AIDS and Behavior最新文献

{"title":"Exploring Perceptions of HPV Risks and Motivations to Vaccination in MSM at a Community-Based HIV Clinic.","authors":"Johnathon S Lueck, Lovesimrjit S Sandhu, Jessica Richman, Crystal Walker, Jon Philip Trujillo, Daniel Callahan, Aidan Collier Smith, Srinivas J Ivatury","doi":"10.1007/s10461-025-04752-5","DOIUrl":"https://doi.org/10.1007/s10461-025-04752-5","url":null,"abstract":"<p><p>Anal cancer incidence has risen significantly over the past four decades, with HIV-positive men who have sex with men (HIV + MSM) facing a disproportionately higher disease burden. Although human papillomavirus (HPV) vaccination can prevent most HPV-related cancers, uptake remains low within this population. To explore perceptions of HPV infection and vaccination, this study employed a cross-sectional survey based on the Health Belief Model (HBM). Recruitment took place at a federally qualified health center in Austin, Texas, serving primarily low-income people living with HIV. Biological males over 18 years old, who have sex with men and are HIV-positive, were eligible. A 36-item survey assessed demographics, sexual behavior, and awareness of HPV and the HPV vaccine within the context of the HBM. Among 49 participants, only 22.45% had received at least one dose of the HPV vaccine. Of those who were unvaccinated, only 23.68% planned to receive the HPV vaccine within the next six months. Overall HPV knowledge was low, with fewer than half recognizing HPV's role in anal cancer. Among the vaccine acceptance group (participants who were vaccinated or intended to be vaccinated), there was a higher perceived severity of HPV-related disease, greater perceived benefits of vaccination, fewer perceived barriers, and a stronger response to physician recommendations. Cost was the only barrier notably linked to non-acceptance. These findings highlight an urgent need to address gaps in awareness of HPV's link to anal cancer and underscore how key HBM constructs-particularly high perceived severity and benefits, and low barriers-predict vaccine acceptance. Interventions should focus on informing HIV + MSM about their susceptibility and emphasizing healthcare provider recommendations. Although the small sample size and single-site recruitment limit generalizability, this study offers critical insights into HPV-related perceptions among HIV + MSM, underscoring the importance of targeted strategies to boost vaccination and reduce HPV-related cancer in this underserved group.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197997","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":"Preexposure Prophylaxis for HIV Prevention: Awareness and Interest among a Northern Midwestern US Indigenous Population.","authors":"Allison O'Rourke, Sean T Allen, Kristin E Schneider, Molly C Reid, Maisie Conrad, Pamela Hughes, Melissa Walls","doi":"10.1007/s10461-025-04775-y","DOIUrl":"https://doi.org/10.1007/s10461-025-04775-y","url":null,"abstract":"<p><p>American Indians/Alaska Natives (hereafter referred to as \"Indigenous Peoples\") experience inequities in rates of HIV infection. Pre-exposure prophylaxis (PrEP) holds considerable potential for reversing HIV inequities among Indigenous Peoples; however, little research has explored PrEP awareness and interest within Indigenous contexts. This research explores PrEP awareness and interest among a population of Indigenous People in the Northern Midwestern United States. We conducted a survey on the reservation lands of a Tribal community in Fall 2022 that included measures of demographics, sociostructural factors, health behaviors, substance use, and PrEP awareness and interest. Eligibility criteria included being aged 18 years or older and having ever used drugs. The analytic sample consisted of surveys from 224 individuals who self-identified as Indigenous and did not report current PrEP use or HIV diagnosis. Univariate and bivariate analyses were conducted to examine differences in PrEP awareness and interest. Approximately one in four (27.7%) participants reported PrEP awareness prior to taking the survey and 17.0% indicated they were interested in taking PrEP. Recent HIV testing was associated with increased PrEP awareness. PrEP interest was significantly associated with reporting: not having health insurance, 2 or more sexual partners in past 6 months, past year STI testing, past year HIV testing, past 6-month drug use, and past 6-month injection drug use. Indigenous participants who reported behaviors associated with increased risk of acquiring HIV were significantly more interested in PrEP utilization. Steps should be taken to increase culturally responsive PrEP awareness and access in Indigenous communities.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197998","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":"Traditional Health Practitioners-Initiated HIV Testing and Counselling: Perspectives from Health Care Workers, Healers and Clients in Rural South Africa.","authors":"Jennifer Hove, Praise Mnisi, Wonderful Mabuza, Ryan G Wagner, Tshegofatso Seabi, Carolyn M Audet","doi":"10.1007/s10461-025-04761-4","DOIUrl":"https://doi.org/10.1007/s10461-025-04761-4","url":null,"abstract":"<p><p>A considerable proportion of people living with HIV remain unaware of their HIV status. In South Africa, individuals in rural areas often receive health care from both allopathic providers and traditional health practitioners (THPs). Our team piloted a task-shifting pilot study to determine the feasibility of THP-led HIV counselling and testing. Our team conducted semi-structured, qualitative interviews with healthcare workers, THPs who completed HIV counselling and testing training, and clients who received a positive test result. Interviews focused primarily on participant opinions about, and experiences with, the intervention and their perspectives on how (and if) this partnership should be maintained. Transcripts were analyzed by two authors, employing phenomenological thematic coding using the socio-ecological model. Our team conducted 33 interviews: 12 with healthcare workers, 11 with THPs, and 10 with clients who received a positive test result. A combination of deeply rooted cultural beliefs in the value of traditional medicine and dissatisfaction with the allopathic health services led most participants to value the introduction of THP-led testing. Concerns about THPs' ability to deliver testing was raised by healthcare workers, but clients reported that THPs delivered testing with fidelity. Several participants spoke about the importance of integrating THPs into the national health system to ensure they had access to test kits and support from clinicians. Integrating THPs into the health system will require the organization of a government-led training program and the creation of an official position for trained THPs within their local clinic.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191273","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":"A Focused PrEP Outreach and Navigation Demonstration Project Using STD Surveillance Data.","authors":"Teagen L O'Malley, Harley Roth, M Reuel Friedman, Michelle Rossi, Sarah E Krier","doi":"10.1007/s10461-025-04754-3","DOIUrl":"https://doi.org/10.1007/s10461-025-04754-3","url":null,"abstract":"<p><p>Despite significant advances in availability of HIV prevention strategies, missed linkages to PrEP continue for individuals who may benefit, including those with a recent STD diagnosis. Given the persistent racial, ethnic, and gender disparities in HIV and STD acquisition, and similar disparities in PrEP coverage, there is a need for novel interventions linking communities across health care settings to comprehensive HIV prevention counseling and services. This article provides a comprehensive overview of the implementation and associated evaluation design of a demonstration project that leverages Pennsylvania's STD surveillance database to identify individuals with a history of recurrent incident STDs and provide them with individualized HIV prevention navigation services. Implementation resulted in the enrollment of149 participants and demonstrated the feasibility of integrating STD surveillance data with prevention navigation to expand PrEP outreach. We present a detailed overview of the evaluation design and implementation of the data-to-HIV prevention model, including a description of the enrolled participants' baseline characteristics, along with feasibility and lessons learned when considering a similar strategy for expanding PrEP outreach.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186276","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":"Undermining America's HIV Prevention Capacity: Wrong and Dangerous.","authors":"Ronald O Valdiserri","doi":"10.1007/s10461-025-04770-3","DOIUrl":"https://doi.org/10.1007/s10461-025-04770-3","url":null,"abstract":"","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179812","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 Acceptability of a Tenofovir-Based Rectal Microbicide Douche among Young Men who Have Sex with Men: Results from ATN-DREAM (ATN 163).","authors":"José A Bauermeister, Willey Lin, Jessica Webster, Louis L Listerud, Tyler Burgese, Allison Agwu, Jessica Coleman Lewis, Thuy Anderson, Lisa Hightow-Weidman, Craig Hendrix, Renata Arrington-Sanders","doi":"10.1007/s10461-025-04763-2","DOIUrl":"10.1007/s10461-025-04763-2","url":null,"abstract":"<p><p>Young men who have sex with men (YMSM) remain disproportionately affected by HIV, yet adherence to daily oral pre-exposure prophylaxis (PrEP) remains suboptimal. Rectal microbicides formulated as douches offer a behaviorally congruent alternative by leveraging existing douching practices. This study assessed the acceptability of a tenofovir-based rectal microbicide douche among YMSM. Eight YMSM (M = 20.9 years; range 18-24 years) participated in a Phase I, open-label, single-arm trial evaluating the safety, pharmacokinetics, and tolerability of a single 600 mg dose of tenofovir delivered in a 125mL rectal douche (NCT04686279). This mixed-methods study included post-dosing behavioral surveys and qualitative in-depth interviews (IDIs) to assess acceptability, tolerability, and perceptions of the product's usability. Interviews were transcribed, coded, and analyzed thematically. Descriptive statistics summarized participant characteristics, douching behaviors, and willingness to use the product in different contexts. Participants reported high acceptability of the rectal microbicide douche, particularly its ease of use and integration into existing sexual health routines. Most (87.5%) indicated they would find the product acceptable for HIV prevention, and 75% reported they would likely use it before every receptive anal intercourse (RAI) event. The episodic dosing regimen was perceived as a benefit, especially for casual sexual encounters. Barriers included product design concerns, privacy, and cost. A rectal microbicide douche was highly acceptable among YMSM, supporting its potential as a novel HIV prevention strategy. Findings underscore the importance of behaviorally congruent interventions and highlight key considerations for future product development, including improved packaging, affordability, and accessibility.Trials Registration: NCT04686279.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172280","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 Lived Experiences of Unhealthy Alcohol Use among Young People with HIV in Southwestern Uganda.","authors":"Raymond Felix Odokonyero, Wilson W Muhwezi, Khamisi Musanje, Naomi Sanyu, Winnie R Muyindike, Anne R Katahoire, Carol S Camlin, Judith A Hahn, Noeline Nakasujja","doi":"10.1007/s10461-025-04712-z","DOIUrl":"https://doi.org/10.1007/s10461-025-04712-z","url":null,"abstract":"<p><p>Unhealthy alcohol use among adolescents and young adults living with HIV (AYAH), is common and poses risks to their health and social wellbeing. However, research that explores comorbid unhealthy drinking and HIV among AYAH is limited in Uganda. We conducted semi-structured in-depth interviews with 14 AYAH who self-reported current alcohol use, recruited from the adolescent immunosuppression (ISS) clinic of Mbarara Regional Referral Hospital in Southwestern Uganda. We explored AYAH's lived experiences with unhealthy alcohol use within the context of HIV. We tape-recorded the interviews, transcribed them verbatim, and used thematic analysis to uncover themes. Five themes emerged relating to AYAH's experiences with unhealthy alcohol use: (1) self-control: AYAH perceived that they had self-determination in the initiation, use, and termination of their drinking. (2) Purpose and meaning: Drinking served the purpose of arousing emotions like happiness, bringing pride, and helping AYAH make friends. (3) Parental monitoring: Parents and caregivers disapproved of excessive drinking leading AYAH to sometimes tell lies to get al.cohol. (4) Use experience: Following alcohol consumption, AYAH experienced effects of intoxication, withdrawal, and sometimes blackouts but these were expected. (5) Disconnection: AYAH with unhealthy drinking attracted a negative image for self and family, as well as HIV-related stigma. The themes improve our understanding of AYAH's alcohol experiences and provide a basis for designing adolescent HIV clinic-level interventions. Interventions should address AYAH's alcohol expectations, re-orient their purpose and meaning to healthier habits, mobilize parental supervision, and provide judgment-free care, delivered by their usual care providers.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172335","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 Effect of Behavioral Regulation on Condomless Anal Sex Among Young Sexual Minority Men: Influences of Sex-Related Substance Use, Partnership Type, and PrEP Use.","authors":"Stephen D Ramos, Bryce F Stamp, Kimberly A Powers, Lisa Hightow-Weidman, Erik D Storholm, Zachary R Soberano, Jacob B Stocks, Matthew T Rosso, Keith J Horvath","doi":"10.1007/s10461-025-04753-4","DOIUrl":"https://doi.org/10.1007/s10461-025-04753-4","url":null,"abstract":"<p><p>The disproportionate HIV burden among young sexual minority men (YSMM) necessitates the study of neurodevelopmental decisional factors impacting transmission-relevant behaviors. We investigated the impact of behavioral regulation on condomless anal sex among YSMM, considering PrEP use, partnership type, and substance use as potential effect measure modifiers. YSMM (n = 120) completed an online baseline survey assessing behavioral regulation, PrEP use, and sociodemographics, and digital daily surveys on sexual behaviors, substance use, and partner type over eight weeks. We used modified Poisson regression, controlling for age, race, ethnicity, and education, to examine the relationship between behavioral regulation index (BRI) scores and condom use during anal sex. We used interaction terms to assess effect measure modification by substance use before or during sex and partnership type, stratified by PrEP use status. Difficulties in behavioral regulation (higher scores) increased the probability of condomless sex while using substances, but this association was not present in the absence of substance use. Behavioral regulation difficulties also contributed to a higher probability of condomless sex with main partners among PrEP non-users. Higher BRI scores were linked to condomless sex in particular contexts (i.e., sex with substances or main partners). These findings highlight the complex relationships between behavioral regulation and sexual behavior in the context of biomedical HIV prevention options and relationship dynamics for YSMM.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172297","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":"Identifying Syndemic Factors and Their Effect on HIV Sexual Risk Behavior Among Gay, Bisexual and Other Men Who Have Sex with Men in Vancouver, Montreal and Toronto.","authors":"Felipe Duailibe, Tian Shen, Wendy Zhang, David Moore, Mark Hull, Justin Barath, Carly Magee, Nathan Lachowsky, Trevor Hart, Joseph Cox, Daniel Grace, Gilles Lambert, Shayna Skakoon-Sparling, Jody Jollimore, Milada Dvorakova, Aki Gormezano, Viviane Dias Lima","doi":"10.1007/s10461-025-04769-w","DOIUrl":"https://doi.org/10.1007/s10461-025-04769-w","url":null,"abstract":"<p><p>We set out to identify syndemic factors associated with HIV sexual risk behavior among HIV-negative gay, bisexual and other men who have sex with men (GBM), and examine associations between syndemic factors and HIV sexual risk behaviors using models of co-occurring epidemics. We used baseline data from 1571 sexually active GBM from the Engage Cohort study, recruited using respondent-driven sampling in Montreal, Toronto, and Vancouver. We explored associations between potential syndemic factors and HIV sexual risk behavior, and used oblique component analysis to reduce the number of variables. Path analysis and logistic regression with interaction terms were used to evaluate the association of syndemic factors with HIV sexual risk behavior. In the mediation model, childhood sexual abuse (CSA) was associated with HIV sexual risk behavior (total effect: c = 0.14, 95% CI 0.06-0.21). This effect was mediated by any intimate partner violence (IPV), transactional sex, polysubstance use, and sexual compulsivity. We observed a multiplicative interaction between CSA and transactional sex: GBM with a history of both had 14 times the odds of HIV sexual risk behavior (aOR of 14.0 95% CI 5.6-35.2) compared to those with neither. The appropriate application of a syndemic approach allowed a nuanced assessment of syndemic factor associations with HIV sexual risk behavior. IPV, transactional sex, sexual compulsivity, and polysubstance use mediated the effect of CSA on HIV sexual risk behavior. Additionally, we found a significant multiplicative interaction between CSA and transactional sex.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126430","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":"Four-Year Experience of HIV Pre-exposure Prophylaxis (PrEP) from an Italian Multicentre Cohort: Incidence of Sexually Transmitted Infections and Renal Toxicity.","authors":"Marianna Menozzi, Maria Daria Di Trapani, Giulia Jole Burastero, Sara Volpi, Gianluca Cuomo, Maria Mazzitelli, Francesco Barbaro, Laura Labate, Anna Maria Cattelan, Antonio Di Biagio, Cristina Mussini","doi":"10.1007/s10461-025-04736-5","DOIUrl":"https://doi.org/10.1007/s10461-025-04736-5","url":null,"abstract":"<p><p>Pre-Exposure Prophylaxis (PrEP) with Tenofovir-Disoproxil/Emtricitabine (TDF/FTC) is efficacious for HIV prevention. PrEP users might be more exposed to other sexually transmitted infections (STIs) and toxicities. Our aim was to evaluate the trend of STIs and toxicities in an Italian PrEP cohort. A retrospective multicentre cohort study (Modena, Genova and Padova) including TDF/FTC-PrEP users followed from Jan-2019 to Jul-2022. Data collection included demographics, toxicities and STIs detection: N.gonorrhoeae (NG), C.trachomatis (CT), M.genitalium (MG), T.vaginalis (TV), T.pallidum (TP), HAV, HBV and HCV. Two-hundred-forty-four persons included: 97% males; median age 39 years (IQR 33-47). A nearly incremental trend was recorded in NG and MG incidences, especially after 2020: from 5.7% to 2.3% in 2020, to 10.3% and 6.5% in 2021 and to 9.6% and 4.8% in the first 7 months of 2022. CT and TP presented a variable trend, while only two TV diagnoses were done. The test for trend for ordered groups across years showed no statistical significance for all the STIs and the annual proportions of subjects with multiple STIs varied. At logistic regression, only history of STIs was associated to risk of new STIs. Twenty cases of nephrotoxicity were recorded, leading to PrEP interruption in 1 case only. Concluding, STIs incidence and nephrotoxicity in our cohort were consistent with other data from literature. In 2020 we observed a lower STIs incidence, probably as consequence of COVID-19 restrictions. An incremental trend could be hypothesized regarding NG, MG and CT incidence. Thus, we suggest STIs monitoring, prophylaxis and treatment to contain their spread among PrEP users.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118565","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}