E Gutiérrez-Velilla, S E Schulz-Medina, V M Dávila-Conn, N P Caballero-Suárez, S Ávila-Ríos
{"title":"Characterization of People Living with HIV Who Inject Drugs in Mexico City: Importance for Transmission and Detection.","authors":"E Gutiérrez-Velilla, S E Schulz-Medina, V M Dávila-Conn, N P Caballero-Suárez, S Ávila-Ríos","doi":"10.1089/apc.2024.0235","DOIUrl":"https://doi.org/10.1089/apc.2024.0235","url":null,"abstract":"<p><p>People who inject drugs (PWID) face a heightened risk of acquiring/transmitting HIV, enhanced by stigma and limited health care access. In Mexico, studies on PWID have focused on the north of the country. This study aimed to delineate characteristics of PWID living with HIV in Mexico City, identify profiles based on the substance injected, and evaluate variables associated with forming transmission clusters. A cross-sectional study was conducted with data from 2019 to 2023. Participants completed a questionnaire on sociodemographic, clinical, and behavioral variables. Bivariate and multi-variate logistic regression analyses were made. Among PWID, 96.3% were male (<i>n</i> = 437), of which 90.1% were men who have sex with men, 1.5% were cisgender females (<i>n</i> = 7), and 2.2% were transgender females (<i>n</i> = 10). PWID were more likely to use drugs during sex (adjusted odds ratio [aOR] = 3.3, 95% confidence interval [CI]: 1.7-6.4, <i>p</i> < 0.001), have more sexually transmitted diseases (aOR = 1.7, 95% CI: 1.1-2.9, <i>p</i> = 0.035), and have less condom use (aOR = 0.5, 95% CI: 0.3-0.8, <i>p</i> = 0.002). The most frequently injected substance was crystal meth, and those who injected it were more likely to have syphilis (aOR = 2.9, 95% CI: 1.2-7.1, <i>p</i> = 0.021), use Grindr (aOR = 3.6, 95% CI: 1.5-8.9, <i>p</i> < 0.001), and engage in high-risk practices (aOR = 6.9, 95% CI: 2.1-22.7, <i>p</i> < 0.001) in the last 3 months. Those under 25 years (<i>p</i> = 0.002), recently infected (<i>p</i> < 0.001), and who practiced insertive anal sex (<i>p</i> < 0.001) were more likely to be part of a cluster. These findings, and the increasing use of crystal meth, underscore the critical need to implement targeted risk-reduction strategies for PWID living with HIV and to design interventions responsive to specific profiles associated with different substances, taking into account not only their risk practices but also protective behaviors such as HIV testing.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817051","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}
Jiali Guo, Samuel C O Opara, Sophia A Hussen, Jithin Sam Varghese
{"title":"Prevalence, Monitoring, Treatment, and Control of Type 2 Diabetes by Race and Sexual Orientation Among Males with HIV.","authors":"Jiali Guo, Samuel C O Opara, Sophia A Hussen, Jithin Sam Varghese","doi":"10.1089/apc.2024.0193","DOIUrl":"10.1089/apc.2024.0193","url":null,"abstract":"","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"539-542"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492837","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}
Tiffany Yuh, Linden Lalley-Chareczko, Dante' Zanders, Harlan Shaw, Terrence Spencer, Dana Serafin, Helen Koenig, Florence Momplaisir
{"title":"Acceptability and Feasibility of Implementing a Home-Based HIV Pre-Exposure Prophylaxis Program in an Urban Clinic.","authors":"Tiffany Yuh, Linden Lalley-Chareczko, Dante' Zanders, Harlan Shaw, Terrence Spencer, Dana Serafin, Helen Koenig, Florence Momplaisir","doi":"10.1089/apc.2024.0159","DOIUrl":"10.1089/apc.2024.0159","url":null,"abstract":"<p><p>Personal and structural barriers to HIV pre-exposure prophylaxis (PrEP) care result in its underutilization and premature discontinuation. A home-based PrEP program comprised of telemedicine visits and/or self-administered lab testing may address some of these barriers. Our objective was to assess the acceptability and feasibility of a home-based PrEP program among stakeholders at an urban HIV and primary care clinic. We used the consolidated framework for implementation research to evaluate determinants of successful implementation of the program. We surveyed and interviewed PrEP patients and their health care team. In a baseline survey of PrEP users (<i>n</i> = 112) administered between May 2021 and August 2022, 65% expressed interest in switching to the home-based PrEP program. Seventeen patients over the course of follow-up through December 2023 started home-based PrEP, including 12 patients who completed both a telemedicine visit and a self-administered lab kit, and 5 patients who completed only a telemedicine visit. Of these, over 80% had positive feedback on the telemedicine visits. Survey results demonstrated excellent acceptability and feasibility of the lab kits. Patients indicated in interviews that the home-based PrEP program provided the strong advantage of convenience. Despite mixed feelings from PrEP providers on telemedicine visits (<i>n</i> = 5), most felt that the program made PrEP care delivery easier for patients and would encourage their patients to use the program if it were a good fit. Barriers to program success included shipping delays and staff turnover during program implementation. In conclusion, uptake of the home-based program was low but program participants expressed high acceptability.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"566-573"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492836","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}
Zhiwen Pi, Ticheng Xiao, Ningjun Ren, Biao Yu, Jinyu Chen, Jingbo Zhang, Lingxi He, Yingming Wang, Huachun Zou, Run Chen, Xiaoxue Chen, Fuli Huang, Yanhua Chen, Hang Chen, Ailing Li, Song Fan
{"title":"Impact of Expanded HIV Testing and Rapid Antiretroviral Therapy Initiation in Southwest China: An Interrupted Time-Series Analysis.","authors":"Zhiwen Pi, Ticheng Xiao, Ningjun Ren, Biao Yu, Jinyu Chen, Jingbo Zhang, Lingxi He, Yingming Wang, Huachun Zou, Run Chen, Xiaoxue Chen, Fuli Huang, Yanhua Chen, Hang Chen, Ailing Li, Song Fan","doi":"10.1089/apc.2024.0205","DOIUrl":"10.1089/apc.2024.0205","url":null,"abstract":"<p><p>This study evaluates the impact of an expanded HIV testing initiative, launched in June 2018 in Luzhou, Sichuan, China, on antiretroviral therapy (ART) initiation rates among people living with HIV (PLWH). Using an uncontrolled interrupted time-series design, we analyzed data from 11,040 PLWH between June 2016 and December 2022, extracted from 108 health facilities via the Center for Disease Control and Prevention's ART database. The primary outcome measures were ART initiation rates within 7 and 30 days of HIV diagnosis. Results showed a significant improvement in the 30-day ART initiation rate following expanded testing, increasing from 46.1% to 90.9% by the study's end. The 7-day initiation rate also improved but remained below 30%. The study found that expanded testing enhanced the role of primary health care institutions in ART initiation. However, the COVID-19 pandemic, beginning January 2020, negatively impacted ART initiation rates, with a slight effect on 30-day rates but a persistent negative impact on 7-day rates. Despite these challenges and an increased HIV burden, Luzhou's ART initiation rates surpassed the national average. This study emphasizes the effectiveness of expanded HIV testing in ensuring timely ART access, crucial for HIV epidemic control, and improved patient outcomes. It also reveals challenges in maintaining HIV services during public health crises, offering insights into health care system resilience. Future research should focus on evaluating long-term treatment outcomes and strategies to support ending the AIDS epidemic.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"551-558"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611979","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}
Siena Senn, Nathan D Roberson, Lauren Brunet, Elise Lankiewicz, Jennifer Sherwood, Brian Honermann, Gregorio Millett
{"title":"Rejection of Federal Guidance by Southern US States and Projected Consequences for Ending the HIV Epidemic.","authors":"Siena Senn, Nathan D Roberson, Lauren Brunet, Elise Lankiewicz, Jennifer Sherwood, Brian Honermann, Gregorio Millett","doi":"10.1089/apc.2024.0182","DOIUrl":"10.1089/apc.2024.0182","url":null,"abstract":"<p><p>Evidence-based HIV programming focused on populations at risk of HIV is critical for sustainable disease prevention. In response to the Tennessee Department of Health decision to reject federal HIV guidance, the present study examines the potential impact of Southern US states adopting policies that direct HIV prevention and testing efforts away from populations \"disproportionately affected\" (DA) by HIV toward populations \"non-disproportionately affected\" (NDA). Descriptive and projection analyses with publicly available data explored the influence of policies emphasizing NDA populations on HIV cases. Across the Southern US, DA populations (cisgender women, men who have sex with men, transgender persons, and people who inject drugs) represent the absolute majority (90%) of diagnosed HIV cases, whereas NDA populations (pregnant women, infants, first responders, and human trafficking victims) represent only a small proportion (2%) of diagnosed HIV cases. Estimated projections show avoidable HIV cases among DA populations in the Southern US alone could aggregate to over 32,000 by 2030 if prevention efforts exclusively concentrate on NDA populations, which approximates the current national annual incidence of 36,000 HIV cases. Prevention efforts aimed at DA populations compared with NDA populations could reduce new infections across the Southern US by 47% versus 1%, respectively, by 2030. Policies disregarding epidemiological data may hinder efforts to end the HIV epidemic, both regionally and nationally.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"559-565"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685812","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}
Franck Mbuntcha Bogni, Shem Kentish, Bao Ngan Tran, Ermais S Araia, Thomas Krahn, George Bayliss, Timothy P Flanigan, Fizza S Gillani
{"title":"Burden of Kidney Disease in an Aging Population Living with HIV in the United States.","authors":"Franck Mbuntcha Bogni, Shem Kentish, Bao Ngan Tran, Ermais S Araia, Thomas Krahn, George Bayliss, Timothy P Flanigan, Fizza S Gillani","doi":"10.1089/apc.2024.0202","DOIUrl":"10.1089/apc.2024.0202","url":null,"abstract":"<p><p>Antiretroviral therapy (ART) has significantly improved mortality rates for individuals living with HIV, but kidney disease remains prevalent, especially among older adults. Our study analyzed the burden of kidney disease in individuals aged 65 and older at The Miriam Hospital Immunology Center in Rhode Island. We calculated estimated glomerular filtration rates using the last creatinine values from 2019 and identified chronic kidney disease (CKD) stages. Results showed a 19% prevalence of moderate or severe CKD among adults living with HIV, rising to 39% for those aged 75 and older. Particularly striking was the increased prevalence among African American adults aged 65+, at 30.4%, rising to 50% for those over 75. In comparison, the National Institute of Diabetes and Digestive and Kidney Diseases reports that CKD stage 3 affects 20.1% of adults aged 65+, compared with just 1.2% in those younger than 65. Gender and racial disparities are evident; CKD stage 3 is more prevalent in females (5.8%) than males (4.4%). Our findings indicate that 32% of HIV-positive females have moderate-to-severe kidney disease, compared with 14% of males. Importantly, we did not account for hypertension, diabetes, and hepatitis C virus infection, which may influence renal outcomes. Our study shows that ART has reduced mortality, as more people with HIV now live longer, while also revealing the disproportionate burden of kidney disease among older adults and racial minorities, as well as a concerning trend among women; therefore, emphasizing the need for targeted health care strategies for high-risk groups.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"543-550"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611975","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}
Donald R Gerke, Jarrod Call, Shanna K Kattari, Ashley Lacombe-Duncan, Brayden A Misiolek
{"title":"Engagement in the HIV Pre-Exposure Prophylaxis Care Cascade in a Statewide Sample of Transgender and Nonbinary Individuals.","authors":"Donald R Gerke, Jarrod Call, Shanna K Kattari, Ashley Lacombe-Duncan, Brayden A Misiolek","doi":"10.1089/apc.2024.0221","DOIUrl":"https://doi.org/10.1089/apc.2024.0221","url":null,"abstract":"<p><p>Although literature regarding HIV prevention among transgender and nonbinary (TNB) people has grown considerably, important gaps remain, particularly in relation to the HIV pre-exposure prophylaxis (PrEP) care cascade. Additional research is needed to understand when and why TNB people exit the PrEP care cascade to inform interventions to better support these populations. Moreover, most studies have focused on transgender women, though transgender men and nonbinary people also experience a disproportionate prevalence of HIV relative to cisgender populations. This study addresses these gaps by exploring engagement in the PrEP care cascade among a statewide convenience sample of 659 transgender women, transgender men, and nonbinary people, and analyzing how gender identity impacts participant likelihood to continue along the cascade. Data come from the 2018 Michigan Trans Health Study and include self-report data on demographics, sexual behavior, and PrEP awareness, information receipt, referral, initiation, and retention. Participants who self-reported vaginal/front hole or anal sex and did not use barriers (<i>n</i> = 318) were considered eligible for PrEP. Only 21.13% of those eligible for PrEP received information about PrEP, 8.18% were referred to PrEP, and 1.57% initiated PrEP use. A significantly greater proportion of transfeminine and participants who identified with multiple/other genders reported receiving PrEP information than those who identified as transmasculine or nonbinary [χ<sup>2</sup> (3, <i>n</i> = 311) =11.34, <i>p</i> = .01]. No other significant gender differences were observed. Providers serving TNB individuals must recognize the diversity of individuals who qualify for information on PrEP, provide trans-affirming care when offering PrEP prescriptions, and consider situating PrEP opportunities in TNB serving spaces to reduce access barriers.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142714936","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}
Maria C Geba, Divya Kalluri, Emma M Mitchell, Tabor Flickinger, Ben Cardenas, Rebecca Dillingham, Tania A Thomas
{"title":"Identifying Motivators, Facilitators, and Barriers to Engagement and Retention in Anal Cancer Screening Among Men and Women with HIV in One Ryan White HIV/AIDS Clinic.","authors":"Maria C Geba, Divya Kalluri, Emma M Mitchell, Tabor Flickinger, Ben Cardenas, Rebecca Dillingham, Tania A Thomas","doi":"10.1089/apc.2024.0171","DOIUrl":"10.1089/apc.2024.0171","url":null,"abstract":"<p><p>Anal squamous cell carcinoma disproportionally affects people with HIV (PWH); however, engagement in anal cancer screening is low in many settings. This study was conducted to assess knowledge and perceptions of anal cancer screening to identify factors in the engagement and retention in prevention services among PWH. Semistructured interviews were conducted among adult PWH eligible for anal cancer screening in our Ryan White HIV/AIDS Program clinic. Descriptive statistics were tabulated; thematic analyses were performed to identify emerging motivators, facilitators, and barriers. Among 26 PWH, 9 had not been screened, 8 had undergone Papanicolaou (Pap) testing alone, and 9 had undergone anoscopy. The median age of the cohort was 55.2 years; 54% identified as men who have sex with men, and 54% identified as Black. In the unscreened cohort, participants were motivated by investing in their health and positive attitudes toward cancer prevention however were deterred by a lack of referral and low awareness about screening. Among those who had Pap testing, trust in healthcare providers and abnormal testing results were motivators to engagement, whereas lack of perceived risk of anal cancer and worry about pain of an anoscopy were prominent barriers. Among those who had anoscopy, perceived risk, positive experience with the procedure, and use of anxiolytics prior to anoscopy were motivators, whereas anxiety around a new cancer diagnosis and negative experience with anoscopy were barriers. Clinics seeking to build or strengthen their anal cancer screening programs can address the barriers described in this study to promote access to anal cancer screening among PWH.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"530-538"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455849","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":"\"AIDS at a Crossroads:\" Highlights from the 2024 UNAIDS Report.","authors":"Jeffrey Laurence","doi":"10.1089/apc.2024.0172","DOIUrl":"10.1089/apc.2024.0172","url":null,"abstract":"","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"493-494"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008087","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":"A Pilot Randomized Control Trial of the Motivational Interviewing to Increase PrEP Uptake Intervention Among Black Women in the United States.","authors":"Sannisha K Dale, Victoria Petrulla, Ian A Wright","doi":"10.1089/apc.2024.0189","DOIUrl":"10.1089/apc.2024.0189","url":null,"abstract":"<p><p>Despite the disproportional impact of HIV, Black individuals are benefiting the least from pre-exposure prophylaxis (PrEP). Motivational interviewing (MI) for PrEP uptake (MI-PrEP) is a two-session culturally tailored intervention incorporating MI strategies to improve PrEP motivation and uptake among cisgender Black women. A pilot randomized control trial was conducted in the Southeastern United States, and 41 women were randomized to MI-PrEP (session 1 with PrEP psychoeducation and MI and session 2 with MI and light case management) or enhanced treatment as usual (ETAU; two sessions of PrEP psychoeducation [videos explaining PrEP]). Women completed one follow-up assessment (1 month after visit 2). Measures captured primary (motivation [via contemplation and readiness ruler] and PrEP uptake via medical records) and secondary outcomes (e.g., PrEP knowledge, barriers to PrEP, and speaking to a provider about PrEP). Difference-in-differences analyses comparing MI-PrEP with ETAU as well as <i>t</i>-tests for within-group changes over time were conducted. Women who completed MI-PrEP (90.5% retained) compared with ETAU (100% retained) had a significantly higher likelihood of speaking to a provider about PrEP (OR = 4.42e7, CI [8.55e6, 2.29e8], DiD = 17.60, se = 0.84, <i>p</i> < 0.001). Within the MI-PrEP group, women had significant increases in PrEP prescription, knowledge, and motivation/contemplation, and significant decreases in financial resources as a PrEP barrier and medical mistrust (MMT). ETAU had within-group increases in PrEP prescription and speaking to a provider, no changes in motivation and MMT, and increases in specific barriers to care (e.g., transportation). MI-PrEP shows promise, and a large-scale study may be beneficial to further assess efficacy and examine implementation.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"517-529"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455848","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}