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AIDS and Behavior

Alexander J Lankowski, Cedric H Bien-Gund, Viraj V Patel, Uriel R Felsen, Richard Silvera, Oni J Blackstock
The effectiveness of HIV pre-exposure prophylaxis (PrEP) depends on adherence, which requires retention in PrEP care. We sought to examine factors associated with six-month retention in PrEP care among individuals prescribed PrEP between 2011 and 2015 in a large, academic health system in the Bronx, New York. We used multivariable logistic regression to identify factors independently associated with six-month retention. Among 107 patients, retention at 6 months was 42%. In the multivariable analysis, heterosexual individuals were less likely to be retained in PrEP care at 6 months, but individuals who received prescriptions from attending physicians were more likely to be retained in care...
October 19, 2018: AIDS and Behavior
Julia Dickson-Gomez, Sergey Tarima, Laura R Glasman, Julia Lechuga, Gloria Bodnar, Lorena Rivas de Mendoza
This article examines the effects of a multi-level, community-based HIV prevention intervention for crack users residing in low-income neighborhoods in San Salvador, El Salvador conducted between August 2011 and June 2016. The intervention consisted of three components introduced sequentially: (1) rapid HIV testing in community settings; (2) a social network HIV testing intervention; and (3) small group interventions with crack users who were members of the same social network. The intervention was evaluated with an interrupted time series design in which we used respondent-driven sampling to conduct 7 cross-sectional surveys with crack users along a 3-4 month period for each assessment (total n = 1597)...
October 19, 2018: AIDS and Behavior
Mary Hawk, Catherine Maulsby, Blessing Enobun, Suzanne Kinsky
Though housing instability is linked to poor HIV health outcomes, studies that assess the HIV treatment cascade by housing status are limited. Using data from a multi-site Retention in Care initiative we constructed HIV treatment cascades for participants (n = 463) of five grantee sites. We found no significant differences in viral suppression at follow-up among participants who were unstably housed at enrollment (49%) as compared to those who were stably housed at enrollment (54%). Among participants with available data at 6- or 12-month follow-up, 94% were engaged in care, 90% were retained in, 94% were on ART, and 71% had suppressed viral load...
October 17, 2018: AIDS and Behavior
Erik D Storholm, Laura M Bogart, Matt G Mutchler, David J Klein, Bonnie Ghosh-Dastidar, Bryce McDavitt, Glenn J Wagner
Black people living with HIV (BPLWH) are less likely to adhere to antiretroviral treatment than are members of other racial/ethnic groups. Data were combined from two studies of BPLWH (n = 239) to estimate adherence trajectories using a semiparametric, group-based modeling strategy over three time-points (spanning 6 months). Analyses identified three groups of individuals (high-stable, moderately low-stable, low-decreasing). Multinomial logistic regressions were used to predict trajectory membership with multiple levels of socio-ecological factors (structural, institutional/health system, community, interpersonal/network, individual)...
October 17, 2018: AIDS and Behavior
Cody Cichowitz, Festo Mazuguni, Linda Minja, Prosper Njau, Gretchen Antelman, James Ngocho, Brandon A Knettel, Melissa H Watt, Blandina T Mmbaga
In 2013, Tanzania adopted the World Health Organization's Option B+ guidelines for prevention of mother-to-child transmission of HIV (PMTCT), whereby all HIV-infected pregnant women initiate lifelong antiretroviral therapy. This study examined retention in PMTCT across critical junctures in the care continuum. This was a retrospective study of patient-level data for a cohort of women enrolled in PMTCT during the first year of Option B+ in Tanzania. Retention in care was described across three periods: (1) the first month of antenatal care (ANC), (2) pregnancy, and (3) the postpartum period...
October 16, 2018: AIDS and Behavior
Qian An, Ruiguang Song, Teresa J Finlayson, Catlainn Sionean, Cyprian Wejnert
We present a simple, comprehensive method for assessing similarity between sex partners of a participant and demonstrate its application using data collected in 2015 as part of CDC's National HIV behavioral surveillance (NHBS) among persons who inject drugs (PWID). We found that the pairwise similarity between sex partners of a survey participant was high. The similarity between second-to-last and third-to-last partners in the past 3 months was significantly higher than that between last and second-to-last partner in partner type, frequency of sex acts, and the contextual characteristics of sex behavior at last sexual encounter...
October 12, 2018: AIDS and Behavior
Kate B Carey, Kate M Guthrie, Carla M Rich, Naomi H Krieger, Alyssa L Norris, Clair Kaplan, Michael P Carey
Alcohol use and sexual behavior co-occur frequently in young women, increasing risk for HIV and other sexually transmitted infections. To inform preventive interventions, we used qualitative methods to better understand how women think about the contribution of alcohol use to sexual risk-taking. Young women (N = 25; M = 22.8 years; 64% White) were recruited from a community-based reproductive health clinic to attend focus groups; a semi-structured agenda was used to investigate both a priori explanatory mechanisms as well as participant-driven explanations for the alcohol-sex association...
October 12, 2018: AIDS and Behavior
Aruna Chandran, Lorie Benning, Rashelle J Musci, Tracey E Wilson, Joel Milam, Adebola Adedimeji, Carrigan Parish, Adaora A Adimora, Jennifer Cocohoba, Mardge H Cohen, Marcia Holstad, Seble Kassaye, Mirjam-Colette Kempf, Elizabeth T Golub
Social support is associated with HIV-related health outcomes. However, few studies have explored this longitudinally. We assessed psychometric properties of the Medical Outcomes Study's Social Support Survey among women in the Women's Interagency HIV Study, and explored the longitudinal effects of social support on HIV medication adherence (HIV-positive women) and healthcare utilization (HIV-positive and negative women). The 15 questions loaded into two factors, with Cronbach's Alpha > 0.95. Over 3 years, perceived emotional support was associated with optimal medication adherence (OR 1...
October 11, 2018: AIDS and Behavior
David P Sheppard, Steven Paul Woods, Paul J Massman, Paul E Gilbert
The increasing prevalence of older adults living with HIV has raised growing concerns about a possible rise in the incidence of neurocognitive disorders due to HIV and other age-related factors. In typical aging, subjective cognitive impairment (SCI) among individuals with normal neurocognitive functioning may be an early manifestation of an incipient neurocognitive disorder. The current study examined the frequency and correlates of SCI in 188 HIV-infected adults without performance-based neurocognitive deficits or a current psychiatric disorder and 133 HIV seronegative comparison participants...
October 11, 2018: AIDS and Behavior
Mitzy Gafos, Rob Horne, Will Nutland, Gill Bell, Caroline Rae, Sonali Wayal, Michael Rayment, Amanda Clarke, Gabriel Schembri, Richard Gilson, Alan McOwan, Ann Sullivan, Julie Fox, Vanessa Apea, Claire Dewsnap, David Dolling, Ellen White, Elizabeth Brodnicki, Gemma Wood, David Dunn, Sheena McCormack
There are still important gaps in our understanding of how people will incorporate PrEP into their existing HIV prevention strategies. In this paper, we explore how PrEP use impacted existing sexual risk behaviours and risk reduction strategies using qualitative data from the PROUD study. From February 2014 to January 2016, we conducted 41 in-depth interviews with gay, bisexual and other men who have sex with men (GBMSM) enrolled in the PROUD PrEP study at sexual health clinics in England. The interviews were conducted in English and were audio-recorded...
October 10, 2018: AIDS and Behavior
Hong Xie, Huiting Yu, Roger Watson, Jing Wen, Lu Xiao, Mao Yan, Yanhua Chen
The study aimed to validate the Health Care Provider HIV/AIDS Stigma Scale among medical staff in China. The validation was conducted in four steps from March to December 2017: translation and back-translation; content validity test with six experts; test-retest reliability testing with 63 medical staff with 2 weeks interval; and structural validation with 349 medical staff from 52 hospitals with a convenience sample,using exploratory factor analysis,including principal component analysis and varimax rotation...
October 10, 2018: AIDS and Behavior
Vivian F Go, Rebecca B Hershow, Tetiana Kiriazova, Riza Sarasvita, Quynh Bui, Carl A Latkin, Scott Rose, Erica Hamilton, Kathryn E Lancaster, David Metzger, Irving F Hoffman, William C Miller
HIV-infected people who inject drugs (PWID) have low uptake of HIV services, increasing the risk of transmission to uninfected injection or sexual partners and the likelihood of AIDS-related deaths. HPTN 074 is a vanguard study assessing the feasibility of an integrated intervention to facilitate treatment as prevention to PWID in Indonesia, Ukraine, and Vietnam. We describe barriers to and facilitators of ART uptake and adherence among PWID. We conducted in-depth interviews with 62 participants, including 25 providers and 37 PWID at baseline across all sites...
October 10, 2018: AIDS and Behavior
Yea-Hung Chen, John Guigayoma, Willi McFarland, Jonathan M Snowden, Henry F Raymond
Using data from the National HIV Behavioral Surveillance of men who have sex with men (MSM), we estimated the prevalence of sexual behaviors among HIV-negative San Francisco MSM between 2004 and 2017. We estimate a recent increase in the 1-year prevalence of pre-exposure prophylaxis (PrEP) use, from 9.8% in 2014 to 44.9% in 2017. Over that same period, we estimate a decrease in the prevalence of consistent condom use, from 18.5 to 9.4%, and an increase in the percent of individuals with multiple condomless anal intercourse partners...
October 10, 2018: AIDS and Behavior
Christy Newman, Shana Hughes, Asha Persson, Hong-Ha M Truong, Martin Holt
As evidence of the safety and effectiveness of HIV pre-exposure prophylaxis (PrEP) has grown, so has attention to the views of prospective users and providers. However, far less attention has been paid to understanding the perspectives of other stakeholders in the rollout of PrEP access programs. We conducted 21 semi-structured qualitative interviews in 2017 with key stakeholders working across the policy, advocacy, research and/or clinical dimensions of the Australian HIV response, before federal support for a subsidised access scheme was achieved...
October 10, 2018: AIDS and Behavior
Amber I Sophus, Jason W Mitchell
PrEP is an important and useful HIV prevention strategy, yet awareness remains low among at-risk populations in the United States and elsewhere in the world. As previous studies have shown PrEP awareness to be important to PrEP uptake, understanding approaches to increase PrEP awareness is imperative. The current systematic review provides an overview of published articles and on-going research on PrEP awareness. Using PRISMA guidelines, two published articles and seven on-going research studies were identified that use different approaches to increase PrEP awareness...
October 10, 2018: AIDS and Behavior
Christian Grov, H Jonathon Rendina, Steven A John, Jeffrey T Parsons
Researchers have established that substance use interferes with anti-retroviral medication adherence among gay and bisexual men (GBM) living with HIV. There is limited parallel examination of pre-exposure prophylaxis (PrEP) adherence among HIV-negative GBM. We conducted retrospective 30-day timeline follow-back interviews and prospective semi-weekly diary data for 10 weeks with 104 PrEP-using GBM, half of whom engaged in club drug use (ketamine, ecstasy, GHB, cocaine, or methamphetamine)-generating 9532 days of data...
October 10, 2018: AIDS and Behavior
K Rivet Amico, Jessica Miller, Christopher Balthazar, Pedro Alonso Serrano, Jennifer Brothers, Sarah Zollweg, Sybil Hosek
Pre-exposure prophylaxis (PrEP) for the prevention of HIV infection among young men who have sex with men is a critical part of the HIV prevention landscape in the US. Given the unique challenges and resources of young MSM negotiating safer sex practices, including PrEP, counseling and supportive discussions to optimize both PrEP use and sexual health protection more generally may facilitate reaching HIV prevention goals. Within the context of a large, open-label PrEP study (ATN110/113), support for sexual health promotion and PrEP use was provided through use of integrated Next Step Counseling (iNSC) as part of study visits...
October 9, 2018: AIDS and Behavior
Corina Leluţiu-Weinberger, H Jonathon Rendina, Massimo Mirandola, Lorenzo Gios, Cinta Folch, Alexandru Rafila, John E Pachankis
Sexual orientation stigma stems from discriminatory social contexts and may ultimately impact the behavioral health of stigmatized individuals through stress-related pathways. Sexual minority stigma is of particular concern in Europe given the diversity of social contexts on the continent and sexual minority men's rapidly increasing risk of HIV infection, especially in Central and Eastern Europe, potentially rooted in stigma. This study assesses whether stigma in the ubiquitous social contexts surrounding sexual minority men (e...
October 9, 2018: AIDS and Behavior
Polly H X Ma, Zenobia C Y Chan, Alice Yuen Loke
Stigma is a primary concern for people living with human immunodeficiency virus (HIV)/AIDS (PLWHA), and has great impact on their and their family members' health. While previous reviews have largely focused on the public stigma, this systematic review aims to evaluate the impact of HIV/acquired immunodeficiency syndrome (AIDS)-related self-stigma reduction interventions among PLWHA and their families. A literature search using eight databases found 23 studies meeting the inclusion criteria. Five types of intervention approaches were identified: (1) psycho-educational intervention, (2) supportive intervention for treatment adherence (antiretroviral therapy), (3) psychotherapy intervention, (4) narrative intervention, and (5) community participation intervention...
October 8, 2018: AIDS and Behavior
Bethany L DiPrete, Brian W Pence, Angela M Bengtson, Richard D Moore, David J Grelotti, Conall O'Cleirigh, Riddhi Modi, Bradley N Gaynes
Little is known about disparities in depression prevalence, treatment, and remission by psychiatric comorbidities and substance use among persons living with HIV (PLWH). We conducted a cross-sectional analysis in a large cohort of PLWH in routine care and analyzed conditional probabilities of having an indication for depression treatment, receiving treatment, receiving indicated treatment adjustments, and achieving remission, stratified by alcohol use, illicit drug use, and panic symptoms. Overall, 34.7% (95% CI 33...
October 4, 2018: AIDS and Behavior
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