Milo Dorfman, Hilary Goldhammer, Damian Krebs, Nicole S Chavis, Demetrios Psihopaidas, Melanie P Moore, Alicia Downes, Greg Rebchook, Sean Cahill, Kenneth H Mayer, Alex S Keuroghlian
{"title":"Interventions for Improving HIV Care Continuum Outcomes Among LGBTQ+ Youth in the United States: A Narrative Review.","authors":"Milo Dorfman, Hilary Goldhammer, Damian Krebs, Nicole S Chavis, Demetrios Psihopaidas, Melanie P Moore, Alicia Downes, Greg Rebchook, Sean Cahill, Kenneth H Mayer, Alex S Keuroghlian","doi":"10.1089/apc.2024.0114","DOIUrl":"10.1089/apc.2024.0114","url":null,"abstract":"<p><p>Lesbian, gay, bisexual, transgender, queer, and all sexually and gender diverse (LGBTQ+) youth with HIV face multiple barriers to progression along the HIV care continuum. We searched PubMed, PsycInfo, clinicaltrials.gov, and the Adolescent Medicine Trials Network for HIV/AIDS Interventions for interventions focused on improving linkage to care, retention in care, adherence to antiretroviral therapy, or viral suppression (VS) among LGBTQ+ youth with HIV in the United States. Included studies were published in English between January 1, 2017 and December 31, 2022, took place in the United States, and had samples with a minimum age of 12 years, a median or mean age of 24 years or less, and with ≥50% reporting an LGBTQ+ identity. Our search identified 11 interventions that met our criteria, of which only three were designed and tailored exclusively for LGBTQ+ populations. Interventions used a variety of modalities, including remote electronic delivery, in-person delivery, or both. Interventions most commonly aimed to enhance self-efficacy, HIV health knowledge, and medication self-management to facilitate improvements in HIV care continuum outcomes. Only two interventions showed statistically significant improvements in VS. More interventions tailored for LGBTQ+ youth are needed to end the HIV epidemic in the United States.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"358-369"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756581","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":"Following the Money: Level of Co-Payment Directly Impacts HIV PrEP Utilization.","authors":"Jeffrey Laurence","doi":"10.1089/apc.2024.0113","DOIUrl":"10.1089/apc.2024.0113","url":null,"abstract":"","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"341-343"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299701","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":"Negotiating and Struggling for a New Life: Stigma, Spirituality, and Coping Strategies of People Living with HIV in Myanmar.","authors":"Heng Xu, Tongyao Wang, Wanjia He, Chengshi Shiu, Thin Nyein Nyein Aung, Saiyud Moolphate, Myo Aung, Min Tun, Sai Htun Lin, Khin Moe Myint, Khine Myint Oo, Rachel Arbing, Weiti Chen","doi":"10.1089/apc.2024.0098","DOIUrl":"10.1089/apc.2024.0098","url":null,"abstract":"<p><p>Although enacted and internalized stigma is a continuing problem for people living with HIV (PLWH) in Southeast Asia, there is little understanding of how PLWH cope with discrimination, exclusion, and other negative outcomes caused by HIV-related stigmatization. This article aims to bridge this gap by analyzing the lived experiences of HIV-related stigmatization and coping strategies among 30 people with HIV in Myanmar, a country heavily influenced by religion, especially Buddhism. Among the 30 study participants, 20 were female and 10 were male, with ages ranging from 18 to 50 years. Through the lens of Bourdieu's concepts of habitus, field, and capital, this article first elucidates the various forms of stigmatization in family, work, social, and other settings as symbolic violence on people with HIV. The present article shows that spirituality serves as a perceptual and action framework for people with HIV to generate reflexivity toward their HIV infection and related stigmatization and to further engage in agentic responses. More importantly, this article demonstrates how people with HIV draw on spirituality to support peers in reclaiming control over their lives and how they are perceived by society. The findings indicate that the local context, especially cultural and religious resources, should be considered when developing interventions to mitigate HIV-related stigmatization in Southeast Asia.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"330-339"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578707","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 Scoping Review of the Current Landscape of Pre-Exposure Prophylaxis and Postexposure Prophylaxis in India.","authors":"Swarnali Goswami, Samruddhi Borate, Sumanth Marupuru, Srujitha Marupuru","doi":"10.1089/apc.2024.0078","DOIUrl":"10.1089/apc.2024.0078","url":null,"abstract":"<p><p>This scoping review aimed to review and summarize the evidence related to the attitudes toward human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP)/postexposure prophylaxis (PEP) among people at risk of HIV, health care workers (HCWs), and the general population in India. A literature search of PubMed, Embase, Scopus, and PsycINFO was conducted from January 1, 2002, to February 1, 2024. The search field contained a combination of keywords and MeSH terms such as: HIV, PrEP, PEP knowledge, awareness, willingness, and practice. Studies published in English language, conducted in India, and having reported at least one prespecified outcome related to PrEP or PEP were included. Of 599 studies identified, 48 were included (PrEP, <i>n</i> = 17 studies; PEP, <i>n</i> = 31 studies). Among the people at risk of HIV, awareness about PrEP was very low (17% or less). However, willingness to use PrEP and interest in knowing more or obtaining PrEP were reported to be high (84-95%). Among the health care professionals, the knowledge and awareness of PEP and its dosing schedule varied from 20% to 96%. The uptake to prevent this occupational hazard was reported to be poor (12-36%). This scoping review highlighted critical research gaps related to PrEP and PEP in India, related to PrEP adherence, outcomes related to nonoccupational PEP, HCW readiness to provide PrEP, etc. Overall, this study indicated the need to design policies and implement interventions aimed toward improving the knowledge, awareness, and uptake of PrEP/PEP in India. An increased focus on improving PrEP/PEP access in India through government schemes at a lower cost is imperative.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"287-304"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154594","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}
Amanda Ribas Rietti Souto, Ese Aikhuele, Maria Esposito, Crissi Rainer, Henna Budhwani, Lisa Hightow-Weidman, Betsy Tolley, Allysha Maragh-Bass
{"title":"Patient and Provider Perceptions of Barriers and Facilitators to Pre-exposure Prophylaxis Access and Adherence in Black and Latinx Young Men Who Have Sex with Men.","authors":"Amanda Ribas Rietti Souto, Ese Aikhuele, Maria Esposito, Crissi Rainer, Henna Budhwani, Lisa Hightow-Weidman, Betsy Tolley, Allysha Maragh-Bass","doi":"10.1089/apc.2024.0083","DOIUrl":"10.1089/apc.2024.0083","url":null,"abstract":"<p><p>In the United States, the use of pre-exposure prophylaxis (PrEP) has led to a substantial decrease in HIV prevalence and incidence. However, some populations, including young men who have sex with men (YMSM) of color, continue to be disproportionately impacted, highlighting the need for tailored interventions addressing barriers to adequate PrEP access. In collaboration with partner clinics, we recruited 19 PrEP clients and 19 PrEP providers (<i>n</i> = 35) to participate in hour-long in-depth interviews. Although client interviews explored personal experiences with stigma, barriers, and motivators to PrEP and information preferences, provider interviews explored providers' perceived stigma in their clinic, perceived barriers and motivators to meeting clients' PrEP needs, and rapport building with clients. Most participants were affiliated with one of the southern partner clinics. Clients and providers noted similar determinants to PrEP access, uptake, and adherence. Both recognized the impact of personal barriers such as routine adjustments and perception of need, as well as institutional barriers such as transportation and financial difficulties. Clients emphasized the role of the client-provider relationship as part of contributing to willingness to disclose information such as HIV status and sexual practices. Providers noted the importance of sexual health and LGBTQ+ topics in their training. Despite limited geographical scope and the sensitive nature of HIV-related topics, this study has several implications. PrEP clinics may benefit from hiring providers who share identities and experiences with YMSM clients of color and operating with a flexible schedule. Medical provider training should include comprehensive sexual health and LGBTQ+ competencies to reduce bias in care.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"315-323"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445255","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}
Cristina Moreno, Rebeca Izquierdo, Belén Alejos, Victoria Hernando, Santiago Pérez de la Cámara, Joaquim Peraire, Juan Macías, Enrique Bernal, Helena Albendín-Iglesias, Begoña Alcaraz, Inés Suárez-García, Santiago Moreno, Inma Jarrín
{"title":"Acceptability of Long-Acting Injectable Antiretroviral Treatment for HIV Management: Perspectives of Patients and Physicians in Spain.","authors":"Cristina Moreno, Rebeca Izquierdo, Belén Alejos, Victoria Hernando, Santiago Pérez de la Cámara, Joaquim Peraire, Juan Macías, Enrique Bernal, Helena Albendín-Iglesias, Begoña Alcaraz, Inés Suárez-García, Santiago Moreno, Inma Jarrín","doi":"10.1089/apc.2024.0093","DOIUrl":"10.1089/apc.2024.0093","url":null,"abstract":"<p><p>We assessed the prevalence and factors associated with HIV-infected patients' interest in trying long-acting injectable antiretroviral treatment (LAI-ART) along with its expected benefits and concerns, and evaluated physicians' opinions about LAI-ART. This study was set within the multi-center prospective CoRIS cohort, comprising HIV-positive adults, naïve to antiretroviral treatment (ART) at study entry, recruited from 2004 onward in 48 centers in Spain. In June 2022, we conducted a 2-day cross-sectional survey among patients across 34 CoRIS centers and sent an online questionnaire to all physicians prescribing ART in 39 CoRIS centers. Of the 271 patients included, 83.3% [95% confidence interval (CI)]: 78.0 - 87.0%) expressed interest in receiving LAI-ART. This interest was higher among men (adjusted odds ratio: 2.96; 95% CI: 1.4-6.12), those aged <50 years (2.41; 1.23 - 4.73), and individuals inconvenienced by oral ART (5.03; 1.47 - 17.15), daily intake (14.65; 3.44-62.46), carrying HIV pills constantly (7.19; 2.88 - 17.96), and taking multiple medications (3.94; 1.58 - 9.85). Among the 154 physicians surveyed, 45.5% believed LAI-ART would be the preferred option for patients. Although most physicians (92.9%) thought LAI-ART could improve patients' quality of life (QoL), concerns were raised by 37.7% and 44.2% of them regarding injection site pain and visit rescheduling, respectively. Interest in LAI-ART was higher among men, those aged <50 years, and individuals finding their oral ART inconvenient. Physicians believed LAI-ART could improve QoL and overcome treatment challenges, yet concerns were raised about its potential usage difficulties. Although most patients were interested in receiving LAI-ART, only less than half of the physicians considered it their preferred option, likely owing to concerns about missed visits and injection site pain.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"305-314"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445236","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}
Harsh Agarwal, Hanna E Huffstetler, Christopher Lopez, Vivian F Go, Sonia Napravnik, Claire E Farel, Sarah E Rutstein
{"title":"\"I Feel Like I Don't Even Have HIV Anymore\"-Facilitators, Barriers, and Experience regarding Use of Long-Acting Injectable Antiretroviral Therapy Among Persons with HIV in North Carolina.","authors":"Harsh Agarwal, Hanna E Huffstetler, Christopher Lopez, Vivian F Go, Sonia Napravnik, Claire E Farel, Sarah E Rutstein","doi":"10.1089/apc.2024.0076","DOIUrl":"10.1089/apc.2024.0076","url":null,"abstract":"<p><p>As access to long-acting injectable antiretroviral therapy (LAI ART) expands, understanding patient perceptions and experiences around LAI should inform equitable scale-up and effective implementation strategies. This study used qualitative research design relying on semi-structured interviews conducted among persons with HIV (PWH) who were either virally suppressed on oral treatment (<i>n</i> = 11) or had received at least one dose of injectables (<i>n</i> = 7). Approximately half of participants identified as male (10/18) and most identified as African American (17/18). Among participants on oral ART, many described the prospect of injectable treatment as likely convenient and discreet, relieving the stress of remembering to take daily pill. Nearly all had heard of LAI ART prior to the interview, often from television or internet commercials. Most were excited about less frequent dosing, though expressed concern about the logistics involved in coming to clinic every two months. Many expressed uncertainties regarding the relative effectiveness of LAI ART compared with oral therapy and were wary of potential pain related to injections. In contrast, all persons on LAI ART described injection-site soreness as manageable. In addition to acknowledging the convenience of every-two-month injections, some persons receiving LAI ART expressed relief by lifting the emotional stress of taking a daily-pill that reminded them of their HIV positive status. Emerging clinical trial data supports the individual and public health benefits of LAI ART, regardless of prior viral-suppression; our work adds to a growing body of literature demonstrating the potential psychological benefits associated with this novel treatment modality for PWH regardless of recent viral-suppression.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"324-329"},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299700","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}
Firdous Khan, Leah B Loerinc, Amy Scheel, Scott E Gillespie, Andres F Camacho-Gonzalez
{"title":"Incidence of Sexually Transmitted Infections in Youth with HIV During Pre-COVID and COVID Era.","authors":"Firdous Khan, Leah B Loerinc, Amy Scheel, Scott E Gillespie, Andres F Camacho-Gonzalez","doi":"10.1089/apc.2024.0060","DOIUrl":"10.1089/apc.2024.0060","url":null,"abstract":"<p><p>Adolescents and young adults (AYAs) living with HIV have high rates of co-sexually transmitted infections (STIs). During the coronavirus disease (COVID) pandemic, STI prevention strategies, including access to testing/treatment facilities, availability of health care workers, and condom availability, may have decreased. This study aimed to determine if differences in STI incidence for first infection and reinfection existed between the pre-COVID and COVID eras in a cohort of AYAs living with HIV in Atlanta, GA. Retrospective chart review was conducted for all patients between ages 13 and 24 at the Grady Ponce Clinic. Two eras were identified: a pre-COVID era (January 1, 2009-December31, 2019) and a COVID era (January 1, 2020-June 30, 2021). STIs recorded included gonorrhea, chlamydia, human papillomavirus, syphilis, trichomonas, herpes simplex virus, lymphogranuloma venereum, hepatitis C, bacterial vaginosis, and chancroid. First and recurrent incidence rates for any STIs were reported. Our sample included 766 sexually active AYAs with HIV. A total of 721 patients were included in the pre-COVID era and 583 (80.9%) had at least one STI. A total of 337 patients were included in the COVID era, and 158 had at least one STI (46.9%). The overall first STI incidence rate increased from 42.47 to 58.67 per 100 person-years (PY) and the recurrent STI incidence rate increased from 121.50 to 169.85 per 100 PY from the pre-COVID to the COVID era (<i>p</i> < 0.001). Our study demonstrated significantly higher incidence rates of first and recurrent STIs in AYAs living with HIV in the COVID era. We urge continuation of existing STI prevention programs to avoid secondary clinical and economic adverse effects of increased infections.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":"38 6","pages":"252-258"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454532","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}
Andrew M O'Neil, Juan Pablo Zapata, Madeline Dang, Javier Lopez-Rios, Katherine G Quinn, Steven A John
{"title":"Navigating Barriers and Opportunities: Perceptions of the Non-Occupational Post-Exposure Prophylaxis Care Continuum Among Young Sexual Minority Men, Aged 17-24, in the United States.","authors":"Andrew M O'Neil, Juan Pablo Zapata, Madeline Dang, Javier Lopez-Rios, Katherine G Quinn, Steven A John","doi":"10.1089/apc.2024.0012","DOIUrl":"10.1089/apc.2024.0012","url":null,"abstract":"<p><p>Human immunodeficiency virus (HIV) is a public health concern among young sexual minority men (YSMM), ages 17 to 24, in the United States. Biomedical prevention methods, such as pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP), can help reduce the risk of HIV transmission among this population. However, there is limited awareness and use of nPEP by YSMM. This study aims to explore the perceptions of YSMM regarding the nPEP care continuum, which consists of three areas of focus: awareness, uptake, and linkage to other HIV prevention services. This study draws on synchronous online focus groups with a sample of 41 YSMM in the United States. Transcripts from the focus groups were analyzed using reflexive thematic analysis. Participants reported limited nPEP awareness and prior use, a process of personal appraisal of nPEP need based on HIV risk and costs, and a preference for PrEP over PEP for long-term HIV prevention. Interventions should be tailored to increase awareness of nPEP among YSMM and reduce addressable barriers to nPEP use for YSMM, including cost and confidentiality concerns, in situations where nPEP is warranted. Finally, more research is needed on how nPEP use can act as a bridge to PrEP initiation for this population.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"267-274"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305209","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}
Amy Lee Hall, Sylvie Naar, Angulique Yvette Outlaw, Thomas Templin, Monique Green Jones, Karen Kolmodin MacDonell
{"title":"Factors Impacting the Treatment Readiness of Youth Starting Antiretroviral Treatment in the United States.","authors":"Amy Lee Hall, Sylvie Naar, Angulique Yvette Outlaw, Thomas Templin, Monique Green Jones, Karen Kolmodin MacDonell","doi":"10.1089/apc.2024.0072","DOIUrl":"10.1089/apc.2024.0072","url":null,"abstract":"","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"249-251"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140920189","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}