AIDS and Behavior最新文献

{"title":"HIV Prevention Product Acceptability and Preference Among Women in Sub-Saharan Africa to Inform Novel Biomedical Options in Development: A Systematic Review","authors":"Wanzirai Makoni,&nbsp;Lara Lorenzetti,&nbsp;Noah Mancuso,&nbsp;Ellen Luecke,&nbsp;Nhi Dinh,&nbsp;Ashwini S. Deshpande,&nbsp;Marie Shoen,&nbsp;Definate Nhamo,&nbsp;Francis M. Simmonds,&nbsp;Alejandro Baez,&nbsp;Thesla Palanee-Phillips,&nbsp;Alexandra M. Minnis","doi":"10.1007/s10461-024-04529-2","DOIUrl":"10.1007/s10461-024-04529-2","url":null,"abstract":"<div><p>The availability of several HIV prevention options may allow women to choose a product that suits their lifestyle and preferences. Product attributes and contextual factors influence product acceptability, which affects uptake and effective use. We conducted a systematic review of acceptability and preference for biomedical HIV prevention products among women in sub-Saharan Africa (SSA) to inform the development of novel products. We used a comprehensive strategy to search three databases for peer-reviewed literature from SSA published between January 2015 and December 2023. A two-stage review process assessed references against eligibility criteria. Data were abstracted using a standardized spreadsheet, then organized by constructs from two theoretical frameworks of acceptability. Results were synthesized based on product classes defined by route of administration. We identified 408 unique references; 100 references met eligibility criteria. References assessed oral PrEP (n = 65), vaginal ring (n = 44), long-acting systemic products (injectable, implant, microarray patch) (n = 28), and other vaginal products (film, insert, gel) (n = 20). Over two-thirds reported qualitative or mixed-methods data, primarily from adolescent girls and young women. Frequent dosing, especially noted for daily oral PrEP, and perceived/experienced side effects were notably negative influences. Most end-users preferred long-acting products (systemically or vaginally delivered), though on-demand products offering user control were also valued. Influencing factors, especially partners, shaped end-user perceptions of product attributes and acceptability. All products were linked to at least some barriers to uptake and/or use, highlighting the need to provide end-users with a range of options and assist them in identifying one that best suits their circumstances and needs. Biomedical HIV prevention development should advance products that address gaps in available options while optimizing favorable product attributes to achieve high acceptability that ultimately supports adoption and use.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 1","pages":"257 - 293"},"PeriodicalIF":2.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455840","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":"Association of Racial Residential Segregation and Other Social Determinants of Health with HIV Late Presentation.","authors":"Fanghui Shi, Jiajia Zhang, Shujie Chen, Xueying Yang, Zhenlong Li, Sharon Weissman, Bankole Olatosi, Xiaoming Li","doi":"10.1007/s10461-024-04535-4","DOIUrl":"https://doi.org/10.1007/s10461-024-04535-4","url":null,"abstract":"<p><p>Understanding social determinants of HIV late presentation with advanced disease (LPWA) beyond individual-level factors could help decrease LPWA and improve population-level HIV outcomes. This study aimed to examine county-level social determinants of health (SDOH) with HIV late presentation. We aggregated datasets for analysis by linking statewide HIV diagnosis data from the South Carolina (SC) Enhanced HIV/AIDS Reporting System and multiple social contextual datasets (e.g., the American Community Survey). All adult (18 years and older) people with HIV diagnosed from 2014 to 2019 in SC were included. Linear mixed models with forward selection were employed to explore the association of county-level SDOH with the county-level three-year moving average percentage of LPWA and average delay time from HIV infection to diagnosis. Around 30% of new HIV diagnoses were LPWA in SC, and the mean delay time for people with LPWA was approximately 13 years. Counties with more racial residential segregation had longer average delay time (Adjusted beta = 5.079, 95% CI: 0.268 ~ 9.889). Regarding other SDOH, the increased percentage of LPWA was associated with fewer Ryan White centers per 100,000 population (Adjusted beta = -0.006, 95% CI: -0.011~-0.001) and higher percentages of the population with less than a high school education (Adjusted beta = 0.008, 95% CI: 0 ~ 0.015). Reducing county-level disparities in LPWA requires multifaceted interventions addressing multiple dimensions of SDOH. Targeted interventions are needed for counties with more Black residential segregation, fewer Ryan White centers, and higher percentages of less than high school education.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455836","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 Outcomes and Intervention Experiences of Enlaces Por La Salud: A Personal Health Navigation Intervention Informed by the Transnational Framework","authors":"Lisa B. Hightow-Weidman,&nbsp;Seul Ki Choi,&nbsp;Isabella Carolyn Aida Higgins,&nbsp;Kelly Knudtson,&nbsp;Clare Barrington","doi":"10.1007/s10461-024-04522-9","DOIUrl":"10.1007/s10461-024-04522-9","url":null,"abstract":"<div><p>Latinos in the United States are disproportionately affected by HIV and experience sub-optimal levels of viral suppression. Enlaces Por La Salud is an individual-level intervention implemented by personal health navigators and guided by the transnational framework to improve HIV care outcomes among newly diagnosed and out-of-care Mexican and Mexican American men and transgender women in North Carolina. The purpose of this study was to assess: (1) changes in HIV care and treatment outcomes among Enlaces participants and (2) intervention engagement and experiences. Ninety-one participants were recruited between October 2014 and August 2017 for a single-arm, mixed-methods design including surveys at baseline, 6 and 12 months and qualitative in-depth interviews immediately following the intervention with an embedded cohort (<i>n</i> = 19). Mean participant age was 36.8 years and most identified as cisgender male (90%). Participants were significantly more likely to have an undetectable viral load at baseline (18%) compared to 6-months (78%) (<i>p</i> &lt; .001). Outcomes were sustained but not significantly increased from 6 to 12 months. Intervention engagement was high with 81% completing all six intervention sessions. In qualitative interviews, participants emphasized the importance of their relationship with the personal health navigators, who provided information, instrumental, and emotional support. A person-centered intervention guided by the lived experience of migration could be an effective way to support Latinos with HIV from diverse countries of origin to achieve viral suppression and improve overall wellbeing.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 1","pages":"294 - 302"},"PeriodicalIF":2.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455839","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 Stigma is Associated with Two-Year Decline in Cognitive Performance Among People with HIV","authors":"Mark K. Britton,&nbsp;Micaela Lembo,&nbsp;Yancheng Li,&nbsp;Eric C. Porges,&nbsp;Robert L. Cook,&nbsp;Ronald A. Cohen,&nbsp;Charurut Somboonwit,&nbsp;Gladys E. Ibañez","doi":"10.1007/s10461-024-04508-7","DOIUrl":"10.1007/s10461-024-04508-7","url":null,"abstract":"<div><p>HIV stigma is associated with suboptimal clinical outcomes and has been cross-sectionally linked to cognitive deficits in people with HIV (PWH). However, it is unclear whether HIV stigma precedes cognitive decline or vice versa. We examined associations in 303 adult PWH (mean age 50.01 (11.91) years; 46% female; 67% non-Hispanic Black) between the abbreviated Berger Stigma Scale score and longitudinal change across the NIH Toolbox Cognition Battery measures. 89% of participants reported experiencing HIV stigma. In unadjusted analyses, greater HIV stigma was associated with worse attention performance at yearly follow-up visits (B = -0.07, 95% CI = -0.13 – -0.01, <i>p</i> = 0.025). When adjusting for clinicodemographic variables, HIV stigma was associated with worse processing speed and global cognition at yearly follow-up visits. This finding suggests that HIV stigma precedes subsequent cognitive decline and highlights the importance of reducing stigma to improve cognitive functioning among PWH.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 1","pages":"90 - 100"},"PeriodicalIF":2.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455841","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":"Engaging Diverse African American/Black and Latine Youth and Emerging Adults Living with HIV into Research: Description of Recruitment Strategies and Lessons Learned","authors":"Samantha Serrano,&nbsp;Leo Wilton,&nbsp;Dawa Sherpa,&nbsp;Charles M. Cleland,&nbsp;Maria Fernanda Zaldivar,&nbsp;Zobaida K. Maria,&nbsp;Corey Rosmarin-DeStefano,&nbsp;Michelle R. Munson,&nbsp;Ariel Salguero Padilla,&nbsp;Marya Gwadz","doi":"10.1007/s10461-024-04524-7","DOIUrl":"10.1007/s10461-024-04524-7","url":null,"abstract":"<div><p>Improving engagement along the HIV care continuum and reducing racial/ethnic disparities are necessary to end the HIV epidemic. Research on African American/Black and Latine (AABL) younger people living with HIV (LWH) is essential to this goal. However, a number of key subgroups are challenging to locate and engage, and are therefore under-represented in research. Primary among these are persons with non-suppressed HIV viral load, severe socioeconomic disadvantage, transgender/gender expansive identities, and refugee/migrant/immigrant populations. Research in community settings is needed to complement studies conducted in medical institutions. The present study describes the efficiency of recruitment strategies used in the community to enroll AABL young and emerging adults LWH ages 19–28 years. Strategies were designed to be culturally responsive and structurally salient. They were: peer-to-peer, social media, classified advertisements (newspaper, craigslist), subway ads, dating apps (Jack’d, Positive Singles), and direct recruitment in community-based organizations. Data were analyzed using mainly descriptive statistics and interpreted using a consensus building approach. We screened 575 individuals in a first step, 409 were eligible (71%), of these 297 presented to the second screening step (73%), but 112 were lost. Almost all presenting at the second step were eligible (98%, 291/297) and 94% enrolled (274/291). Peer-to-peer, dating app (Jack’d), direct recruitment, and craigslist were the most efficient strategies. Recruitment on dating apps was superior to the peer-to-peer approach in yielding eligible participants (OR = 1.5; 95% CI: 0.98–2.3; <i>p</i> = 0.06). The sample enrolled was diverse with respect to HIV viral suppression, gender identify, sexual orientation, immigration status, and barriers to HIV care engagement. We discuss the advantages and disadvantages of each strategy. Recruitment is a vital aspect of research and warrants attention in the empirical literature.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 1","pages":"356 - 376"},"PeriodicalIF":2.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455837","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 Denial in the COVID Era","authors":"Tara C. Smith","doi":"10.1007/s10461-024-04528-3","DOIUrl":"10.1007/s10461-024-04528-3","url":null,"abstract":"<div><p>Though scientific consensus regarding HIV causation of AIDS was reached decades ago, denial of this conclusion remains. The popularity of such denial has waxed and waned over the years, ebbing as evidence supporting HIV causation mounted, building again as the internet facilitated connection between denial groups and the general public, and waning following media attention to the death of a prominent denier and her child and data showing the cost of human life in South Africa. Decades removed from these phenomena, HIV denial is experiencing another resurgence, coupled to mounting distrust of public health, pharmaceutical companies, and mainstream medicine. This paper examines the history and current state of HIV denial in the context of the COVID pandemic and its consequences. An understanding of the effect of this phenomenon and evidence-based ways to counter it are lacking. Community-based interventions and motivational interviewing may serve to contain such misinformation in high-risk communities.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 1","pages":"309 - 316"},"PeriodicalIF":2.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-024-04528-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455838","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}

{"title":"Barriers and Facilitators to Implementing Keep It Up!, A Digital Health Intervention, in Community-Based Organizations","authors":"Alithia Zamantakis,&nbsp;Juan Pablo Zapata,&nbsp;Isaac Greenawalt,&nbsp;Ashley A. Knapp,&nbsp;Nanette Benbow,&nbsp;Brian Mustanski","doi":"10.1007/s10461-024-04525-6","DOIUrl":"10.1007/s10461-024-04525-6","url":null,"abstract":"<div><p>Despite ongoing investments in the development and testing of new digital interventions for HIV prevention, the widespread use of interventions with proven effectiveness remains limited. This study assessed real-world implementation of a digital HIV prevention intervention, Keep It Up!. The study aimed to identify barriers and facilitators to implementing Keep It Up! within community-based organizations (CBOs) serving racially diverse sexual and gender minoritized populations. The Keep It Up! trial is a type III effectiveness-implementation hybrid trial to compare two delivery approaches: direct-to-consumer and CBO-based implementation. This manuscript focuses on the CBO-based approach through interviews with CBO staff members before and during implementation (<i>n</i> = 37 and <i>n</i> = 25, respectively). Interviews were coded according to the Consolidated Framework for Implementation Research and thematically analyzed. Staff highlighted adaptability, leadership engagement, compatibility, and organizational culture as facilitators of Keep It Up! implementation. Identified barriers included self-efficacy, motivation, staff turnover, and partnerships and connections. CBO infrastructure, capacity, research experience, and processes influenced the relative importance of these barriers and facilitators. This study is one of the first to detail barriers and facilitators experienced by staff implementing a digital HIV prevention intervention in CBOs. Interviews illuminated the need for interventions like Keep It Up! for young men who have sex with men and detailed the need for additional strategies to assist CBOs unfamiliar with implementing digital health interventions.</p><p>\u0000 <b>Trial Registration Number</b>: NCT03896776.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"28 12","pages":"3944 - 3955"},"PeriodicalIF":2.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399115","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":"Improvements in Patient-Reported Outcomes After 12 Months of Maintenance Therapy With Cabotegravir + Rilpivirine Long-Acting Compared With Bictegravir/Emtricitabine/Tenofovir Alafenamide in the Phase 3b SOLAR Study","authors":"Cristina Mussini,&nbsp;Charles Cazanave,&nbsp;Eisuke Adachi,&nbsp;Beng Eu,&nbsp;Marta Montero Alonso,&nbsp;Gordon Crofoot,&nbsp;Vasiliki Chounta,&nbsp;Irina Kolobova,&nbsp;Kenneth Sutton,&nbsp;Denise Sutherland-Phillips,&nbsp;Rimgaile Urbaityte,&nbsp;Alice Ehmann,&nbsp;Jenny Scherzer,&nbsp;Patricia de los Rios,&nbsp;Ronald D’Amico,&nbsp;William Spreen,&nbsp;Jean van Wyk","doi":"10.1007/s10461-024-04490-0","DOIUrl":"10.1007/s10461-024-04490-0","url":null,"abstract":"<div><p>SOLAR (NCT04542070; registered 2020–09-09) is a Phase 3b study that demonstrated the noninferior virological efficacy of switching to cabotegravir + rilpivirine long-acting (CAB + RPV LA) dosed every 2 months vs. continuing daily oral bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) over 12 months. Participants were randomised (2:1) to switch to CAB + RPV LA or to continue BIC/FTC/TAF. Patient-reported endpoints included treatment preference, treatment satisfaction (12-item HIV Treatment Satisfaction Questionnaire status version), acceptability of injections (Perception of Injection questionnaire [acceptability domain]) and three single-item questions exploring psychological challenges related to HIV treatment (fear of disclosure, adherence-related anxiety and reminder of HIV status). Of 670 participants, 447 participants switched to CAB + RPV LA and 223 continued BIC/FTC/TAF. Overall, 18% were female, median age was 37 years and 31% were non-White. At Month 12, CAB + RPV LA significantly improved treatment satisfaction vs. BIC/FTC/TAF (mean [95% confidence interval (CI)] change: + 3.36 [2.59, 4.13] vs. −1.59 [−2.71, −0.47]; p &lt; 0.001). At Month 12, a higher proportion of CAB + RPV LA arm participants reported improvements across the psychological challenges related to HIV treatment questions compared with BIC/FTC/TAF participants. Participants indicating ≥ 1 psychological challenge at baseline experienced a statistically significant and clinically meaningful improvement in treatment satisfaction after 12 months of CAB + RPV LA vs. continuing BIC/FTC/TAF (adjusted difference [95% CI]: 7.96 [5.65, 10.26]; p &lt; 0.001). Most (90%, 382/425) questionnaire respondents preferred CAB + RPV LA vs. BIC/FTC/TAF (5%, 21/425). Switching to CAB + RPV LA was associated with significantly improved treatment satisfaction and relief from the fear of disclosure, anxiety surrounding adherence and reminder of HIV status.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 1","pages":"64 - 76"},"PeriodicalIF":2.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-024-04490-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387285","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}

{"title":"Satisfaction Amongst Drug-dependent Population with Methadone Maintenance Treatment Services, A Comparison between Public and Private Clinics: Implications for Private Sector Engagement in the Delivery of Methadone Maintenance Programs Across Vietnam","authors":"Tuan Anh Le,&nbsp;Lien My Hoang Tran,&nbsp;Long Hoang Nguyen,&nbsp;Vu Anh Trong Dam,&nbsp;Ryan G. Chiu,&nbsp;Albert Ren,&nbsp;Quang Nhat Nguyen,&nbsp;Giang Thu Vu,&nbsp;Zaw Maung,&nbsp;Laurent Boyer,&nbsp;Carl A. Latkin,&nbsp;Roger C.M. Ho,&nbsp;Cyrus S.H. Ho","doi":"10.1007/s10461-024-04521-w","DOIUrl":"10.1007/s10461-024-04521-w","url":null,"abstract":"<div><p>In Vietnam, the public sector has largely been responsible for delivering methadone maintenance treatment (MMT) services. However, with foreign aid anticipated to decline in the coming years, the involvement of the private sector in delivering MMT services is critical to ensure the continued sustainability of MMT programs across Vietnam. This study aims to evaluate patient satisfaction and identify correlated factors among Vietnamese drug users undergoing MMT in both public and private methadone clinics. A cross-sectional study was conducted in one private and two public methadone facilities in Nam Dinh, a province in the North of Vietnam. A convenience sampling technique was applied to recruit 395 participants. Data was collected through 20-minute face-to-face interviews using a structured questionnaire. Multivariate Tobit regression was utilized to measure associated factors with patient satisfaction. Results showed that patients were highly satisfied with MMT services in both public and private; however, they expected a higher degree of comprehensive care services. Compared with public facilities, the satisfaction level of patients in private facilities was significantly lower in the following aspects: health administration and professional capacity of health workers. However, there were insignificant differences in regard to infrastructure, equipment, and availability of medical services resources, supporting a promising role of the private sector in supporting the expansion of the MMT programs in Vietnam. Integrating MMT with other physical and mental healthcare services, along with strategies for improving administrative procedures and health workers’ capacity in private clinics, are critical implications of this study.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"28 12","pages":"4127 - 4135"},"PeriodicalIF":2.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387296","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":"Correlates of Sleep Health among Older-Age People with and without HIV in Uganda","authors":"Moka Yoo-Jeong,&nbsp;Aneeka Ratnayake,&nbsp;Yao Tong,&nbsp;Alexander C. Tsai,&nbsp;Robert Paul,&nbsp;Zahra Reynolds,&nbsp;Christine S. Ritchie,&nbsp;Janet Seeley,&nbsp;Susanne S. Hoeppner,&nbsp;Flavia Atwiine,&nbsp;Samson Okello,&nbsp;Noeline Nakasujja,&nbsp;Deanna Saylor,&nbsp;Meredith Greene,&nbsp;Stephen Asiimwe,&nbsp;Edna Tindimwebwa,&nbsp;Jeremy Tanner,&nbsp;Brianne Olivieri-Mui,&nbsp;Mark J. Siedner","doi":"10.1007/s10461-024-04512-x","DOIUrl":"10.1007/s10461-024-04512-x","url":null,"abstract":"<div><p>There is a growing population of older people with HIV (PWH) in Uganda. Sleep problems disproportionately affect older people and PWH. This study aimed to estimate correlates of sleep health among older Ugandans (aged ≥ 50 years) with and without HIV, using data from the Quality of Life and Aging with HIV in Rural Uganda Study. We used the Pittsburgh Sleep Quality Index to assess sleep quality, duration, and efficiency. We fitted multivariable linear and logistic regression models to estimate the associations between sleep outcomes and variables selected based on the Senescent Sleep Model: age, HIV serostatus, loneliness, urbanicity, symptoms of depression and anxiety, and perceived stress. Of 556 participants, 271 were PWH and 285 were people without HIV (PWoH). There were no statistically significant differences in sleep outcomes by HIV serostatus. Of the total sample, most reported very good (32.79%) or fairly good sleep quality (49.37%). The mean sleep duration was 6.46 h (SD = 1.74). The mean sleep efficiency was 73.98% (SD = 19.52%) with 36.69% having optimal (≥ 85%) sleep efficiency. A positive depression screen was associated with worse sleep quality (adjusted odds ratio [aOR] = 0.21; 95% CI [0.12, 0.36]), shorter sleep duration (b=-0.44; 95% CI [-0.60, -0.28]), and worse sleep efficiency (aOR = 0.51; 95% CI[0.31, 0.83]). Interventions targeting depression may improve sleep among older Ugandans, independent of HIV serostatus. Longitudinal studies are needed to determine the potential bidirectionality of this relationship and elucidate pathways to support sleep health among older Ugandans.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"28 12","pages":"4179 - 4187"},"PeriodicalIF":2.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-024-04512-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387284","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}