AIDS and Behavior最新文献

{"title":"Tobacco and Cannabis Co-use by HIV Status Among United States Adults: Results from the 2021-2023 National Survey on Drug Use and Health.","authors":"Juhan Lee, Ana Paula Xingru Yin, Andrea H Weinberger","doi":"10.1007/s10461-025-04817-5","DOIUrl":"https://doi.org/10.1007/s10461-025-04817-5","url":null,"abstract":"<p><p>Tobacco and cannabis use are prevalent among adults with HIV and co-use is associated with drug dependence and negative health outcomes such as lung disease. This study examined the co-use of tobacco and cannabis by HIV status overall and by sociodemographics. Data came from the adult sample from the 2021-2023 National Survey on Drug Use and Health. Adjusted multinomial logistic regressions were performed on tobacco cannabis co-use by HIV status, adjusting for covariates. We tested potential interaction effects between HIV status and each sociodemographic factor (i.e., age, sex, race/ethnicity, income, state-level medical cannabis legalization status) on the outcome. Among total adult respondents (N = 139,524), 0.4% (weighted) reported lifetime HIV diagnosis and 8.2% reported past-month tobacco and cannabis co-use. After adjusting for covariates, adults with HIV, compared with adults without HIV, were more likely to report past-month tobacco and cannabis co-use (aRRR = 3.35, 95% CI = 1.79, 6.27). We also observed that race/ethnicity and state-level medical cannabis legalization status modified the association between HIV diagnosis and tobacco and cannabis co-use. This study observed a higher prevalence of tobacco and cannabis co-use among adults with HIV overall and identified subgroup sociodemographic differences by race/ethnicity and state-level medical cannabis legalization.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558812","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":"Suboptimal Patient-Provider Communication About Undetectable = Untransmittable and HIV Transmission Risk in Australia and the US.","authors":"Sarah K Calabrese, Martin Holt, David A Kalwicz, Justino J Flores, Kaosisochukwu C Onochie, Benjamin R Bavinton, Bridget Haire, Anthony K J Smith, James MacGibbon, Loren Brener, Timothy R Broady, John Rule, Bruce Richman, Carla Treloar","doi":"10.1007/s10461-025-04783-y","DOIUrl":"https://doi.org/10.1007/s10461-025-04783-y","url":null,"abstract":"<p><p>The Undetectable = Untransmittable (U = U) campaign aims to raise global awareness that people living with HIV whose viral load is undetectable cannot sexually transmit HIV. Healthcare providers are uniquely positioned to disseminate the U = U message. Our study explored patient-provider communication about U = U and HIV risk from the perspectives of gay, bisexual, and other men living with HIV (MLHIV) and healthcare providers engaged in HIV treatment and prevention service delivery. We conducted 40 semi-structured interviews with key informants recruited through HIV community-based and professional organizations in Australia (n = 20) and the US (n = 20). Key informants included 20 MLHIV and 20 providers. Data were analyzed thematically. MLHIV were cisgender men aged 29-67 years (M[SD] = 52[13.1]). Providers were cisgender adults aged 30-65 years (M[SD] = 38[9.0]). MLHIV preferred that providers use clear and direct language to explain U = U. When prompted to explain U = U as they would to patients, 8 of 10 Australian and 4 of 10 US providers used language consistent with those preferences. MLHIV, especially US MLHIV, reported that their providers' explanation of the U = U message was often absent, ambiguous, or inaccurate in practice. Such suboptimal communication aligned with the skepticism about U = U and concerns about patient behavior (e.g., adherence) expressed by several providers in the study. Providers relayed multiple reservations regarding new World Health Organization recommendations about informing patients that low-level viremia (detectable viral load ≥ copies/mL) conferred \"almost zero\" risk. Many Australian and US providers would benefit from training developed in collaboration with people living with HIV to improve patient-provider communication about U = U and HIV transmission risk.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551725","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":"The HIV Anxiety Scale (HAS): Developing and Validating a Measure of Human Immunodeficiency Virus (HIV) Anxiety.","authors":"Liam Cahill, Anthony J Gifford, Bethany A Jones, Daragh T McDermott","doi":"10.1007/s10461-025-04690-2","DOIUrl":"10.1007/s10461-025-04690-2","url":null,"abstract":"<p><p>Most research assessing human immunodeficiency virus (HIV) anxiety relies on single-item measures or psychometric measures that are outdated in terms of concepts and language. There is a critical need for a robust, reliable, and contemporary measure to identify populations at risk of avoiding HIV testing, treatment, and prevention, thereby supporting global HIV eradication goals. Focus groups informed the initial development of the HIV Anxiety Scale (HAS), revised through expert feedback. The factor structure was assessed in two studies. In Study 1, an Exploratory Factor Analysis (EFA) was conducted with 251 participants. In Study 2, a Confirmatory Factor Analysis (CFA) with 200 participants was performed alongside validity, internal consistency, and measurement invariance assessments. Studies 1 and 2 elicited a 3-factor model, resulting in a 16-item measure with the following subscales: Psychosocial Implications of HIV, Lifestyle Implications of HIV, and HIV Testing Anxiety. The HAS demonstrated a good factor structure, acceptable validity and excellent internal consistency across diverse groups in Study 2. The HAS provides a contemporary, robust measure of HIV anxiety, addressing limitations of previous tools and contributing to efforts to identify and support populations at risk of HIV avoidance behaviours. We recommend that future research continue to validate and test this new measure, but it offers a standardised tool to inform targeted interventions for HIV testing, prevention, and treatment.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2258-2271"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787424","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":"Evaluating the Effects of the COVID-19 Pandemic on HIV Testing, Enrollment, ART Use and Mortality in Suriname Using Interrupted Time Series Analysis.","authors":"Deborah Stijnberg, M McKee, E Commiesie, M Adhin, W Schrooten","doi":"10.1007/s10461-025-04683-1","DOIUrl":"10.1007/s10461-025-04683-1","url":null,"abstract":"<p><p>Our study evaluates the changes in HIV testing, new enrollments in the HIV surveillance system, treatment, and mortality of people with HIV during and after the SARS-CoV-2 (COVID-19) pandemic in Suriname. A retrospective population-based study was conducted, using interrupted time series analyses with data from the HIV surveillance system from January 2013 until December 2023. The commencement of the COVID-19 pandemic lead to a decline in HIV testing, enrollment, treatment initiation, and the annual number of individuals receiving treatment, respectively, by 16%, 32%, 40%, and 2% in 2020 compared to 2019. The mortality rate among people with HIV went from 7.8 in 2019 to 26 per 100,000 in 2022. The regression model showed an immediate significant effect at the start of the COVID pandemic for the HIV enrollments and the yearly number of people on treatment. For HIV mortality there is significant sustained effect. An overall decline in HIV services resulted in an increased mortality in 2021 and 2022. Innovative strategies and additional human and financial investments are needed to regain and improve access to health services and reverse the current epidemical trend.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2189-2195"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966175","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":"Socio-ecological Determinants of Detectable Viremia among Pregnant People Living with HIV in South Brazil: The Role of Stimulant Use Disorder and Homelessness.","authors":"Christopher Justin Hernandez, Fernando Echegaray, Kavya Sundar, Lanbo Z Yang, Mary Catherine Cambou, Eddy R Segura, Marineide Gonçalves de Melo, Breno Riegel Santos, Ivana Rosângela Dos Santos Varella, Karin Nielsen-Saines","doi":"10.1007/s10461-025-04639-5","DOIUrl":"10.1007/s10461-025-04639-5","url":null,"abstract":"<p><p>Pregnant patients living with HIV are a priority group for the recruitment into the HIV healthcare cascade to prevent adverse maternal and neonatal health outcomes. Understanding the structural, interpersonal, and individual factors that are associated with detectable HIV viremia is of importance to guide outreach and intervention priorities. This was a retrospective cohort study of pregnant patients living with HIV who delivered from January 1, 2017, to December 31, 2023, at a tertiary-level hospital and referral institution for HIV care in Porto Alegre, Brazil. The socio-ecological model was used to guide hypothesis testing regarding associations with detectable viremia. In total, 549 patients were included, of whom 110 (20%) were found to have detectable viremia. Significant differences between detectable and undetectable viremia included prenatal care, homelessness, having a sero-different partner, and stimulant use. Multivariable associations included prenatal care (adjusted Risk Ratio [aRR] = 0.20, 95% Confidence Interval [95% CI] = 0.15-0.26), homelessness (aRR = 4.02, 95% CI = 2.74-0.26), stimulant use disorder (aRR = 3.30, 95% CI = 2.23-4.87), crack use (aRR = 2.82, 95% CI = 1.85-4.29), and cocaine use (aRR = 1.89, 95% CI = 1.17-3.06). Intervention research should focus on housing and mental health services, and how to mitigate their impact on HIV healthcare. Intervention research is greatly needed as current tools may not be sufficient to tackle the issue of stimulant use disorder and its effects on ART adherence.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2066-2076"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078403","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":"Geosocial-networking App Use Among Men who Have Sex with Men in High HIV Community Viral Load Areas of Baltimore City.","authors":"Errol L Fields, Kimberly N Evans, Yang Liu, Nicole Thornton, Amanda Long, Mudia Uzzi, Zaneta Gaul, Kate Buchacz, Hope King, Jacky M Jennings","doi":"10.1007/s10461-025-04676-0","DOIUrl":"10.1007/s10461-025-04676-0","url":null,"abstract":"<p><p>Geosocial networking applications (GSN apps) are important tools for HIV/sexually transmitted infection prevention among men who have sex with men (MSM). Strategies for identifying high transmission and acquisition among GSN app users are needed to prioritize public health response. Community viral load (CVL) is associated with HIV transmission and can be used to identify populations with behaviors/environment associated with HIV/STI risk. We sought to determine user profile characteristics and utilization patterns associated with GSN app use in high CVL census tracts (CT). We used routine HIV surveillance data from in-care individuals and their viral loads at the point of diagnosis to estimate CVL in 200 CTs across Baltimore City. CTs were ordered based on CVL and categorized into quantiles from high to low. Among GSN user profiles, multiple imputation methods were used to complete missing profile characteristics. We then used imputed datasets to explore the association between profile characteristics, app utilization times, and app use in high CVL CTs using a Poisson regression model with robust error variances. Data on 606 profiles were collected originally and imputed 50 times to create a complete data set for analysis. GSN app users were aged 18-65 years [mean = 33.9, 95% confidence interval (CI): 33.1-34.7], with 52.2% Black (95% CI: 47.9- 56.5%), 6.8% living with HIV (95% CI: 4.4- 9.2%), 39.1% in high CVL CTs (95% CI: 35.2- 43.0%), 50.6% use at nighttime (95% CI: 46.7- 54.6%) and 51.6% use during the weekend (95% CI: 47.6- 55.6%). Black MSM users [Relative risk (RR) = 1.12, 95% CI: 1.04-1.20] were associated with GSN app use in high CVL CTs. MSM with profiles listing versatile sex position preference (RR = 1.12, 95% CI: 1.02-1.23) and profiles listing top sex position preference (RR = 1.13, 95% CI: 1.03-1.23) were associated with GSN app use in high and medium CVL CTs. GSN app user profiles of people in high and medium CVL CTs, especially Black MSM and those who report top and versatile sexual positions, may benefit from online prevention messages and real-time notification of health resources presently available in their communities to reduce HIV transmission.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2125-2134"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699434","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":"Alcohol Use and the Pre-exposure Prophylaxis Continuum of Care Among Men in Rural South Africa: Results from a Longitudinal Study.","authors":"Alison C Castle, Jacob Busang, Jaco Dreyer, Carina Herbst, Nonhlanhla Okesola, Natsayi Chimbindi, Thembelihle Zuma, Jana Jarolimova, Judith A Hahn, Christina Psaros, Sheela V Shenoi, Maryam Shahmanesh, Mark J Siedner","doi":"10.1007/s10461-025-04694-y","DOIUrl":"10.1007/s10461-025-04694-y","url":null,"abstract":"<p><p>Despite freely available oral HIV pre-exposure prophylaxis (PrEP), HIV incidence among young men in South Africa remains high. This study explores the impact of alcohol use on PrEP initiation and continuation among South African men. We performed a secondary data analysis from a trial involving men aged 16-29, randomly selected in KwaZulu-Natal. Participants were referred to sexual health services, and those who were HIV negative and sexually active were offered oral PrEP. Alcohol consumption was categorized using AUDIT-C criteria as no/low risk (0-3) and hazardous alcohol use (4-12). Primary outcomes were PrEP initiation and continuation, defined as refilling prescriptions for ≥ 4 months. Logistic regression models adjusted for clinical and demographic confounders estimated relationships between PrEP initiation/continuation and alcohol use. Among 325 men analyzed, average age was 22.9 years (SD 3.6), with 146 (45%) reporting hazardous alcohol consumption. PrEP initiation was greatest among the hazardous/very-high risk group (40%), with the lowest uptake among men who do not use alcohol (17%). In multivariate analyses, those with hazardous alcohol use remained more likely to initiate PrEP compared to those with no/low risk alcohol use (aOR 1.96, 95%CI 1.13-3.40; p-value = 0.017). Only 27% (24/88) remained on PrEP at 4 months, with continuation similar between alcohol use groups (aOR 1.56, 95%CI: 0.47-5.12, p = 0.47). Hazardous alcohol use is prevalent among men in rural South Africa and associated with increased PrEP initiation. However, overall PrEP continuation was low and consistent across alcohol use levels. Hazardous alcohol use should not deter PrEP implementation efforts to engage young men.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2312-2323"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787683","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":"HIV and Syphilis Prevalence, Trends and Factors Affecting HIV Testing Among Female Sex Workers in Morocco.","authors":"Lisa Johnston, Gauri Phatak, Houssine El Rhilani, Amina El Kettani, Ibtissam Khoudri, Katherine R McLaughlin","doi":"10.1007/s10461-025-04679-x","DOIUrl":"10.1007/s10461-025-04679-x","url":null,"abstract":"<p><p>We investigate factors affecting ever HIV testing and HIV testing in the past 12 months among female sex workers (FSW) in Agadir, Rabat, Fes, and Tangier, Morocco over four rounds of HIV biological and behavioral surveillance surveys (2012, 2016, 2019, and 2023). Findings are used to inform programmatic and policy responses and provide information to monitor epidemic trends. The 2012, 2016, 2019, and 2023 FSW surveys were carried out by the Ministry of Health and Social Protection National AIDS Program, and the National Institute of Hygiene with support from UNAIDS and the Global Fund. HIV prevalence decreased with no evidence of significant declining trends over time in Agadir, Fes, and Tangier, and increased with evidence of a strong linear trend in Rabat. Syphilis prevalence showed a strong linear decrease in all four cities. Ever had an HIV test and having had an HIV test in the past 12 months showed evidence of a strong linear trend increase for all cities. We found that ever had HIV testing and had an HIV test in the past 12 months were associated with experiences of sexual violence, condom possession, and HIV knowledge. Despite the progress made in containing HIV in Morocco, the concentration of HIV remains higher in marginalized groups, such as FSW, and continued efforts to improve and expand the quality of existing HIV services are needed. Investigamos los factores que afectan las pruebas de VIH y las pruebas de VIH en los últimos 12 meses entre mujeres trabajadoras sexuales (MTS) en Agadir, Rabat, Fez y Tánger, Marruecos, durante cuatro rondas de encuestas de vigilancia biológica integrada del VIH (2012, 2016, 2019 y 2023). Los hallazgos se utilizan para informar respuestas programáticas y políticas y proporcionar información para monitorear las tendencias epidémicas. Las encuestas de MTS de 2012, 2016, 2019 y 2023 fueron realizadas por el Programa Nacional contra el SIDA del Ministerio de Salud y Protección Social y el Instituto Nacional de Higiene con el apoyo de ONUSIDA y el Fondo Mundial. La prevalencia del VIH disminuyó sin evidencia de tendencias decrecientes significativas a lo largo del tiempo en Agadir, Fez y Tánger, y aumentó con evidencia de una fuerte tendencia lineal en Rabat. La prevalencia de la sífilis mostró una fuerte disminución lineal en las cuatro ciudades. Para los casos donde alguna vez se realizaron una prueba de VIH en la vida y se realizó una prueba de VIH en los últimos 12 meses mostraron evidencia de una fuerte tendencia lineal de aumento en todas las ciudades. Además, descubrimos que dichos casos se asociaron con experiencias de violencia sexual, o que estaban en posesión de condones y conocimiento del VIH. A pesar de los avances logrados en la contención del VIH en Marruecos, la concentración del VIH sigue siendo mayor en los grupos marginados, como las MTS, y se necesitan esfuerzos continuos para mejorar y ampliar la calidad de los servicios de VIH existentes.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2158-2167"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Preference for Injectable Pre-exposure Prophylaxis among Young Women in Kenya.","authors":"Kidist Zewdie, John Kinuthia, Daniel Matemo, Cynthia Wandera, Valarie Kemunto, Irene Cherotich, Tecy Oyambra, Mercy Bi, Esther Achieng, Steven Odhiambo, Beatrice Oduor, Daniel Sajita, Cole Grabow, Jennifer Morton, Renee Heffron, Kenneth K Mugwanya","doi":"10.1007/s10461-025-04687-x","DOIUrl":"10.1007/s10461-025-04687-x","url":null,"abstract":"<p><p>Longer acting HIV pre-exposure prophylaxis (PrEP) products are effective options for HIV prevention that require less user-dependence. As programs are preparing to launch delivery of these longer acting products, it is important to understand users' needs and preferences. We conducted a cross-sectional study among women seeking services at 12 family planning clinics in Kisumu, Kenya. Participants were sexually active HIV-negative women ≥15 years, with at least one characteristic that is more common among women who acquire HIV. We assessed PrEP product preferences among PrEP-experienced and inexperienced women. We used descriptive statistics to summarize participants' characteristics, product preferences, and willingness to use different PrEP modalities. We used univariate and multivariate models to assess factors related to preferences for injectable PrEP. A total of 457 participants were enrolled, including 341 with no oral PrEP experience and 116 with recent oral PrEP experience. The median age was 26 [IQR:23-30], 83% were married or cohabiting and 31% reported using injectable contraceptives. Among participants without prior PrEP experience, 74% preferred injectable PrEP, 19% preferred oral PrEP, and 4% preferred the vaginal ring. Among previous oral PrEP users, 82% preferred injectable PrEP, 16% preferred oral PrEP, and only 2% preferred the dapivirine vaginal ring. Only perceived PrEP stigma was significantly associated with injectable PrEP preference (PR: 1.21, 95% CI 1.09, 1.37, P=0.001). Reproductive-age women in Kenya have a strong interest in long-acting injectable PrEP. Product rollout and implementation needs to consider women's preference and devise best approaches to deliver injectable PrEP.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2234-2242"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699435","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":"Increasing Sustained Viral Suppression Among Youth Living with HIV: A Randomized Controlled Trial of Stepped Care Intervention.","authors":"Elizabeth Mayfield Arnold, Mary Jane Rotheram-Borus, Joan Christodoulou, Matthew M Yalch, Debra A Murphy, Peter Norwood, W Scott Comulada, Dallas Swendeman","doi":"10.1007/s10461-025-04692-0","DOIUrl":"10.1007/s10461-025-04692-0","url":null,"abstract":"<p><p>This study aimed to decrease viral load (VL) to increase viral suppression (VS) among youth living with HIV (YLH) ages 12-24. This study was a stepped care randomized controlled trial. Sixty-eight YLH with established infection, without VS, and with at least two follow-ups (N = 68) were randomized to a control condition (n = 25) or a stepped care intervention (n = 43), and repeatedly assessed for up to 24 months. Both conditions received referrals for health services and a daily automated text-messaging and monitoring intervention (AMMI). YLH in stepped care who were unsuppressed at 4-month assessments stepped up to peer support and later to coaching. Random effects regressions examined VL trajectories over time as well as trajectories of secondary outcomes. There was significant evidence suggesting a different longitudinal trajectory of VLs for the two conditions. The control condition had improved VLs at about 12 months and then started to return to higher VLs. The stepped-care condition improved over the same time period and remained relatively stable. We estimated that the average VL was lower in the stepped care condition at 24 months, but we cannot claim a statistically significant difference between conditions. Both intervention groups appeared to have positive intervention impacts suggesting some benefits of the AMMI intervention. The improvement in VL at 24 months for stepped care compared to the control condition are suggestive of a viable intervention strategy that warrants further study.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2287-2298"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787499","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}