JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Veterans Aging Cohort Study Index 2.0 Shows Improved Discrimination of Neurocognitive Impairment and Frailty in People with HIV","authors":"Cynthia Y. Yan, Sarah A. Cooley, B. Ances","doi":"10.1097/qai.0000000000003458","DOIUrl":"https://doi.org/10.1097/qai.0000000000003458","url":null,"abstract":"\u0000 \u0000 This study examined whether the revised VACS2.0 index (including serum albumin, body mass index (BMI), and white blood cell (WBC) count) had stronger correlations with cognitive function, brain volume, and frailty in PWH ≥ 50 years compared to the VACS1.0.\u0000 \u0000 \u0000 \u0000 and Methods: Neuropsychological performance (NP) Z-scores (learning, retention, executive functioning (EF), psychomotor function/processing speed (PM/PS), language, and global cognition), and neuroimaging measures (brain volumetrics) were analyzed in PWH (n = 162). A subset of the sample (n = 159) was defined as either frail (n = 18) or non-frail (n = 141) according to the Fried phenotype criteria. Brain volumes, NP scores, and frailty subgroups were analyzed with both VACS scores, albumin, BMI, and WBC count using Pearson's significance tests and independent T-tests.\u0000 \u0000 \u0000 \u0000 Higher VACS scores significantly correlated with lower brain volumes. Higher VACS2.0 scores were associated with lower NP in the EF and PM/PS domains and were primarily driven by albumin. VACS1.0 scores did not correlate with cognition Z-scores. There was no relationship between frailty status and VACS1.0. PWH who were frail had significantly greater VACS2.0 scores than non-frail PWH.\u0000 \u0000 \u0000 \u0000 The addition of albumin to the VACS index improved its correlations with NP and frailty in PWH. While low albumin levels may contribute to cognitive decline or frailty, the reverse causality should also be considered. These findings suggest that the VACS2.0 index (especially albumin) is a valuable measure for clinicians to improve outcomes in PWH.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140999861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Using Additional HIV Self-Test Kits as an Incentive to Increase HIV Testing within Assisted Partner Services","authors":"Unmesha Roy Paladhi, David A. Katz, George Otieno, James P. Hughes, Harsha Thirumurthy, Harison Lagat, S. Masyuko, Monisha Sharma, P. Macharia, R. Bosire, M. Mugambi, Edward Kariithi, C. Farquhar","doi":"10.1097/qai.0000000000003455","DOIUrl":"https://doi.org/10.1097/qai.0000000000003455","url":null,"abstract":"\u0000 \u0000 Incentives have shown mixed results in increasing HIV testing rates in low-resource settings. We investigated the effectiveness of offering additional self-tests (HIVSTs) as an incentive to increase testing among partners receiving assisted partner services.\u0000 \u0000 \u0000 \u0000 Western Kenya\u0000 \u0000 \u0000 \u0000 We conducted a single-crossover study nested within a cluster-randomized controlled trial. Twenty-four facilities were randomized 1:1 to 1) control: provider-delivered testing, or 2) intervention: offered one HIVST or provider-delivered testing for six months (pre-implementation), then switched to offering two HIVSTs for six months (post-implementation). A difference-in-differences approach using generalized linear mixed models, accounting for facility clustering and adjusting for age, sex, and income, was used to estimate the effect of the incentive on HIV testing and first-time testing among partners in APS.\u0000 \u0000 \u0000 \u0000 March 2021-June 2022, 1127 index clients received APS and named 8155 partners, among whom 2333 reported a prior HIV diagnosis and were excluded from analyses, resulting in 5822 remaining partners: 3646 (62.6%) and 2176 (37.4%) in the pre- and post-implementation periods respectively. Overall, 944/2176 (43%) partners were offered a second HIVST during post-implementation, of whom 34.3% picked up two kits, of whom 71.7% reported that the second kit encouraged HIV testing. Comparing partners offered one vs. two HIVSTs showed no difference in HIV testing (relative risk[RR]:1.01, 95%Confidence Interval[CI]:0.951-1.07) or HIV testing for the first time (RR:1.23, 95%CI:0.671-2.24).\u0000 \u0000 \u0000 \u0000 Offering a second HIVST as an incentive within APS did not significantly impact HIV testing or first-time testing, although those opting for two kits reported it incentivized them to test.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140998090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness From the CARISEL Study: Phase 3b Hybrid Type III Implementation Study Integrating Cabotegravir + Rilpivirine Long-Acting Into European Clinical Settings","authors":"Celia Jonsson-Oldenbüttel, Jade Ghosn, M. van der Valk, Eric Florence, Francisco Vera, Stéphane De Wit, Agathe Rami, Fabrice Bonnet, Laurent Hocqueloux, K. Hove, M. Ait-Khaled, Rebecca DeMoor, Gilda Bontempo, Christine L Latham, Cassidy A. Gutner, Supriya Iyer, Martin Gill, M. Czarnogorski, Ronald D’Amico, J. van Wyk","doi":"10.1097/qai.0000000000003448","DOIUrl":"https://doi.org/10.1097/qai.0000000000003448","url":null,"abstract":"\u0000 \u0000 Cabotegravir + rilpivirine long-acting (CAB + RPV LA) dosed every 2 months (Q2M) is a complete regimen for the maintenance of HIV-1 virologic suppression. Here, we report Month 12 clinical outcomes in patient study participants (PSPs) in the CARISEL study.\u0000 \u0000 \u0000 \u0000 CARISEL is a Phase 3b implementation–effectiveness study.\u0000 \u0000 \u0000 \u0000 CARISEL was designed as a two-arm, unblinded study with centers randomized to either enhanced or standard implementation arms. For PSPs, the study is single arm, unblinded, and interventional; all PSPs switched from daily oral therapy to CAB + RPV LA dosed Q2M. The primary objective was to evaluate the perceived acceptability, appropriateness, and feasibility of CAB + RPV LA implementation for staff participants (presented separately). Clinical secondary endpoints assessed through Month 12 included: the proportion of PSPs with plasma HIV-1 RNA ≥50 copies/mL and <50 copies/mL (Snapshot algorithm), incidence of confirmed virologic failure (CVF; two consecutive plasma HIV-1 RNA levels ≥200 copies/mL), adherence to injection visit windows, and safety and tolerability.\u0000 \u0000 \u0000 \u0000 430 PSPs were enrolled and treated; mean age was 44 years (30% ≥50 years), 25% were female (sex at birth), 22% were persons of color. At Month 12, 87% (n=373/430) of PSPs maintained HIV-1 RNA <50 copies/mL, with 0.7% (n=3/430) having HIV-1 RNA ≥50 copies/mL. One PSP had CVF. The safety profile was consistent with previous findings. Overall, results were similar between implementation arms.\u0000 \u0000 \u0000 \u0000 CAB + RPV LA Q2M was well tolerated and highly effective in maintaining virologic suppression with a low rate of virologic failure.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141009133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Incidence, Risk Factors, Impact, and Related Stigma among a Cohort of Persons with HIV in Washington, DC","authors":"Shannon K. Barth, Anne K. Monroe, Patricia Houston, Debra A Benator, Michael A Horberg, Amanda D. Castel","doi":"10.1097/qai.0000000000003447","DOIUrl":"https://doi.org/10.1097/qai.0000000000003447","url":null,"abstract":"\u0000 \u0000 Studies on the incidence of COVID-19 among persons with HIV (PWH) present varied results. Few studies have investigated the impact of COVID-19 infection on health and socioeconomic factors or COVID-19 stigma. We sought to measure the incidence and severity of COVID-19 infection among a cohort of PWH, characterize associated risk factors and impact, and document perceptions of COVID-19-related stigma.\u0000 \u0000 \u0000 \u0000 Data for this cross-sectional study come from the COVID-19 survey of participants in the DC Cohort longitudinal study from October 30, 2020 through December 31, 2022. Survey results were linked to electronic health records, including HIV labs and COVID test results. We conducted analyses comparing demographic, socioeconomic, HIV measures, and stigma among those with and without self-reported COVID-19.\u0000 \u0000 \u0000 \u0000 Out of 1,972 survey respondents, 17% self-reported COVID-19 infection, with greatest incidence in the Omicron wave of the pandemic. We found statistically significant differences by age, employment status, essential worker status, education, and household income. Longer duration of HIV diagnosis was associated with greater incidence of COVID-19. PWH who were overweight or obese had greater incidence of COVID-19 compared to those who were not. Over 40% of PWH with COVID-19 reported experiencing at least one form of COVID-19-related stigma.\u0000 \u0000 \u0000 \u0000 We observed a high incidence of COVID-19 infection among PWH in DC. Further, a substantial proportion of PWH with COVID-19 reported experiencing COVID-19 related stigma. These findings add to the existing literature on COVID-19 co-infection among PWH and highlight the need for awareness and support for those experiencing COVID-19 stigma.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"42 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECTS OF COMBINATION OF ETHANOL WITH RITONAVIR, LOPINAVIR OR DARUNAVIR ON EXPRESSION AND LOCALIZATION OF THE ER-ASSOCIATED SET PROTEIN AND INFECTION OF HIV-1 PSEUDOVIRUS IN PRIMARY HUMAN CELLS","authors":"Cheng Ji, Liting Chen, Marina Kaypaghian","doi":"10.1097/qai.0000000000003411","DOIUrl":"https://doi.org/10.1097/qai.0000000000003411","url":null,"abstract":"","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"36 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141010769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and immunogenicity of a DNA vaccine with subtype C gp120 protein adjuvanted with MF59® or AS01B: a phase 1/2a HIV-1 vaccine trial","authors":"Nigel Garrett, One B Dintwe, Cynthia L. Monaco, Megan Jones, K. Seaton, E. C. Church, N. Grunenberg, Julia Hutter, Allan C. deCamp, Yunda Huang, Huiyin Lu, P. Mann, Sam T. Robinson, Jack R. Heptinstall, Ryan Jensen, Giuseppe Pantaleo, S. Ding, M. Koutsoukos, Mina C. Hosseinipour, Olivier Van Der Meeren, P. Gilbert, G. Ferrari, E. Andersen-Nissen, M. McElrath, G. Tomaras, Glenda E. Gray, L. Corey, Jim Kublin","doi":"10.1097/qai.0000000000003438","DOIUrl":"https://doi.org/10.1097/qai.0000000000003438","url":null,"abstract":"Despite progress in HIV prevention and treatment, an estimated 1.3 million people were newly infected with HIV in 2022,1 highlighting the urgent need for an effective vaccine. To date, the RV144 trial remains the only HIV vaccine trial that has demonstrated partial efficacy against acquisition.2 The Pox-Protein Public-Private Partnership (P5) was established with the aims of improving on RV144 by developing a vaccine capable of protecting against a broader diversity of HIV strains and achieving a better understanding of immune responses associated with preventing HIV infection.3 Vaccine concepts in the P5 program have focused on clade C immunogens, targeting predominant strains of East and Southern Africa, where approximately half of the 39 million people living with HIV reside.1\u0000 \u0000 The RV144 regimen, originally designed to protect against subtype B/E strains, was adapted to incorporate clade C antigens and adjuvanted with MF59®.4 This regimen demonstrated adequate immunogenicity in the HVTN100 phase 1/2a trial,5 and was further evaluated in the HVTN702 efficacy trial in South Africa, but ultimately discontinued due to non-efficacy.6 In parallel, the P5 designed the correlates program: a series of phase 1/2a trials to evaluate vaccine candidates based on favorable immune profiles of putative correlates of protection. These trials employed novel prime-boost and co-administration regimens, varied protein doses, and used new adjuvants and vaccine delivery systems, with an emphasis on shared immunological endpoints to allow for cross-study comparisons.\u0000 Preclinical studies have shown promising immune responses using DNA/protein combination vaccines.7,8 A comparison of responses between HVTN100 (ALVAC) and HVTN111 (DNA) trials indicated that DNA priming with a protein boost led to increased antibody and cellular responses compared to priming with the canarypox vector.9 In the HVTN105 trial, both a DNA prime-protein boost and a co-administration regimen induced potent and durable V1/V2 binding antibody responses (a known correlate of lower HIV-1 infection risk in RV144), with co-administration inducing early antibody responses.10 Furthermore, in the HVTN096 trial, including gp120 Env protein at the priming stage, co-administered with either NYVAC or DNA, elicited earlier and even greater antibody responses.11\u0000 \u0000 The adjuvant system 01 (AS01) has been successfully tested in vaccine trials for other infectious diseases including malaria,12 shingles,13,14 and tuberculosis.15 Some HIV vaccine studies have also used AS01 and have shown that it contributes to the induction of robust and persistent cellular and humoral responses.16,17 MF59® has likewise been used in several licensed vaccines and pre-clinical studies,18 inducing strong and durable T-cell memory and humoral responses. MF59® was also used in HVTN studies with ALVAC 5 and was therefore chosen for comparison with AS01B in this trial.\u0000 Thus, the aim of the HVTN108 trial was to evaluate the safety a","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"87 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The HIV Care Cascade for Older Adults in Rural South Africa: A Longitudinal Cohort Study (2014-2019)","authors":"J. Rohr, J. Manne-Goehler, F. Gómez-Olivé, K. Kahn, Till W. Bärnighausen","doi":"10.1097/qai.0000000000003445","DOIUrl":"https://doi.org/10.1097/qai.0000000000003445","url":null,"abstract":"\u0000 \u0000 As people with HIV grow older, stable engagement in care is essential for healthy aging. We evaluate the HIV care cascade for older adults in rural South Africa at two time points cross-sectionally and assess movement in the cascade over time.\u0000 \u0000 \u0000 \u0000 We evaluated cascade stage at Waves 1 (2014-2015) and 2 (2018-2019) of HAALSI, a population-based longitudinal cohort study in Mpumalanga Province, South Africa.\u0000 \u0000 \u0000 \u0000 Biomarker screening defined cascade stages (HIV+/No antiretroviral therapy [ART]; ART+/Unsuppressed viral load; ART+/Suppressed viral load). Between-wave probability of death, cascade progression, regression, cascade transitions, and sociodemographic predictors were assessed with Poisson regression. The impact of death was considered using the Fine and Gray competing risk model.\u0000 \u0000 \u0000 \u0000 We observed higher prevalence of ART with viral suppression over time (50% in Wave 1 vs. 70% in Wave 2). Among those alive, the oldest age group (70+ yo) was most likely to have cascade progression (aRR for treatment initiation vs. 40-49 yo: 1.38 (95% CI: 1.02-1.86)). However, there was significant risk of death and cascade regression. Death between waves reached 40% for 70+ year olds who were ART+/Unsuppressed. In competing risk models, older age was associated with equivalent or less cascade progression.\u0000 \u0000 \u0000 \u0000 Older age groups who were unsuppressed on treatment and males had poorer cascade outcomes. Improvements observed in HIV treatment coverage over time for older adults must be interpreted in the context of high risk of death for older HIV-positive adults, especially among those failing treatment.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"55 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141017769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of anal HPV infection and anal HSIL among MSM 50 years and older living with or without HIV","authors":"Alexandra L. Hernandez, Joan F. Hilton, Christopher Scott Weatherly, J. M. Berry-Lawhorn, N. Jay, Cristina E Brickman, Chia-ching J Wang, Jason Kauffman, Joanne Calderon, S. Farhat, M. Costa, Arezou Sadighi Akha, T. Darragh, J. Palefsky","doi":"10.1097/qai.0000000000003450","DOIUrl":"https://doi.org/10.1097/qai.0000000000003450","url":null,"abstract":"\u0000 \u0000 Anal cancer is caused by human papillomavirus (HPV), particularly HPV-16, and is preceded by anal high-grade squamous intraepithelial lesions (HSIL). The incidence of anal cancer is highest among men who have sex with men (MSM) living with HIV (MSMLWH) and increases with age. However, most previous studies of anal HPV infection and anal HSIL were performed on men under 50 years of age, and relatively little is known about HSIL among older MSMLWH or MSM not living with HIV (MSM-Not-LWH).\u0000 \u0000 \u0000 \u0000 We enrolled MSM who were aged 50+ during 2018-2022 in San Francisco, California.\u0000 \u0000 \u0000 \u0000 129 MSMLWH and 109 MSM-not-LWH participated. All participants had anal HPV DNA testing (Atila Biosystems) and high-resolution anoscopy with biopsy of visible lesions.\u0000 \u0000 \u0000 \u0000 Among MSMLWH, 47% had anal HSIL, 19% had HPV-16, and 51% had other oncogenic anal HPV types (excluding HPV-16). Among MSM-not-LWH, 37% had anal HSIL, 22% had HPV-16, and 34% had other oncogenic anal HPV types. Increasing age was not statistically associated with prevalent HSIL, HPV-16, or other oncogenic HPV infections in MSMLWH or MSM-not-LWH. HPV-16 (OR:45.1, 95% CI:15.8-129), other oncogenic HPV types (OR:5.95, 95% CI:2.74-12.9) were associated with increased odds of anal HSIL, adjusted for age, income, education, and HIV status.\u0000 \u0000 \u0000 \u0000 The prevalence of oncogenic anal HPV, anal HPV-16, and anal HSIL remain very high in older MSMLWH and MSM-not-LWH. With recent evidence showing that treating anal HSIL prevents anal cancer, MSM aged 50+ should be considered for anal cancer screening.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"19 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression, substance use and factors associated with sexual risk behaviors among adults living with HIV in the Asia-Pacific region","authors":"J. Ross, S. Teeraananchai, A. Avihingsanon, M. Lee, R. Ditangco, R. Rajasuriar, Jung Ho Kim, S. Gatechompol, Iris Chan, Maria Isabel Echanis Melgar, M. Chong, A. Jiamsakul, Annette H. Sohn, Matthew Law, Jun Yong Choi","doi":"10.1097/qai.0000000000003446","DOIUrl":"https://doi.org/10.1097/qai.0000000000003446","url":null,"abstract":"\u0000 \u0000 Mental health and substance use disorders are common among people living with HIV and are associated with high-risk sexual behaviors, such as unprotected sex and multiple sexual partners, but Asia-Pacific data are limited.\u0000 \u0000 \u0000 \u0000 Adult PLHIV in care at five Asia-Pacific HIV clinics were enrolled at routine clinic visits between July 2019 and June 2020. Depression, substance use, sexual practice and socio-demographic data were collected using PHQ-9, ASSIST, and a study-specific questionnaire. Clinical data were accessed from medical records. Risk factors for medium- to high-risk sexual practices, defined based on total scores from the sexual practice questionnaire assessing number of sexual partners and condom use, were analyzed using logistic regression. Moderate to severe depression was defined as a PHQ-9 score >9, and moderate- to high-risk substance use as an ASSIST score >11 for alcohol or >4 for other substances.\u0000 \u0000 \u0000 \u0000 Among 723 participants, median age was 38 years, 89% were male, 99% were on ART and 37% had medium- to high-risk sexual practices. Medium- to high-risk sexual practices were more common among those <30 years old, unemployed, and HIV status disclosed, and were more likely in participants with moderate to severe depression (aOR 2.09, 95%CI 1.17–3.74) compared to none to minimal depression, and moderate- to high-risk substance use (aOR 1.73, 95%CI 1.23–2.44) compared to those without.\u0000 \u0000 \u0000 \u0000 Further integration of comprehensive sexual risk reduction strategies, mental health services and substance use harm reduction within HIV clinical settings in the region is needed.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"3 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}