AIDS and Behavior最新文献

{"title":"Factors Associated with ART Adherence and Sustained Viral Suppression Among US Young Adults with HIV, 2015-2022.","authors":"Kasonde M M Mwaba, Krishna Kiran Kota, Damian J Denson, Yishiow Kuo, Jen-Feng Lu, Kirk D Henny, Linda Beer","doi":"10.1007/s10461-026-05192-5","DOIUrl":"10.1007/s10461-026-05192-5","url":null,"abstract":"<p><p>US young adults with HIV (YAWH) face service accessibility, social, and structural challenges and are less likely to be adherent to antiretroviral therapy (ART) and achieve sustained viral suppression (SVS) than older adults. We examined factors associated with ART adherence and SVS among US YAWH aged 18-24 years taking ART using data from the 2015-2022 cycles of Medical Monitoring Project. We reported weighted prevalences of 100% ART dose adherence over the past 30 days and SVS over the past 12 months with 95% confidence intervals (CIs). We estimated prevalence ratios (PRs) to assess associations (p < 0.05) between adherence and SVS with key social and structural factors and health-related needs. During 2015-2022, 36.1% of YAWH were adherent and 42.9% achieved SVS. Black/African American and Hispanic/Latino YAWH were less likely to be ART adherent than White YAWH. ART adherence was less likely among YAWH who experienced homelessness, food insecurity, >1 unmet subsistence service needs, and > 1 non-HIV medical care services unmet need. Compared to White YAWH, Black/African American YAWH were less likely to achieve SVS. Not achieving SVS was associated with unemployment and homelessness. Approximately one third of YAWH had 100% ART adherence and less than half achieved SVS. There is a need for a comprehensive approach that addresses social and structural barriers to improve health outcomes among YAWH.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547511","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":"Sociodemographic and Behavioral Characteristics and HIV and Syphilis Prevalence Among Partners of Transgender Women in Buenos Aires, Argentina","authors":"Julian L. Garcia,&nbsp;Carina Cesar,&nbsp;Mariela Ceschel,&nbsp;Diego Salusso,&nbsp;Carla Petriglieri,&nbsp;Felipe Bilbao,&nbsp;Luciano Maldonado,&nbsp;Carolina F. Perez,&nbsp;Romina Caballero,&nbsp;Ines Aristegui,&nbsp;Maria Ines Figueroa,&nbsp;Pedro Cahn","doi":"10.1007/s10461-026-05172-9","DOIUrl":"10.1007/s10461-026-05172-9","url":null,"abstract":"<div><p>Transgender women (TW) bear high HIV and syphilis burden, but little is known about their partners (PTW). We conducted a cross-sectional study at a voluntary HIV-testing center in Argentina (June/2023–January/2025). PTW were individuals reporting sex with TW, regardless of other partners’ genders. We compared sociodemographic and behavioral characteristics and HIV and syphilis prevalence among PTW, men who have sex with men (MSM), and TW. We included 211 PTW, 1715 MSM, and 152 TW. PTW median age was 30 years and 65% identified as cisgender men. PTW also reported sex with cisgender women (74.9%) and men (53.6%); 22.1% reported transactional sex. HIV and syphilis prevalences in PTW (3.3%, 5.2%) were lower than TW (10.5%, 27.0%) and similar to MSM (6.1%, 8.7%). Syphilis was associated with transactional sex and inversely associated with having sex with cisgender men (p &lt; .05), underscoring the need for tailored prevention strategies for PTW.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"30 9","pages":"2789 - 2796"},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519888","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":"Do Geographic Barriers and Community Vulnerability Impact PrEP Use Among Transgender Latinas in the US South? Findings from the ChiCAS Study","authors":"Amanda E. Tanner,&nbsp;Thomas P. McCoy,&nbsp;Lilli Mann-Jackson,&nbsp;Jorge Alonzo,&nbsp;Tamar Goldenberg,&nbsp;Lucero Refugio Aviles,&nbsp;Sandy K. Aguilar-Palma,&nbsp;Eunyoung Y. Song,&nbsp;Amanda Y. Kong,&nbsp;Scott D. Rhodes","doi":"10.1007/s10461-026-05246-8","DOIUrl":"10.1007/s10461-026-05246-8","url":null,"abstract":"<div><p>Transgender (trans) Latinas in the United States face disproportionately higher HIV rates and persistently low use of pre-exposure prophylaxis (PrEP) despite awareness. While geographic access to PrEP has been identified as a barrier in other populations, little is known about how spatial access and community-level vulnerability shape PrEP use among trans Latinas in the US South. Using data from the randomized intervention-waitlist control trial of <i>ChiCAS</i> (<i>N</i> = 144), we examined (1) proximity to Spanish-language PrEP providers, (2) neighborhood vulnerability using the Social Vulnerability Index (SVI), Structural Racism Effect Index (SREI), and the Index of Concentration at the Extremes (ICE), and (3) their associations with PrEP use among trans Latinas at baseline and 6-month follow-up. Multivariable models tested whether baseline contextual factors modified intervention effects. Overall, 15.3% of participants lived in a PrEP desert (≥ 30-minute drive to a Spanish-language PrEP provider). Participants resided in highly vulnerable neighborhoods. Neither PrEP desert status nor community-level vulnerability indices were significantly associated with PrEP use at baseline or follow-up. However, SREI significantly moderated intervention effects (interaction adjusted odds ratio [aOR] = 4.55; 95% confidence interval [CI]:1.08–19.2), with greater intervention impact in areas of higher structural vulnerability. Findings suggest that structural racism, not geographic proximity, more strongly shape PrEP access and use among trans Latinas. Culturally responsive, bilingual interventions like <i>ChiCAS</i> may be particularly effective in structurally disadvantaged settings. Future efforts must address structural and social determinants alongside spatial access to achieve PrEP equity.</p></div>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":"30 9","pages":"2898 - 2907"},"PeriodicalIF":2.5,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496988","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":"Implementation of State Prescription Drug Monitoring Program Mandatory Checking Requirements and Prescribed Opioid Analgesic Use Among Women With and Without HIV in The Women's Interagency HIV Study: A Longitudinal Observational Study Using Staggered Adoption Difference-in-differences Analyses.","authors":"Danielle F Haley, Vivian F Go, Michael R Winter, Kathryn D Thompson, Ni Pengsheng, Michael P Williams, Andrew Edmonds, Alicia Diggs, David B Hanna, Mardge Cohen, Mirjam-Colette Kempf, Phyllis Tien, Morgan M Philbin, Deborah L Jones, Andrea K Knittel, Elizabeth F Topper, Gina Wingood, Jack A DeHovitz, Seble Kassaye, Leo Beletsky","doi":"10.1007/s10461-026-05218-y","DOIUrl":"10.1007/s10461-026-05218-y","url":null,"abstract":"<p><p>Implementation of prescription drug monitoring programs requiring mandatory checking when prescribing or dispensing reduces opioid analgesic (OA) prescribing. OA receipt varies by individual-level factors, including HIV status. Mandatory prescription drug monitoring program checking requirements (MPDMPs) may exacerbate inequities if prompts trigger biased decision-making around clinical need for OAs. We examined whether MPDMP implementation was associated with changes in self-reported use of prescribed OAs among women and whether associations varied by HIV status. We conducted staggered adoption difference-in-differences analyses using 11 semi-annual data waves (2014-2019) from the Women's Interagency HIV Study, a multisite observational cohort of women with and without HIV. Among 1,720 women, 71% had HIV; 61% were non-Hispanic Black. €The percentage of participants reporting prescribed OA use at baseline was comparable for women with HIV (16.5%) and without HIV (15.1%) but varied by race/ethnicity (non-Hispanic white 22.9%; non-Hispanic Black 13.6%; Hispanic 14.1%). In the adjusted model controlling for baseline age, race/ethnicity, education, HIV status, and census tract socioeconomic characteristics, MPDMP implementation was associated with a 3.6% percentage-point reduction in the probability prescribed OA use (average treatment effect on the treated = -0.036, 95% confidence interval - 0.060 to - 0.011). There was no significant evidence of variation by HIV status. MPDMPs reduce prescribed OA use in individuals. MPDMP implementation raises important questions about the role of provider bias in balancing reductions in overprescribing with maintaining access to OAs for those with special medical needs. Future research examining subgroups is needed to fully characterize MPDMP benefits and harms.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496957","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":"Acceptability, Barriers, and Facilitators to Home-Based Syphilis Self-testing: A Scoping Review.","authors":"Minjeong Kim, Michael Sanchez, Karah Greene, Christina Hersh, Troy Burks, DeAnne Turner","doi":"10.1007/s10461-026-05250-y","DOIUrl":"https://doi.org/10.1007/s10461-026-05250-y","url":null,"abstract":"<p><p>Syphilis remains a persistent global health concern despite the availability of effective treatment. Regular screening is essential for prevention and early detection, yet clinic-based testing uptake is often limited by stigma, accessibility, and lengthy procedures. Home-based syphilis self-testing has emerged as an alternative approach to expand syphilis testing access. This scoping review synthesized current evidence on acceptability, barriers, and facilitators of home-based syphilis self-testing and identified gaps in existing literature. A systematic search of peer-reviewed studies published between January 2001 and March 2025 was conducted in PubMed, CINAHL, Embase, and Scopus. This review followed PRISMA-ScR and Arksey and O'Malley's scoping review framework. Data were analyzed thematically guided by the socio-ecological model. Eight studies met the inclusion criteria. Home-based syphilis self-testing was generally acceptable across populations and settings. Most barriers and facilitators were identified at the individual level. The primary barrier that emerged was the difficulty of blood sampling through finger prick, followed by low risk perception, limited knowledge, and concerns about accuracy. Facilitators included enhanced privacy, convenience, and rapid results; prior testing experience also facilitated using a home-based syphilis self-test. Partners, healthcare providers, and community context, acted as both facilitators and barriers, influencing the individual's willingness to test. Home-based syphilis self-testing has the potential to increase syphilis testing uptake and early detection. To fully understand its potential, further research and strategies are needed to support independent testing and supportive environments, and to adopt home-based syphilis self-testing in real-world settings.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496905","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":"HIV-Related Stigma in People Living with HIV: A Cross-Sectional Analysis of a Portuguese Clinical Cohort.","authors":"Helder Gemo, Ana Gorgulho, Francisca Bartilotti, Dara Mbanze, Cristóvão Figueiredo, Joana Fragoso, Sofia Nunes, Daniel Coutinho, Carlos Azevedo, Tiago Teixeira, Andre Oliveira, Luis Malheiro","doi":"10.1007/s10461-026-05240-0","DOIUrl":"https://doi.org/10.1007/s10461-026-05240-0","url":null,"abstract":"<p><p>HIV-related stigma remains a barrier to well-being and long-term care despite effective antiretroviral therapy. We conducted a cross-sectional analysis using baseline data from a prospective real-world cohort of adults receiving routine HIV care in northern Portugal. Overall HIV stigma was the primary outcome, and associations with sociodemographic, clinical, laboratory, behavioral, and patient-reported variables were examined using univariable and multivariable linear regression. Among 467 participants, the median overall stigma score was 30 (Q1-Q3, 26-35), and disclosure concerns had the highest median subscale score. The multivariable model was statistically significant, F(7,429) = 10.254, p < 0.001, adjusted R² = 0.129. Higher overall stigma was independently associated with HIV-1 viral load ≥ 200 copies/mL (B = 4.489, 95% CI 0.660 to 8.318, t = 2.304, p = 0.022), anxiety symptoms (B = 0.318 per point, 95% CI 0.120 to 0.515, t = 3.166, p = 0.002), and depressive symptoms (B = 0.236 per point, 95% CI 0.031 to 0.441, t = 2.259, p = 0.024). A history of opportunistic infection was associated with lower stigma (B = -1.826, 95% CI -3.524 to -0.128, t = -2.114, p = 0.035). Higher quality-of-life scores were consistently associated with lower stigma (t values ranging from - 10.690 to -4.161, all p < 0.001). These findings support routine stigma-sensitive and psychologically informed HIV care to identify psychosocial needs and potentially improve well-being and treatment outcomes.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468244","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 Socioecological Perspective on Sexual Health Promotion Choices Among Youth At-Risk for and Living with HIV in Los Angeles and New Orleans.","authors":"Curtis Wong, Katherine A Lewis, Alice M Ma, Hailey Valles, Dianna Polanco, Yara Tapia, Manuel A Ocasio, Rhitishah Yuva Raju, Elizabeth M Arnold, Dallas Swendeman","doi":"10.1007/s10461-026-05226-y","DOIUrl":"10.1007/s10461-026-05226-y","url":null,"abstract":"<p><p>Youth in the US remain at high relative risk for HIV and sexually transmitted infections compared to other age groups despite increasing diversity in the available tools to reduce HIV risk through behavioral strategies, biomedical methods, and treatment as prevention. Previous research has shown that acceptability and appeal of prevention methods vary across youth, and over-emphasis on any one strategy may overlook youth's autonomy to make their own informed decisions about their sexual health. We use a socioecological framework to understand factors influencing sexual health promotion choices among youth at-risk for or living with HIV. Youth ages 16-24 years old in Los Angeles and New Orleans participated in a strengths-based coaching intervention in Adolescent HIV Medicine Trials Network (ATN) studies. A total of 257 youth completed a baseline strengths assessment with a coach. We analyzed qualitative strengths assessment coach case notes to understand youth's sexual health promotion preferences and influencing factors across socioecological levels. Participants described 7 types of sexual health promotion strategies: Relationship dynamics; Not sexually active; STI testing; Condom use; PrEP use; PEP use; and HIV Viral suppression. Participants also described factors at intrapersonal, interpersonal, and community levels that impacted their preferred sexual health promotion strategies. Youth at-risk for or living with HIV make informed decisions around their sexual health based on a variety of intersecting factors across socioecological levels. These complex decisions demonstrate youth's autonomy and emphasize the importance of better incorporating patient-centered care within youth's sexual health.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468319","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":"Characterizing the Geography of Drug Use Networks and Behaviors Among People Who Inject Drugs in the Baltimore Metropolitan Region.","authors":"Amy Wesolowski, Catherine Schluth, Kyra H Grant, Danielle German, Carl Latkin, Gregory M Lucas, Gregory D Kirk, Shruti H Mehta, Becky L Genberg","doi":"10.1007/s10461-026-05227-x","DOIUrl":"10.1007/s10461-026-05227-x","url":null,"abstract":"<p><p>The geography of injection drug use in the United States continues to evolve and expand outside of urban areas, yet there is little understanding of the extent to which urban and non-urban networks of people who inject drugs (PWID) interact, which has implications for HIV and hepatitis C transmission (HCV). Here, we characterize individuals with mixed geography PWID networks in the Baltimore, Maryland region, as well as prospective associations with injection-related risk behaviors. Nested within the AIDS Linked to the IntraVenous Experience (ALIVE) study, an ongoing community-based cohort of former and current PWID in Baltimore, Maryland, we conducted an ego-centric drug use network survey among n = 237 PWID who reported any injection drug use in the last 12 months from across the metropolitan region in 2018-2019 and examined prospective associations between network geography and injection drug use, sharing, and non-fatal overdose at 6-month follow-up visits. Of the 237 individuals surveyed, 59% (n = 141) had exclusively city-based networks and 41% (n = 87) had mixed-geography networks (defined as ego or at least one network tie with residential location outside of the city). Compared to PWID with uniformly city-based networks, those with mixed-geography networks were more likely to report sharing needles and injection equipment on follow-up, after adjusting for individual characteristics. Network-based interventions focused on PWID who cross geographic borders may be important to stay ongoing HCV transmission and prevent HIV resurgence.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468332","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":"Neighborhood Violence and Safety: Report from the MACS WIHS Combined Cohort Study.","authors":"Mardge H Cohen, Rohan G Rajagopal, Elizabeth Daubert, Kaitlin Bodnar, Aruna Chandran, David B Hanna, Deborah L Jones, Mirjam-Colette Kempf, Jennafer Kwait, Daniel Merenstein, Matthew J Mimiaga, Catalina Ramirez, Anna A Rubtsova, Valentina Stosor, Phyllis C Tien, Tracey Wilson","doi":"10.1007/s10461-026-05229-9","DOIUrl":"10.1007/s10461-026-05229-9","url":null,"abstract":"<p><p>Neighborhood violence and safety concerns are associated with poor health outcomes including HIV acquisition/transmission, and possible lack of viral suppression. Using a cross-sectional analytic design, we determined the prevalence of neighbourhood violence and safety concerns among participants in the MACS WIHS Combined Cohort Study, a large US cohort of men and women with and without HIV. We used multivariable logistic regression to assess factors associated with perceptions of neighborhood violence (weapon and gang fights, sexual assault, robbery or mugging) and safety concerns (feeling safe walking at night). Most participants perceived their neighborhoods as violent (59%) and unsafe (69%). Black participants, women, those with lower income, less formal education, substance use, and those with higher levels of stress, depressive symptoms, and frailty scores had greater odds of perceiving neighborhood violence and safety concerns. Among women, those who missed ≥1 HIV clinic appointment were twice as likely to report their neighborhoods as unsafe. Women reporting marijuana use (OR 1.29, 95% CI: 1.00, 1.646) or meeting the definition for frailty (OR 1.37, 95% CI: 1.04, 1.83) reported higher odds of neighborhood violence. Among men, smoking or substance use were associated with higher odds of perceiving violence and safety concerns. Men with depressive symptoms were more than twice as likely to report neighborhood safety concerns than men without symptoms. The intersection of previous HIV-related risk factors and reported neighborhood violence and safety emerged as highly significant and warrants efforts to better understand and address structural challenges to comprehensive care for people with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468278","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":"Resilience and Its Determinants Among Adolescents and Young Adults with Perinatally Acquired HIV Enrolled in a Peer-Led Mentorship Program in India.","authors":"Anita Shet, Michael Raj, Siddha Sannigrahi, Babu Seenappa, Lakshmikanth Reddy, Ashley Sharma, Akshay G Narayanan, S K Satish Kumar, Lakshmi Ganapathi","doi":"10.1007/s10461-026-05241-z","DOIUrl":"https://doi.org/10.1007/s10461-026-05241-z","url":null,"abstract":"<p><p>Adolescents and young adults with perinatally acquired HIV (APHIV) face intersecting challenges that compromise resilience, an important determinant of treatment engagement and health outcomes. Evidence on peer-led interventions to strengthen resilience among APHIV in South Asia remains limited. We evaluated resilience and its correlates among participants in the I'mPossible Fellowship, a peer-led mentorship program in India. We conducted a cross-sectional evaluation of 216 APHIV who completed the 24-month fellowship in southern India in 2024. Trained youth investigators administered surveys assessing sociodemographic, educational, and clinical characteristics. Resilience was measured using the Child and Youth Resilience Measure-Revised (CYRM-R). Low resilience was defined as CYRM-R score ≤ 33rd percentile. Multivariable logistic regression identified independent correlates of low resilience. Participants had a mean age of 18.7y (range 9-24). For 50%, both parents were deceased, and 43% lived in childcare institutions. Median resilience scores were high (74, IQR 69-78), and 91% were virally suppressed. Independent correlates of low resilience were loss of both parents (aOR 4.35, 95% CI 2.09-9.06), school discontinuation (aOR 2.43, 95% CI 1.10-5.34), and communication barriers at HIV clinics (aOR 5.83, 95% CI 2.69-12.64). These findings were consistent across sensitivity analyses using alternative CYRM-R thresholds. At the stringent resilience threshold of ≤ 15th percentile, unsuppressed viral load emerged an additional significant correlate of low resilience. We conclude that APHIV participating in this peer-led mentorship program demonstrated high resilience and viral suppression. Results highlighted modifiable structural and psychosocial vulnerabilities that could inform targeted interventions to improve outcomes among those facing the greatest adversity.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468238","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}