales, Irene Portilla-Tamarit","doi":"10.1080/09540121.2025.2562234","DOIUrl":"https://doi.org/10.1080/09540121.2025.2562234","url":null,"abstract":"<p><p>Although evidence suggests an association between sexual sensation seeking (SSS) and self-esteem (SE), the moderating effect of chemsex on this relationship has not been extensively examined, particularly in men who have sex with men (MSM) with HIV. The main aim of the present study was to analyze the relationship between SSS and SE, evaluating the possible moderation effects of the chemsex, in a sample of 99 MSM with HIV from Spain. Sociodemographic and chemsex were evaluated utilizing an ad-hoc questionnaire. The Rosenberg Self-Esteem Scale and Sexual Sensation Seeking Scale were also utilized. Higher SSS scores were positively and significantly associated with chemsex practice. A significant correlation between SSS and SE was found only among MSM who engaged in chemsex. Specifically, chemsex significantly moderated the relationship between SSS and SE, but only in the participants who practiced it. As shown, there is a different association between SSS and SE depending on the practice of chemsex; showing an inverse relationship in the group who practice it. Intervention programs are needed to reduce risky sexual behaviors in this population, especially in those individuals who present higher SSS.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-14"},"PeriodicalIF":1.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187110","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}