Siwei Hou, Chenguang Du, Yuan Hao, Yuting Xia, Qinying Wang, Mengting Li, Guifeng Ding, Liran Xu, Bin Zhang, Wenyu Gao, Gaurav Dave
{"title":"Physical Activity, Positive Coping, and Psychological Distress Among People Living with HIV/AIDS in Henan, China: A Moderated Mediation Analysis.","authors":"Siwei Hou, Chenguang Du, Yuan Hao, Yuting Xia, Qinying Wang, Mengting Li, Guifeng Ding, Liran Xu, Bin Zhang, Wenyu Gao, Gaurav Dave","doi":"10.1089/apc.2024.0253","DOIUrl":"10.1089/apc.2024.0253","url":null,"abstract":"<p><p>This study aims to investigate the mediating role of positive coping in the relationship between physical activity and psychological distress (PD) among people living with HIV/AIDS (PLWHA) in Henan, China, and to explore the moderating factor regarding this relationship. A cross-sectional study was conducted among 517 PLWHA, recruited from four cities in Henan province. Path analysis was employed to examine the mediating effect of positive coping in the link between physical activity and PD. Additionally, a moderated mediation analysis was performed to assess the moderated effect on this relationship. The indirect effect of physical activity on PD via positive coping was statistically significant (β = -0.02, SE = 0.01, 95% confidence interval (CI) [-0.04, -0.01], <i>p</i> < 0.05), confirming partial mediation. The total effect of physical activity on PD was significant (β = -0.10, SE = 0.03, 95% CI [-0.16, -0.04], <i>p</i> < 0.05). Infection duration moderated the mediation effect, with a stronger impact of positive coping on reducing PD observed in participants with an infection duration of less than 10 years (β = -0.52, SE = 0.16, <i>p</i> < 0.001 for <5 years; β = -0.38, SE = 0.12, <i>p</i> < 0.001 for 5-10 years). Physical activity plays a pivotal role in reducing PD among PLWHA by promoting positive coping mechanisms. These findings highlight the importance of incorporating physical activity interventions early in the disease progression, as this may enhance coping skills and mitigate PD.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"116-123"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naomi P Newton, Alexis K Jones, Monica Bahamon, Daniel Hercz, Giselle Gallo Rodriguez, Maiya Cowan, Lauren Middlebrooks, Patricia Panakos, Hector Chavez, Lilly Lee
{"title":"Barriers to Universal HIV Screening of Adolescents in a Pediatric Emergency Department in Miami, Florida.","authors":"Naomi P Newton, Alexis K Jones, Monica Bahamon, Daniel Hercz, Giselle Gallo Rodriguez, Maiya Cowan, Lauren Middlebrooks, Patricia Panakos, Hector Chavez, Lilly Lee","doi":"10.1089/apc.2024.0238","DOIUrl":"10.1089/apc.2024.0238","url":null,"abstract":"<p><p>The Centers for Disease Control and Prevention recommends universal human immunodeficiency virus (HIV) screening in emergency departments (EDs) for patients (above 13 years). In 2017, Jackson Health System (Miami, FL) established a successful adult ED-based universal opt-out HIV screening program. However, when expanded to its affiliated pediatric ED (PED) as an opt-in protocol, only 1.3% of all adolescents received universal screening (only 1.7% were tested based on their chief complaints). We explore barriers to PED testing by comparing the attitudes of providers, patients, and caregivers. Institutional review board-approved surveys were administered anonymously to each group. Raw aggregate data were analyzed for trends. Providers' responses were stratified by role and responses were compared via a Mann-Whitney test. Twenty-four providers responded; they agreed that testing is warranted (x = 3.58 σ 1.32) and not time-consuming (x = 2.33 σ 1.05). There was no agreement on the perceived role of providers to perform testing. Attendings reported a high chance of breaching patients' confidentiality (x̄ = 3.27 σ 1.35), while nurses did not (x̄ = 2.33 σ 1.51). Of the 62 patient responses, 62.9% were amenable to testing, 69.4% would consent to 4th-generation serum testing if less invasive options (e.g., oral swabs) were unavailable, and 77.4% would inform caregivers of results. Of the 37 caregiver responses, 91.9% felt comfortable with their child consenting to testing. In this population, patients and caregivers appear amenable to universal screening. Low testing rates may be explained by providers' disagreement on their role to perform testing and concerns about confidentiality. Future studies should further explore protocol-based flaws and providers' views.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"94-101"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lissa Moran, Alicia T Bolton, Andres Maiorana, Mary A Guzé, Beth Bourdeau, Starley B Shade, Greg M Rebchook, Parya Saberi, Michelle Palomares, Graham Hinchcliffe, Alex S Keuroghlian, Demetrios Psihopaidas, Janet J Myers, Kimberly A Koester
{"title":"Insights on HIV Care Engagement Strategies from Seven Interventions Serving Key Populations in the United States: A Qualitative Study.","authors":"Lissa Moran, Alicia T Bolton, Andres Maiorana, Mary A Guzé, Beth Bourdeau, Starley B Shade, Greg M Rebchook, Parya Saberi, Michelle Palomares, Graham Hinchcliffe, Alex S Keuroghlian, Demetrios Psihopaidas, Janet J Myers, Kimberly A Koester","doi":"10.1089/apc.2024.0164","DOIUrl":"10.1089/apc.2024.0164","url":null,"abstract":"<p><p>As HIV diagnoses continue to decrease and rates of viral suppression increase in the United States, key populations of underserved individuals represent a disproportionate share of those left undiagnosed, unengaged in care, and not virally suppressed. In 2021, the Health Resources and Services Administration's HIV/AIDS Bureau funded 20 HIV care organizations across the United States to implement seven innovative evidence-based interventions to engage individuals in the following four focus areas: LGBTQ+ youth, people with substance-use disorder, individuals with incarceration experience, and those for whom telehealth may reduce barriers to care. This article explores themes of implementer experiences common across interventions serving the four focus areas. Data sources include key informant interviews (<i>n</i> = 94) with members of the implementation teams, observation, and document review. Thematic analytic methods were first inductive, identifying semantic themes from observation and document review, then deductive, selecting coded interview data for analysis of latent themes present and salient across focus areas. We identified three main themes as follows: (1) challenging by design, (2) enhanced client-centered care, and (3) leveraging relationships. We present these themes as distinct concepts and discuss how they operate in relation to one another using the Exploration, Preparation, Implementation, Sustainment framework. Teams implementing interventions to engage people with HIV who remain out of care may benefit from adopting the following: an enhanced client-centered orientation with a focus on understanding the context of clients' lives; a high level of organizational and programmatic flexibility; an individualized, trauma-informed approach to enrollment and intervention delivery; and thoughtfully cultivated relationships among implementers, clients, and organizational partners.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"102-115"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth A Yonko, Katie B Biello, Carolina Cormack Orellana, Olly Richards, Connor Wright, Kiana Aminzadeh, Kenneth H Mayer, Matthew J Mimiaga
{"title":"DoxyPEP Implementation Preferences for Bacterial STD Prevention Among Gay, Bisexual, and Other Men Who Have Sex with Men Living With and Without HIV in Los Angeles: A Mixed-Methods Approach.","authors":"Elizabeth A Yonko, Katie B Biello, Carolina Cormack Orellana, Olly Richards, Connor Wright, Kiana Aminzadeh, Kenneth H Mayer, Matthew J Mimiaga","doi":"10.1089/apc.2024.0252","DOIUrl":"10.1089/apc.2024.0252","url":null,"abstract":"<p><p>Bacterial sexually transmitted diseases (STDs) remain prominent in the United States among gay, bisexual, and other men who have sex with men (GBMSM). Doxycycline for post-exposure prophylaxis (DoxyPEP) is a regimen by which the antibiotic doxycycline is taken after sex to prevent bacterial STDs, such as, chlamydia, gonorrhea, and syphilis. Despite this, this study was conducted because there are a limited number of publications that describe GBMSM's knowledge of, and interest in, taking DoxyPEP and preferences regarding its implementation. We conducted a mixed-methods study between November 2023 and March 2024. Participants (<i>N</i> = 21) completed a semi-structured interview and survey and were eligible if they were a cisgender man who reported having anal sex with another man in the past year and lived in the greater Los Angeles area. Interviews were recorded and transcribed and were analyzed using thematic content analysis. The majority of participants identified as gay (90%) and a racial/ethnic minority (86%); 33% were living with HIV and 43% had been diagnosed with an STD in the prior year. Participants' mean age was 40 years (standard deviation [SD] = 15) and they reported an average of 4.5 (SD = 2.27) sexual partners in the past year. Interviews revealed that knowledge of DoxyPEP was low (28%), but most (81%) were interested in using DoxyPEP after learning about its potential. The vast majority were willing to pay $10-$20 for a 1-month supply but preferred that it be free or covered by insurance. Most preferred to get DoxyPEP from a medical provider or over-the-counter at a pharmacy. Others suggested sexualized venues, such as private sex parties, bathhouses, sex clubs, etc. The greatest concerns about its use included possible side effects, antibiotic resistance, or that it would lead to decreased condom use and increased number of sex partners. A common misconception was that DoxyPEP could prevent both a bacterial STD and HIV. DoxyPEP has strong potential as a widely accepted STD prevention method, but its successful adoption will require proactive strategies to increase GBMSM's knowledge. Implementation programs might consider nontraditional venues where sex between men is regularly occurring.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"84-93"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bona S H Hutahaean, Sarah E Stutterheim, Kai J Jonas
{"title":"Religion, Faith, and Spirituality as Barriers and Facilitators to Antiretroviral Therapy Initiation Among People with HIV in Indonesia.","authors":"Bona S H Hutahaean, Sarah E Stutterheim, Kai J Jonas","doi":"10.1089/apc.2024.0245","DOIUrl":"https://doi.org/10.1089/apc.2024.0245","url":null,"abstract":"<p><p>Indonesia is a country deeply rooted in religion, faith, and spirituality. These aspects significantly determine individuals' decision-making and behavior, including health care decisions. Given the suboptimal attainment of the HIV-cascade targets in the country, we conducted a study to explore the role of religion, faith, and spirituality on antiretroviral therapy (ART) initiation. Our study involved individual interviews with 67 participants recruited from community health centers, public hospitals, and private clinics, predominantly Muslim, including 17 untreated people with HIV (ART-naïve), 30 people with HIV on treatment (ART-experienced), and 20 HIV service providers. Findings revealed that many individuals perceived HIV as a godly punishment related to individual failure (prior risk-prone behaviors), generating shame, guilt, and stigma. Perceiving religion as punitive and unforgiving and holding fatalistic beliefs was linked to postponed ART initiation. Conversely, perceiving religion as loving and forgiving, seeking forgiveness through religious practices, viewing ART intake as a \"collaborative\" effort with God, and engaging in righteous deeds facilitated ART initiation. These findings indicated that religion, faith, and spirituality can serve as both barriers and facilitators to ART initiation, depending on individuals' faith-based practices and perceptions of religion, whether punishing or forgiving. We recommend that people with HIV and health care providers better recognize the role of religion, faith, and spirituality in coping with shame, guilt, and stigma after an HIV diagnosis. This recognition can facilitate informed decisions regarding ART initiation, ultimately improving health outcomes for individuals with HIV in Indonesia.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven Meanley, Lidia Rodriguez Garcia, Nadra E Lisha, Ali Ahmed, Anastasia Korolkova, Tony Figueroa, Elizabeth Nguyen, Michael J Peluso, Lillian B Cohn, Steven Deeks, Karine Dubé, John Sauceda
{"title":"Exploring Stigma and Self-Image: Mixed-Methods Insights from HIV Cure-Related Research Participants Undergoing Analytical Treatment Interruptions.","authors":"Steven Meanley, Lidia Rodriguez Garcia, Nadra E Lisha, Ali Ahmed, Anastasia Korolkova, Tony Figueroa, Elizabeth Nguyen, Michael J Peluso, Lillian B Cohn, Steven Deeks, Karine Dubé, John Sauceda","doi":"10.1089/apc.2024.0254","DOIUrl":"10.1089/apc.2024.0254","url":null,"abstract":"<p><p>This mixed-methods study explored self-image among people with HIV participating in an HIV cure-related study involving analytical treatment interruptions (ATIs). Using both quantitative and qualitative approaches, we described how self-image emerged across study participation, focusing on internalized stigma, emotional strengths, and the psychosocial dimensions of study participation. Data come from the SCOPE-ATI substudy (NCT00187512) of the University of California San Francisco SCOPE cohort (NCT04359186). Quantitative data were collected at three timepoints: pre-ATI (<i>n</i> = 15), post-ATI (<i>n</i> = 12), and end of the study (<i>n</i> = 14). We observed a general decline in self-image scores over time. However, participants maintained a moderately high agreement with statements about contributing to reducing HIV stigma through their involvement in the study. Qualitative interviews were collected pre-ATI (<i>n</i> = 11), during ATI (<i>n</i> = 8), and post-ATI (<i>n</i> = 6). Qualitative findings revealed two major themes shaping self-image: (1) experiencing and reconciling internalized HIV stigma and (2) self-evaluations in relation to life purpose. Many participants expressed disappointment at having to resume antiretroviral therapy, viewing it as a reminder of their HIV status and its associated stigma. Nevertheless, some found purpose and pride in their participation, motivated by altruistic contributions to improving future HIV control options. The findings highlight the emotional complexities of participating in HIV cure research and underscore the need for psychosocial support throughout ATI studies. While most participants experienced a decline in self-image, some derived meaning and empowerment from their involvement. This study suggests that addressing emotional well-being and reinforcing participants' contributions to science can enhance their experience in future research.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gaia Cologgi, Claudia Bartalucci, Monica Melchio, Lucia Taramasso, Bianca Bruzzone, Matteo Bassetti, Antonio Di Biagio
{"title":"A Proposal for a Tool to Reduce the Frequency of HIV RNA Monitoring in People with HIV Treated with Long-Acting Antiretrovirals.","authors":"Gaia Cologgi, Claudia Bartalucci, Monica Melchio, Lucia Taramasso, Bianca Bruzzone, Matteo Bassetti, Antonio Di Biagio","doi":"10.1089/apc.2025.0010","DOIUrl":"https://doi.org/10.1089/apc.2025.0010","url":null,"abstract":"","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Damian Krebs, Hilary Goldhammer, Milo Dorfman, Melanie P Moore, Nicole S Chavis, Demetrios Psihopaidas, Alicia Downes, Beth Bourdeau, Parya Saberi, Chris Grasso, Kenneth H Mayer, Alex S Keuroghlian
{"title":"Telehealth Interventions to Improve HIV Care Continuum Outcomes: A Narrative Review.","authors":"Damian Krebs, Hilary Goldhammer, Milo Dorfman, Melanie P Moore, Nicole S Chavis, Demetrios Psihopaidas, Alicia Downes, Beth Bourdeau, Parya Saberi, Chris Grasso, Kenneth H Mayer, Alex S Keuroghlian","doi":"10.1089/apc.2024.0237","DOIUrl":"https://doi.org/10.1089/apc.2024.0237","url":null,"abstract":"<p><p>Interventions that leverage telehealth technologies have the potential to improve health outcomes among people with HIV who experience multiple complex barriers to care. To assess the current state of knowledge on telehealth interventions for people with HIV in the United States, we searched the literature for recent (2019-2023) telehealth interventions designed to improve outcomes along the HIV care continuum, including linkage to care, retention in care, antiretroviral therapy adherence, and viral suppression. Our search identified 23 interventions. Text messaging was the most common telehealth delivery mode, followed by videoconferencing, commercially available applications, and novel applications. Nine interventions used more than one delivery mode. Common features across interventions to address barriers along the HIV care continuum included: HIV care self-management and monitoring tools; HIV treatment and adherence education; resources and referrals provision; live messaging for ongoing support or urgent issues; videoconference-based coaching, counseling, case management, or care; online peer-to-peer support; ecological momentary assessments to monitor and address barriers; and game-based elements to increase engagement. Interventions were reported as acceptable and feasible, with several showing an effect on antiretroviral therapy adherence. Further research is needed to fully leverage the potential of telehealth for ending the HIV epidemic in the United States.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding the PrEP Care Continuum for Adults: Health Care Providers' Perspectives on Barriers, Facilitators, and Missed Opportunities.","authors":"Chen Zhang, Wonkyung Chang, Yu Liu","doi":"10.1089/apc.2024.0241","DOIUrl":"10.1089/apc.2024.0241","url":null,"abstract":"<p><p>Pre-exposure prophylaxis (PrEP) is an effective strategy in reducing HIV transmission, yet its uptake remains suboptimal. Health care providers play a vital role in facilitating PrEP access and care. This qualitative study explores health care providers' perspectives on the oral PrEP care continuum for adults, emphasizing barriers, facilitators, and missed opportunities in PrEP implementation. Drawing on interviews with 18 primary care providers in New York State, our research investigates multi-level factors influencing PrEP awareness, initiation, and management. Findings reveal significant barriers at the patient level, such as low awareness, stigma, and misconceptions about HIV risk. Provider-level challenges include knowledge gaps, discomfort in discussing sexual health, and logistical constraints. Structural factors such as insufficient infrastructure and high costs impede consistent PrEP management. Facilitators identified include proactive provider-patient communication, educational resources, and workflow integration strategies. Subgroup analyses highlight variations in attitudes based on provider demographics and experience. Younger and female providers are more proactive in discussing PrEP, while older and male providers often perceive it as less relevant. Nurses emphasize patient education and trust-building, contrasting with physicians' focus on logistical challenges. Providers experienced in prescribing PrEP view it as a valuable prevention tool, while nonprescribers report hesitancy and limited familiarity. Discrepancies in patient-perceived versus actual HIV risk, as well as provider assumptions about patient candidacy for PrEP, underscore the need for routine, stigma-free discussions about HIV prevention. This study emphasizes the importance of targeted provider training, system-level support, and inclusive policies to enhance PrEP uptake. Addressing these barriers and leveraging facilitators can advance public health efforts, fostering equitable and effective HIV prevention strategies.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"61-69"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}