AIDS and Behavior最新文献_第2页

Assessing Mediation and Moderation of an Efficacious Physical Activity Intervention for African American Men Living with HIV: The Influence of Self-Efficacy in Behavior Change. 评估非裔美国男性HIV感染者有效身体活动干预的中介和调节作用：自我效能感对行为改变的影响。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-22 DOI: 10.1007/s10461-025-04871-z

Soojong Kim, Terri-Ann Kelly, Larry D Icard, Loretta S Jemmott, John B Jemmott

{"title":"Assessing Mediation and Moderation of an Efficacious Physical Activity Intervention for African American Men Living with HIV: The Influence of Self-Efficacy in Behavior Change.","authors":"Soojong Kim, Terri-Ann Kelly, Larry D Icard, Loretta S Jemmott, John B Jemmott","doi":"10.1007/s10461-025-04871-z","DOIUrl":"https://doi.org/10.1007/s10461-025-04871-z","url":null,"abstract":"This research evaluates the mediation and moderation of an efficacious physical activity (PA) intervention designed for African American men living with human immunodeficiency virus (HIV). Physical activity is a crucial element in managing the health of individuals with HIV, but African American men represent a population that is disproportionately affected by HIV and often faces barriers to engaging in regular PA. We analyzed data obtained from a randomized controlled trial (N = 302) that recruited African American men living with HIV who are 40 years or older and randomly assigned them to a PA intervention group or a health-awareness control group. We collected data at baseline, immediate post-intervention, and 3-, 6-, and 12-month post-intervention. We examined whether the intervention's effect on adherence to PA guidelines was mediated through the Reasoned Action Approach and the Social Cognitive Theory constructs, including attitudes, social norms, self-efficacy, and intention. We explored whether individual characteristics, including Body Mass Index (BMI), Waist-Hip Ratio (WHR), age, education level, and marital status, influenced the intervention's effect. We found that self-efficacy mediated the intervention's effect (α × β × γ product = 0.125, 95% ACI [0.053, 0.229]) by influencing intentions. Statistical analyses did not identify significant moderations of the intervention effect by age, marital status, education level, BMI, or WHR. These findings suggest that interventions to enhance PA among African American men living with HIV should particularly focus on boosting self-efficacy to exercise. Future research should explore additional psychological mechanisms and potential moderators to further refine and tailor PA interventions for this population.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111761","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}

引用次数: 0

"I Stopped to Prove them Wrong:" Reasons for Discontinuing Daily Oral HIV Pre-exposure Prophylaxis Among Women at High Risk of HIV in Tanzania-A Convergent Mixed Methods Study. “我停下来证明他们错了：”坦桑尼亚艾滋病毒高危妇女停止每日口服艾滋病毒暴露前预防的原因-一项收敛混合方法研究。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-22 DOI: 10.1007/s10461-025-04879-5

Wigilya P Mikomangwa, Emmy Metta, Kåre Moen, Elia J Mmbaga, Melkizedeck T Leshabari, Stephen M Kibusi, Christopher R Sudfeld, Muhammad Bakari, Appolinary A R Kamuhabwa, Gideon Kwesigabo

{"title":"\"I Stopped to Prove them Wrong:\" Reasons for Discontinuing Daily Oral HIV Pre-exposure Prophylaxis Among Women at High Risk of HIV in Tanzania-A Convergent Mixed Methods Study.","authors":"Wigilya P Mikomangwa, Emmy Metta, Kåre Moen, Elia J Mmbaga, Melkizedeck T Leshabari, Stephen M Kibusi, Christopher R Sudfeld, Muhammad Bakari, Appolinary A R Kamuhabwa, Gideon Kwesigabo","doi":"10.1007/s10461-025-04879-5","DOIUrl":"https://doi.org/10.1007/s10461-025-04879-5","url":null,"abstract":"High discontinuation of pre-exposure prophylaxis (PrEP) among high-risk women undermines its effectiveness. However, there is limited evidence on the reasons for PrEP discontinuation among female sex workers in sub-Saharan Africa. Exploring population-specific reasons for PrEP discontinuation will guide the design of client-centered strategies. Thus, we explored the reasons for PrEP discontinuation among female sex workers in Tanzania using mixed methods from 2022 to 2023 in Tanga, Tanzania. Participants were recruited through respondent-driven sampling and followed up for 12 months, and quantitatively interviewed at months 1, 6, and 12. In-depth interviews were carried out alongside the 12-month survey with purposely sampled female sex workers who had discontinued PrEP. Separate descriptive (and log-binomial regression) and thematic analyses were performed, and the insights were compared and integrated. We enrolled 313 participants with a median age of 27 years (IQR: 23-32). At 6 months, 61.5% (95% CI 54.3-68.4) had stopped taking PrEP for ≥ 3months, increasing to 67.4% (95% CI 60.2-74.0) at 12 months. Self-perceiving to be at \"medium\" to \"high\" risk of HIV had a 20% lower risk of stopping PrEP for ≥ 3months compared to self-perceiving to be at low or no risk (aRR 0.8, 95% CI 0.783-0.896). Participants discontinued PrEP because of medical and pharmacological challenges; perceived negative social norms and societal pressures; perceived undesirable pill characteristics and dosing schedules; low self-assessed HIV risk; perceived low benefit of PrEP; and low self-efficacy in adhering to PrEP. Our findings highlight the need for a multi-component intervention to promote PrEP retention.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111738","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}

引用次数: 0

Identifying Predictors of Problematic Substance Use Among Youth Living with HIV in Uganda: A Machine Learning Approach. 确定乌干达艾滋病毒感染者中有问题物质使用的预测因素：机器学习方法。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-18 DOI: 10.1007/s10461-025-04840-6

Claire Najjuuko, Rachel Brathwaite, Massy Mutumba, Saltanat Childress, Sylivia Nannono, Phionah Namatovu, Chenyang Lu, Fred M Ssewamala

{"title":"Identifying Predictors of Problematic Substance Use Among Youth Living with HIV in Uganda: A Machine Learning Approach.","authors":"Claire Najjuuko, Rachel Brathwaite, Massy Mutumba, Saltanat Childress, Sylivia Nannono, Phionah Namatovu, Chenyang Lu, Fred M Ssewamala","doi":"10.1007/s10461-025-04840-6","DOIUrl":"https://doi.org/10.1007/s10461-025-04840-6","url":null,"abstract":"Substance use among youth is a significant public health issue, particularly in low resource settings in Sub-Saharan Africa (SSA), where it contributes to HIV transmission and poor engagement in HIV care. This study employs machine learning (ML) techniques to develop models for predicting problematic substance use (PSU) among youth living with HIV (YLHIV) in Uganda, aiming to identify important multilevel risk factors and compare predictive performance of ML algorithms. Utilizing a cross-sectional dataset of 200 YLHIV aged 18-24 in Uganda, we trained and evaluated six predictive models, through 10-fold cross validation. Model performance was assessed using area under receiver operating characteristic curve (AUROC), and precision recall curve (AUPRC). Subsequent feature importance analysis revealed key predictors of PSU. The random forest model achieved the best discriminative performance with an AUROC of 0.78 (0.01) and AUPRC of 0.75 (0.02). Key predictors of PSU spanned individual, interpersonal, and community dimensions including depression, sexual risk-taking behaviors, monthly income, adverse childhood experiences, family involvement in selling alcohol, friends enabling access to alcohol, exposure to community educational campaigns against alcohol, household size, and knowledge of alcohol effects on HIV treatment. Our findings highlight ML's potential in predicting PSU among YLHIV and provide insights to guide targeted interventions and support policy formulations mitigating PSU effects on HIV management.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079512","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}

引用次数: 0

Mechanisms of Action and Preliminary Impact of a Stigma-Mitigation Training to Enable Healthcare Discussions About Anal Pleasure and Health in China: A Sequential Explanatory Mixed Methods Pilot Study. 在中国，缓解耻辱感训练的作用机制和初步影响使有关肛门愉悦和健康的医疗保健讨论成为可能：一项顺序解释混合方法试点研究。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-18 DOI: 10.1007/s10461-025-04878-6

Bryan A Kutner, Kathrine Meyers, Yumeng Wu, Benjamin Lane, Gang Yang, Baichun Hou, Iván C Balán

{"title":"Mechanisms of Action and Preliminary Impact of a Stigma-Mitigation Training to Enable Healthcare Discussions About Anal Pleasure and Health in China: A Sequential Explanatory Mixed Methods Pilot Study.","authors":"Bryan A Kutner, Kathrine Meyers, Yumeng Wu, Benjamin Lane, Gang Yang, Baichun Hou, Iván C Balán","doi":"10.1007/s10461-025-04878-6","DOIUrl":"https://doi.org/10.1007/s10461-025-04878-6","url":null,"abstract":"Stigma toward anal sex impedes engagement in health services that are vital to Ending the HIV Epidemic. We evaluated a stigma-reduction training to build HIV worker capacity to address anal pleasure and health during HIV service encounters in China. In a sequential explanatory mixed-methods design, we assessed the training's preliminary impact on anal health promotion activities and, based on the Theoretical Domains Framework, mechanisms of action among 51 health workers. We conducted descriptive statistics, bivariate comparisons, and thematic analyses based on pre/post-training online surveys and post-training in-depth interviews. The frequency of anal health promotion activities among the 38 participants who completed pre/post-training surveys increased by 7-8% of the scale range, but not significantly (p-values between 0.06 and 0.08). Mechanisms for discussing anal sex (knowledge, skills, role responsibility, self-efficacy, organizational acceptability, and positive emotions) shifted from baseline (5%-36% range), primarily due to boosts in knowledge and skills (28% and 36%, all p < .05). Additional mechanisms of comfort addressing sexual orientation, anal health, and sex-related concerns also increased (4-14% range, all p < .05). Qualitative analysis revealed mechanistic themes of heightened empathy, weakened stereotypes, and a shift toward accepting role responsibility to discuss anal sex. Gay and bisexual workers reported notable personal growth to optimize their own anal health. Although knowledge and communication skills increased provider confidence, some participants remained hesitant to initiate discussion during HIV service encounters. For most participants the theoretically-informed training activities operated as hypothesized, to enhance mechanisms that could increase provider-initiated discussion of anal pleasure and health.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079474","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}

引用次数: 0

Comparison of Self-Reported Substance Use with Outcomes of Urine Testing among Men Who Have Sex with Men in Africa Participating in HPTN 075. 参加HPTN 075的非洲男男性行为者自我报告的物质使用与尿液检测结果的比较

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-13 DOI: 10.1007/s10461-025-04832-6

Theodorus G M Sandfort, Susan H Eshleman, Justin Knox, Autumn Breaud, Katie Weaver, Emily Kerubo, Ravindre Panchia, Erica L Hamilton, Vanessa Cummings, Bill Clarke

{"title":"Comparison of Self-Reported Substance Use with Outcomes of Urine Testing among Men Who Have Sex with Men in Africa Participating in HPTN 075.","authors":"Theodorus G M Sandfort, Susan H Eshleman, Justin Knox, Autumn Breaud, Katie Weaver, Emily Kerubo, Ravindre Panchia, Erica L Hamilton, Vanessa Cummings, Bill Clarke","doi":"10.1007/s10461-025-04832-6","DOIUrl":"10.1007/s10461-025-04832-6","url":null,"abstract":"Research linking substance use with HIV risk behaviors and antiretroviral therapy adherence is typically based on self-reported data. However, studies in high-income countries show that men who have sex with men (MSM) often underreport substance use when compared to objective biological testing. Such comparisons have not been conducted among MSM in sub-Saharan Africa. We compared self-reported and objectively measured substance use among MSM participating in HPTN 075, a multi-site observational cohort study conducted in Kenya, Malawi, and South Africa. Urine samples (n = 734) from 382 participants were tested for the alcohol metabolite ethyl glucuronide and 43 other substances. These tests detect alcohol use in the prior 48-72 h and other substances up to 7 days earlier, depending on the drug. Of the 734 samples, 159 (21.7%) tested positive for ethyl glucuronide. Self-reported alcohol use was available for 97.5% of these cases and confirmed in 141 (91.0%) of them. Sixty samples (8.2%) tested positive for at least one of the 43 other substances. Self-report data were available for 95.0% of those, but use was acknowledged in only 19 (33.3%) cases. These findings suggest that alcohol use is generally reported accurately, while drug use is substantially underreported-likely due to legal prohibitions and social stigma. Incorporating objective substance testing alongside self-reports is recommended to improve the accuracy of substance use measurement in behavioral and clinical HIV research, especially in contexts where stigma or criminalization may inhibit disclosure.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051545","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}

引用次数: 0

Using Latent Profile Analysis to Identify Stigma Typologies Among a Sample of Women Living with HIV and Who Inject Drugs in Ukraine. 使用潜伏剖面分析，以确定耻辱类型的妇女感染艾滋病毒和谁注射毒品在乌克兰的样本。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-12 DOI: 10.1007/s10461-025-04845-1

Shannon Fuller, Omeid Heidari, Karin Tobin, Julia Burlaka, Melissa Davey-Rothwell, Tetiana Kiriazova, Jill Owczarzak

{"title":"Using Latent Profile Analysis to Identify Stigma Typologies Among a Sample of Women Living with HIV and Who Inject Drugs in Ukraine.","authors":"Shannon Fuller, Omeid Heidari, Karin Tobin, Julia Burlaka, Melissa Davey-Rothwell, Tetiana Kiriazova, Jill Owczarzak","doi":"10.1007/s10461-025-04845-1","DOIUrl":"https://doi.org/10.1007/s10461-025-04845-1","url":null,"abstract":"Women living with HIV (WLWH) who inject drugs experience intersecting forms of stigma that adversely impact care engagement and health outcomes. We used latent profile analysis to identify typologies of intersecting stigma among WLWH who inject drugs and examined individual, social, and health care-related factors associated with these typologies. Surveys were collected from WLWH in Ukraine (n = 297) between 2019 and 2020. Six scales for internalized and enacted stigma related to HIV and drug use were used, then multinomial logistic regression assessed factors associated with profile membership. Four profiles emerged: \"low stigma\" (reference group, estimated 32.3% of the sample), \"internalized stigma only\" (49.2%), \"social network stigma\" (12.1%), and \"provider stigma\" (6.4%). Some degree of internalized stigma for both HIV and drug use was present across all profiles, including the reference group. Drug use stigma scores were generally higher than those for HIV. After adjusting for age, income, and time since HIV diagnosis, participants engaged in HIV care had significantly lower odds of being in the \"provider stigma\" profile compared to the reference group (aOR = 0.26, 95% CI: 0.08-0.86, p < 0.05), while a higher frequency of injection drug use had greater association with the \"provider stigma\" profile (aOR = 8.26, 95% CI: 1.55-44.16, p < 0.05). History of intimate partner violence was associated with the \"internalized stigma only\" (aOR = 3.21, 95% CI: 1.51-6.82, p < 0.01) and \"social network stigma\" (aOR = 3.42, 95% CI: 1.15-10.22, p < 0.05) profiles. These findings illustrate the value of latent profile analysis in understanding intersectional stigma and highlight the need for tailored interventions to address stigma among WLWH who inject drugs.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038930","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}

引用次数: 0

Evaluating Cross-Sectional Associations Between Cannabis Use and Prospective Memory in People with HIV. 评估艾滋病毒感染者大麻使用与前瞻性记忆之间的横断面关联。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-12 DOI: 10.1007/s10461-025-04851-3

Mark K Britton, Elie Haddad, Yancheng Li, Eric C Porges, Natalie E Chichetto, Charurut Somboonwit, Gladys E Ibañez, Ronald A Cohen, Robert L Cook

{"title":"Evaluating Cross-Sectional Associations Between Cannabis Use and Prospective Memory in People with HIV.","authors":"Mark K Britton, Elie Haddad, Yancheng Li, Eric C Porges, Natalie E Chichetto, Charurut Somboonwit, Gladys E Ibañez, Ronald A Cohen, Robert L Cook","doi":"10.1007/s10461-025-04851-3","DOIUrl":"https://doi.org/10.1007/s10461-025-04851-3","url":null,"abstract":"Prospective memory (PM) deficits are common among people with HIV (PWH) and are linked to poor clinical outcomes. Risk factors for PM deficits in PWH are poorly understood. While cannabis use is associated with worse PM in people without HIV, it is unclear whether this association generalizes to PWH. Three hundred and seven PWH (79% with regular cannabis use) completed the Memory for Intentions Test (MIST). Associations between regular use (vs. no/minimal lifetime use) and MIST score were evaluated. Among participants with regular use, bivariate associations were evaluated between MIST score and self-reported cumulative 30-day THC dose, use frequency, duration of heaviest lifetime use, age of first use, and use motivation (predominantly-recreational, predominantly-therapeutic, or combined). Confounding was addressed with linear regressions adjusted for age and Wechsler Test of Adult Reading. Cannabis use (vs. non-use) was not significantly associated with MIST score in unadjusted or adjusted models (β = - 0.04, 95% CI = - 0.29, 0.21, p = 0.74). After confounder adjustment, no associations between cannabis variables and MIST score reached statistical significance. The largest (albeit nonsignificant) effect in adjusted models was found for use motivation: participants with combined use showed better MIST performance vs. predominantly-recreational use (β = 0.28, 95% - 0.02, 0.57, p = 0.067). Participants reporting predominantly-therapeutic use vs. predominantly-recreational use performed similarly (β = 0.03, 95% CI = - 0.30, 0.37, p = 0.85). PM was not significantly associated with cannabis use in PWH. Associations between motivation for use and PM in PWH warrant further investigation.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038991","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}

引用次数: 0

Gay Community Connectedness, Internalized Homonegativity, and HIV Pre-Exposure Prophylaxis (PrEP) Attitudes and Use Among Men Who Have Sex with Men in Georgia: A Mediation Analysis. 乔治亚州男同性恋者中的同性恋社区联系、内化的同性恋阴性和HIV暴露前预防（PrEP）态度和使用：一项中介分析。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-12 DOI: 10.1007/s10461-025-04870-0

Mohammad Rifat Haider, Golam Sarwar, Liyuan Wang, Md Sharful Islam Khan, Monique J Brown, Nathan Hansen, Jeremy J Gibbs

{"title":"Gay Community Connectedness, Internalized Homonegativity, and HIV Pre-Exposure Prophylaxis (PrEP) Attitudes and Use Among Men Who Have Sex with Men in Georgia: A Mediation Analysis.","authors":"Mohammad Rifat Haider, Golam Sarwar, Liyuan Wang, Md Sharful Islam Khan, Monique J Brown, Nathan Hansen, Jeremy J Gibbs","doi":"10.1007/s10461-025-04870-0","DOIUrl":"https://doi.org/10.1007/s10461-025-04870-0","url":null,"abstract":"Georgia has one of the highest HIV diagnosis rates in the U.S., yet only 33% of Pre-Exposure Prophylaxis (PrEP) users in the Deep South live there. This study aims to determine the potential mediational role of internalized homonegativity and attitudes towards PrEP between gay community connectedness and PrEP use among men who have sex with men (MSM) living in Georgia. Participants (N = 121) completed an online survey in June 2020. PrEP use (yes/no) was defined by the question \"the last time you had sex, were you taking PrEP, like Truvada?\" The study also used the \"8-item Identification and Involvement with the Gay Community scale\", \"9-item internalized homophobia scale\", and a \"3-item PrEP attitude scale\". Path analysis was performed using Stata 17.0. After adjusting for sociodemographic characteristics, positive associations were observed between attitudes towards PrEP and PrEP use (β = 0.11; p = < 0.001), and gay community connectedness (GCC) and PrEP attitudes (β = 0.17, p < 0.001). Conversely, negative associations were found between GCC and internalized homonegativity (β=-0.71, p < 0.001), and internalized homonegativity and PrEP use (β=-.01, p = 0.031). GCC was not significantly associated with PrEP use (β=-.01; p = 0.196). However, the indirect effects of GCC on PrEP use through PrEP attitudes (β = 0.01, p < 0.001) and internalized homonegativity (β = 0.02, p = 0.041) were statistically significant. These findings indicate that PrEP attitudes and internalized homonegativity mediate the relationship between GCC and PrEP use among MSM. Thus, improving attitudes toward PrEP and reducing internalized homonegativity through fostering GCC among MSM may improve PrEP use and persistence.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038958","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}

引用次数: 0

Delivering HIV-Positive Test Results via Phone: Who Never Answered? Correlates of Undelivered Reactive HIV Results in a U.S. National Cohort of Sexual and Gender Minority Individuals. 通过电话传递艾滋病毒阳性检测结果：谁从未接过电话？在美国国家性和性别少数人群中未分娩的反应性HIV结果的相关性。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-09 DOI: 10.1007/s10461-025-04858-w

Michelle Dearolf, Drew A Westmoreland, Chloe Mirzayi, Yan Guo, Alexa D'Angelo, David W Pantalone, Adam W Carrico, Christian Grov

{"title":"Delivering HIV-Positive Test Results via Phone: Who Never Answered? Correlates of Undelivered Reactive HIV Results in a U.S. National Cohort of Sexual and Gender Minority Individuals.","authors":"Michelle Dearolf, Drew A Westmoreland, Chloe Mirzayi, Yan Guo, Alexa D'Angelo, David W Pantalone, Adam W Carrico, Christian Grov","doi":"10.1007/s10461-025-04858-w","DOIUrl":"10.1007/s10461-025-04858-w","url":null,"abstract":"Self-testing for HIV is an accessible, effective testing method for clinical and research contexts. From 2017 to 2022, we conducted annual, mail-in HIV testing with participants in our U.S. national longitudinal cohort of 6253 sexual and gender minority (SGM) individuals. Using multivariable logistic regression, we examined factors associated with failure to deliver HIV-positive results by phone despite extensive outreach. Of 16,000 samples tested, 315 were reactive (98% cisgender sexual minority men). We successfully delivered two-thirds of reactive results (n = 209). Unsuccessful result delivery was associated with frequent (once/week or more) methamphetamine use (OR = 2.195, p = .004), one or more recent HIV-positive sexual partner(s) (OR = 2.764, p < .001), and at least one indicator of socioeconomic vulnerability (OR = 2.413, p < .001). In the adjusted model, only socioeconomic vulnerability (AOR = 1.864, p = .034) and recent HIV-positive partner(s) (AOR = 2.220, p = .005) remained significant. Finally, we performed an exploratory cross-sectional mediation analysis, which suggested the impact of frequent methamphetamine use on failure to deliver HIV results was mediated by socioeconomic vulnerability, with significant indirect effect (ab = - 0.056, p = .002) and total effect (c = - 0.184, p = .008). Although remote self-testing can help SGM access HIV testing, difficulties remain in successfully delivering stigmatizing and stressful information like HIV results-particularly to those using methamphetamine or experiencing socioeconomic vulnerabilities, and those with HIV-positive sex partner(s) who may suspect a positive result. Tailored strategies are needed to better connect these populations into the status-neutral HIV care continuum.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022650","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}

引用次数: 0

Social Determinants of Health and HIV Diagnosis Rates in U.S. Counties, Comparing Ending the Epidemic (EHE) and Non-EHE Priority Jurisdictions. 美国各县健康和艾滋病毒诊断率的社会决定因素，比较结束流行病（EHE）和非EHE优先管辖区。

IF 2.4 2区医学

AIDS and Behavior Pub Date : 2025-09-08 DOI: 10.1007/s10461-025-04865-x

Elizabeth Lockhart, Elyse Llamocca, Geoff Kahn, Amy Loree, DeAnne Turner

{"title":"Social Determinants of Health and HIV Diagnosis Rates in U.S. Counties, Comparing Ending the Epidemic (EHE) and Non-EHE Priority Jurisdictions.","authors":"Elizabeth Lockhart, Elyse Llamocca, Geoff Kahn, Amy Loree, DeAnne Turner","doi":"10.1007/s10461-025-04865-x","DOIUrl":"https://doi.org/10.1007/s10461-025-04865-x","url":null,"abstract":"In the U.S., HIV diagnoses have remained steady over the past decade - despite the availability of condoms and pre-exposure prophylaxis. Factors such as adverse Social Determinants of Health (SDoH) may contribute to the sustained HIV diagnosis rate. This study sought to identify SDoH factors associated with HIV diagnosis rates in U.S. counties and between Ending the Epidemic (EHE) priority jurisdictions and non-EHE jurisdictions. We obtained county-level data from publicly available sources. We fit Poisson regression models to estimate associations between separate county-level SDoH factors and county-level HIV diagnosis rates among 344 U.S. counties and 82 EHE priority jurisdictions. Among all U.S. counties, five factors were associated with HIV diagnosis rates. In all U.S. counties, higher percent of renter-occupied housing with rent at least 30% of household income, percent of population with no health insurance, presence of medically underserved area, and percent of housing units that are overcrowded were associated with HIV diagnosis rates. For three factors (percent of populations with less than a high school education, Index of Dissimilarity, and number of social organizations), associations with HIV diagnosis rates were significantly different between non-EHE and EHE priority jurisdictions. Future research should examine SDoH drivers of HIV diagnoses, including how they impact HIV prevention efforts. Long term, these efforts can help develop novel interventions to reduce HIV transmission.","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013666","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}

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