AIDS patient care and STDs最新文献

{"title":"Protecting the Dolls: HIV Risk Among Transgender Women as LGBTQ+ Rights and Global HIV Prevention Strategies Engage New Politics.","authors":"Jeffrey Laurence","doi":"10.1177/10872914251368784","DOIUrl":"10.1177/10872914251368784","url":null,"abstract":"","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820361","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":"Patient Perspectives on Rapid Antiretroviral Treatment Initiation for HIV: Implications for Best Practices.","authors":"Trevor Lee, Ank E Nijhawan, Yordanos M Tiruneh, Jeremy Y Chow","doi":"10.1177/10872914251364667","DOIUrl":"https://doi.org/10.1177/10872914251364667","url":null,"abstract":"<p><p>Rapid start of antiretroviral therapy (ART) has been recommended by the World Health Organization since 2017 and is an important approach toward optimizing HIV care. Our objective was to understand the experiences of people with HIV (PWH) undergoing rapid start and to synthesize lessons learned to improve our program. This mixed-methods study recruited newly diagnosed patients establishing care at an urban safety-net clinic in Dallas, TX, between 2021 and 2022. Eligible PWH were ART-naïve and diagnosed with HIV within 12 months prior to the rapid start visit. Participants completed baseline and follow-up surveys 3-12 months after enrollment. A subset of participants completed semi-structured interviews to capture their experiences with HIV and elucidate barriers and facilitators to rapid start. Interviews were evaluated using thematic analysis. Qualitative and quantitative findings were integrated to develop best practices. In total, 199 participants (35.5 ± 11.6 years; 73.9% men; 39.7% Black; 48.7% Hispanic; 38.2% heterosexual risk transmission of HIV) participated in the study. Completed surveys and interviews (<i>n</i> = 20) centered around five themes: (1) social and emotional needs, (2) patient-centered approach, (3) cultural competence, (4) structural navigation, and (5) longitudinal support. Key elements of a rapid start program include evaluating and fostering support networks; emphasizing patient-centered care like tailored education on HIV; acknowledging distinctive cultural values and behaviors of the patients; improving structural factors, including support for insurance issues; and strengthening longitudinal support past the rapid start visit. Such lessons can serve as a blueprint for other practices, particularly in the US South, looking to establish or strengthen rapid start programs.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803199","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":"Differential Effects of Substance Use on HIV Care and Symptom Outcomes: A Longitudinal Analysis Among People with HIV.","authors":"Audrey Hang Hai, Rebecca Schnall, David Scott Batey","doi":"10.1177/10872914251364664","DOIUrl":"https://doi.org/10.1177/10872914251364664","url":null,"abstract":"<p><p>Among people with HIV (PWH), those with suboptimal antiretroviral therapy (ART) adherence face heightened risk for poor clinical outcomes. Substance use is a critical barrier in this population, yet most research treats substance use as a homogeneous risk factor. This study examined the differential effects of specific substances on HIV-related outcomes among PWH with suboptimal ART adherence. Using data from a randomized controlled trial conducted in New York City and Birmingham, AL (<i>N</i> = 300; July 20, 2023 to May 7, 2024), we tested whether baseline use of 10 substance classes predicted ART adherence self-efficacy, self-reported ART adherence, HIV self-management, and symptom distress at 6 and 12 months. Linear regression models were estimated across multiply imputed datasets, adjusting for intervention assignment, site, sociodemographic, and baseline outcomes. Results indicated that baseline cocaine use was significantly associated with lower self-reported adherence at 6 months (<i>β</i> = -5.03, <i>p</i> < 0.050), methamphetamine use predicted poorer HIV self-management at 12 months (<i>β</i> = -2.92, <i>p</i> < 0.050), hallucinogen use predicted lower adherence self-efficacy at 12 months (<i>β</i> = -20.26, <i>p</i> < 0.050), and inhalant use was associated with greater HIV symptom distress at 6 months (<i>β</i> = 8.33, <i>p</i> < 0.050). No significant associations were observed for cannabis, heroin, prescription opioids, stimulants, sedatives, or other substances. Findings highlight the importance of moving beyond generalized models of substance use in HIV care to account for the unique ways different substances affect HIV care and symptom outcomes. Tailoring interventions to substance-specific risk profiles may improve outcomes for PWH.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803197","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":"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":"10.1089/apc.2025.0024","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"300-305"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","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}

{"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":"10.1089/apc.2025.0061","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"306-315"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","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}

{"title":"<i>Letter:</i> High Acceptance of Pre-exposure Prophylaxis Prescriptions Among Pregnant Patients Regardless of Syphilis Stage: Experience in a Southern United States.","authors":"Whitney N Kleinmann, Kristen Warncke, April Gorman, Emily H Adhikari","doi":"10.1089/apc.2025.0058","DOIUrl":"10.1089/apc.2025.0058","url":null,"abstract":"","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"297-299"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961781","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":"Measuring Pre-Exposure Prophylaxis (PrEP) Stigma Among Adolescent Girls and Young Women in Western Kenya: Scale Development, Validation, and Associations with PrEP Adherence.","authors":"Sarah T Roberts, Sophie Otticha, Erica N Browne, Carla Bann, Laura Nyblade, Miriam Hartmann, Marylyn Ochillo, Kawango Agot","doi":"10.1177/10872914251361105","DOIUrl":"10.1177/10872914251361105","url":null,"abstract":"<p><p>Qualitative studies suggest stigma is a barrier to pre-exposure prophylaxis (PrEP) adherence among adolescent girls and young women (AGYW) in sub-Saharan Africa, but there are few quantitative data or validated measures available. This study sought to develop and validate a scale to measure PrEP stigma among AGYW in western Kenya. An initial scale was developed, then pilot tested with 200 AGYW taking PrEP. The final scale was used in a longitudinal study with 250 AGYW to assess the prevalence and sources of PrEP stigma and to test whether PrEP stigma is associated with PrEP adherence, measured by hair tenofovir levels. The pilot testing resulted in the final 17-item Young Women's PrEP Stigma Scale (YW-PSS) with subscales for perceived, anticipated, experienced, and internalized PrEP stigma, high internal consistency (Cronbach's alpha = 0.81), and evidence of divergent and construct validity. In the longitudinal study, 72% of participants reported any perceived PrEP stigma, 64% any anticipated stigma, 35% any experienced stigma, and 15% any internalized stigma. The most commonly reported stigma perpetrators were friends, male partners, and men and women from the community. Participants with higher total, perceived, or experienced PrEP stigma scores were significantly less likely to have high PrEP adherence, while anticipated and internalized stigma were not associated with PrEP adherence. Findings from this study support the validity and reliability of the YW-PSS among AGYW in Kenya and suggest that PrEP stigma is highly prevalent and predicts poor PrEP adherence. Stigma reduction interventions are needed to support PrEP adherence and well-being in this population.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"323-338"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705999","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":"Provider Perspectives on the Data-to-Suppression Initiative in Ryan White Part A Housing and Behavioral Health Programs.","authors":"Meghan Peterson, Connor Emmert, William You, Mary Irvine, Tigran Avoundjian, Denis Nash, Honoria Guarino","doi":"10.1177/10872914251361088","DOIUrl":"10.1177/10872914251361088","url":null,"abstract":"<p><p>The New York City \"Data-to-Suppression\" (D2S) initiative was launched to improve HIV viral suppression among Ryan White HIV/AIDS Program Part A (RWPA) clients through a combination of surveillance-based, client-level reporting and capacity-building activities with RWPA housing and behavioral health service providers. This study qualitatively examines provider perspectives on its implementation. Drawing from 8 RWPA-funded agencies participating in D2S, we conducted semistructured interviews with 24 purposively sampled providers from 8 RWPA-funded agencies participating in D2S, including patient navigators engaged in D2S outreach, patient navigator supervisors, and administrators. Interviews were conducted between August and November 2022. The interviews explored four topics: (1) D2S workflow and benefits, (2) implementation facilitators, (3) implementation barriers, and (4) areas for improvement. Providers reported that D2S was easy to implement and identified clients in need of additional support. Suggestions for improvement included issuing more timely reports, adding more detailed data to reports, and focusing the intervention on agencies where behavioral health and housing program staff do not already have access to clients' HIV care and viral suppression status. Providers described barriers such as organizational capacity constraints (e.g., hiring and retaining staffing levels) and clients' difficulty with maintaining viral suppression due to competing needs. Qualitative feedback from the providers responsible for delivering an intervention is critical to identifying refinements that could strengthen engagement in intervention implementation and thus critical to achieving and sustaining the intended impact.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"316-322"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648268","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":"From Misunderstanding to Marginalization: The Role of Knowledge in HIV-Related Discrimination and Risk Behavior Among Adolescents in Germany.","authors":"Gunda Waldmann, Stefan Zippel, Markus Reinholz, Corbinian Fuchs","doi":"10.1089/apc.2025.0050","DOIUrl":"10.1089/apc.2025.0050","url":null,"abstract":"<p><p>Adolescents frequently demonstrate limited knowledge about HIV/AIDS, contributing to persistent stigma, misconceptions, and risky behaviors. These knowledge gaps and stigmatizing attitudes hinder effective HIV prevention and health outcomes. Understanding the sources of adolescents' HIV knowledge and identifying demographic disparities can inform targeted educational interventions. We conducted a cross-sectional, anonymous survey with 2110 adolescents aged 14-18 in Munich, Germany, prior to an extracurricular sexual health lecture between November 2023 and February 2024. The questionnaire assessed sociodemographics, HIV knowledge, sources of information, attitudes toward people living with HIV (PLHIV), and risk perceptions. Data were analyzed using descriptive and inferential statistics to identify knowledge gaps and demographic trends. Significant misconceptions about HIV transmission and prevention were observed, with 40.9% of students uncertain about transmission routes. Male students and those in nonacademic school tracks exhibited higher rates of uncertainty and misinformation. Social media, particularly TikTok, emerged as a major but inconsistent source of HIV information, alongside schools. Stigmatizing attitudes, such as discomfort with PLHIV, were linked to knowledge gaps and misinformation. Demographic factors, including gender and educational background, significantly influenced both knowledge and attitudes. These findings underscore the need for targeted, inclusive educational interventions to bridge HIV knowledge gaps and reduce stigma among adolescents. Leveraging both traditional school-based education and reliable digital platforms can address misconceptions and promote empathy toward PLHIV. Efforts to standardize comprehensive sexual health curricula and develop accurate online resources are critical to improving adolescent health literacy and fostering inclusive attitudes.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"281-288"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367735","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":"HEalth Record Optimization for Identifying Candidates for HIV PRe-Exposure Prophylaxis: A Community-Informed Approach to Model Development.","authors":"Meredith E Clement, Jennifer Thomas, Clare Kelsey, Tonya Jagneaux, Catherine O'Neal, Stephen Lim, Shannon Widman, Julia Marcus, Nwora Lance Okeke, Sarah Wilson","doi":"10.1089/apc.2025.0022","DOIUrl":"10.1089/apc.2025.0022","url":null,"abstract":"<p><p>Electronic health record (EHR)-based models to identify individuals who may benefit from pre-exposure prophylaxis (PrEP) outperform traditional risk scores and may alleviate challenges associated with PrEP initiation. Pre-implementation work is critical to ensure algorithms are optimized for the local context, particularly given regional differences in the US HIV epidemic. To inform the derivation and implementation of EHR-based models within health systems in New Orleans and Baton Rouge, Louisiana, we conducted focus group discussions (FGDs) with community advocates and in-depth interviews (IDIs) with emergency department, primary care, and HIV-trained clinicians. We asked about their perspectives on HIV epidemiology and PrEP uptake and sought suggestions for locally relevant variables to optimize model performance. FGDs and IDIs were audio-recorded and analyzed using thematic analysis. From January to March 2023, FGDs were conducted with 18 community advocates and IDIs with 12 clinicians. Community advocates did not believe that PrEP had reduced local HIV incidence, primarily due to a lack of inclusive marketing. Clinicians noted that improving PrEP uptake would require better access to education, PrEP providers, and affordable medication. Community advocates suggested adding sexual assault history and number of pregnancies to the model; clinicians suggested adding hepatitis B, more sexually transmitted infection treatment modalities, incarceration history, and opiate use. To optimize model implementation, community advocates emphasized the need to convey model output respectfully and compassionately, and clinicians suggested involving ancillary staff in PrEP discussions. Although evidence supports the use of EHR-based models to identify PrEP candidates, local stakeholders can provide unique insight into optimizing model performance and implementation.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"266-272"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}