AIDS and Behavior最新文献

{"title":"Stigma, Discrimination and Other Social-Structural Factors Associated with Barriers to Counselling or Therapy among Women Living with HIV Who have Experienced Violence in Metro Vancouver, Canada","authors":"Colleen Dockerty,&nbsp;Kate Shannon,&nbsp;Wendee Wechsberg,&nbsp;Colleen Thompson,&nbsp;Mary Kestler,&nbsp;Melissa Braschel,&nbsp;Kathleen Deering","doi":"10.1007/s10461-024-04456-2","DOIUrl":"10.1007/s10461-024-04456-2","url":null,"abstract":"<div><p>Women living with HIV face high social and structural inequities that place them at heightened risk for gender-based violence and mental health conditions, alongside health services access inequities, with almost no research done to better understand access to mental health services. This study therefore examined social and structural factors associated with barriers to counselling or therapy amongst women living with HIV who experienced lifetime physical and/or sexual violence in Metro Vancouver, Canada. Bivariate and multivariable logistic regression using generalized estimating equations (GEE) were used and adjusted odds ratios (AOR) and 95% Confidence Intervals ([95%CIs] are reported). From Sept/15-Aug/21, 1695 observations were collected among 279 participants. In multivariable analysis, with all variables measured in the last six months, experiencing any barriers to counselling or therapy was significantly associated with having thoughts or attempts of suicide (AOR:1.64 [1.02–2.66]), lacking coverage for health care (AOR:1.60 [1.17–2.18]), and everyday discrimination (AOR:1.02 [1.00-1.04]) and anticipated (AOR:1.57 [1.04–2.36]), enacted (AOR:1.48 [1.02–2.16]) or internalized (AOR:1.53 [1.07–2.20]) HIV stigma. Access to interdisciplinary mental health care services should be improved. Social and structural interventions to reduce HIV stigma and discrimination are urgently needed.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"28 11","pages":"3919 - 3928"},"PeriodicalIF":2.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279033","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":"Technology-Based Interventions, with a Stepped Care Approach, for Reducing Sexual Risk Behaviors and Increasing PrEP Initiation Among Transgender and Gender Expansive Youth and Young Adults.","authors":"Cathy J Reback, Demetria Cain, Joshua A Rusow, David Benkeser, Lindsey Schader, Bevin A Gwiazdowski, Simone J Skeen, Marissa Hannah, Marvin Belzer, Marne Castillo, Kenneth H Mayer, Mary E Paul, Jonathan Hill-Rorie, Nathan Dorcey Johnson, Julie McAvoy-Banerjea, Travis Sanchez, Lisa B Hightow-Weidman, Patrick S Sullivan, Keith J Horvath","doi":"10.1007/s10461-024-04513-w","DOIUrl":"https://doi.org/10.1007/s10461-024-04513-w","url":null,"abstract":"<p><p>TechStep was a technology-based trial, with a stepped care approach, to reduce sexual risks and increase PrEP uptake among transgender and gender expansive youth and young adults (15-24 years old). From October 2019 to September 2021, 254 participants were randomized into: 1) Text (n = 82), or 2) Webapp (n = 87), or 3) Control (n = 85). At the 3-month follow-up assessment, those randomized to Text and Webapp and did not demonstrate improvement on primary outcomes were re-randomized to receive virtual eCoaching (Text + or Webapp +), or to remain in their initial condition without eCoaching. Results showed no effect on condomless encounters at 6-month, the primary endpoint, when comparing the Webapp + (0.33 decrease; 95%CI: -0.01, 0.67, p-value = 0.057) or the Text + (0.27 decrease; 95%CI: -0.13, 0.68, p-value = 0.181) conditions to the Control condition. However, in secondary analyses, condomless encounters were significantly reduced for Text compared to Control. The rate of PrEP uptake was low for all study arms.Trial registration: Clinical Trials # NCT04000724 (registered June 26, 2019).</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279034","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 Scoping Review of Factors Associated with HIV Acquisition in the Context of Humanitarian Crises","authors":"Dini Harsono, Swarali Atre, Hanna Peterson, Kate Nyhan, Dina Garmroudi, J. Lucian Davis, Winnie Ho, Kaveh Khoshnood","doi":"10.1007/s10461-024-04504-x","DOIUrl":"https://doi.org/10.1007/s10461-024-04504-x","url":null,"abstract":"&lt;p&gt;Humanitarian crises—natural or human-made events that can threaten communities’ health, safety, security, and well-being—may affect the HIV epidemic dynamics. Common aspects of humanitarian crises such as poverty, powerlessness, disruptions to the health systems, and social instability can contribute to a person’s vulnerability to HIV infection through increased risk behaviors and limited access to health services. Guided by the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) reporting guidelines, we conducted a scoping review of literature published in English between January 1990 and March 2022 to characterize the global evidence of modifiable and non-modifiable factors for HIV acquisition in the context of humanitarian crises. We systematically searched, screened, and synthesized literature from MEDLINE, Embase, Global Health (all accessed via Ovid), and Scopus, and also grey literature through websites of humanitarian agencies and relevant non-government organizations, the International AIDS Society’s abstract databases, and Google Scholar. We considered studies presenting empirical data on HIV prevalence, incidence, or risk factors in humanitarian crises-affected populations, including refugees, asylum seekers, and internally displaced persons. Forty-nine studies met the inclusion criteria. The majority of studies were quantitative (n = 43, 87.8%) and cross-sectional (n = 37, 75.5%) in design. Most were single-country studies (n = 43, 87.8%) and conducted in Sub-Saharan Africa (n = 31, 63.3%). We identified 5 non-modifiable factors for HIV acquisition (i.e., age, gender, location, place of birth or origin, and ethnicity) and 60 modifiable factors that we further classified into five categories, namely 18 policy and structural, 9 sociocultural, 11 health and mental health, 16 sexual practice, and 6 humanitarian crisis-related traumatic event factors. Within the modifiable categories, factors that were most often investigated were education level, marital status, sexually transmitted infection diagnosis, condom use, and experience of rape or sexual trauma, respectively. Informed by the findings, we applied the social-ecological model to map the identified multidimensional factors associated with HIV acquisition at the levels of individual, social and sexual networks, community, public policy, and the context of humanitarian crises. The current review provides a comprehensive, global analysis of the available evidence on HIV prevalence, incidence, and risk factors in humanitarian crises and implications for potential programs and research. Future research is warranted to further understand the directionality of the non-modifiable and modifiable factors affecting HIV acquisition, and the multilevel barriers and facilitators to the uptake of HIV prevention strategies in the context of humanitarian crises. Such research ","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"40 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263067","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 of County-Level Social Determinants of Health with COVID-19 Related Hospitalization Among People with HIV: A Retrospective Analysis of the U.S. National COVID Cohort Collaborative (N3C)","authors":"Jessica Y. Islam,&nbsp;Eric Hurwitz,&nbsp;Dongmei Li,&nbsp;Marlene Camacho-Rivera,&nbsp;Jing Sun,&nbsp;Sandra Safo,&nbsp;Jennifer M. Ross,&nbsp;Kenneth Wilkins,&nbsp;Shukri Hassan,&nbsp;Elaine L. Hill,&nbsp;Bohdan Nosyk,&nbsp;Cara Varley,&nbsp;Nada Fadul,&nbsp;Charisse Madlock-Brown,&nbsp;Rena C. Patel,&nbsp;the N3C consortium","doi":"10.1007/s10461-024-04466-0","DOIUrl":"10.1007/s10461-024-04466-0","url":null,"abstract":"<div><p>Individually, the COVID-19 and HIV pandemics have differentially impacted minoritized groups due to the role of social determinants of health (SDoH) in the U.S. Little is known how the collision of these two pandemics may have exacerbated adverse health outcomes. We evaluated county-level SDoH and associations with hospitalization after a COVID-19 diagnosis among people with (PWH) and without HIV (PWOH) by racial/ethnic groups. We used the U.S. National COVID Cohort Collaborative (January 2020-November 2023), a nationally-sampled electronic health record repository, to identify adults who were diagnosed with COVID-19 with HIV (n = 22,491) and without HIV (n = 2,220,660). We aggregated SDoH measures at the county-level and categorized racial/ethnic groups as Non-Hispanic (NH) White, NH-Black, Hispanic/Latinx, NH-Asian and Pacific Islander (AAPI), and NH-American Indian or Alaskan Native (AIAN). To estimate associations of county-level SDoH with hospitalization after a COVID-19 diagnosis, we used multilevel, multivariable logistic regressions, calculating adjusted relative risks (aRR) with 95% confidence intervals (95% CI). COVID-19 related hospitalization occurred among 11% of PWH and 7% of PWOH, with the highest proportion among NH-Black PWH (15%). In evaluating county-level SDoH among PWH, we found higher average household size was associated with lower risk of COVID-19 related hospitalization across racial/ethnic groups. Higher mean commute time (aRR: 1.76; 95% CI 1.10–2.62) and higher proportion of adults without health insurance (aRR: 1.40; 95% CI 1.04–1.84) was associated with a higher risk of COVID-19 hospitalization among NH-Black PWH, however, NH-Black PWOH did not demonstrate these associations. Differences by race and ethnicity exist in associations of adverse county-level SDoH with COVID-19 outcomes among people with and without HIV in the U.S.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"28 1 supplement","pages":"136 - 148"},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10461-024-04466-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263222","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":"PrEP Stigma as a Minority Stressor among Black Sexual Minority Men: A Mixed-Methods Study","authors":"Rodman Turpin, Aaron D. Camp, C. J. Mandell, Julia Mandeville, Rochelle R. Davidson Mhonde, Jamil Smith, Hongjie Liu, Typhanye Dyer, Kenneth H. Mayer, Bradley Boekeloo","doi":"10.1007/s10461-024-04481-1","DOIUrl":"https://doi.org/10.1007/s10461-024-04481-1","url":null,"abstract":"<p>Black sexual minority men (BSMM) remain disproportionately affected by HIV, yet Pre-exposure prophylaxis (PrEP) uptake in this population remains relatively low. Informed by minority stress theory, PrEP stigma may manifest in and exacerbate societal marginalization based on sexuality and race. We used an exploratory sequential mixed-methods approach to determine if PrEP-specific stigma was associated with reduced PrEP uptake among BSMM, and qualitatively explored how PrEP use is stigmatized among BSMM. We analyzed cross-sectional data from a pilot sample of BSMM (<i>n</i> = 151) collected in late 2020 in the United States, testing for associations between PrEP stigma and PrEP use using modified Poisson regression. Subsequently, we selected participants (<i>n</i> = 23) from this sample for qualitative interviews starting in 2022. Responses to questions related to PrEP stigma were analyzed using thematic analysis. PrEP stigma was associated less than half the PrEP use (aPR = 0.43, 95% CI = 0.24, 0.75) among BSMM after adjustment. Qualitatively, we identified three major themes in how PrEP use is stigmatized among BSMM: PrEP-specific sexual stigma, intersections between PrEP and HIV stigma, and PrEP misinformation and disinformation. Aligned with minority stress theory, each theme was based in part in stigma related to sexuality or race. We found strong relationships between PrEP stigma and PrEP use independent of several sociobehavioral factors. Each of our themes were based in part in minority stressors, and underscore the importance of culturally competent PrEP promotion efforts towards BSMM. Addressing stigma is a core component of health equity efforts towards ending the HIV epidemic.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"45 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263225","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":"Profile of Persons Recently Infected with HIV-1 in Belgium: New Insights to Tailor Prevention Efforts","authors":"C. Vanden Bulcke, J. Deblonde, C. Necsoi, J. Van Praet, E. Van Cutsem, L. Mertens, F. Vanroye, K. Stoffels, L. Debaisieux, V. Mortier, S. Callens, C. Verhofstede","doi":"10.1007/s10461-024-04488-8","DOIUrl":"https://doi.org/10.1007/s10461-024-04488-8","url":null,"abstract":"<p>Despite wide availability of prevention and treatment services, including the ongoing roll-out of pre-exposure prophylaxis (PrEP), the HIV epidemic is not under control in Belgium. Hence, there is a recognized need to improve case finding and early diagnosis to curb the further spread of HIV more effectively. The objective of the present study was to improve insight into the profiles of persons recently infected with HIV-1 and on their prevention trajectory. Between May 2018 and December 2022, we selected persons diagnosed in Belgium within three months of the presumed infection date. We then analyzed information collected using a questionnaire covering topics on HIV testing, sexually transmitted infections (STIs), PrEP use, sexual behavior, partner notification and substance use. The data obtained were analyzed alongside information derived from phylogenetic cluster analysis of the viral source of infection. A total of 93 persons with a recent HIV-1 infection completed the questionnaire, the majority (74%) being MSM, 14% were heterosexual women and 12% were heterosexual men. Nearly one-third of participants engaged in sexual activity with an average of 2 to 5 casual partners around the presumed time of infection. A significant percentage reported frequent substance use during sexual activity (65%), being previously diagnosed with STI (65%) and using condoms infrequently (44%). 63% reported a testing frequency of at least one HIV test per year before being diagnosed and 46% notified their previous sex partner(s) after being diagnosed. Over 20% of respondents (including 11 MSM, 4 heterosexual men and 5 heterosexual women) reported exclusive sexual activity with their steady partner. Eight participants (9%, all MSM, 75% born outside of Belgium) reported PrEP use in the past. No significant differences in behavioral characteristics were found between persons who were part of a local transmission cluster (48%) and persons that were not part of a cluster (47%). The study results revealed that the majority of persons diagnosed early with HIV-1 infection in Belgium exhibited characteristics corresponding to a high-at-risk population and were aware of this risk, as evidenced by a high testing frequency. However, partner notification rates were low and use and awareness of PrEP limited. A notable group of persons not corresponding to the high-risk profiles was also identified. This information may help to expose missed opportunities for prevention and contribute to enhancing the implementation of future prevention measures.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"46 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263223","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":"Recent and Local HIV Infections among Newly Diagnosed Cases in Two Districts of Chongqing, China (2019–2021)","authors":"Yaping He, Guohui Wu, Tianyu Tan, Rongrong Lu, Wei Zhang, Chao Zhou","doi":"10.1007/s10461-024-04472-2","DOIUrl":"https://doi.org/10.1007/s10461-024-04472-2","url":null,"abstract":"<p>Newly diagnosed HIV cases often do not clearly indicate whether they are recent or long-standing infections. We collected the history of HIV antibody testing, sexual behavior and initial CD4 + T cell (CD4) count of newly diagnosed HIV/AIDS to determine the time and location of HIV infections. Of the included 612 cases, 17.3% were classified as recent HIV infection. Recent HIV infections were higher in cases aged &lt; 30 (adjusted odds ratio [AOR] = 4.267, 95% Confidence Interval [CI] 1.856–9.813) and 30–49 (AOR = 2.847, 95%CI 1.356–5.977) vs. ≥50, and the transmission mode was men who have sex with men (MSM) (AOR = 4.130, 95%CI 1.815–9.399) was higher than heterosexual contact. Of the 582 cases, 80.8% were classified as local HIV infection (An infection occurred in the two survey districts). Local HIV infections were higher in cases being single and divorced/widowed (AOR = 2.511, 95% CI 1.271–4.962) vs. being married, residing in the survey districts ≥ 5 years (AOR = 168.962, 95%CI 64.942-439.593) vs. &lt; 1 year, transmission mode was MSM (AOR = 8.669, 95%CI 2.668–28.163) vs. heterosexual contact, and acquired infections through spouses or steady partners (AOR = 11.493, 95%CI 3.236–40.819) vs. commercial partners. Both recent and local HIV infections were higher in cases whose transmission mode was MSM, we recommended using internet platforms and MSM dating apps for HIV education and intervention, promoting internet intervention tools to raise awareness about HIV and facilitate early detection.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"12 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263226","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":"Recall and Appraisal of the Risks, Benefits, and Objectives of Interrupting HIV Treatment in an HIV Cure-Related Study","authors":"Anastasia Korolkova, Samuel O. Ndukwe, Lynda Dee, Steven G. Deeks, Michael J. Peluso, Rebecca Hoh, Antonio Rodriguez, Jeremy Sugarman, Lidia Rodriguez Garcia, Karine Dubé, John A. Sauceda","doi":"10.1007/s10461-024-04485-x","DOIUrl":"https://doi.org/10.1007/s10461-024-04485-x","url":null,"abstract":"<p>The goal of HIV cure research is to either eliminate HIV from the body or durably suppress it in the absence of antiretroviral therapy (ART). This research often requires participants to interrupt ART. However, there are numerous risks associated with ART interruptions and therefore it is critical to understand how people with HIV (PWH) who participate recall the elements of consent, to safeguard their rights and welfare. Participants were recruited from the SCOPE Analytic Treatment Interruption (SCOPE-ATI: NCT04359186) study at the University of California San Francisco. We interviewed 12 SCOPE-ATI participants to assess their recall of informed consent elements and therapeutic misconception, using the Brief Informed Consent Evaluation Protocol (BICEP). Interviewees were primarily older adults, male, White, and non-Hispanic/Latinx. Their responses indicated that they understood the primary purpose of the SCOPE-ATI study to be scientific research. Nearly all participants demonstrated high recall of key elements of consent and no therapeutic misconception. We also found that the role of study staff was a major factor in participants’ appraisal of risks and that associated psychosocial risks of pausing ART were of minimal concern (e.g., anxiety off ART, possible forward HIV transmission to sex partners). As HIV cure research expands, it is important to reiterate the duty of the investigative team to clearly communicate with participants about the associated risks and to assess their understanding throughout these studies.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"16 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263224","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 of Partnership Types and Quality on Cognitive Performance Among Midlife and Older Sexual Minority Men With or Without HIV","authors":"Moka Yoo-Jeong, Andrea M. Weinstein, Deanna Ware, Mark Brennan-Ing, Steven Shoptaw, Linda A. Teplin, Sabina A. Haberlen, M. Reuel Friedman, Michael W. Plankey","doi":"10.1007/s10461-024-04501-0","DOIUrl":"https://doi.org/10.1007/s10461-024-04501-0","url":null,"abstract":"<p>Partnership status among sexual minority men (SMM) is a potentially important yet underexplored predictor of cognitive functioning. Using data from the understanding patterns of healthy aging among men who have sex with men substudy of the Multicenter AIDS Cohort Study, we assessed the associations of partnership status and quality with cognitive performance in middle-aged and older SMM, adjusting for sociodemographic and clinical covariates. Partnership status was classified into four types: “only a primary partnership,” “only a secondary partnership,” “both a primary and secondary relationship,” and “neither a primary nor secondary relationship.” Partnership quality was assessed based on perceived support or strain from partners. Cognitive performance was evaluated using the <i>z</i>-scores on the Symbol Digit Modalities Test (SDMT), Trail Making Test Parts A (TMT-A) and B (TMT-B), and a composite <i>Z</i>-score that summed the SDMT, TMT-A, and TMT-B <i>z</i>-scores. Among 1067 participants (median age 60, 85.7% college educated), having a primary partner was associated with better cognitive performance (<i>Z</i>-score composite <span>(widehat{upbeta })</span>= 0.41 [95% CI 0.12–0.70]), TMT-A (<span>(widehat{upbeta })</span>= 0.16 [95% CI 0.02–0.30]), and TMT-B (<span>(widehat{upbeta })</span>= 0.19 [95% CI 0.06–0.33]). Support from secondary partners was also linked to better cognition. Additionally, there was a significant interaction between partnership and HIV status, indicating that SMM with HIV and both primary and secondary partners showed better cognitive outcomes than unpartnered SMM with HIV. These findings suggest that having a primary partner and receiving support from secondary partners may contribute to better cognitive health among middle-aged and older SMM, especially those with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"21 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269896","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":"Food Insecurity Prevalence and Risk Factors among Persons with HIV in a Southeastern US Clinical Care Setting","authors":"Lara A. Valerio, Michelle Castillo Rzepka, Thibaut Davy-Mendez, Alexia Williams, Angela Perhac, Sonia Napravnik, Seth A. Berkowitz, Claire E. Farel, Amy L. Durr","doi":"10.1007/s10461-024-04497-7","DOIUrl":"https://doi.org/10.1007/s10461-024-04497-7","url":null,"abstract":"<p>Food insecurity (FI) is associated with adverse health outcomes for persons with HIV (PWH). Little is known about FI among PWH in southern or non-urban settings. We examined FI prevalence, risk factors, and access to services in a southeastern HIV clinic. Among PWH in the UNC CFAR HIV Clinical Cohort who were screened for FI as part of HIV care between 2021 and 2022, we estimated unadjusted prevalence ratios (PRs) comparing the probability of reporting FI by demographic and clinical characteristics. The 479 PWH screened for FI were 65% cisgender men, 62% non-Hispanic Black PWH, a median of 54 years old (IQR 41–62), and 93% with an HIV viral load (VL) &lt; 200 copies/mL. FI prevalence was 36.3% (95% CI 32.3%-40.9%). Cisgender women and transgender adults were more likely to report FI than cisgender men (PRs 1.24 [95% CI 0.97–1.59] and 2.03 [1.32–3.12], respectively). Compared with White PWH, the PR was 1.71 (1.20–2.42) for Black and 2.44 (1.56–3.82) for Hispanic PWH. The PR was 1.42 (0.98–2.05) for PWH with VL ≥ 200 versus &lt; 200 copies/mL. Having no or public versus private health insurance was also associated with FI. PWH with FI had a high prevalence of comorbidities including hypercholesterolemia (49%) and hypertension (48%), though these were not associated with FI. Almost half of PWH with FI were not accessing a food pantry or nutrition assistance program. Identifying FI in PWH is critical as FI is common and may contribute to viral non-suppression, poor comorbidity control, and gender and racial/ethnic health disparities in PWH.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"61 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142226114","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}