AIDS and Behavior最新文献

{"title":"Substance Use Classes Among YMSM in an HIV Digital Health Intervention Program: Implications for Acceptability, Engagement, and Health Outcomes.","authors":"Juan Pablo Zapata, Gregory Swann, Alithia Zamantakis, Krystal Madkins, Elizabeth Caitlin Anne Danielson, Brian Mustanski","doi":"10.1007/s10461-025-04619-9","DOIUrl":"10.1007/s10461-025-04619-9","url":null,"abstract":"<p><p>Young men who have sex with men (YMSM) have high rates of substance use, which increases their risk for HIV. Digital Health Interventions (DHI) have the potential to address HIV risk overall and reduce harms in the context of substance use. However, there is limited research on how YMSM with different substance use patterns respond to HIV DHIs and how these programs impact participant outcomes. In this study, we used latent class analysis (LCA) to identify subgroups of participants with specific substance use behaviors in the Keep It Up! (KIU! ) program, an HIV DHI with prior documented effectiveness. This study involved 2,124 participants in a Type III Hybrid trial, comparing two implementation strategies: one via 22 community-based organizations and another through direct-to-consumer recruitment. Evaluations were done at baseline and 12-week follow-up. This analysis identified four classes of substance use: Low Use (minimal alcohol risks, low illicit drug use, infrequent marijuana), Heavy Use (highest alcohol problems, frequent marijuana, elevated illicit drug use), Alcohol and Marijuana Use (high alcohol problems, frequent marijuana), and Methamphetamine and GBH Use (low alcohol risk, moderate marijuana frequency, high illicit drug use). Participants in the Meth & GHB User class were more likely to have an STI at baseline compared to those in the Low User class. Moreover, Heavy Use, Alcohol & Marijuana Use, and Meth & GHB Use reported a greater number of condomless anal sex partners compared to Low Use. Additionally, although Alcohol & Marijuana Use were more likely to use PrEP at the time of their most recent casual partner at baseline, they exhibited the smallest increase in PrEP use during follow-up compared to the other substance use classes. Our analysis did not unveil substantial differences in the success of implementation in terms of reach, suggesting that both implementation strategies effectively engaged YMSM with different levels of substance use. Our research showed a similar level of engagement, as evidenced by the completion rates of modules and time spent, across all substance use classes. However, those within the Meth & GHB category found the intervention highly acceptable, but less so compared to Low Use and Alcohol & Marijuana Use. Understanding how distinct substance use profiles influence intervention outcomes and exploring varied implementation methods can augment future prevention endeavors, broadening the scope and impact of public health initiatives.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045472","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":"Efficacy of an Online Self-compassion Group Intervention for Sexual Minority Men Living with HIV: A Pilot Randomized Controlled Trial.","authors":"Xinyi Li, Qiong Liu, Yihui Yang, Xi Wang, Guangyu Zhou","doi":"10.1007/s10461-025-04624-y","DOIUrl":"https://doi.org/10.1007/s10461-025-04624-y","url":null,"abstract":"<p><p>Sexual minority men living with HIV face challenges affecting their quality of life and medication adherence. While self-compassion has shown promise in improving quality of life, targeted interventions for this group remain limited. This pilot study evaluated the efficacy of an online self-compassion group intervention on quality of life and medication adherence among sexual minority men living with HIV. A six-week online intervention, adapted from the Mindful Self-Compassion program, was implemented in a two-arm randomized controlled trial with 28 participants, comparing the intervention to a waitlist control group. The primary outcomes were quality of life and self-compassion, with medication adherence as a secondary outcome. Measures were taken at baseline, mid-intervention, post-intervention, and 1-month follow-up. Linear mixed-effects model showed that the intervention significantly improved quality of life and medication adherence at post-intervention. Although self-compassion showed no significant improvement, over-identification, an uncompassionate self-responding component, showed marginal improvement at follow-up. This pilot study provides preliminary evidence that a self-compassion intervention may improve quality of life and medication adherence in sexual minority men living with HIV, warranting further research with larger sample sizes and a focus on the underlying mechanisms.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045462","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":"Can HIV Post-Exposure Prophylaxis Services Change the Sexual Behavior Characteristics of Men Who Have Sex with Men? A Cohort Study in Guangzhou, China.","authors":"Yuzhou Gu, Jinhan Fu, Yefei Luo, Lishan Zhan, Fanghua Liu, Wenting Zeng, Huifang Xu, Yongheng Lu, Yanshan Cai, Zhigang Han","doi":"10.1007/s10461-024-04604-8","DOIUrl":"https://doi.org/10.1007/s10461-024-04604-8","url":null,"abstract":"<p><p>This study examines the impact of HIV post-exposure prophylaxis (PEP) on sexual behavior changes in men who have sex with men (MSM), aiming to assess a comprehensive HIV prevention strategy integrating biomedical and behavioral interventions to maximize PEP service effectiveness. From a Guangzhou MSM cohort, participants without prior PEP experience were included. The exposed group received PEP services during follow-up (June 2019-April 2022), while controls did not. Cox proportional hazard regression models assessed PEP's effects on sexual behavior changes. Of 411 participants (mean age: 30.72), 14.1% received PEP during follow-up. The exposed group showed a higher likelihood of reducing Internet partner-seeking (aHR: 3.58, 95%CI: 1.80-7.10, P < 0.001), decreasing anal intercourse partners (aHR: 3.81, 95%CI: 2.14-6.82, P < 0.001) in the past 6 months, lowering last week's anal intercourse occurrences (aHR: 3.95, 95%CI: 2.33-6.68, P < 0.001), and improving condom use during past 6 months' anal intercourse (aHR: 3.94, 95%CI: 1.75-8.90, P = 0.001) and the most recent anal intercourse (aHR: 4.96, 95%CI: 1.77-13.88, P = 0.002) compared to controls. To sum up, PEP services contribute significantly to positive sexual behavior changes in MSM. Strengthening behavioral interventions at PEP's baseline and follow-up stages is crucial for maximizing comprehensive preventive impact on both biomedical and behavioral aspects in MSM.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045397","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":"High Prevalence of Posttraumatic Stress Disorder Symptoms Found in Well-Treated People with HIV after the Introduction of Patient-Reported Outcome Measures.","authors":"Kevin Moody, Colette Smit, Pythia T Nieuwkerk, Maarten Bedert, Elise Nelis, Jeannine Nellen, Kim Sigaloff, Annouschka Weijsenfeld, Laura Laan, Claire Bruins, Suzanne E Geerlings, Marc van der Valk","doi":"10.1007/s10461-025-04617-x","DOIUrl":"https://doi.org/10.1007/s10461-025-04617-x","url":null,"abstract":"<p><p>People with HIV (PWH) are at greater risk of experiencing mental health problems, such as depression and post-traumatic stress disorder (PTSD). The purpose of our study was to determine the prevalence of posttraumatic stress disorder PTSD in PWH. PWH in care Amsterdam University Medical center (Amsterdam UMC) with access to the electronic patient portal were offered patient-reported outcome measures (PROMs) between May 2022 and May 2023, including the PC-PTSD-5 screen for PTSD as part of routine clinical care. Risk factors for a clinically relevant PC-PTSD-5 score were determined using univariate and multiple logistic regression analyses. Of 2476 PWH included, 1384 (55.9%) had access to the electronic patient portal of whom 474 (34.2%) completed the PC-PTSD-5. PWH without access to the patient portal were more often female, born in low- and middle-income countries, acquired HIV more often via heterosexual contact, and had worse HIV-related outcomes compared to those with access. Of 474 PWH who completed the PC-PTSD-5 screening question, 62 (13.1%) reached the threshold for clinically relevant PTSD. Age less than 50 years (OR 2.29, 95% CI: 1.21-4.35), and having originated from low- or middle-income countries (OR 2.02, 95% CI: 1.09-3.76) were associated with PTSD. Our findings show that 13% of PWH with a well-controlled HIV infection with access to the electronic patient portal at Amsterdam UMC experienced clinically relevant PTSD complaints.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045467","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":"Acceptability and Feasibility of Self-Collected Dried Blood Spot Specimens for Viral Load Monitoring among Rural Older People Living with HIV.","authors":"Jennifer L Walsh, Sabina Hirshfield, Steven A John, Katherine G Quinn, Olivia H Algiers, Timothy L McAuliffe, Andrew E Petroll","doi":"10.1007/s10461-024-04599-2","DOIUrl":"https://doi.org/10.1007/s10461-024-04599-2","url":null,"abstract":"<p><p>Self-collected dried blood spot (DBS) samples may be useful in monitoring viral load (VL) in research studies or clinically given that they eliminate the need for participants to travel to study sites or laboratories. Despite this, little information exists about monitoring VL using DBS self-collected at home, and no information exists on DBS for this use among older rural people living with HIV (PLH), a population that could benefit from self-collection given difficulty accessing care. We report on the feasibility and acceptability of self-collected DBS samples, DBS VL results, concordance between self-reported and DBS VL, and factors associated with DBS detectable VL in a rural Southern U.S. sample of PLH aged 50 years and older. Between 2021 and 2022, 61 older rural PLH from 9 Southern U.S. states (M_age = 58, 25% female) completed survey measures and self-collected DBS specimens at home; 51 of these participants completed the same procedures at 3-month follow-up. Nearly all participants (96-98%) collected DBS specimens that could be successfully analyzed for VL, and participants found self-collection highly acceptable. Approximately one quarter of participants had quantifiable detectable VL (≥ 839 copies/mL) at each time point. Concordance between self-reported and DBS VL was 69% at baseline and 82% at follow-up; the majority of those with DBS detectable VL self-reported undetectable VL (86% at baseline and 60% at follow-up). Self-collection of DBS specimens for VL monitoring can add value to research conducted remotely, including research associated with the care of rural and/or older PLH.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045350","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":"Patterns of Social Support and LGBTQ + Community Involvement Among Gay, Bisexual, and Other Men Who Have Sex with Men in Australia and Their Effect on HIV-Related Outcomes: A Latent Class Analysis.","authors":"Curtis Chan, Benjamin R Bavinton, Horas T H Wong, John Rule, Loc Nguyen, Steven Spencer, Martin Holt","doi":"10.1007/s10461-025-04632-y","DOIUrl":"https://doi.org/10.1007/s10461-025-04632-y","url":null,"abstract":"<p><p>Peer support from social networks of gay, bisexual, and other men who have sex with men (GBMSM) has been recognised as a critical driver of engagement with HIV prevention. Using data from an online cross-sectional survey of 1,032 GBMSM aged 18 or over in Australia, a latent class analysis was conducted to categorise participants based on social support, LGBTQ + community involvement, and social engagement with gay men and LGBTQ + people. Comparisons between classes were assessed using multivariable multinomial logistic regression. Participants were allocated into four classes: 'Gay men focused' (n = 293, 28.4%) with high levels of support from gay men, 'High and diverse' (n = 75, 7.3%) with high support from people with a range of gender and sexual identities, 'Moderate overall' (n = 177, 17.2%) who reported some support from all sources, and 'Low overall' (n = 487, 47.2%) who had low support. Lifetime HIV testing was lower in the 'Low overall' (78.0%) and 'Moderate overall' (81.9%) classes compared to the 'Gay men focused' (96.9%) and 'High and diverse' (93.3%) groups. Among non-HIV-positive participants (n = 971), lifetime PrEP use was lower in the 'Low overall' (28.9%) than the 'Gay men focused' group (56.2%) but similar in the 'High and diverse' (59.7%) and 'Moderate overall' (37.5%) groups. Greater levels of social engagement with gay men and LGBTQ + people were associated with higher levels of HIV testing and PrEP use. Interventions are needed to reach GBM who are less engaged with GBMSM networks or LGBTQ + communities.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045470","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":"Aging Concerns Related to Sexuality and Gender: HIV Prevention and Healthy Aging.","authors":"Ryan J Watson, Peter S McCauley, Amanda Taylor, Ethan Morgan, Brendan Jacka, Lisa A Eaton","doi":"10.1007/s10461-025-04627-9","DOIUrl":"https://doi.org/10.1007/s10461-025-04627-9","url":null,"abstract":"<p><p>Healthy aging is an important area of research across many populations, but less work has focused on this area among sexual and gender diverse individuals relative to the general population. On the whole, it is known that as the U.S. population ages, increasing attention is needed to understand the intersections between aging, health, and wellbeing. One area of consideration to address in regard to healthy aging is that of HIV prevention, in particular, pre-exposure prophylaxis (PrEP) use. For the current study we assessed these factors in a cross-sectional survey designed to assess disease status and related risk factors among a sample of individuals ≥ 50 years of age (N = 794, M_age = 58.5, range = 50-88) who resided in a metropolitan area in Ohio, USA. Results demonstrated that as overall age increased, general aging concerns decreased. Although HIV status was not related to general aging concerns, in additional models, lifetime PrEP use and six-month PrEP use were both related to greater aging concerns. When evaluating sexual orientation-specific aging concerns, we noted the opposite direction in terms of its relationship with age; as these concerns increased so did age. Further, cisgender women, transgender women, transgender men, and those identifying with a different identity each reported greater sexual orientation related aging concerns compared with cisgender men. Based on the current findings, additional research is needed to more fully understand aging related concerns for older individuals who identify as sexual orientation diverse.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031768","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":"Analysis of Clinical Outcomes Following Implementation of a Rapid Antiretroviral Therapy Initiation Protocol at a Local HIV Clinic.","authors":"Harit Agroia, Leyla Mousli, Rajat Bansil, Kristin Walsh","doi":"10.1007/s10461-024-04607-5","DOIUrl":"https://doi.org/10.1007/s10461-024-04607-5","url":null,"abstract":"<p><p>Rapid antiretroviral therapy (ART) refers to initiating HIV treatment within seven days of diagnosis. Multidisciplinary teams that implement rapid ART protocols can be effective in addressing the holistic needs of HIV patients. The purpose of this study was to evaluate a multidisciplinary team's implementation of a rapid ART protocol through a retrospective pre and post study design among 627 patients referred to a local HIV clinic between January 2017 and December 2022. We observed a 46% difference in the median number of days from diagnosis to first visit (p < 0.001) between pre implementation (\"pre\") [median days = 13] and post implementation groups (\"post\") [median days = 7] and a 17% difference in median days from first visit to viral suppression (p < 0.05) between pre (median days = 63) and post groups (median days = 52). An adjusted Cox proportional hazards model showed a higher probability of having a first visit with a medical provider following diagnosis sooner in the post group compared to the pre group (hazard ratio [HR]: 1.53, p < 0.001). The post group also had a higher probability of achieving viral suppression sooner compared to the pre group (HR: 1.55, p < 0.01) where 98% achieved viral suppression in the post group within 12-months compared to 90% in the pre group. These results show that after the introduction of a rapid ART protocol implemented by a multidisciplinary team, there were significantly shorter days to first visit and greater viral suppression outcomes among the post group compared to the pre group.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998484","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":"Estimating the Cost-Saving Threshold of a Rural Syringe Services Program Before and During the COVID-19 Pandemic.","authors":"Sean T Allen, Brian W Weir, Molly Reid, Kristin E Schneider, Allison O'Rourke, Tim Hazelett, Michael E Kilkenny, Carl Latkin","doi":"10.1007/s10461-025-04615-z","DOIUrl":"https://doi.org/10.1007/s10461-025-04615-z","url":null,"abstract":"<p><p>This study aimed to examine shifts in the cost-savings threshold of a rural syringe services program (SSP) that resulted in the 12-months following the identification of the COVID-19 pandemic. We compared SSP operational costs during the 12-months immediately before and after identification of the COVID-19 pandemic using administrative data from the Cabell-Huntington Harm Reduction Program (CHHRP), which is operated by the Cabell-Huntington Health Department in West Virginia. Data included monthly counts of client encounters, sterile syringe distribution, and HIV testing. Cost-savings threshold analyses were conducted to estimate the number of HIV infections that would have to be averted for the CHHRP to be cost-saving in the 12-months before and after the identification of the COVID-19 pandemic. In the 12-months following identification of the COVID-19 pandemic, there was a 13.6% reduction in the number of client encounters and a 69.3% reduction in the number of HIV tests administered at the CHHRP. From the healthcare perspective, in the 12-months before and after the pandemic, the CHHRP cost $190,151 and $116,727, respectively. The number of averted HIV infections required for the CHHRP to be cost-saving was less than one across both time periods and for all estimates of lifetime HIV-related medical costs. There were shifts in the operational costs at the CHHRP after the identification of the COVID-19 pandemic; however, the costs of providing harm reduction services were significantly less than lifetime HIV treatment costs for a single person. Increasing investments in harm reduction is essential for eliminating HIV transmission.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998496","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":"Trajectories of HIV Visit Engagement During the Perinatal Period among Women in Lilongwe, Malawi.","authors":"Danielle Giovenco, Yu Li, Wiza Kumwenda, Madelyn Frey, Shaphil Wallie, Mina C Hosseinipour, Angela M Bengtson","doi":"10.1007/s10461-024-04605-7","DOIUrl":"https://doi.org/10.1007/s10461-024-04605-7","url":null,"abstract":"<p><p>Longitudinal patterns of engagement in care among women living with HIV (WHIV) during the perinatal period are poorly understood. We employed group-based trajectory modeling to (1) describe trajectories of HIV visit engagement; and (2) identify predictors of membership in suboptimal care trajectories. Data came from a prospective cohort study across five urban clinics in Lilongwe, Malawi conducted between February 2020 and August 2022. Participants were followed from entry into antenatal care (ANC) through 9 months postpartum. Trajectories were defined for 375 participants based on whether (1) ≥1 HIV care visit was attended; or (2) ≥1 HIV care visit was missed for each three-month interval during follow-up. Over a maximum of 15 months of follow-up, we identified two distinct trajectory groups for each HIV visit engagement outcome: \"lower\" (7%) vs. \"consistently high\" (93%) probability of attending a visit groups and \"higher\" (86%) vs. \"consistently low\" (14%) probability of missing a visit groups. Age <25 years (odds ratio (OR) = 3.82, 95% CI 1.25, 11.73) or >1 hour of travel time to the clinic (OR = 3.54, 95% CI 1.44, 8.69) were associated with membership in the \"lower\" probability of attending a visit trajectory group. Enrollment after the start of the COVID-19 pandemic (OR = 0.23, 95% CI 0.07, 0.74) and higher gestational age at enrollment (OR = 0.28, 95% CI 0.09, 0.86) were protective against membership in the \"lower\" probability of attending a visit and the \"higher\" probability of missing a visit trajectory groups, respectively. In settings where missed visits are common, visit attendance may be an important indicator of care engagement.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998537","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}