AIDS and Behavior最新文献

{"title":"Analysis of Clinical Outcomes Following Implementation of a Rapid Antiretroviral Therapy Initiation Protocol at a Local HIV Clinic","authors":"Harit Agroia,&nbsp;Leyla Mousli,&nbsp;Rajat Bansil,&nbsp;Kristin Walsh","doi":"10.1007/s10461-024-04607-5","DOIUrl":"10.1007/s10461-024-04607-5","url":null,"abstract":"<div><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 &lt; 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 &lt; 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 &lt; 0.001). The post group also had a higher probability of achieving viral suppression sooner compared to the pre group (HR: 1.55, p &lt; 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></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 4","pages":"1340 - 1351"},"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,&nbsp;Brian W. Weir,&nbsp;Molly Reid,&nbsp;Kristin E. Schneider,&nbsp;Allison O’Rourke,&nbsp;Tim Hazelett,&nbsp;Michael E. Kilkenny,&nbsp;Carl Latkin","doi":"10.1007/s10461-025-04615-z","DOIUrl":"10.1007/s10461-025-04615-z","url":null,"abstract":"<div><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></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 5","pages":"1449 - 1457"},"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,&nbsp;Yu Li,&nbsp;Wiza Kumwenda,&nbsp;Madelyn Frey,&nbsp;Shaphil Wallie,&nbsp;Mina C. Hosseinipour,&nbsp;Angela M. Bengtson","doi":"10.1007/s10461-024-04605-7","DOIUrl":"10.1007/s10461-024-04605-7","url":null,"abstract":"<div><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 &lt;25 years (odds ratio (OR) = 3.82, 95% CI 1.25, 11.73) or &gt;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></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 4","pages":"1316 - 1326"},"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}

{"title":"Intentions to Use PrEP Among a National Sample of Transgender and Gender-Expansive Youth and Emerging Adults: Examining Gender Minority Stress, Substance Use, and Gender Affirmation","authors":"Sabrina R. Cluesman,&nbsp;Marya Gwadz,&nbsp;Charles M. Cleland","doi":"10.1007/s10461-025-04613-1","DOIUrl":"10.1007/s10461-025-04613-1","url":null,"abstract":"<div><p>Transgender and gender-expansive young people, ages 13–24 years, experience disproportionate HIV risk yet are among those with the lowest US PrEP uptake rates (&lt; 10%). Factors influencing PrEP outcomes for this population are poorly understood. This study examines the effects of gender minority stressors, gender affirmation, and heavy substance use on their PrEP outcomes using data from the CDC’s 2018 START study (<i>N</i> = 972). A conceptual model integrating the gender minority stress and gender affirmation models was developed, mapping relevant START items onto it. Structural equation modeling (Mplus-8.9) was used to examine factors related to their PrEP intentions. Most participants were 18–24 (68%), trans-female (46%), white (45%), and reported heavy substance use (40%). Medical discrimination increased internalized transphobia (b = 0.097, SE = 0.034, <i>p</i> = 0.005) and perceived stigma (b = 0.087, SE = 0.034, <i>p</i> = 0.010). Family rejection increased perceived stigma (b = 0.181, SE = 0.032, <i>p</i> &lt; 0.001) and heavy substance use (b = 0.260, SE = 0.053, <i>p</i> &lt; 0.001). Perceived stigma also increased heavy substance use (b = 0.106, SE = 0.037, <i>p</i> = 0.004). Perceived stigma (b=-0.085, SE = 0.027, <i>p</i> = 0.002) and heavy substance use (b=-0.161, SE = 0.031, <i>p</i> &lt; 0.001) decreased PrEP intentions, while gender affirmation increased them (b = 0.045, SE = 0.019, <i>p</i> = 0.020). A 1-point increase in gender affirmation reduced heavy substance use risk by -0.179 (SE = 0.030, <i>p</i> &lt; 0.001) in the presence of family rejection and by -0.074 (SE = 0.041, <i>p</i> = 0.074) when perceived stigma was present. This study underscores heavy substance use as a potential barrier to PrEP uptake for transgender/gender-expansive youth. Future research could explore how gender affirmation acts as a protective factor against the negative impact of family rejection and perceived stigma on heavy substance behaviors among these populations.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 5","pages":"1428 - 1448"},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998533","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":"“You’re in an Image of a Man but Not a Man”: A Qualitative Analysis of Intersectional Stigma Among Men with HIV Experiencing Subfertility in Rural Southwestern Uganda","authors":"Madeline C. Pratt,&nbsp;Moran M. Owembabazi,&nbsp;Alex T. Menninger,&nbsp;Eunice Kanini,&nbsp;B. Rosemary Kansiime,&nbsp;Patricia M. Smith,&nbsp;Janet M. Turan,&nbsp;Lynn T. Matthews,&nbsp;Esther C. Atukunda","doi":"10.1007/s10461-025-04611-3","DOIUrl":"10.1007/s10461-025-04611-3","url":null,"abstract":"<div><p>Many men with HIV (MWH) want to have children and may encounter HIV- and infertility-related stigma experiences. Integration of reproductive health and HIV care for men is rare. When available, safer conception care focuses on HIV prevention but lacks fertility support. We conducted qualitative in-depth interviews in Uganda with 30 MWH who desired more children and self-reported no partner pregnancy after 12 or more months of conception attempts. We separately interviewed 10 female partners. Interviews explored stigma experiences and factors impacting engagement in HIV and reproductive care. We used vignettes to elicit responses to stories of couples experiencing challenges of HIV and subfertility. The study team discussed, coded, and analyzed data from individual participant interview transcripts, inductively identifying emergent themes. The following overarching themes emerged: (1) Reproductive goals often take priority over HIV prevention among HIV-affected couples in this context, influenced by multi-level subfertility stigma in society. (2) MWH may pursue behaviors that increase risk of HIV transmission to meet their reproductive goals. (3) Men and women are eager to maintain their primary partnerships, prevent HIV transmission, and meet their reproductive goals with guidance from healthcare providers. Further research is needed on the causes of subfertility and infertility among HIV-affected couples in East Africa to better support their conception goals. Additionally, studies on the intersection of HIV and infertility stigma in high-fertility, high-HIV prevalence areas are essential for designing interventions that meet couples’ social, emotional, and medical needs.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 5","pages":"1414 - 1427"},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-025-04611-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998471","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":"Infection and Persistent Infection of Human Papillomavirus Among HIV-Negative Men Who Have Sex with Men in Xinjiang, China: A Prospective Cohort Study","authors":"Guozhen Zhang,&nbsp;Heng Yang,&nbsp;Juyuan Bian,&nbsp;Shulipan Asilibieke,&nbsp;Tian Tian,&nbsp;Henry S. Lynn,&nbsp;Jianghong Dai","doi":"10.1007/s10461-024-04569-8","DOIUrl":"10.1007/s10461-024-04569-8","url":null,"abstract":"<div><p>Anal HPV infection is particularly prevalent among men who have sex with men (MSM). The purpose of this study was to understand the status and influencing factors of HPV infection in MSM in Urumqi, Xinjiang, in order to provide suggestions for policy formulation. A prospective cohort study was conducted among HIV-negative MSM in Urumqi Xinjiang between April 2016 and June 2023. 824 MSM were recruited. Data were collected anal swab results from self-administered questionnaires and laboratory tests. A Cox regression model was employed to analyze factors associated with HPV infection. The prevalence rates of high-risk HPV and low-risk HPV were 37.99% and 25.97%. Receptive anal intercourse is a well-established risk factor for both incident and persistent HPV infections among MSM. For new high-risk HPV infections, the adjusted hazard ratio is 1.55 (95% <i>CI</i>: 1.28—1.89), and for persistent high-risk HPV infections, the <i>aHR</i> is 1.95 (95% <i>CI</i>: 1.48—2.57). Similarly, for low-risk HPV, receptive anal intercourse increases the risk of incidence (<i>aHR</i> = 1.34, 95% <i>CI</i>: 1.07–1.67) and persistent infection (<i>aHR</i> = 1.64, 95% <i>CI</i>: 1.18—2.29). Seeking sexual partners in bathhouses raised the risk of low-risk HPV infections (<i>aHR</i> = 1.36, 95% <i>CI</i>: 1.05—1.76). Young MSM may face a higher risk of HPV infection. Implementing targeted HPV vaccination catch-up programs for the MSM population in Urumqi could offer significant societal benefits.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 3","pages":"834 - 847"},"PeriodicalIF":2.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982493","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":"Sexual Networks and Behavioral Characteristics of HIV-Positive Male Military Members, Female Sex Workers, and Male Civilians","authors":"Michael P. Grillo,&nbsp;Karen Saylors,&nbsp;Bonnie R. Tran,&nbsp;Nichelle Brown,&nbsp;Osika Tripathi,&nbsp;Jordan Killion,&nbsp;Carol Macera,&nbsp;Babacar Faye,&nbsp;Ernest C. Chisoko,&nbsp;Mapoma Kabengele,&nbsp;Anthony M. Mutombe,&nbsp;Cyrille F. Djoko,&nbsp;Davey Smith,&nbsp;Antoine Chaillon","doi":"10.1007/s10461-024-04580-z","DOIUrl":"10.1007/s10461-024-04580-z","url":null,"abstract":"<div><p>Military members and female sex workers (FSWs) may be more likely to acquire or transmit HIV. Mapping HIV transmission across these high-risk populations and identifying behaviors associated with sexual network clustering are needed for effective HIV prevention approaches. A cross-sectional study recruited participants newly diagnosed with HIV among militaries, civilians, and FSWs in Zambia, Senegal, and Democratic Republic of the Congo (DRC). Participants were interviewed on behaviors and provided blood samples for HIV-1 partial pol sequencing. Genetic-distance based network analyses inferred putative relationships between HIV-1 partial pol sequences. Bivariate logistic regression models identified variables associated with clustering in a sexual network. 908 participants were included (n = 313 FSWs, n = 297 military, n = 298 civilians). 311 blood samples were sequenced and had survey data, of which 93 (29.9%) were genetically linked, forming 36 transmission clusters. All but one cluster were comprised of participants from the same country, including one large cluster (n = 12; 9 FSWs and 3 civilians) from DRC. A large mixed-country cluster (n = 9) including 7 men (4 civilians, 3 military) and 2 FSWs was observed. The odds of clustering in a sexual network were elevated for DRC participants, FSWs, and those cohabitating with a sexual partner. Findings underscore the importance of identifying linkages in high-risk populations to develop tailored HIV prevention strategies. Linkages across risk groups and countries illustrate the potential role of mobile populations in HIV transmission and acquisition. Larger studies including HIV recency testing may better elucidate biological and behavioral interactions between military, civilians, and FSWs.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 3","pages":"993 - 1003"},"PeriodicalIF":2.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-024-04580-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977166","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":"Assessing the Risk of Sexually Transmitted Infections among Men who have Sex with Men in San Francisco during COVID-19: A Socio-ecological Analysis","authors":"Christopher Justin Hernandez,&nbsp;Dillon Trujillo,&nbsp;Moranda Tate,&nbsp;Glenda Baguso,&nbsp;Jerry Quintana,&nbsp;Katherine C. McNaughten,&nbsp;Jennifer P. Jain,&nbsp;Glenn-Milo Santos,&nbsp;Sean Arayasirikul,&nbsp;Willi McFarland,&nbsp;Erin C. Wilson","doi":"10.1007/s10461-024-04608-4","DOIUrl":"10.1007/s10461-024-04608-4","url":null,"abstract":"<div><h3>Background</h3><p>Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections, a disparity that has only worsened in recent years. During the COVID-19 pandemic, an overall increasing trend remained.</p><h3>Methods</h3><p>We utilized data from the MSM cycle of the National HIV Behavioral Surveillance (NHBS) study in San Francisco, California, conducted from June 2021 through December 2021, to identify socio-ecological disruptions during the COVID-19 pandemic that were associated with sexually transmitted infections.</p><h3>Results</h3><p>In total, 505 participants were surveyed, and approximately 24% of the participants reported having been diagnosed with an STI infection within the past 12 months. In the adjusted Poisson regression models, socio-ecologic factors that were independently associated with STI infection included barriers to STI testing due to COVID-19 (aRR 1.62, 95% CI 1.18–2.23), sex with partners part of small social circles/pods (aRR 2.41, 95% CI 1.41–4.12), sex with partners whose risk for COVID-19 was not known (aRR 3.53, 95% CI 2.05–6.06), and an increase or relapse in recreational substance use (aRR 2.01, 95% CI 1.49–2.72).</p><h3>Conclusions</h3><p>These findings indicate the importance of enacting comprehensive policies that not only address an ongoing global pandemic but also consider its potential effects on other public health epidemics, such as sexually transmitted infections among men who have sex with men.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 4","pages":"1352 - 1361"},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963306","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":"Impact of COVID-19 Public Health Measures on Antiretroviral Therapy Use Among Ugandans Living with HIV in Sero-Different Couples","authors":"Timothy R. Muwonge,&nbsp;Erika Feutz,&nbsp;Rogers Nsubuga,&nbsp;Jane M. Simoni,&nbsp;Florence Nambi,&nbsp;Lylianne Nakabugo,&nbsp;Sylvia Namanda,&nbsp;Joseph Kibuuka,&nbsp;Dorothy Thomas,&nbsp;Ingrid T. Katz,&nbsp;Katherine K. Thomas,&nbsp;Norma C. Ware,&nbsp;Monique A. Wyatt,&nbsp;Herbert Kadama,&nbsp;Andrew Mujugira,&nbsp;Renee Heffron","doi":"10.1007/s10461-025-04612-2","DOIUrl":"10.1007/s10461-025-04612-2","url":null,"abstract":"<div><p>Antiretroviral therapy (ART) use and HIV suppression among people living with HIV (PLHIV) are critical for HIV control and prevention. Extreme restrictions on movement early during the COVID-19 pandemic in Uganda may have impeded the ability to initiate and sustain access to and use of ART. From our stepped-wedge cluster-randomized trial of an integrated PrEP and ART intervention for HIV-serodifferent couples at 12 ART clinics in Uganda, we identified participants who enrolled and had a 6-month post-ART initiation viral load measured before the beginning of the first COVID-19 lockdown (Period 1), participants whose enrollment and 6-month viral load measurement straddled pre-COVID and COVID lockdown times (Period 2), and participants whose enrollment and 6-month viral load were quantified entirely during COVID-19 (Period 3). ART and viral load data were abstracted from standard-of-care HIV clinic records. We used adjusted generalized estimating equation models to compare viral suppression between the different periods. We enrolled 1,381 PLHIV, including 896 (64.9%) in Period 1, 260 (18.8%) in Period 2, and 225 (16.3%) in Period 3. Almost all (1371, 99.3%) initiated ART within 90 days of enrollment and 59.2% had baseline CD4 &gt; 350 cells/mm³. Among those enrolled, 88.8% of participants in Period 1 were virally suppressed (&lt; 1000 copies/mL) within six months of ART initiation, 80.5% in Period 2, and 88.2% in Period 3. All pairwise comparisons demonstrated statistically similar levels of viral suppression. Despite COVID-19 lockdown measures, PLHIV in serodifferent partnerships successfully initiated ART and attained and maintained viral suppression.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 5","pages":"1409 - 1413"},"PeriodicalIF":2.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-025-04612-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942550","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":"Experiences with Oral Pre-Exposure Prophylaxis (PrEP) Service Delivery and Use Among Adolescent Girls and Young Women (AGYW) in Routine Primary Care Settings, South Africa","authors":"Catherine E. Martin,&nbsp;Lorrein S. Muhwava,&nbsp;Siphokazi Dada,&nbsp;Fiona Scorgie,&nbsp;Saiqa Mullick","doi":"10.1007/s10461-024-04596-5","DOIUrl":"10.1007/s10461-024-04596-5","url":null,"abstract":"<div><p>In South Africa, oral PrEP was included in national guidelines as part of a combination HIV prevention package for adolescent girls and young women (AGYW) in 2017. Understanding their experiences of accessing and using PrEP is necessary to evaluate and improve PrEP service delivery approaches. This descriptive study explored AGYW’s knowledge and understanding of PrEP, their experiences and influences on PrEP access and use in real world settings in South Africa. We conducted 44 in-depth interviews with female PrEP users (15-24 years) enrolled in Project PrEP. Interviews were audio recorded and transcribed for analysis using thematic analysis procedures. Participants reported positive experiences and overall satisfaction with accessing health services (i.e., youth-friendly clinic spaces, friendly and non-judgemental staff, privacy during consultations). Distance from the clinic, long queues, negative provider attitudes, and occasional stock-outs were key health service barriers to accessing PrEP. Individual motivating factors to continued PrEP use included creating daily pilltaking routines and the goal to remain HIV negative, while barriers included pill fatigue, frequent clinic visits, and side-effects. Positive relationships with partners and family facilitated disclosure of PrEP use, while stigma was identified as a community barrier to accessing PrEP services. Our study highlights AGYWs' experiences with PrEP access and use in a real-world setting. Facilitators and barriers identified in this study can be leveraged to strengthen efforts to support young women and ensure effective PrEP use. The findings also contribute to the development of appropriate service delivery.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"29 4","pages":"1216 - 1227"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-024-04596-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942547","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}