AIDS and Behavior最新文献

{"title":"Negotiating Access to Healthcare and Experience of Stigma Among Cisgender Gay Men Diagnosed with Mpox During the 2022 Epidemic in France: A Qualitative Study.","authors":"Marie Dos Santos, Manuela Salcedo, Marion Mora, Martin Siguier, Annie Velter, Vincent Leclercq, Gabriel Girard","doi":"10.1007/s10461-025-04739-2","DOIUrl":"https://doi.org/10.1007/s10461-025-04739-2","url":null,"abstract":"<p><p>During the global Mpox epidemic of 2022/2023, the first cases in France were identified on 20 May 2022 among gay men. Scientific data on the experience of individuals concerned during the peak of the epidemic in France are scarce. This paper describes the results of the qualitative phase of the French ad hoc ANRS Mpox-SHS study, which was conducted in September/October 2022 among gay men diagnosed with Mpox.Study participants highlighted that they were not surprised at being diagnosed with Mpox, given that they were more exposed to sexually transmitted diseases in general because they had several partners and they were a target group of prevention campaigns.In contrast, the rapidity and extent of the disease's symptoms (pain, rashes, scabs, etc.) surprised many of them. All participants mentioned strong barriers to accessing appropriate care, the most-cited being stigma. Participants felt they were treated like \"plague victims\". Furthermore, most reported serious social and psychological consequences of being diagnosed with Mpox, arising from their fear that their sexual orientation and/or their sexual practices would be exposed. Moreover, respondents highlighted having an erratic Mpox care pathway, being sent from one health provider to another to receive care. Finally, participants explained that they implemented various negotiation strategies with their healthcare providers, sexual partners, and their employers during their illness.This study highlights the importance of using community health to better understand the development of an epidemic and its impact on affected individuals.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962114","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":"Family Influences on Antiretroviral Therapy Adherence in Youth with HIV in the United States: A Systematic Review.","authors":"Violeta J Rodriguez, Miranda Gessert, Arianna Guerra","doi":"10.1007/s10461-025-04721-y","DOIUrl":"https://doi.org/10.1007/s10461-025-04721-y","url":null,"abstract":"<p><p>HIV poses a significant issue in the United States and understanding how HIV-positive populations adhere to treatments, specifically with antiretroviral therapy (ART), is vital for researchers to find approaches to improve medication adherence. This systematic review aims to explore barriers that children, adolescents, and young people (ages < 25) in the United States may face by exploring family interventions and factors influencing ART adherence. This study conducted a literature search using various databases to retrieve studies within the United States. A total of 36 studies identified family factors (n = 29) and various interventions (n = 7). Across both categories, studies indicated the critical role of family involvement in adherence outcomes. The review also identified significant barriers to ART adherence, including complex medication regimens, HIV-related stigma, and psychosocial stressors. Due to the diverse barriers, policymakers and healthcare providers should focus on a holistic approach to support ART adherence in HIV-positive youth.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951340","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":"Diagnosis of Learning Disabilities but not Academic Difficulties Alone is Associated with Neurocognitive Impairment in People Living with HIV: Evidence from Clinical Research to Support and Refine the Current HAND Diagnostic Guidelines.","authors":"Aneeka Ratnayake, Lucette A Cysique, Sean B Rourke","doi":"10.1007/s10461-025-04711-0","DOIUrl":"https://doi.org/10.1007/s10461-025-04711-0","url":null,"abstract":"<p><p>Diagnosing HIV-associated neurocognitive disorder (HAND) is a complex process aimed at determining the role of HIV versus other causes of neurocognitive impairment. In treated people with living long-term HIV infection, this process is further complicated by the presence of multiple medical and psychiatric comorbidities and varied educational history. Evidence-based research is therefore needed to refine the 2007 HAND diagnostic criteria on how to consider multimorbidity in making differential diagnoses. This is the case for presence of academic difficulties versus diagnosis of learning disabilities (LD), which have not been systematically studied in relation to HAND, and especially in relation to the presence of cognitive and depressive symptoms. The current study included 903 people with HIV referred for a comprehensive neuropsychological assessment of HAND at the Neurobehavioural Clinical-Research Unit (St. Michael's Hospital in Toronto, ON, Canada). Pre-morbid ability was assessed prior to standard testing and participants were classified into LD groups: No learning disabilities (n = 474), academic difficulties (n = 352) or diagnosed learning disability (LD, n = 77). The neuropsychological test battery assessed domains of complex attention, learning and memory, psychomotor efficiency, and executive functioning, and performance was adjusted with demographic corrections. Neurocognitive impairment (NCI) status was determined using the global deficit score method (GDS ≥ 0.5 detecting at least mild global NCI). Depressive symptoms were assessed with the Beck Depression Inventory (BDI), and cognitive symptoms with the Patient's Assessment of Own Functioning (PAOFI). Logistic regression models were used to assess odds of NCI in the three groups while considering main and interactive effects of clinically relevant depression (BDI > 10) or elevated cognitive symptoms (PAOFI > 3). Only LD diagnosis was significantly associated with increased odds of NCI, OR = 1.90, 95% CI (1.15, 3.14). In the same model, both cognitive symptoms, OR = 1.97, 95% CI (1.50, 2.58), and depression symptoms OR = 1.39, 95% CI (1.06, 1.82) were also significantly associated with increased odds of NCI, but not their interaction. Diagnosis of LD, but not academic difficulties alone, is associated with increased odds of NCI among treated persons living with HIV who are clinically referred. While this was in part independent of depression and cognitive symptoms, adults with HIV and LD diagnosis who had high depression and cognitive symptoms had greatest odds of NCI. These findings assist in the refinement of the current HAND diagnostic guidelines.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956436","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":"Rapid Diffusion of Awareness and Uptake of Doxy-PEP among Men who Have Sex with Men in San Francisco.","authors":"Antonio A M Moscatelli, Paloma L Ramirez, Bow Suprasert, Moranda Tate, Stephanie E Cohen, Maria Amelia S M Veras, Glenda Baguso, Erin C Wilson, Willi McFarland","doi":"10.1007/s10461-025-04728-5","DOIUrl":"https://doi.org/10.1007/s10461-025-04728-5","url":null,"abstract":"<p><p>In October 2022, the San Francisco Department of Public Health published guidelines for doxycycline post-exposure prophylaxis (doxy-PEP) to prevent bacterial sexually transmitted infections (STI) among men who have sex with men (MSM). We evaluated awareness and use of doxy-PEP using data from the National HIV Behavioral Surveillance in 2023 in San Francisco (N = 533). In the year following the publication of the guidelines, 66.6% of MSM reported awareness of doxy-PEP, and 19.3% had used it. Among MSM who are not living with HIV, awareness of doxy-PEP was associated with higher educational levels, condomless sex, bacterial STI diagnoses, and PrEP use; use was associated with STI diagnoses and PrEP use. Among MSM living with HIV, both awareness and use were associated with younger age. These findings indicate rapid dissemination and early adoption of doxy-PEP in a priority population in a real-world setting.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963583","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":"\"We Live in Different Chicagos\": Racial/Ethnic Differences in the Neighborhood Affiliations of Young Men Who Have Sex with Men as Drivers of HIV Risk.","authors":"Elizabeth A McConnell, Michelle Birkett","doi":"10.1007/s10461-025-04734-7","DOIUrl":"https://doi.org/10.1007/s10461-025-04734-7","url":null,"abstract":"<p><p>Racial disparities in HIV are well-documented and pervasive, particularly impacting Black young men who have sex with men (YMSM), and are not explained by differences in individual risk behaviors. The Network-Individual-Resource (NIR) Model of HIV Transmission and Prevention (Johnson et al. in AIDS Behav 14:S204-S221, 2010) suggests that focusing on the broader network-level environments of YMSM holds strong promise for identifying social-contextual factors that may drive these racial disparities. Empirically, numerous studies have demonstrated links between neighborhood-level factors and HIV risk among YMSM (Bauermeister et al. in J Sex Res 54:446-464, 2017). This mixed-methods study aimed to characterize racial differences in the broader contexts (i.e., neighborhood affiliations) within which YMSM meet their sex partners, which may in turn shape HIV risk. Using an innovative explanatory sequential design, multilevel network and geospatial data from an existing longitudinal cohort of YMSM in Chicago were visualized (Phase 1) and subsequently used to guide interviews with a subsample of participants in the broader parent study (Phase 2). Grounded theory was used to analyze interview data, leading to the identification of several salient differences in Black, White, and Latino YMSM's neighborhood-level affiliations, including racial segregation and resource inequality, White spatial insularity, profound Black-White segregation, and Black and Latino neighborhood bridging. From a network perspective, these racial differences in neighborhood-level affiliations have strong potential to help explain the disproportionate burden of HIV among Black YMSM. Findings highlight the importance of attending to the social context within which individual risk behaviors take place and underscore the importance of broader structural change to address racial disparities in HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957896","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":"Assessing the Implementation Fidelity of a Patient-Centered, Combination Adherence Strategy to Support HIV Antiretroviral Therapy and Pre-Exposure Prophylaxis Adherence During Pregnancy and Breastfeeding in Malawi.","authors":"Friday Saidi, Lauren A Graybill, Twambilile Phanga, Katie R Mollan, Getrude Msowoya, Mercy Tsidya, Mary Chindevu, Donnie Makonokaya, Kellie Freeborn, Nora E Rosenberg, Lauren M Hill, Sam Phiri, Wilbroad Mutale, Benjamin H Chi, K Rivet Amico","doi":"10.1007/s10461-025-04737-4","DOIUrl":"https://doi.org/10.1007/s10461-025-04737-4","url":null,"abstract":"<p><p>The use of antiretroviral drugs has been proven effective in preventing and treating HIV; however, adherence remains a challenge. In two parallel pilot studies, we implemented a combination adherence intervention involving patient-centered counseling and adherence supporter training, tailored for HIV treatment (ART) or prevention (PrEP) during pregnancy and breastfeeding. The intervention included Integrated Next Step Counseling (iNSC), focused on well-being and medication adherence, with an option to involve a social support member. Independent auditors assessed implementation fidelity for 151 participants (51 women living with HIV and 100 PrEP-eligible women) by scoring iNSC sessions using a standard checklist. High fidelity was observed overall in both study populations, with variability between counselors observed. The results demonstrate the ability to assess implementation fidelity in a behavioral intervention aimed at supporting adherence to antiretroviral drugs among pregnant women and offers critical information on the complexities of implementation of iNSC in a real-world setting.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956262","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":"Sexually Transmitted Infection (STI) Incidence and Risk Factors Among People with HIV (PWH): Insights from a 13-Year Cohort Study in South Carolina.","authors":"Salome-Joelle Gass, Shujie Chen, Jiajia Zhang, Bankole Olatosi","doi":"10.1007/s10461-025-04744-5","DOIUrl":"https://doi.org/10.1007/s10461-025-04744-5","url":null,"abstract":"<p><p>The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina's HIV and STI surveillance systems were linked, and all PWH aged 18 and older who were diagnosed with HIV between 2007 to April 2018 were included. Cohort demographics were analyzed using descriptive statistics and chi-squared tests, and a Cox Proportional Hazards model examined time to first STI after HIV diagnosis. The study found an increase in the incidence of gonorrhea, chlamydia, and syphilis over the study period. Young adults, men, Black individuals, MSM, and urban residents were found to be at increased risk for STI diagnosis. Clinical risk factors associated with increased STI risk included lower initial CD4 counts, and higher initial viral loads. The findings underscore a considerable STI burden among PWH in South Carolina. To mitigate STI transmission in the context of HIV, targeted interventions for high-risk populations are needed.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965879","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":"Adolescent Perceptions of HIV Testing Access and Utilization Across Two States with Varying Laws Regulating Minors' Access to Confidential Sexual Health Services: A Qualitative Study in Connecticut and New Jersey.","authors":"Christina Aivadyan, Bryce Puesta Takenaka, Jaleah Rutledge, Trace Kershaw","doi":"10.1007/s10461-025-04738-3","DOIUrl":"https://doi.org/10.1007/s10461-025-04738-3","url":null,"abstract":"<p><p>Confidentiality concerns have been identified as a significant barrier to sexual health service utilization for adolescents. This qualitative study compares perceptions of HIV testing access and utilization among sexually active adolescents in two U.S. states with varying laws regulating minors' access to confidential sexual health services. Between November 2022 and June 2023, we conducted semi-structured interviews with a purposive sample of 60 sexually active adolescents aged 16-17 in Connecticut (i.e., where confidentiality for HIV testing is mandated; n = 30) and New Jersey (i.e., where confidentiality for HIV testing is not mandated; n = 30). Guided by Andersen's behavioral model of health services use, we used Dedoose software to identify key themes and explore areas of thematic convergence and divergence across states. Overall, we identified few thematic differences between states. Despite stressing the importance of confidentiality, most participants reported a lack of awareness of state laws regulating minors' access to confidential sexual health services. Confidential care-i.e., having time alone with a healthcare provider during visits, the ability to self-consent to services, and the privacy of health information maintained-was identified as a key theme underlying perceptions of HIV testing access and utilization. Participants connected receipt of confidential care to increased comfort engaging in discussion of sexual health issues, disclosing sensitive sexual health information, and testing for HIV. Findings suggest that confidentiality concerns may be a key mechanism that can be acted upon to increase adolescent HIV testing uptake.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956100","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":"Comprehensive Analysis and Leveraging Online Innovations to Improve HIV and STI Prevention and Treatment Services in Major Cities of Thailand.","authors":"Panyaphon Phiphatkunarnon, Nittaya Phanuphak, Rena Janamnuaysook, Do Tran, Boon-Leong Neo, Worawit Tepsan","doi":"10.1007/s10461-025-04714-x","DOIUrl":"https://doi.org/10.1007/s10461-025-04714-x","url":null,"abstract":"<p><p>Despite a 50% reduction in new HIV cases since 2010, HIV and sexually transmitted infections (STIs) remain pressing public health challenges in Thailand, particularly among marginalized and high-risk populations. This study examined 8,865 bookings made between October 1, 2023, and September 30, 2024, through Love2Test.org (L2T), a mobile platform launched in December 2020 to provide accessible sexual health services, including HIV testing and STI screening. Applying descriptive analysis, service utilization analysis, and K-means clustering, the study uncovered booking patterns, user demographics, and behavioral trends. L2T attracted a diverse user base, with 32.15% aged 15-24, 47.06% aged 25-34, 2.6% identifying as transgender women, and 16.59% as non-binary individuals, underscoring its inclusivity. HIV testing (38%) and STI screening (28%) were the most requested services, while Bangkok accounted for 74.5% of bookings, highlighting geographic disparities in access. Cluster analysis identified three user groups: older males seeking HIV tests, younger males and middle-aged non-binary individuals utilizing PrEP and STI screening, and a mixed group accessing both services. With 158,639 visitors and 8,865 service bookings, resulting in a visit-to-booking rate of 5.59%, L2T has proven instrumental in delivering confidential, targeted care to vulnerable groups. By addressing service gaps and promoting HIV testing, PrEP education, and STI prevention, L2T strengthens public health efforts. Expanding its outreach and improving service availability beyond Bangkok present opportunities to further reduce health disparities and bolster Thailand's response to HIV and STI challenges.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959763","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":"Heroin, Fentanyl, Intentional Fentanyl Use and HIV Transmission in a Community-Recruited Sample of Persons Who Inject Drugs, New York City: 2021-2023.","authors":"Don C Des Jarlais, Chenziheng Allen Weng, Jonathan Feelemyer, Mehrdad Khezri, Marley Reynoso, Sarah Kimball, Anneli Uuskula, Courtney McKnight","doi":"10.1007/s10461-025-04732-9","DOIUrl":"https://doi.org/10.1007/s10461-025-04732-9","url":null,"abstract":"<p><p>We examined drug use patterns and HIV transmission among persons who inject drugs (PWID) in New York City from 2021 to 2024. Modified respondent-driven sampling was used to recruit PWID from October 2021-February 2024. A structured questionnaire measured demographics, drug use behaviors and overdose experiences (within previous 6 months). Urinalysis was conducted for recent substance use and serum samples were collected for HIV antibody testing. HIV incidence was estimated using a previously published algorithm. We recruited 463 PWID; high percentages of participants reported problematic life circumstances including unstable housing (45%), food insecurity (67%) and drug use problems: 25% reported a recent non-fatal overdose and 55% daily injecting. Fentanyl use was detected in 86% of urinalyses, heroin in 67%, cocaine in 78%, heroin without fentanyl in 1%, and fentanyl and cocaine in 69%. A moderate number of PWID (24%) reported intentional fentanyl use, which was associated with increased food insecurity, unstable housing, injection frequency, cocaine use, and recent non-fatal overdoses and recent receptive syringe sharing. HIV seroprevalence was 6%; there were three likely seroconversions in 1052 total person-years at risk (PYAR) from March 2020 to the times of interviews; estimated HIV incidence rate was 0.19/100 PYAR, 95% CI 0.12-1.67. Despite the increased HIV risks associated with intentional fentanyl use, HIV transmission among PWID has remained low, comparable to pre-fentanyl and pre-COVID-19 levels. Continued monitoring of drug use patterns and increased services for intentional fentanyl use are needed.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955396","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}