Journal of acquired immune deficiency syndromes (1999)最新文献

{"title":"Trends in HIV prevention outcomes among Northern and Indigenous adolescents: A repeated cross-sectional study of arts-based sexual health workshops in the Northwest Territories, Canada.","authors":"Ying Wang, Carmen H Logie, Aryssa Hasham, Kayley Inuksuk Mackay, Renée Monchalin, Candice L Lys","doi":"10.1097/QAI.0000000000003965","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003965","url":null,"abstract":"<p><strong>Background: </strong>Arts-based sexual health workshops may improve adolescent sexual health, yet limited studies have evaluated outcome trends over time. This study examined HIV prevention outcomes before and after school-based workshop participation among adolescents in the Northwest Territories (NWT), Canada.</p><p><strong>Methods: </strong>We analyzed seven waves of pretest and immediate posttest data from adolescents aged 13-18 years in 17 NWT communities from 2018-2019 to 2024-2025. Surveys assessed sociodemographic characteristics, HIV knowledge, and condom use self-efficacy (CUSE). Paired-samples t-tests examined pretest to posttest differences. Mixed-effects linear regression models examined trends in change scores across school years and adjusted for the number of previously completed arts-based sexual health workshops.</p><p><strong>Results: </strong>The pretest sample included 1,936 workshop observations; 1,579 had paired outcome data. Mean age was 13.64 years (SD=1.47); 48.86% were cisgender girls, 19.62% identified as lesbian, gay, bisexual, or queer, 70.05% identified as Indigenous, and 68.16% lived outside of Yellowknife in rural settings. HIV knowledge increased from 2.74 (SD=3.13) to 8.05 (SD=4.18), with a large effect size (Cohen's dz=1.30). CUSE increased from 19.59 (SD=4.40) to 20.32 (SD=4.70), with a small effect size (Cohen's dz=0.15). HIV knowledge gains increased across school years, particularly among older adolescents and cisgender girls. CUSE gains also increased; no sociodemographic interaction was statistically significant.</p><p><strong>Conclusion: </strong>Arts-based sexual health workshop participation was associated with immediate improvements in HIV knowledge and CUSE across seven school years among Northern and Indigenous adolescents in the NWT. Findings support continued evaluation of culturally responsive, arts-based HIV prevention in Northern and remote settings.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893317","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":"Associations between self-reported PrEP use and short and long-term pharmacologic metrics of PrEP adherence among Kenyan women.","authors":"Jennifer Velloza, Aliza Adler, Deepalika Chakravarty, David V Glidden, Gakuo Maina, Charlene Biwott, Catherine Kiptinness, Matthew A Spinelli, Hideaki Okochi, Purba Chatterjee, Nelly Mugo, Kenneth Ngure, Monica Gandhi","doi":"10.1097/QAI.0000000000003967","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003967","url":null,"abstract":"<p><strong>Background: </strong>Biomarkers provide reliable information on oral PrEP pill-taking. It remains unclear whether self-reported PrEP adherence has value when used in combination with pharmacologic measures. We examined associations between self-reported and biomarker-based PrEP adherence metrics to improve identification of those with low adherence in resource-constrained settings.</p><p><strong>Methods: </strong>HIV-uninfected women using oral tenofovir (TFV)-based PrEP were enrolled (N=100) in the Point-of-Care Urine Monitoring for Adherence trial in Kenya from 2021-2022. Participants were randomized 1:1 to standard-of-care or urine-based-point-of-care assay-informed drug-level feedback. Adherence was measured at enrollment and quarterly through 12 months via urine, hair and self-report. A positive urine assay (TFV≥1500 ng/mL) indicated short-term adherence. TFV hair concentration≥0.023 ng/mg indicated long-term adherence (4-times-weekly dosing). Self-reported adherence was calculated as the mean score (range=0-100) on a 2-item scale. Generalized estimating equations estimated longitudinal associations between self-reported adherence and biomarkers. Receiver-operating-characteristic curves assessed self-report as a predictor of biomarker metrics.</p><p><strong>Results: </strong>At enrollment, 68.7% had a positive urine assay, 83.7% had detectable hair TFV, and median self-reported adherence was 100 (IQR=90-100). At Month 12, participants with higher adherence scores were more likely to have hair TFV concentrations≥0.023 ng/mg (aRR=1.44; 95% CI=1.20-1.72; p-value<0.001) and positive urine results (aRR=1.56; CI=1.43-1.69; p-value=<0.001). Areas-under-the-curve for self-report as a predictor of hair levels were 0.64 in a model with self-report and 0.74 in a model with both self-report and urine testing.</p><p><strong>Conclusions: </strong>Associations between self-reported and biomarker-verified PrEP adherence demonstrated accurate reporting. Incorporating biomarkers in studies may result in improved adherence and/or improved accuracy of self-report.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893278","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 AND SEVERITY OF STEATOTIC LIVER DISEASE IN WOMEN WITH AND WITHOUT HIV.","authors":"Maria J Duarte, Phyllis C Tien, Mark H Kuniholm, Yifei Ma, Chloe L Thio, David B Hanna, Mallory D Witt, Carling Skvarca, James Brock, Audrey L French, Maria Alcaide, Michelle Floris-Moore, Eric C Seaberg, Ighovwerha Ofotokun, Michael Plankey, Valentina Stosor, Jennifer C Price","doi":"10.1097/QAI.0000000000003964","DOIUrl":"10.1097/QAI.0000000000003964","url":null,"abstract":"<p><strong>Introduction: </strong>Steatotic liver disease (SLD) is highly prevalent in people with HIV (PWH) and is a major cause of morbidity and mortality in this population. However, it remains unclear whether SLD is influenced by HIV infection and whether the clinical management of PWH who have SLD should differ from non-HIV populations.</p><p><strong>Methods: </strong>Liver steatosis and fibrosis were assessed using vibration-controlled transient elastography (VCTE) among 1,580 women (1,117 with HIV; 463 without) enrolled in the Women's Interagency HIV Study between 2013 and 2018. Steatosis was defined by a controlled attenuation parameter (CAP) ≥248 dB/m, and clinically significant fibrosis by liver stiffness ≥7.1 kPa. Participants were classified according to the AASLD diagnostic algorithm for SLD. Differences in fibrosis prevalence by HIV status were evaluated, and multivariable logistic regression was performed to identify factors associated with SLD and fibrosis, adjusting for age, ethnicity, BMI, alcohol use, diabetes, and smoking.</p><p><strong>Results: </strong>Prevalence of SLD was 740 of 1580 (47%) and did not differ by HIV serostatus. Most SLD was metabolic dysfunction-associated steatotic liver disease (MASLD; 629 of 740 [82%]). HIV infection was associated with higher odds of clinically significant fibrosis only among women with SLD (adjusted OR 1.48, 95% CI 1.01-2.16, p=0.04; HIV*SLD interaction among entire cohort p=0.03).</p><p><strong>Discussion: </strong>In this study, most SLD in women living with HIV is classified as MASLD. HIV infection is associated with higher odds of hepatic fibrosis only among those with SLD. Further work is needed to understand how HIV may potentiate fibrosis in the setting of SLD.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription of Long-Acting Antiretroviral Therapy Among U.S. Adults with HIV.","authors":"Linda Beer, Stacy M Crim, Yunfeng Tie, Jesse O'Shea, Jason A Craw, Eve Koehler, Kate Buchacz, Joseph Prejean","doi":"10.1097/QAI.0000000000003963","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003963","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable antiretroviral therapy (LA-ART) has enormous potential benefit for increasing viral suppression among persons with HIV (PWH).</p><p><strong>Setting: </strong>U.S. HIV care facilities.</p><p><strong>Methods: </strong>We analyzed data on past 12-month LA-ART prescriptions collected over 3 annual data collection cycles (2021-2023) from probability samples of U.S. adults with HIV (collected 6/1/2021-5/30/2024, N=11,524). We report weighted percentages of PWH prescribed LA-ART and use prevalence ratios (PRs) with predicted marginal means and 95% confidence intervals (CIs) to quantify differences in prescription of LA-ART over time and between groups.</p><p><strong>Results: </strong>The percentage of PWH prescribed LA-ART increased from 0.4% (CI 0.2-0.7) in the 2021 cycle to 3.4% (CI 2.8-3.9) in the 2023 cycle (PR 7.8 [CI 4.5-13.6]). During the 2022-2023 cycles, prescription of LA-ART was higher among those living in Northeastern Medical Monitoring Project (MMP) states versus Southern MMP states (3.4% [CI 2.4-4.3] vs. 1.9% [CI 1.3-2.5], PR 1.8 [1.2-2.8]) and those receiving care at Ryan White HIV/AIDS program (RWHAP)-funded versus non-funded facilities (2.9% [CI 2.4-3.4] vs. 1.8% [CI 1.3-2.4], PR 1.6 [CI 1.1-2.2]). Older age (>50 vs. <40 years) was also associated with lower ART prescription.</p><p><strong>Conclusion: </strong>Prescription of LA-ART is increasing among U.S. adults with HIV, though prevalence remains low. LA-ART uptake lagged in the South, where HIV infections and negative health outcomes are disproportionately high. Comprehensive HIV care delivery-such as found in RWHAP-facilities-may facilitate LA-ART adoption.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893313","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":"Government to Government Model for HIV Service Delivery-An Approach for Country and Program Ownership in 4 Provinces of Zambia.","authors":"Keith Mweebo, Annie Mwila, Kiva F Tinglof, Mark W Tenforde, Brian Muyunda, Gregory Parent, Maybin Mumba, Thomas Mupashi, Diane Morof, Jennifer Nel, Leoda Hamomba, Nzali Kancheya, Linos Mwiinga, Eugenia Zulu, Callistus Kaayunga, Mathews Ngambi, Simulyamana A Choonga, Lloyd Mulenga, Michele Montandon, Brittney Baack, Steven Y Hong, Isaac Zulu, Genessa Giorgi, Andrew Auld, Simon Agolory","doi":"10.1097/QAI.0000000000003894","DOIUrl":"10.1097/QAI.0000000000003894","url":null,"abstract":"<p><strong>Introduction: </strong>Beginning in fiscal year (FY) 2019, the US Centers for Disease Control and Prevention in Zambia transitioned from nongovernmental organizations to a government to government provincial health office service delivery model in 4 provinces in Zambia. We reviewed programmatic and financial data during and after this transition to assess outcomes of service delivery and financial investment through a government-led approach.</p><p><strong>Methods: </strong>Programmatic performance using US President's Emergency Plan for AIDS Relief Monitoring, Evaluation, and Reporting and expenditure reporting data were used to assess changes over the period of transition. Data were reviewed across 6 FYs from October 2018-September 2019 (FY19) through October 2023-September 2024 (FY24) in 4 provinces. Programmatic and expenditure performance indicators were analyzed across time.</p><p><strong>Results: </strong>From FY19 to FY24, the number of people living with HIV (PLHIV) on antiretroviral therapy (ART) across the 4 provinces increased from 495,552 to 680,781 (37%). Viral load coverage and suppression in the transition provinces increased from 345,849/472,554 to 592,399/672,403 (15%) and 313,384/345,849 to 578,832/592,399 (7%), respectively. Annual President's Emergency Plan for AIDS Relief financial investments for care and treatment activities (in 2019 US dollars) increased by $12.7 million (25%) from $38.3 million in FY19 to $51.0 million in FY21, as the amount invested in direct service delivery increased concurrently with investments to implementing partners. From FY21 to FY24, spending declined by $21.0 million (41%), whereas the total number of PLHIV on ART increased. The amount spent per PLHIV on ART decreased from $79 in FY21 to $44 in FY24 (44%).</p><p><strong>Conclusions: </strong>The government-led model in Zambia shows a path forward to achieving HIV program success, reductions in costs, and expanded government ownership of the HIV program.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"1024-1031"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Time-Space Methodologies to Detect Clusters of HIV Transmission: A Comparison of Advanced Methods in Washington State, 2010-2022.","authors":"Steven Erly, Hao Yan, Sarah Holte, Yajun Mei, Roxanne P Kerani","doi":"10.1097/QAI.0000000000003904","DOIUrl":"10.1097/QAI.0000000000003904","url":null,"abstract":"<p><strong>Background: </strong>Identification of HIV transmission clusters is a key activity under the \"Respond\" pillar of the United States' Ending the HIV Epidemic initiative, but the most common method for detecting time-space clusters has low predictive value for future diagnoses in Washington state. We compared different methodologies with the current Centers for Disease Control and Prevention (CDC) standard to identify alternative techniques for guiding public health outbreak response locally.</p><p><strong>Setting: </strong>Washington state, 2010-2022.</p><p><strong>Methods: </strong>Using Washington state HIV surveillance data, we applied 4 methods of detecting anomalies in time series [CDC time-space cluster detection criteria, SaTScan purely temporal, Cumulative Sum (CUSUM), and Log-CUSUM] to the monthly HIV diagnoses at the county level and evaluated predictive ability for increases in diagnoses using micro and macro rate ratios (number of new diagnoses in a region 1-12 months after cluster detection relative to a baseline the year before).</p><p><strong>Results: </strong>There were 5335 new diagnoses in Washington state between 2010 and 2022. The CUSUM method detected 57 clusters and had the highest macro (3.7) and micro (1.7) rate ratios in the month after cluster detection. Over a 12-month period, the log-CUSUM had the highest predictive value (54 clusters, macro 1.7, micro 1.3).</p><p><strong>Conclusions: </strong>The CUSUM methods showed superior ability to identify regions of sustained increases in HIV diagnoses and should be considered for HIV cluster detection and response activities.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"957-963"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B and C Prevention, Screening, and Diagnostic Services at HIV Treatment Sites: International Epidemiology Databases to Evaluate AIDS.","authors":"Mark H Kuniholm, Gad Murenzi, Niharika Samala, Evy Yunihastuti, Gilles Wandeler, H Nina Kim, Marie K Plaisy, Hugo Perazzo, Christella Twizere, Francesca Odhiambo, Rohan Bopage, Guy Muula, Vincent Lo Re, Albert Minga, Alvaro López-Iñiguez, Dominique M Nsonde, Charles Kasozi, Dewi K Wati, Matthew P Fox, Gregory D Kirk, Eugene Messou, Carina Cesar, Peter V Ebasone, Helen Byakwaga, Jeremy Ross, Cleophas Chimbetete, George A Yendewa, Antoine Jaquet, Regina C M Succi, Fernanda Maruri, Ellen Brazier","doi":"10.1097/QAI.0000000000003896","DOIUrl":"10.1097/QAI.0000000000003896","url":null,"abstract":"<p><strong>Background: </strong>Prevention, screening, and diagnostic services for hepatitis B virus (HBV) and hepatitis C virus (HCV) can prevent morbidity and mortality in people receiving HIV care. However, there is limited information about the availability of HBV and HCV services at HIV clinics globally.</p><p><strong>Methods: </strong>The International epidemiology Databases to Evaluate AIDS (IeDEA) conducted surveys of service delivery and practices at participating HIV treatment centers from 7 regions. We used 2023 survey data to measure availability of HBV vaccination, HBV and HCV screening, HBV surface antigen (HBsAg), HBV DNA, HCV antibody, and HCV RNA testing. Multivariable logistic regression models were used to test associations of site characteristics with HBV and HCV services.</p><p><strong>Results: </strong>HBV vaccination was available on-site at 67.7% of 204 HIV treatment sites. Screening for HBV and HCV at HIV care enrollment was reported by 72.1% and 50% of sites, respectively. HBsAg, HBV DNA, HCV antibody, and HCV RNA testing were available on-site at 77%, 47.6%, 61.8%, and 44.6% of sites, respectively. Sites serving predominately rural (vs. urban) populations were less likely to report on-site availability of HBV DNA [odds ratio (OR):0.07; 95% confidence interval: 0.01 to 0.68; P = 0.02], HCV antibody (OR = 0.18; 95% CI: 0.04 to 0.92; P = 0.04), and HCV RNA (OR = 0.10; 95% CI: 0.01 to 0.90; P = 0.04) testing.</p><p><strong>Conclusion: </strong>Life-saving services such as HBV vaccination, HBsAg, and HCV antibody testing were available on-site at most HIV treatment sites participating in the IeDEA network. Lower availability at rural sites suggests that expansion of services is important to eliminate HBV and HCV as public health problems in people receiving HIV care.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"964-972"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk Factors for Non-AIDS Comorbidities After COVID-19 in People Living With HIV in Atlanta, Georgia.","authors":"Cecilia Castellano, Caitlin A Moran, Minh T Nguyen, Vijay Ramesh, Cecile D Lahiri","doi":"10.1097/QAI.0000000000003901","DOIUrl":"10.1097/QAI.0000000000003901","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) infection rates disproportionately affect persons with underlying health conditions. People living with HIV (PLWH) acquire COVID at a higher rate than those without HIV and may be at risk for developing incident comorbidities after acute infection. Risk factors for, and incidence of, post-COVID non-AIDS comorbidities (NACM) in PLWH remain unknown.</p><p><strong>Setting: </strong>We assessed incidence of and risk factors for post-COVID NACM among PLWH using data from the Emory Center for AIDS Research Registry between March 1, 2020, and September 30, 2022. We assessed 8 NACM: cardiometabolic disease, cardiovascular disease, chronic kidney disease, diabetes mellitus, hypertension, lung disease, neurologic disease, and psychiatric disease.</p><p><strong>Methods: </strong>Incidence of and risk factors for post-COVID NACM were evaluated using Cox proportional hazards regression models.</p><p><strong>Results: </strong>Among 3540 PLWH (median age 51 years, 69% male, 86% Black, median CD4 + T cell count 415 cells/mm 3 , 72% HIV RNA <200 copies/mL), 261 (7%) COVID+. COVID+ participants had a higher baseline NACM burden (38% vs 9% with > 3 NACM), a longer time to developing any NACM (198 vs 96 days), and similar risk of developing any NACM compared with the COVID-group [hazard ratio (95% confidence interval) 0.65 (0.45, 0.93)].</p><p><strong>Conclusions: </strong>PLWH during the COVID pandemic were at risk for incident NACM regardless of COVID infection status. Although limited by small sample size, our findings suggest that the pandemic itself, beyond infection, may have contributed to an increase in post-COVID comorbidities in PLWH, particularly among those with preexisting comorbidities.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"973-981"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for PrEP Program Attributes Among Black Women Across the Southern United States: A Discrete Choice Experiment.","authors":"Amber I Sophus, Jason W Mitchell, Joanna Fernandez Fuentes, Shawndasia Collins, Joyonna Gamble-George, Alex Dubov","doi":"10.1097/QAI.0000000000003905","DOIUrl":"10.1097/QAI.0000000000003905","url":null,"abstract":"<p><strong>Background: </strong>HIV disproportionately affects cisgender Black women (CBW), yet fewer than 2% of eligible CBW use preexposure prophylaxis (PrEP); an effective biomedical HIV prevention method. To improve PrEP uptake, this study identified CBW's preferences for key features of PrEP delivery programs using a discrete choice experiment (DCE).</p><p><strong>Methods: </strong>CBW were recruited, screened online, and completed a one-time DCE survey. Participants completed 14 choice tasks involving 6 PrEP program attributes: (1) administration method, (2) access location, (3) health care integration, (4) provider demographics, (5) payment options, and (6) support services. Hierarchical Bayes models estimated attribute importance; latent class analysis was used to group participants by similar preferences.</p><p><strong>Results: </strong>Among 390 participants, administration method was the top-ranked attribute (48%), followed by provider demographics (13.2%), and access location (12%). Preferences clustered into 5 groups. Group 1 (n = 82), younger women with high educational attainment, preferred telehealth initiated bi-monthly injectable PrEP. Group 2 (n = 82), older women with lower HIV vulnerability, favored oral and injectable PrEP prescribed by a physician during women's health visits. Group 3 (n = 108) had the highest HIV vulnerability, showed strong interest in PrEP, preferred the vaginal ring accessed through pharmacies or telehealth. Group 4 (n = 59) had the lowest access to health care, preferred injectable PrEP in clinical settings with income-based cost adjustments. Group 5 (n = 59), 1 of the youngest and economically advantaged, favored the vaginal ring from a pharmacy.</p><p><strong>Conclusions: </strong>Findings indicate administration method, provider type, and access location mattered most to CBW for PrEP programming, indicating the need to use multiprong approaches to bolster PrEP uptake.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"988-998"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978566","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":"Brief Report: Sustainability of the Effects of Linkage Case Management on Posthospitalization HIV Outcomes: The Daraja Randomized Clinical Trial.","authors":"Megan Willkens, Benson Issarow, Godfrey A Kisigo, Severin Kabakama, Elialilia Okello, Thomas Rutachunzibwa, Derick Deogratias, Daniel W Fitzgerald, Philip Ayieko, Myung Hee Lee, Lisa R Metsch, Sean M Murphy, Saidi Kapiga, Robert N Peck","doi":"10.1097/QAI.0000000000003900","DOIUrl":"10.1097/QAI.0000000000003900","url":null,"abstract":"<p><strong>Introduction: </strong>In this prespecified analysis of a clinical trial to assess the effect of linkage case management on posthospital outcomes in people with HIV, we sought to evaluate the sustainability of the intervention effects from 12 to 24 months.</p><p><strong>Methods: </strong>Participants in the Daraja trial were followed 12 months beyond the primary end point of 12 months to assess the sustainability of HIV outcomes 24 months after hospital discharge. Study outcomes were continuity in HIV care, persistent ART adherence, and sustained viral load suppression through 24 months, achieved at both 12-month and 24-month time points.</p><p><strong>Results: </strong>Findings from 12 months after Daraja intervention completion indicate the sustainable effects of linkage case-management in people with HIV who had been hospitalized at the time the intervention was initiated. Intervention participants achieved higher rates of continuity in HIV care (78.6% vs 66.3%, P = 0.008), persistent ART adherence (74.1% vs 61.0%, P = 0.006), and persistent HIV viral load suppression (70.1% vs 57.6%, P = 0.01) compared with the standard of care sustained from through 24 months. The intervention effect on time to HIV clinic linkage and ART initiation also remained significant at 2 years with >10% of control participants remaining untreated after 2 years.</p><p><strong>Conclusions: </strong>The Daraja intervention had a sustained effect on retention in HIV care, ART adherence, and viral load suppression among hospitalized people with HIV.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"1021-1023"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}