AIDS and Behavior最新文献

{"title":"HIV Seroprevalence, Incidence, and Viral Suppression Among Ugandan Males with Bar or Sex Worker Partners: A Population-Based Study.","authors":"Xinyi Feng, Kate Grabowski, Fred Nalugoda, Godfrey Kigozi, Larry W Chang, Andrea Wirtz, Caitlin E Kennedy, Gertrude Nakigozi, Eshan U Patel, Anthony Ndyanabo, Hadijja Nakawooya, Thomas C Quinn, Ronald M Galiwango, David Serwadda, Victor Ssempijja, Steven J Reynolds, Aaron A R Tobian, Robert Ssekubugu","doi":"10.1007/s10461-026-05281-5","DOIUrl":"https://doi.org/10.1007/s10461-026-05281-5","url":null,"abstract":"<p><p>Female bar or sex workers (FBSWs) in Eastern Africa experience a high burden of HIV, but population-level data on HIV seroprevalence, incidence, and viral suppression among their male partners are limited. We identified 2,420 men who had ever reported sex with FBSWs in the past year among 17,438 male participants through longitudinal population-based HIV surveillance in southern Uganda (2013-2020), spanning four surveys in four Lake Victoria fishing communities (HIV seroprevalence ~40%) and 37 inland agrarian and trading communities (~12%). Primary outcomes were HIV seropositivity, incident infection, and viral suppression (< 200 copies/mL). Prevalence and incidence rate ratios (PR, IRR) were estimated using Poisson regressions with 95% confidence intervals (CIs). Among 17,438 male participants (35,273 visits), 2,420 (13.9%) reported FBSW partners at ≥ 1 study visit, who were generally older, less educated, had lower incomes, and were more likely to be previously married. Men with FBSW partners had significantly higher HIV seroprevalence than those without (32.6% vs. 10.3%; PR=3.16, 95% CI=2.93-3.40). Overall, 154 incident HIV infections occurred over 27,396 person-years of follow-up, with men with FBSW partners having higher incidence than those without (1.93 vs. 0.44/100 person-years; IRR=4.37, 95% CI=3.04-6.16). Viral suppression among men with HIV was similar between groups, but population-level HIV viremia was 1.6 times higher (95% CI=1.41-1.84) among men with FBSW partners due to their higher background seroprevalence. Men in Uganda frequently report sex with FBSWs, which is associated with a significantly higher risk of HIV acquisition. Tailored HIV prevention strategies, including approaches to promote PrEP uptake, may help reduce the HIV burden in this population.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102839","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":"Prevention Effective Practice: Development and Preliminary Evaluation of a Proposed Composite Outcome for Status-Neutral HIV Prevention Research.","authors":"Jae M Sevelius, A Rain Mocello, Torsten B Neilands, Maria Amelia Veras, Jose Luis Gomez, Katia C Bassichetto, Sheri A Lippman","doi":"10.1007/s10461-026-05290-4","DOIUrl":"https://doi.org/10.1007/s10461-026-05290-4","url":null,"abstract":"<p><p>Status-neutral HIV prevention frameworks require outcome measures to evaluate prevention and care strategies across populations without separate endpoints for people living with and without HIV. We developed and conducted a preliminary evaluation of a proposed composite outcome measure, \"prevention effective practice,\" integrating behavioral and biomedical prevention practices into a single binary outcome. Using longitudinal data from 392 transgender women not living with HIV in São Paulo, Brazil, we assessed whether prevention effective practice predicted subsequent HIV seroconversion. Prevention effective practice incorporated sufficient PrEP use, condom use, abstinence from sex, and absence of injection risk. Despite the small number of seroconversions (n = 11), prevention effective practice demonstrated preliminary predictive utility, with a Brier score of 0.0030, sensitivity of 0.59 (95%CI 0.56, 0.62), and specificity of 0.70 (95%CI 0.41, 0.99). These findings support further evaluation of prevention effective practice as a proposed status-neutral outcome measure, including validation among people living with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102842","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":"Adverse Childhood Experiences and HIV Prevalence Among Adolescent Girls and Young Women in Rural South Africa: The Role of Household and Community Violence.","authors":"Lamisa Naushin, Sumaya Mall, Stephanie M DeLong, Audrey Pettifor, Marie Stoner","doi":"10.1007/s10461-026-05297-x","DOIUrl":"https://doi.org/10.1007/s10461-026-05297-x","url":null,"abstract":"<p><p>Adverse childhood experiences (ACEs) are common among adolescent girls and young women (AGYW) in Sub-Saharan Africa, who also face a high burden of HIV. While prior research has focused on behavioural pathways linking ACEs and HIV, less attention has been given to the broader spectrum of adversities themselves, particularly household and community violence. This study examined the association between cumulative and individual ACEs and HIV prevalence among AGYW in rural South Africa. This cross-sectional study analysed data from the 2017 follow-up visit of the HIV Prevention Trials Network (HPTN) 068 randomised controlled trial. ACEs were dichotomised into physical abuse, emotional abuse, witnessing verbal violence at home, witnessing physical violence at home, and witnessing community violence. Early sexual debut (< 14 years) served as a proxy for childhood sexual abuse given the lack of a sexual abuse variable. A cumulative ACE score was created. Descriptive statistics assessed ACE prevalence, and logistic regression examined associations with HIV prevalence. HIV prevalence was 11.48%. While 38% of AGYW reported no ACEs, 62% experienced at least one. Cumulative ACEs were not significantly associated with HIV prevalence. However, physical abuse (aOR 1.57; 95% CI 1.03-2.41) and witnessing physical violence at home (aOR 1.63; 95% CI 1.07-2.49) were associated with higher odds of HIV infection. Specific ACEs, particularly childhood physical abuse and witnessing household violence, were associated with increased HIV risk among AGYW. Targeted, trauma-informed interventions are warranted to reduce vulnerability and support HIV prevention efforts.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102861","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 Tailored Messages for 28-Week Exercise Sustainability in People with HIV.","authors":"Paul F Cook, Allison R Webel, Melissa P Wilson, Christine Horvat Davey, Vitor H F Oliveira, Vincent Khuu, Samantha Matzio, Grace L Kulik, Samantha MaWhinney, Catherine M Jankowski, Kristine M Erlandson","doi":"10.1007/s10461-026-05317-w","DOIUrl":"https://doi.org/10.1007/s10461-026-05317-w","url":null,"abstract":"<p><p>People with HIV (PWH) are at increased risk for cardiovascular diseases and other age-related comorbidities. These risks can be reduced through moderate to vigorous physical activity (MVPA), but MVPA can be difficult to sustain over time. We tested tailored text messages combined with motivational interviewing (MI) to sustain MVPA among PWH. Messages were created using Two Minds Theory and matched to daily survey responses about exercise barriers. 118 PWH ages ≥ 50 were initially randomized to high-intensity interval training or continuous moderate-intensity exercise. After 16 weeks, 92 participants were re-randomized to receive either tailored messages plus MI, or educational control messages, for 12 weeks. Both groups completed daily barrier surveys and wore an ActiGraph monitor for 1 week/month. PWH in the tailored-messaging plus MI group maintained their MVPA, ending at M = 30.5 min per day (SD = 36.7), compared to a decrease among PWH in the educational-control group, ending at M = 26.0 (SD = 25.8), F(1, 255) = 5.76, p = .02, d = 0.51 for the group-by-time interaction using intent-to-treat principles. Findings were similar based on both actigraphy and self-reported MVPA, and were robust to attrition. PWH in the tailored-messaging group also reported higher exercise self-efficacy and better perceived health over time, relative to the educational-control group. Exploratory analyses suggested that the tailored messages' effects were additive to motivational interviewing. In this study, an automated tailored-messaging intervention led to sustained MVPA. Tailored messages were superior to non-tailored educational messages, and may help PWH maintain their long-term health.Trial registry ClinicalTrials.gov study NCT04550676.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102910","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":"Disparities in HIV Pre-exposure Prophylaxis Reversal and Abandonment by Race and Income: An Intersectional Approach.","authors":"Rahel Dawit, Charlie H Nguyễn, John W Jackson, Lauren C Zalla, Philip A Chan, Amy S Nunn, Lorraine T Dean","doi":"10.1007/s10461-026-05313-0","DOIUrl":"https://doi.org/10.1007/s10461-026-05313-0","url":null,"abstract":"<p><p>Daily use of pre-exposure prophylaxis (PrEP) effectively prevents HIV, yet uptake remains uneven, particularly among lower socioeconomic and minoritized populations. Approximately 20% of newly approved PrEP prescriptions are reversed (a newly prescribed oral PrEP prescription that is not picked up at the pharmacy within 7-14 days), and most are subsequently abandoned (reversed prescription that is not picked up within a year). The roles of race and income in these outcomes are not well characterized. We analyzed Symphony HealthCare Analytics data on first-time, insurance-approved 30-day oral PrEP prescriptions for lower-income NHB, higher-income NHB, lower-income NHW, and higher-income NHW (referent group) men and women. Intersectional disparities in prescription reversal and abandonment were decomposed into joint, referent race, referent income, and excess intersectional components, stratified by gender. The total sample was 28,019, which included 2,463 women and 25,556 men. Among men, reversal and abandonment were higher among lower-income NHB men compared to higher-income NHW men. Joint disparities were 4.5% for reversal and 3.7% for abandonment, with less than half explained by race or income alone, suggesting an additional intersectional effect. Among women, reversal and abandonment were higher among higher-income NHW women compared to lower-income NHB women. Joint disparities were -11.4% and  -12.9%, respectively, and were largely explained by independent race and income effects, with attenuation of intersectional disparities. Both financial and racial factors contribute to PrEP prescription reversal and abandonment, with patterns differing by gender. Interventions addressing cost barriers and structural inequities, alongside gender-specific strategies, may improve PrEP uptake and persistence.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102817","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 Knowledge Deficits in Youth Living with HIV: Missed Opportunities for Education and Engagement.","authors":"Matthew J Grant, Elsa Bjornlund, Jaylyn Waddel, Vicki J Tepper","doi":"10.1007/s10461-026-05282-4","DOIUrl":"https://doi.org/10.1007/s10461-026-05282-4","url":null,"abstract":"<p><p>Adolescents and young adults (AYA) bear a disproportionate burden of HIV in the United States, yet gaps in HIV‑related knowledge may undermine engagement in care, antiretroviral therapy (ART) adherence, and prevention efforts. We conducted a cross‑sectional survey of AYA receiving care at a hospital‑based clinic to assess HIV/STI knowledge and its association with clinical and demographic factors. Participants completed a survey capturing demographic variables, health behaviors, and a six‑item HIV/STI knowledge assessment. Electronic medical records were used to ascertain HIV status, mode of acquisition, viral suppression, and STI history. Associations between categorical predictors and item‑level knowledge were evaluated using Pearson's chi‑square tests. Among 76 participants (42.1% aged 22-25; 53.9% female), 46 (60.5%) were living with HIV, including 25 (54.3%) with perinatally acquired. Overall knowledge was low, with fewer than half of participants answering most items correctly, except for viral load monitoring (52.6%). Participants living with HIV were more likely to correctly identify HIV prevention strategies than peers without HIV (χ²(1) = 5.22, p=.022). Among those with HIV, adolescent‑acquired infection was associated with higher knowledge regarding prevention (χ²(1) = 10.99, p<.001) and viral load monitoring (χ²(1) = 5.46, p=.019) compared with perinatal infection. Knowledge did not differ by viral suppression, age, gender, or STI history. These findings demonstrate substantial HIV‑related knowledge gaps among AYA, including those living with HIV, and challenge assumptions that longer disease duration confers expertise. Developmentally tailored education and routine knowledge assessment may strengthen engagement in care and optimize long-term outcomes for youth with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcomes Among Virally Suppressed People Living with HIV Switching to Dolutegravir/Lamivudine vs. Continuing Bictegravir/Emtricitabine/Tenofovir Alafenamide from the Randomized DYAD Study.","authors":"Charlotte-Paige Rolle, Jamie Castano, Vu Nguyen, Federico Hinestrosa, Edwin DeJesus","doi":"10.1007/s10461-026-05315-y","DOIUrl":"https://doi.org/10.1007/s10461-026-05315-y","url":null,"abstract":"<p><p>In the DYAD study, switching to dolutegravir/lamivudine (DTG/3TC) was noninferior to continuing bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in virologically suppressed adults. Here, we present changes in patient-reported outcomes (PROs) among participants who completed Week (W) 48. DYAD used PRO measures to evaluate HIV- and antiretroviral-related symptoms (HIV-SI) and treatment satisfaction (HIVTSQ/c) at baseline, W24, and W48. Symptoms described as bothersome versus not bothersome were compared across time by treatment group using chi-squared testing. Changes from baseline in HIV-SI and HIVTSQ/c scores were compared between treatment groups using adjusted ANCOVA models. Overall, 134 on DTG/3TC and 65 on B/F/TAF completed W48. At W24, 16% on DTG/3TC reported headache as bothersome versus 6% on B/F/TAF (p = 0.04); however, at W48, there was no significant difference in headache. At W48, 10% on DTG/3TC reported diarrhea as bothersome versus 0% on B/F/TAF (p = 0.01); however, there was no significant difference in diarrhea at W24. There were no other significant differences in bothersome symptoms through W48. At W48, both DTG/3TC and B/F/TAF participants demonstrated small, nonsignificantly different reductions in HIV-SI symptom score (-5.9 versus -4.3; adjusted treatment difference, -1.6; 95% confidence interval [CI]: -4.8, 1.5) and treatment satisfaction score (-3.7 versus -3.2; adjusted treatment difference, -0.5; 95% CI: -6.5, 5.5). In DYAD, both DTG/3TC and B/F/TAF were associated with similar, small reductions in overall symptom burden and stable treatment satisfaction scores at W48. These data support DTG/3TC as a switch option with comparable symptom burden and treatment satisfaction to modern 3-drug integrase inhibitor-based regimens.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079216","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":"Co-designing a Blueprint for Home Delivery of Long-Acting Injectable Pre-exposure Prophylaxis for Sexual Minority Men in Chicago.","authors":"Amelia E Van Pelt, Elizabeth Casline, Byrd G M Cook, Andrew B L Berry, Gregory Phillips, Jorge Cestou, Brian Mustanski, Rinad S Beidas","doi":"10.1007/s10461-026-05316-x","DOIUrl":"https://doi.org/10.1007/s10461-026-05316-x","url":null,"abstract":"<p><p>Reducing HIV incidence requires effective implementation of evidence-based prevention practices. Long-acting injectable cabotegravir (CAB-LA) offers a new form of effective prevention, but maximizing uptake requires co-designing implementation strategies with impacted populations. In Chicago, where HIV disproportionately impacts sexual minority men (SMM), a community-focused innovation tournament identified home-based CAB-LA delivery as the top strategy. Through a partnership with key constituents, this research aimed to operationalize this strategy for SMM (≥ 13 years) in Chicago, with particular attention to Black SMM and Latino SMM populations, through human-centered design (HCD). A four-hour, in-person workshop convened 19 transdisciplinary participants (e.g., SMM, clinicians, public health leadership, community-based organization leadership, implementation scientists) to co-create a preliminary blueprint for home-based delivery. Virtual follow-up semi-structured interviews with 10 workshop participants elicited feedback on the blueprint. Rapid qualitative analysis refined the blueprint, and final materials were produced in English and Spanish. Key phases of the home-based delivery strategy included: pre-implementation (e.g., outreach; procurement of shots), implementation (e.g., identification of staffing; administration in homes), and maintenance (e.g., post-administration and re-engagement). Patient actions focused on indicating preferences for visit, preparing home for visit, and scheduling follow-up care. Clinician actions emphasized prescribing CAB-LA, sharing financing information, and administration procedures. This research produced a blueprint for a co-designed strategy of \"low-barrier PrEP.\" Future efforts will develop complementary implementation strategies and will test the success of home-based delivery on increasing the uptake of CAB-LA among SMM. The HCD approach can also provide a framework for co-design approaches across the HIV care continuum.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079409","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":"Neighborhood Resources Indirectly Linked to HIV Medication Adherence Through Social Determinants of Health Among Digitally Surveyed Partnered Men Who Have Sex with Men.","authors":"Loren M Dobkin, Luis A Parra, Alison R Walsh, Erin M Kahle","doi":"10.1007/s10461-026-05306-z","DOIUrl":"https://doi.org/10.1007/s10461-026-05306-z","url":null,"abstract":"<p><p>Despite advances in antiretroviral (ARV) medications, the most common regimens require daily pill-taking. While there is consensus that social determinants of health (SDoH) hinder ARV adherence, these are typically measured and intervened upon at the individual level. Meanwhile, the relationship among neighborhood conditions, individual exposure to SDoH, and HIV medication adherence is not well understood. To explore pathways among them, we used structural equation modeling (SEM), linking a neighborhood disadvantage index (NDI) to baseline data from a national cohort study of intimate partner violence among partnered gay, bisexual and other men who have sex with men living with HIV. Among 371 participants, SEM analysis supported an indirect association of NDI to low ARV adherence (b=0.03; 95% confidence interval [0.01, 0.06]), through cumulative exposure to SDoH. Understanding the contribution of neighborhood conditions to SDoH exposure may improve HIV medication interventions, destigmatizing disclosure of non-adherence and the selection of correspondingly forgiving regimens.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068835","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":"Disclosure of HIV Positive Status and Network Characteristics Among a Cohort of People Living with HIV in Western Kenya.","authors":"Adel Mburia-Mwalili, Karla D Wagner, Lukoye Atwoli, Francesca Odhiambo, Haosen Sun, Jayne Lewis-Kulzer, Suzanne Goodrich, Kara Wools-Kaloustian, Jennifer L Syvertsen","doi":"10.1007/s10461-026-05300-5","DOIUrl":"https://doi.org/10.1007/s10461-026-05300-5","url":null,"abstract":"<p><p>Disclosure of HIV serostatus is critical in managing the health and well-being of people living with HIV/AIDS (PLWHA), yet the decision to disclose is shaped by complex interpersonal and contextual factors. The purpose of this study was to examine patterns of HIV status disclosure and social support, and to characterize disclosure networks among a cohort of PLWHA in Kenya. We conducted a cross-sectional egocentric social network analysis of 174 PLWHA and their network members to examine whether characteristics of participants (egos), their networks, and network members (alters) were associated with HIV serostatus disclosure. Generalized linear mixed model (GLMM) examined alter characteristics, social support, trust levels, and an interaction between trust and intimate partners in predicting disclosure. The model was also stratified by trust to assess differences between low and high trust. Overall, 163 (93.7%) participants disclosed their HIV status to at least one person in their network. In the multivariable analyses stratified by trust, in ego-alter dyads where trust is high, the odds of disclosure are higher (aOR 35.34, 95% CI [10.05-124.32]) if the alter is a partner and a child (aOR 3.60, 95% CI [1.31-9.87]). In addition, disclosure was significantly more likely with alters perceived to provide health-related support (aOR 16.43, 95% CI [8.17-33.03]) or emotional support (aOR 3.20, 95% CI [1.75-5.86]). In Kenya, where disclosure decisions intersect with social dynamics, understanding the characteristics of disclosure networks can inform public health interventions that strengthen supportive relationships and reduce barriers to disclosure.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068819","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}