AIDS and Behavior最新文献

{"title":"Latino Sexual Minority Men Living with HIV in South Florida have Varied Experiences of Intersectional Discrimination: A Mixed Methods Pilot Study.","authors":"Emily M Cherenack, Jaislene Viñas, Sol Fernandez-Nocito, Jennifer V Chavez, Favour Ebiala, Omar Valentin, Joseph P De Santis","doi":"10.1007/s10461-025-04691-1","DOIUrl":"10.1007/s10461-025-04691-1","url":null,"abstract":"<p><p>Culturally tailored behavioral interventions are needed to improve HIV treatment outcomes among Latino gay, bisexual, and other sexual minority cisgender men (LSMM) living with HIV. From 2022 to 2023, this study collected cross-sectional survey data (n = 58) and qualitative interview data (n = 10) to describe intersectional discrimination and obtain insights for tailoring interventions to address discrimination among LSMM living with HIV in Miami, Florida, USA. The sample was diverse in age (range 21-75), sexual orientation (83% gay, 17% bisexual), and country of origin (71% born outside the USA), with many participants born in Cuba (28%), and more than half of participants (64%) completing the study in Spanish. Experiences of discrimination varied, with 41% personally experiencing discrimination in the past year. Over one-third reported experiences of violence due to discrimination (36% physically attacked, 35% sexually assaulted). Lifetime discrimination was most often attributed to sexual orientation (60%). All forms of discrimination were more severe among men from minoritized racial groups, and some forms of discrimination varied by time spent living in the USA. In interviews, discrimination was described as less severe in the USA compared to countries of origin, driven in part by religiosity and machismo. The impacts of discrimination ranged from mild and temporary to traumatic and persistent. Intervention suggestions included focusing on broad stressors, offering group- and individual options, prioritizing in-person interventions, offering trauma-informed care, and providing legal and immigration services. Findings demonstrate the need for multiple interventions to meet the varied needs, experiences, and preferences of LSMM living with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2272-2286"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699439","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":"Pre-Incarceration Healthcare Use and Access Barriers among Men with HIV and those at-Risk for Contracting HIV: A Case Study of an Urban Jail.","authors":"Victoria L Phillips, Jacob A Pluznik, Mallory E Epting, Eleni M O'Donovan, Matthew J Akiyama, Anne C Spaulding","doi":"10.1007/s10461-025-04674-2","DOIUrl":"10.1007/s10461-025-04674-2","url":null,"abstract":"<p><p>Approximately 1.5% of incarcerated people live with HIV. Limited information on their pre-incarceration healthcare use which could inform discharge planning efforts to link them to treatment is available. We investigate factors associated with pre-incarceration healthcare use and access barriers for a status-neutral HIV cohort. We collected data via self-report from men with HIV (n = 22) or at-risk of contracting HIV (n = 77) who entered the Washington, DC, Department of Corrections jail from November 2020 to June 2021. We analyzed pre-incarceration hospital, emergency department (ED), physician and mental health visits, and access barriers using t-tests, chi-square tests, and logistic regressions informed by the Anderson Behavioral Model of healthcare utilization. During the year prior to incarceration, more than half of men visited the ED, while less than 20% visited a physician. Over half the sample viewed medical care as too expensive, even though 75% were insured. Depressed men were significantly more likely to report access barriers. Homelessness was the only factor found to be significantly associated with a greater likelihood of urgent and acute care use. Neither HIV status, insurance status, educational level nor race affected healthcare use by type of service. Pre-incarceration men with or at-risk of contracting HIV have limited contact with community physicians who are critical to HIV management. Given the effect of unstable housing on the types of healthcare used, programs to promote HIV treatment and pre-exposure prophylaxis (PrEP) should consider embedding condition-specific discharge planning into an approach addressing a wider array of needs.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2107-2116"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Violence and the Increased Risk of HIV among MSM in Nigeria.","authors":"Babayemi O Olakunde, Daniel A Adeyinka, Chukwugozie Ujam, Ashenafi S Cherkos, Hidayat B Yahaya, Chinwedu D Ndukwe, James O Anenih","doi":"10.1007/s10461-025-04675-1","DOIUrl":"10.1007/s10461-025-04675-1","url":null,"abstract":"<p><p>Gay men and other men who have sex with men (MSM) are disproportionately affected by HIV and prone to sexual violence. While the association between HIV and sexual violence is well documented, the evidence is not conclusive from the few available studies among MSM in sub-Saharan Africa. The objective of this study was to estimate the prevalence of sexual violence and its association with HIV among MSM in Nigeria. The study was a secondary data analysis of the 2020 Integrated Biological & Behavioral Surveillance Survey (IBBSS) conducted among key populations in Nigeria's six geopolitical zones. Sexual violence was operationalized as self-reported forced sex by any person in the past 12 months. We performed weighted descriptive statistics and logistic regression analysis. The prevalence of sexual violence in the 4,324 MSM included in the analysis was 16.4% (95%CI = 15.3-17.5%). The highest prevalence was among MSM who reported injection drug use (49.0%, 95% CI = 41.7-56.6%), followed by those who engaged in transactional sex (29.6%, 95%CI = 27.0-32.2%). Among MSM who reported sexual violence, 36.1% (95%CI = 32.6-39.7%) tested HIV positive compared with 23.2% (95% CI: 21.8-24.6) in those who did not. After controlling for sociodemographic and behavioral characteristics, MSM who had been victims of sexual violence had higher odds of testing HIV positive (aOR = 1.87, 95%CI = 1.53-2.29). Sexual violence is prevalent and associated with HIV among MSM in Nigeria. Our findings further support the call to address sexual violence in this key population through the integration of preventive and care interventions into existing HIV programmes.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2117-2124"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623171","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":"Epidemiologic and Economic Impacts of Halting National HIV Prevention Efforts.","authors":"David R Holtgrave","doi":"10.1007/s10461-025-04757-0","DOIUrl":"10.1007/s10461-025-04757-0","url":null,"abstract":"<p><p>News outlets are reporting that CDC's HIV prevention program including its Ending the HIV Epidemic (EHE) efforts are slated to be defunded. One way to estimate the potential impacts of halting HIV prevention in the nation is to use mathematical modeling to provide informed estimates of the epidemiologic and economic impacts of this purported policy shift. We describe here a basic transmission rate model to estimate the HIV-related epidemiologic and economic horizon through 2030 as if funding were untouched and as if it were to be ended. This model is compared to other lenses through which to view the halting of national HIV prevention. Through any employed analytic lens, the result seems similar - ending HIV prevention efforts means the epidemic will get worse, lives will be lost, and not only will money not be saved but the net additional medical costs will rapidly increase. If this worsening of the epidemic comes to pass, the nation will enter the next decade far worse off than it is now, and efforts to get back to the current HIV-related \"starting place\" will need to be larger, more intensive, and much more expensive. There was a national hope that the ending of the current decade would indeed be the end of the epidemic; but if HIV prevention support is stopped, we would not be able to experience this important and joyous HIV elimination milestone in 2030 but rather be left to witness just how much worse the epidemic may get.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2033-2036"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092518","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":"Associations Between HIV-Related Stigma, Trust, and Testing Behaviors Among the General U.S. Adult Population.","authors":"Sue Hyon Kim, Stephen Bonett, José Bauermeister, Alison M Buttenheim, Laura E Starbird","doi":"10.1007/s10461-025-04684-0","DOIUrl":"10.1007/s10461-025-04684-0","url":null,"abstract":"<p><p>HIV testing is essential to achieving the 95-95-95 targets, yet lifetime HIV testing rates in the United States fall below established guidelines. Building on similar healthcare contexts where stigma hinders access and trust mitigates its negative effect, this exploratory study examined the relationship between HIV-related stigma (HRS) and testing behavior, focusing on the role of trust in healthcare providers (HCPs). We used data from the 2022 General Social Survey, a nationally representative sample of the general population. HRS was evaluated across three domains: perceived social discrimination towards people living with HIV (PLWH), avoidance due to unfounded fear of transmission, and moral judgement. Weighted stratified logistic regression was employed to examine how the relationship between HRS and testing behavior varied across different levels of trust in HCPs. Among participants with low trust in HCPs, the avoidance of PLWH due to unfounded fears was associated with lower odds of undergoing HIV testing. In the high trust group, none of the HRS domains were associated with HIV testing; instead, testing was linked to the individual's engagement in HIV-risk behaviors. Our findings reveal a complex interplay between HRS, trust, and testing behavior, highlighting the need for collective action to address misconceptions about HIV transmission and promote awareness of risk behaviors, with concurrent efforts to foster trust in HCPs.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2196-2204"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699431","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":"Online Peer Support for Youth at Higher Risk of or Living with HIV: A Qualitative Content Analysis.","authors":"Alice M Ma, Katherine A Lewis, Mahnoor Wani, Camellia Liu, Sabrina Ghalambor, Rhitishah Yuva Raju, Curtis Wong, Dallas Swendeman, Sue Ellen Abdalian, Elizabeth Arnold, Robert Bolan, Yvonne Bryson, Antwon Chaplin, W Scott Comulada, Ruth Cortado, Catherine Donahue, Maria Isabel Fernandez, Risa Flynn, Jasmine Fournier, William Gertsch, Kelsey Ishimoto, Sergio Jimenez, Tara Kerin, Jeffrey Klausner, Jody Kussin, Sung-Jae Lee, Marguerita Lightfoot, Norweeta Milburn, Jasmine Mosafer, Aaron Moses, Debra A Murphy, Karin Nielsen, Manuel A Ocasio, Diana Polanco, Wilson Ramos, Cathy J Reback, Panteha Hayati Rezvan, Mary Jane Rotheram-Borus, Wenze Tang, Yara Tapia, Demi Thomas, Stacey Urauchi","doi":"10.1007/s10461-025-04677-z","DOIUrl":"10.1007/s10461-025-04677-z","url":null,"abstract":"<p><p>With the rise of technology-based interventions for HIV risk reduction among adolescents, research is needed to assess how youth participate in these strategies. We used qualitative content analysis to examine youth's posts in an online peer support intervention through the Adolescent Trials Network (ClinicalTrials.gov NCT03134833, registered May 1, 2017) for youth at higher risk of or living with HIV. We analyzed 308 posts across 85 conversations related to sexual health from 144 peer support participants. Conversation topics included risk reduction, partner navigation, sexual activity, awareness/advocacy, and consent/harassment. Results may inform the design, adaptation, and implementation of digital peer support interventions.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2135-2143"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639360","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":"\"A Tricky Dance\": Ryan White Service Experiences Among American Indian/Alaska Native Two-Spirit and LGBTQ + People Living with HIV.","authors":"Chase Bryer, William Lodge, Paul Goulet, Julie A Baldwin","doi":"10.1007/s10461-025-04688-w","DOIUrl":"10.1007/s10461-025-04688-w","url":null,"abstract":"<p><p>Advancements in HIV treatment and care have led to a growing number of American Indian and Alaska Native (AI/AN) Two-Spirit and LGBTQ + (2S/LGBTQ +) people living with HIV. However, their experiences within the Ryan White HIV/AIDS Program (RWHAP) remain underexplored. In this brief report, we conducted a secondary qualitative analysis using reflexive thematic analysis of 15 in-depth interviews with AI/AN 2S/LGBTQ + people living with HIV. Findings revealed that many RWHAP recipients became HIV advocates, contributing to healthy aging. Participants highlighted the effectiveness of the RWHAP in addressing immediate needs, while also emphasizing the need for greater representation and culturally congruent care. Future research should focus on exploring culturally congruent care services for AI/AN 2S/LGBTQ + individuals, particularly for those aging with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2243-2248"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699429","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":"Trends in HIV Incidence among Female Sex Workers and Men who Have Sex with Men in Nairobi, Kenya, 2009-2021.","authors":"Hellen Babu, Stuart Gilmour, Mbilu Byron, Rhoda Kabuti, Festus K Muriuki, Jinghua Li, Junko Tanuma, Joshua Kimani","doi":"10.1007/s10461-025-04686-y","DOIUrl":"10.1007/s10461-025-04686-y","url":null,"abstract":"<p><p>Female Sex Workers (FSW) and men who have sex with men (MSM) in Kenya remained disproportionately burdened by HIV. Our study aims to estimate trends in HIV incidence and identify characteristics associated with the rate of infection among these populations over the past decade. Data were collected at Sex Workers Outreach Program (SWOP) in Nairobi County from 2009 to 2021. We included records of 3,595 FSW and 581 MSM with a negative HIV test at enrolment and at least one follow-up test. We compared survival time between MSM and FSW using the Kaplan Meier log-rank test and used multiple Poisson regression to estimate incidence rate ratios. A steady decline in HIV infection was observed from 2009 to 2019 but increased in 2020 and 2021. The crude incidence rate was 1.46 (95% CI: 1.29-1.65) cases per 100 person-years. The incidence rate among MSM was 8.08 (6.73-9.69) per 100 person-years and 0.8 (95% CI: 0.7-1.0) per 100 person-years of follow-up among the FSW. In multivariate analysis, MSM had 16.14 times the risk of HIV infection compared to FSW (95% CI: 9.20-28.32), with relative risk declining in older age groups until over 50, where MSM and FSW experienced similar risk. For every successive year since 2009, the risk of HIV infection declined (annual IRR:0.73, 95% CI: 0.71-0.75). Continued and accelerated efforts targeted at MSM and FSW are needed to ensure the observed decline in HIV incidence continues in line with the UNAIDS-2030 global targets.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2226-2233"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787427","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":"Challenges Faced by Perinatally-Infected Kenyan Adolescents and Youth Living with HIV During the COVID-19 Pandemic.","authors":"Manjot Singh, Winstone Nyandiko, Allison Delong, Celestine Ashimosi, Dennis Munyoro, Janet Lidweye, Jack Nyagaya, Whitney Biegon, Josephine Aluoch, Ashley Chory, Edwin Sang, Eslyne Jepkemboi, Millicent Orido, Vladimir Novitsky, Joseph W Hogan, Rachel Vreeman, Rami Kantor","doi":"10.1007/s10461-025-04689-9","DOIUrl":"10.1007/s10461-025-04689-9","url":null,"abstract":"<p><p>Wellness challenges experienced by adolescents and youth living with HIV (AYLWH) during COVID-19 are unknown and could guide HIV care in resource-limited settings. Between February/2021 and July/2022, perinatally-infected AYLWH at the Academic Model Providing Access to Healthcare (AMPATH) in western Kenya completed surveys assessing psychological, physical, socioeconomic, and antiretroviral nonadherence challenges and underwent viral load (VL) testing evaluating for virologic (VL > 40 copies/mL) or treatment (VL > 1,000 copies/mL) failure. Patterns in challenges, nonadherence, and VL measures by enrolment were evaluated using general additive models. Associations between challenges and nonadherence scores were quantified using linear regression; associations between non-adherence and failure were quantified using logistic regression. Both were adjusted for age, gender, and clinic. Among 442 participants enrolled in this cross-sectional study (median age 17 years, 49% female), 89% reported challenges (48% psychological, 66% physical, 62% socioeconomic) and 74% reported nonadherence. Significant between-individual variations by enrolment date were noted in physical challenges (e.g., illnesses and hospitalizations). Reporting more psychological, physical, or socioeconomic challenges were each associated with higher nonadherence. Higher nonadherence was associated with virologic and treatment failure (OR = 1.22 per 1-unit higher nonadherence, 95% CI = 1.01-1.47, p < 0.036; and OR = 1.29, 95% CI = 1.01-1.64, p < 0.035, respectively). Kenyan AYLWH faced psychological, physical, and socioeconomic challenges during the COVID-19 pandemic. Although longitudinal studies are needed to determine whether these challenges exceed pre-pandemic levels or contribute to the observed increased antiretroviral nonadherence and treatment failure, our findings provide support for the important relationships among these measures and may help clinicians and caregivers identify opportunities for interventions to support this vulnerable population.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2249-2257"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668854","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":"Evaluation of a Phone-Based Program to Increase Adherence to Antiretrovirals Among PLWH: A Pilot Study.","authors":"Sri Yona, Rita Ismail, Elly Nurachmah, Syamilatul Khariroh, Untung Sujianto, Windu Santoso, Sulistyo Asmoro Bangun, Joachim G Voss","doi":"10.1007/s10461-025-04681-3","DOIUrl":"10.1007/s10461-025-04681-3","url":null,"abstract":"<p><p>Adherence to antiretroviral therapy (ART) is a major challenge for people living with HIV (PLWH). The purpose of this pilot study was to evaluate the six criteria for a phone-based intervention program for PLWH in Indonesia using a mixed methods feasibility study design. PLWH were included who took ART for at least 3 months, who had a cell phone, access to the internet, and the WhatsApp application. Thirty eligible respondents completed demographic information and shared their daily ART frequency during the enrolment visit. Motivational and health promotion messages were sent in the form of text message, images, and video links 30 min before their scheduled medication time for 3 months (October-December 2020). All respondents were retained until the end of the program. Necessity: Identified a need to be reminded when their ARTs were due. Feasibility: The participants were used to WhatsApp in their daily lives. Acceptability: The respondents responded well to the messages. Safety: None of the respondents experienced a mental distress due to involuntary HIV disclosure or stigma. Fidelity: The program delivered 79 to 91% of the messages. Challenges of the phone-based program centred around technical issues, human error user error, and environmental problems. Cost: The program could be delivered for less than $3 a day. The program met the six criteria for a useful intervention and can be applied to promote adherence to ART in remote regions of Indonesia.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":"2168-2178"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699433","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}