AIDS patient care and STDs最新文献

"We're Going to Be Here": Providers' Perspectives on Implementing a Revised HIV Care Coordination Program. “我们将在这里”：提供者对实施修订后的艾滋病毒护理协调计划的看法。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-12 DOI: 10.1089/apc.2025.0047

Connor Emmert, Tigran Avoundjian, Mary Irvine, Thamara Tapia-Munoz, Rachel Schenkel, Miguel Hernandez, Sarah Kozlowski, Denis Nash, Honoria Guarino

{"title":"\"We're Going to Be Here\": Providers' Perspectives on Implementing a Revised HIV Care Coordination Program.","authors":"Connor Emmert, Tigran Avoundjian, Mary Irvine, Thamara Tapia-Munoz, Rachel Schenkel, Miguel Hernandez, Sarah Kozlowski, Denis Nash, Honoria Guarino","doi":"10.1089/apc.2025.0047","DOIUrl":"https://doi.org/10.1089/apc.2025.0047","url":null,"abstract":"As HIV outcomes continue to improve, disparities in viral suppression and care engagement persist, exacerbated by socioeconomic inequities, mental health stressors, systemic racism, HIV-related stigma, and other forms of discrimination. HIV care coordination programs address structural and psychosocial barriers to care and treatment, but these interventions must adapt to the evolving circumstances and perspectives of those expected to participate in them to achieve and sustain maximal impact. In 2009, the New York City Department of Health implemented a Ryan White-funded HIV Care Coordination Program (CCP). The CCP has demonstrated effectiveness, particularly among those newly diagnosed with HIV and those out of care or unsuppressed in the prior year. However, implementation challenges prompted a 2018 redesign to increase provider and client engagement. We conducted 30 semi-structured interviews with providers from six agencies delivering the revised CCP to examine barriers and facilitators to implementation. Providers highlighted the revised CCP's flexible, client-centered approach as a strength, allowing for personalized care plans and improved client engagement. Additionally, they emphasized the contributions of driven, committed staff. However, providers noted several barriers associated with the revised model or its implementation context, including increased paperwork burden, unrealistic service expectations, understaffing, and burnout from uncompensated emotional labor. Our findings suggest the value of retaining a client-centered model while streamlining administrative processes, enhancing training and support for providers, and increasing staff-client ratios. Adjustments based on providers' experience with a complex intervention can improve the fit of the intervention to its intended delivery settings and promote sustainability.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273948","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}

引用次数: 0

Implementation Barriers and Facilitators in a Pilot Long-Acting HIV Treatment Intervention for Trans Women Living with HIV in San Francisco. 旧金山跨性别女性HIV感染者长效HIV治疗干预试点的实施障碍和促进因素。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-06 DOI: 10.1089/apc.2024.0259

Erin C Wilson, Janet Myers, Geovanny Muñoz Acosta, Sofia Sicro, Emily Schaeffer, Cat-Dancing Alleyne, Alfonso Diaz, Nicole Walker, Janie Vinson, Susan Buchbinder, Hyman Scott, Albert Liu

{"title":"Implementation Barriers and Facilitators in a Pilot Long-Acting HIV Treatment Intervention for Trans Women Living with HIV in San Francisco.","authors":"Erin C Wilson, Janet Myers, Geovanny Muñoz Acosta, Sofia Sicro, Emily Schaeffer, Cat-Dancing Alleyne, Alfonso Diaz, Nicole Walker, Janie Vinson, Susan Buchbinder, Hyman Scott, Albert Liu","doi":"10.1089/apc.2024.0259","DOIUrl":"https://doi.org/10.1089/apc.2024.0259","url":null,"abstract":"Little is known about long-acting HIV treatment implementation with trans women. We piloted and evaluated the implementation of novel strategies to increase uptake and use of long-acting HIV treatment among trans women in San Francisco. In 2022, qualitative formative nominal groups (n = 8) and in-depth interviews with providers (n = 11) were conducted to elicit facilitators and barriers to long-acting HIV treatment delivery among trans women living with HIV and to inform a pilot delivery model. Between August 2023 and August 2024, participants were enrolled into the program. Sequential mixed methods were used to evaluate formative and implementation data to understand barriers to starting long-acting treatment. Barriers for trans women were concerns about side effects, fear of needles, and difficulty adhering to bi-monthly injections. They were also concerned about missed injections from lack of transportation and incarceration and medical mistrust. Providers were most concerned with participant adherence due to social determinants (e.g., housing) and behavioral health challenges (e.g., methamphetamine use, mental health disorders). Buttock fillers and implants, patient worries about interactions with hormones, clinical barriers (e.g., availability of genotyping data), insurance, and managing prescriptions were also potential barriers. A significant barrier to implementation was the burden on referring clinic providers for eligibility screening and many trans women who were referred declined participation or were not eligible due to contraindicated clinical histories. Our study identified barriers to implementing long-acting HIV treatment among trans women living with HIV and provides novel implementation insights for clinics and interventions serving this community.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232935","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}

引用次数: 0

Exploring Preferences, Concerns, and Implementation of Different Long-Acting Antiretroviral Strategies for Youth with HIV Facing Adherence Challenges. 探索偏好，关注和实施不同长效抗逆转录病毒策略的青年艾滋病毒面临的坚持挑战。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-05 DOI: 10.1089/apc.2025.0039

Ashle Barfield, Elise Tirza Ohene-Kyei, Raina Smith, Maria Trent, Jamie Perin, Kevon-Mark Jackman, Steven Huettner, Ethel Weld, Amanda Haines, Allison Agwu

{"title":"Exploring Preferences, Concerns, and Implementation of Different Long-Acting Antiretroviral Strategies for Youth with HIV Facing Adherence Challenges.","authors":"Ashle Barfield, Elise Tirza Ohene-Kyei, Raina Smith, Maria Trent, Jamie Perin, Kevon-Mark Jackman, Steven Huettner, Ethel Weld, Amanda Haines, Allison Agwu","doi":"10.1089/apc.2025.0039","DOIUrl":"https://doi.org/10.1089/apc.2025.0039","url":null,"abstract":"Youth living with human immunodeficiency virus (YHIV) aged 13-25 often struggle with adherence to daily oral antiretroviral treatment (ART) regimens. Recently approved intramuscular injectable long-acting ART (LA-ART) may promote adherence and improve longitudinal health outcomes. The study explores the willingness to use LA-ART strategies among YHIV. This cross-sectional pilot study included a telephone-based survey embedded into a randomized controlled trial of an intervention (NCT03600103) designed to enhance viral suppression among YHIV with baseline adherence challenges and detectable viremia. Participants completed 34-item telephone surveys between October 2021 and February 2022 to evaluate preferences and willingness to use four LA-ART delivery alternatives [intramuscular injection (IM), subcutaneous injection (SC), subdermal implant (SDI), and LA-ART pills] compared with daily oral ART. Long-acting pills were most preferred (84%, 16/19), while 79% of participants (15/19) expressed willingness to try IM, 79% (15/19) SC, and 74% (14/19) SDI. However, when asked to choose only one method, most (58%, 11/19) selected IM as the method that would work best. The arm was the preferred injection site (73% [8/11]) compared with the thigh (18% [2/11]). Willingness to use LA-ART was higher with less frequent injections, e.g., for IM LA-ART, 47% (9/19) were willing to try weekly vs. 79% (15/19) were willing to try every three-month injections. YHIV experiencing adherence challenges are willing to use novel LA-ART delivery methods. Addressing concerns around LA-ART methods and educating YHIV on their efficacy could help increase uptake, which could reduce rates of non-adherence in YHIV.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223996","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}

引用次数: 0

Quantitative and Qualitative Perspectives of Participants Who Received Long-Acting Injectable Cabotegravir-Rilpivirine at Home or in Clinic. 在家中或诊所接受长效注射卡波特韦-利匹韦林的参与者的定量和定性观点。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-04 DOI: 10.1089/apc.2025.0024

Angela D Moreland, Rochelle Hanson, Stephanie E Kirk, Hayley Berry, Virginia Fonner, Jamila Williams, Eric G Meissner

{"title":"Quantitative and Qualitative Perspectives of Participants Who Received Long-Acting Injectable Cabotegravir-Rilpivirine at Home or in Clinic.","authors":"Angela D Moreland, Rochelle Hanson, Stephanie E Kirk, Hayley Berry, Virginia Fonner, Jamila Williams, Eric G Meissner","doi":"10.1089/apc.2025.0024","DOIUrl":"https://doi.org/10.1089/apc.2025.0024","url":null,"abstract":"Injectable antiretroviral options for the treatment of HIV-1 infection have demonstrated the potential to reduce pill fatigue, improve medication adherence, increase patient satisfaction, and reduce stigma compared to oral antiretroviral therapy. In a recent non-randomized observational study, we previously examined safety and efficacy outcomes for participants who chose where to receive long-acting cabotegravir/rilpivirine over a 12-month period. This study demonstrated that at-home administration of long-acting cabotegravir/rilpivirine by a home health provider was comparably safe, effective, and associated with high satisfaction compared to in-clinic administration. To further understand the experience and impact of this intervention from the perspective of study participants, we analyzed quantitative end-of-intervention surveys and qualitative exit interviews offered to study participants after completion of the intervention. Using a grounded theory approach to analyze exit interviews, we conducted an iterative process of establishing codes, grouping the codes into key concepts, and organizing concepts into broader themes. We identified six broad themes related to the participant experience that involved (1) strengths of injectable therapy, (2) negatives of injectable therapy, (3) treatment setting preference, (4) reasons for preferring injectable therapy at home, (5) reasons for preferring injectable therapy in the clinic, and (6) general impressions related to injectable therapy. This work provides insight into patient perceptions and preferences regarding injectable HIV therapy, perspectives that will be important to consider for efforts designed to enhance accessibility of injectable HIV therapy and optimize the patient experience.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214625","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}

引用次数: 0

HIV and Ongoing Methamphetamine Use: A Grounded Theory of Engagement in HIV Care from the BASE Study. HIV和持续的甲基苯丙胺使用：BASE研究中HIV护理参与的基础理论。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-02 DOI: 10.1089/apc.2025.0061

Liam Heerten-Rodriguez, Jason D Coleman, Sofia Jawed-Wessel, Joshua P Havens

{"title":"HIV and Ongoing Methamphetamine Use: A Grounded Theory of Engagement in HIV Care from the BASE Study.","authors":"Liam Heerten-Rodriguez, Jason D Coleman, Sofia Jawed-Wessel, Joshua P Havens","doi":"10.1089/apc.2025.0061","DOIUrl":"https://doi.org/10.1089/apc.2025.0061","url":null,"abstract":"The co-occurrence of HIV and substance use disorders (SUDs) presents significant challenges for engagement in HIV care, with an estimated 48% of people living with HIV (PLWH) also having an SUD. This qualitative substudy of the BASE clinical trial employed constructivist grounded theory methodology to understand factors influencing engagement in HIV care among PLWH with ongoing SUDs. Fifteen participants who completed the BASE study participated in semistructured interviews about their experiences with HIV care engagement. Median age was 40 (range 21-61), 80% male sex, 27% Black, and 27% Hispanic. The analysis resulted in a model centered on three intrapersonal factors: motivation for care, capacity to remember care behaviors, and ability to engage in care. These factors existed within a broader context of stigma, ongoing substance use, and financial insecurity, which created significant barriers to care engagement. However, participants identified interpersonal relationships and clinic interventions as important facilitators that helped them maintain engagement in care. The study provides novel insights by developing a model directly from patient perspectives, conceptualizing engagement as existing on a spectrum, and identifying varied ways participants accessed motivation through relationships. These findings could inform the development of more effective interventions that account for the specific needs of people living with both HIV and SUDs.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197993","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}

引用次数: 0

Ending AIDS: HIV, ART, and PrEP in the Context of New Global Political Realities. 终结艾滋病：新的全球政治现实背景下的艾滋病毒、抗逆转录病毒疗法和预防措施。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-01 Epub Date: 2025-04-11 DOI: 10.1089/apc.2025.0049

Jeffrey Laurence

引用次数: 0

Gaps in HIV Treatment and Care Cascade Among Men and Transfeminine Persons Who Have Sex with Men in Kenya, Malawi, and South Africa: Findings from the HIV Prevention Trials Network 075 Study (2015-2017). 肯尼亚、马拉维和南非男性和男男性行为者在艾滋病毒治疗和护理方面的差距：来自艾滋病毒预防试验网络075研究（2015-2017）的发现。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-01 Epub Date: 2025-04-08 DOI: 10.1089/apc.2025.0028

Theo G M Sandfort, Daniel Szydlo, Jessica M Fogel, Yamikani Chimwaza, Charlotte E Rinnooy Kan, Erica L Hamilton, Victor Mudhune, Ravindre Panchia, Doerieyah Reynolds

{"title":"Gaps in HIV Treatment and Care Cascade Among Men and Transfeminine Persons Who Have Sex with Men in Kenya, Malawi, and South Africa: Findings from the HIV Prevention Trials Network 075 Study (2015-2017).","authors":"Theo G M Sandfort, Daniel Szydlo, Jessica M Fogel, Yamikani Chimwaza, Charlotte E Rinnooy Kan, Erica L Hamilton, Victor Mudhune, Ravindre Panchia, Doerieyah Reynolds","doi":"10.1089/apc.2025.0028","DOIUrl":"10.1089/apc.2025.0028","url":null,"abstract":"Improving HIV outcomes for men who have sex with men (MSM) in sub-Saharan Africa requires addressing gaps in the HIV treatment cascade. This study examined these gaps among 71 treatment-naive MSM with HIV in the HIV Prevention Trials Network 075, a 1-year prospective biobehavioral cohort study (2015-2017) across four sub-Saharan African sites. Following a positive diagnosis, 86% of participants sought HIV care. Reasons for not having sought care or delays included a lack of perceived health issues and practical challenges. Most participants (80%) who engaged in care were prescribed antiretroviral therapy (ART). Although self-reported adherence was high, over one-third of those prescribed ART had no detectable antiretroviral drugs (ARVs) at the study's conclusion. ARV detection was significantly associated with study site, higher income, and experienced homophobia. The highest adherence rates were observed at the site offering direct, integrated treatment, underscoring the potential of \"one-stop shop\" services to mitigate intra-, interpersonal, and structural barriers. Despite a supportive study environment, gaps remain in linking MSM and transfeminine individuals to sustained HIV care and ART adherence. Given the urgency of addressing HIV among these populations, targeted interventions that promote engagement in care and adherence to treatment are critical.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"224-232"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802207","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}

引用次数: 0

Factors Influencing Oral Pre-, Post-, and Doxycycline Post-Exposure Prophylaxis Uptake Among Substance-Using Men Who Have Sex with Men in the Rural Southern US. 影响美国南部农村男男性行为药物使用者口服多西环素暴露前、后和后预防摄取的因素

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-01 Epub Date: 2025-05-05 DOI: 10.1089/apc.2025.0051

Vinh Tang, Benjamin N Montemayor, Christopher Owens

{"title":"Factors Influencing Oral Pre-, Post-, and Doxycycline Post-Exposure Prophylaxis Uptake Among Substance-Using Men Who Have Sex with Men in the Rural Southern US.","authors":"Vinh Tang, Benjamin N Montemayor, Christopher Owens","doi":"10.1089/apc.2025.0051","DOIUrl":"10.1089/apc.2025.0051","url":null,"abstract":"Substance-using men who have sex with men (MSM), especially those in rural areas, face a heightened risk of HIV and sexually transmitted infections (STIs). Despite increased risk, uptake of HIV pre-exposure prophylaxis (PrEP), HIV post-exposure prophylaxis (PEP), and doxycycline post-exposure prophylaxis (Doxy-PEP) remains low among rural MSM. The multi-domain factors influencing past-year use of oral PrEP, PEP, and Doxy-PEP among substance-using MSM in the rural southern US remain unknown. A cross-sectional study of rural substance-using MSM (n = 345) in the Southern US was conducted from February 29 to March 23, 2024. Three series of bivariate and multivariate logistic regression analyses were conducted. Past-year PrEP use was significantly associated with HIV-negative status (adjusted odds ratio [aOR] = 2.55, 95% confidence interval [CI]: 1.12-5.80, p = 0.025), past-year STI diagnosis (aOR = 2.23, 95% CI: 1.19-4.15, p = 0.012), past-year HIV testing (aOR = 3.40, 95% CI: 1.05-10.9, p = 0.040), and past-year STI testing (aOR = 10.09, 95% CI: 2.25-45.37, p = 0.003). Past-year PEP use was significantly associated with past-year STI diagnosis (aOR = 3.70, 95% CI: 1.33-10.32, p = 0.012) and oral sex (aOR = 0.09, 95% CI: 0.01-0.63, p = 0.015). Finally, past-year Doxy-PEP use was significantly associated with past year-STI diagnosis (aOR = 4.44, 95% CI: 2.03-9.71, p < 0.001). Results underscore the need for integrated care across primary care, pharmacy, and substance use treatment settings to improve screening, education, and prescription of HIV/STI preventative biomedical pharmaceuticals for substance-using MSM.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"233-244"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965503","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}

引用次数: 0

Universal "Test and Treat" for HIV Had Little Effect on Outcomes, but Missed Clinic Visits Threaten Success of Botswana's National Antiretroviral Treatment Program. 普遍的艾滋病毒“检测和治疗”对结果影响甚微，但错过的门诊就诊威胁着博茨瓦纳国家抗逆转录病毒治疗计划的成功。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-01 Epub Date: 2025-05-20 DOI: 10.1089/apc.2025.0042

Lentlametse Mantshonyane, Joseph Jarvis, Bogadi Loabile, Marlene B Nkete, Ronald Monnaatlala, Gaone Makwinja Mmolai, Atlasaone Mosomodi, Robert Gross

{"title":"Universal \"Test and Treat\" for HIV Had Little Effect on Outcomes, but Missed Clinic Visits Threaten Success of Botswana's National Antiretroviral Treatment Program.","authors":"Lentlametse Mantshonyane, Joseph Jarvis, Bogadi Loabile, Marlene B Nkete, Ronald Monnaatlala, Gaone Makwinja Mmolai, Atlasaone Mosomodi, Robert Gross","doi":"10.1089/apc.2025.0042","DOIUrl":"10.1089/apc.2025.0042","url":null,"abstract":"In 2016, Botswana changed the policy to institute universal \"test and treat\" (UTT) in people with human immunodeficiency virus or HIV (PWH). It is unclear whether these policy changes have yielded any clinical benefits or harms. We conducted a retrospective cohort analysis of PWH aged ≥18 years to compare patient outcomes in individuals who received antiretroviral treatment (ART) under (1) the introduction of UTT and (2) rapid versus delayed ART start, at two clinics in Gaborone, Botswana, between 2014 and 2020. Multivariate logistic regression and propensity score models were used to control for potential confounding and selection bias. Of the 2008 participants who had a complete plasma HIV RNA at 1 year following ART initiation, 59 (2.9%) experienced virologic failure, and 665 (33.1%) were lost to follow-up (LTFU). Higher LTFU was recorded in UTT than in delayed ART period (43% vs 31%, p < 0.001); the same trend was upheld on further examination treating all LTFU as treatment failure (47% vs 37%, p < 0.001). In adjusted models, neither the UTT policy: odds ratio (OR) 1.91 [95% confidence interval (CI): 0.90, 3.56] nor rapid ART start: OR 1.31 (95% CI: 0.75, 2.34) was associated with viral failure. UTT was not associated with LTFU: OR 1.04, 95% CI (0.75, 1.45). Missed clinic visits were associated with viral failure regardless of policy period: OR 1.17 (95% CI: 1.03, 1.31) or rapid start: OR 1.20 (95% CI: 1.07,1.35). Neither UTT policy nor rapid ART start was associated with any one of the composite unfavorable outcomes. However, missing clinic visits was an independent risk factor for unfavorable outcomes.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"215-223"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109340","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}

引用次数: 0

Using Structural Equation Modeling to Examine Barriers and Facilitators of HIV Pre-Exposure Prophylaxis Willingness and Length of Use in Men Who Have Sex with Men Who Use Substances in Eight Southern US Cities. 使用结构方程模型来检查美国南部八个城市中与使用药物的男性发生性关系的男性的HIV暴露前预防意愿和使用时间的障碍和促进因素。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2025-06-01 Epub Date: 2025-05-22 DOI: 10.1089/apc.2025.0036

Melissa M Ertl, Christina Woodhouse, David Meche, David W Forrest, Joshua Fegley, Margaret Paschen-Wolff, Tanja C Laschober, Mary A Hatch, C Mindy Nelson, Lynette Wright, Susan Tross

{"title":"Using Structural Equation Modeling to Examine Barriers and Facilitators of HIV Pre-Exposure Prophylaxis Willingness and Length of Use in Men Who Have Sex with Men Who Use Substances in Eight Southern US Cities.","authors":"Melissa M Ertl, Christina Woodhouse, David Meche, David W Forrest, Joshua Fegley, Margaret Paschen-Wolff, Tanja C Laschober, Mary A Hatch, C Mindy Nelson, Lynette Wright, Susan Tross","doi":"10.1089/apc.2025.0036","DOIUrl":"10.1089/apc.2025.0036","url":null,"abstract":"Men who have sex with men who use substances (SU-MSM) can benefit from pre-exposure prophylaxis (PrEP) for HIV prevention, especially in Southern US cities where HIV incidence is high; however, uptake remains low. Identifying barriers and facilitators is crucial for developing and implementing strategies to enhance uptake. Few studies of PrEP barriers and facilitators have focused on Southern SU-MSM, and most existing studies have not robustly measured such barriers and facilitators. In this study, 225 SU-MSM were recruited from community STI clinics, syringe services programs, or substance use treatment programs in eight Southern cities. Using structural equation modeling, we examined latent variable constructs of barriers and facilitators (i.e., affordability, burden, risk compensation, side effects, and stigma) and their associations with both willingness to take PrEP and length of PrEP use. Greater concern over affordability was robustly associated with more willingness to take PrEP under a variety of conditions. Risk compensation was associated with greater length of PrEP use, suggesting a major motivator to remain on PrEP was the perceived freedom to forego condoms during sex. Findings advance research on measurement of barriers and facilitators of PrEP willingness and uptake and highlight the importance of addressing affordability in PrEP implementation.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"245-256"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118536","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}

引用次数: 0