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AIDS and Behavior

Russell A Brewer, Sarah Chrestman, Snigdha Mukherjee, Karen E Mason, Typhanye V Dyer, Peter Gamache, Mary Moore, DeAnn Gruber
We explored the correlates of linkage to HIV medical care and barriers to HIV care among PLWH in Louisiana. Of the 998 participants enrolled, 85.8% were successfully linked to HIV care within 3 months. The majority of participants were male (66.2%), African American (81.6%), and had limited education (74.4%). Approximately 22% of participants were Black gay and bisexual men. The most common reported barrier to care was lack of transportation (27.1%). Multivariable analysis revealed that compared with Black gay and bisexual men, White gay and bisexual men were significantly more likely to be linked to HIV care (adjusted prevalence ratio, aPR 1...
April 11, 2018: AIDS and Behavior
Nada Fadul, Sarah J Willis, Jenna Donovan, Aimee Wilkin, Amy Durr Heine, Anna LeViere, Ciarra Dortche, Evelyn Byrd Quinlivan
The NC-LINK Project initiated both clinic-based retention services and state public health bridge counselor-based (SBCs) re-engagement services to retain and re-engage people living with HIV infection (PLWH) in care. The goal of this project is to compare efforts between clinic-based retention and SBC re-engagement services to determine whether patients are more or less likely to remain in HIV care services. Clinic appointment data were used to identify patients who were last seen more than 6-9 months prior...
April 10, 2018: AIDS and Behavior
Brian Mustanski, Daniel T Ryan, Thomas A Remble, Richard T D'Aquila, Michael E Newcomb, Ethan Morgan
Suppressing HIV viral load through daily antiretroviral therapy (ART) substantially reduces the risk of HIV transmission, however, the potential population impact of treatment as prevention (TasP) is mitigated due to challenges with sustained care engagement and ART adherence. For an undetectable viral load (VL) to inform decision making about transmission risk, individuals must be able to accurately classify their VL as detectable or undetectable. Participants were 205 HIV-infected young men who have sex with men (YMSM) and transgender women (TGW) from a large cohort study in the Chicago area...
April 10, 2018: AIDS and Behavior
William L Jeffries, Kevin M Greene, Gabriela Paz-Bailey, Donna Hubbard McCree, Lamont Scales, Richard Dunville, Suzanne Whitmore
This study sought to determine why young men who have sex with men (MSM) have higher HIV incidence rates than older MSM in the United States. We developed hypotheses that may explain this disparity. Data came from peer-reviewed studies published during 1996-2016. We compared young and older MSM with respect to behavioral, clinical, psychosocial, and structural factors that promote HIV vulnerability. Compared with older MSM, young MSM were more likely to have HIV-discordant condomless receptive intercourse. Young MSM also were more likely to have "any" sexually transmitted infection and gonorrhea...
April 9, 2018: AIDS and Behavior
Putu Duff, Mary Kestler, Patience Chamboko, Melissa Braschel, Gina Ogilvie, Andrea Krüsi, Julio Montaner, Deborah Money, Kate Shannon
To better understand the structural drivers of women living with HIV's (WLWH's) reproductive rights and choices, this study examined the structural correlates, including non-consensual HIV disclosure, on WLWH's pregnancy decisions and describes access to preconception care. Analyses drew on data (2014-present) from SHAWNA, a longitudinal community-based cohort with WLWH across Metro-Vancouver, Canada. Multivariable logistic regression was used to model the effect of non-consensual HIV disclosure on WLWH's pregnancy decisions...
April 7, 2018: AIDS and Behavior
Angela M Bengtson, Brian W Pence, Kimberly A Powers, Mark A Weaver, Matthew J Mimiaga, Bradley N Gaynes, Conall O'Cleirigh, Katerina Christopoulos, W Christopher Mathews, Heidi Crane, Michael Mugavero
Depressive symptoms vary in severity and chronicity. We used group-based trajectory models to describe trajectories of depressive symptoms (measured using the Patient Health Questionnaire-9) and predictors of trajectory group membership among 1493 HIV-infected men (84%) and 292 HIV-infected women (16%). At baseline, 29% of women and 26% of men had depressive symptoms. Over a median of 30 months of follow-up, we identified four depressive symptom trajectories for women (labeled "low" [experienced by 56% of women], "mild/moderate" [24%], "improving" [14%], and "severe" [6%]) and five for men ("low" [61%], "mild/moderate" [14%], "rebounding" [5%], "improving" [13%], and "severe" [7%])...
April 6, 2018: AIDS and Behavior
Sophia A Hussen, Kirk A Easley, Justin C Smith, Neeta Shenvi, Gary W Harper, Andres F Camacho-Gonzalez, Rob Stephenson, Carlos Del Rio
Social capital, the sum of an individual's resource-containing social network connections, has been proposed as a facilitator of successful HIV care engagement. We explored relationships between social capital, psychological covariates (depression, stigma and internalized homonegativity), and viral suppression in a sample of young Black gay, bisexual and other men who have sex with men (YB-GBMSM). We recruited 81 HIV-positive YB-GBMSM 18-24 years of age from a clinic setting. Participants completed a cross-sectional survey, and HIV-1 viral load (VL) measurements were extracted from the medical record...
April 4, 2018: AIDS and Behavior
Valerie A Earnshaw, Laura M Bogart, Ingrid Courtney, Holly Zanoni, David R Bangsberg, Catherine Orrell, Kathy Goggin, Ingrid T Katz
The UNAIDS 90-90-90 treatment targets aim to dramatically increase the number of people who initiate antiretroviral therapy (ART) by 2020. Greater understanding of barriers to ART initiation in high prevalence countries like South Africa is critical. Qualitative semi-structured interviews were conducted with 30 participants in Gugulethu Township, South Africa, including 10 healthcare providers and 20 people living with HIV (PLWH) who did not initiate ART. Interviews explored barriers to ART initiation and acceptability of theory-based intervention strategies to optimize ART initiation...
April 4, 2018: AIDS and Behavior
Carol-Ann Swain, Steven Sawicki, Diane Addison, Benjamin Katz, Kelly Piersanti, Abigail Baim-Lance, Daniel Gordon, Bridget J Anderson, Denis Nash, Clemens Steinbock, Bruce Agins
Existing data dissemination structures primarily rely on top-down approaches. Unless designed with the end user in mind, this may impair data-driven clinical improvements to Human Immunodeficiency Virus (HIV) prevention and care. In this study, we implemented a data visualization activity to create region-specific data presentations collaboratively with HIV providers, consumers of HIV care, and New York State (NYS) Department of Health AIDS Institute staff for use in local HIV care decision-making. Data from the NYS HIV Surveillance Registry (2009-2013) and HIV care facilities (2010-2015) participating in a Health Resources and Services Administration (HRSA) Systems Linkages and Access to Care project were used...
April 2, 2018: AIDS and Behavior
Jenna Donovan, Kristen Sullivan, Aimee Wilkin, Nada Fadul, Amy Heine, Jennifer Keller, Anna LeViere, Evelyn Byrd Quinlivan
Poor retention in care is associated with higher viral load (VL) results and decreased rates of viral load suppression (VS) in people living with HIV (PLWH). Therefore, improving retention in HIV care is a priority of national significance. The NC-LINK Retention Project utilized a systematic approach to identify, locate, and attempt to return to care patients who did not attend a clinic appointment for 6-9 months. Clinical and surveillance data were used to evaluate associations between patient characteristics and VL outcomes...
April 2, 2018: AIDS and Behavior
Quyen Thi Tu Bui, Deborah Bain Brickley, Van Thi Thu Tieu, Nancy K Hills
We conducted a cross-sectional study to examine the perceptions of quality of life among people living with HIV who received home-based care services administered through outpatient clinics in Ho Chi Minh City, Viet Nam. Data were collected from a sample of 180 consecutively selected participants (86 cases, 94 controls) at four outpatient clinics, all of whom were on antiretroviral therapy. Quality of life was evaluated using the WHOQOL-BREF instrument. In adjusted analysis, those who received home-based care services had a quality of life score 4...
March 31, 2018: AIDS and Behavior
A S Terzian, N Younes, A E Greenberg, J Opoku, J Hubbard, L P Happ, P Kumar, R R Jones, A D Castel
Distance to HIV care may be associated with retention in care (RIC) and viral suppression (VS). RIC (≥ 2 HIV visits or labs ≥ 90 days apart in 12 months), prescribed antiretroviral therapy (ART), VS (< 200 copies/mL at last visit) and distance to care were estimated among 3623 DC Cohort participants receiving HIV care in 13 outpatient clinics in Washington, DC in 2015. Logistic regression models and geospatial statistics were computed. RIC was 73%; 97% were on ART, among whom 77% had VS. ZIP code-level clusters of low RIC and high VS were found in Northwest DC, and low VS in Southeast DC...
March 30, 2018: AIDS and Behavior
Phillip W Schnarrs, Danielle Gordon, Ryan Martin-Valenzuela, Thankam Sunil, Adolph J Delgado, David Glidden, Jeffrey T Parsons, Joe McAdams
Correct and consistent condom use has been the primary method of HIV prevention until the FDA approve the use of PrEP in 2012. While strong evidence existing regarding the efficacy of PrEP, uptake has remained slower than anticipated. While work is underway to better understand the factors impacting uptake, the majority of this work as been focused on white gay, bisexual, and other men who have sex with men (GBMSM) living in metropolitan regions of the coastal U.S. The current study used a community-based framework to assess perceived social norms through a elicitation survey...
March 30, 2018: AIDS and Behavior
Sarah T Roberts, Brian P Flaherty, Ruth Deya, Linnet Masese, Jacqueline Ngina, R Scott McClelland, Jane Simoni, Susan M Graham
Gender-based violence (GBV) is common among female sex workers (FSWs) and is associated with multiple HIV risk factors, including poor mental health, high-risk sexual behavior, and sexually transmitted infections (STIs). Prior studies have focused on GBV of one type (e.g. physical or sexual) or from one kind of perpetrator (e.g., clients or regular partners), but many FSWs experience overlapping types of violence from multiple perpetrators, with varying frequency and severity. We examined the association between lifetime patterns of GBV and HIV risk factors in 283 FSWs in Mombasa, Kenya...
March 30, 2018: AIDS and Behavior
Jessica P Ridgway, Ellen A Almirol, Jessica Schmitt, Todd Schuble, John A Schneider
Using geospatial analysis, we examined the relationship of distance between a patient's residence and clinic, travel time to clinic, and neighborhood violent crime rates with retention in care or viral suppression among people living with HIV (PLWH). For HIV-positive patients at a large urban clinic, we measured distance and travel time between home and clinic and violent crime rate within a two block radius of the travel route. Kruskal-Wallis rank sum was used to compare outcomes between groups. Over the observation period, 2008-2016, 219/602 (36%) patients were retained in care...
March 29, 2018: AIDS and Behavior
Janan J Dietrich, Erica Lazarus, Michele Andrasik, Stefanie Hornschuh, Kennedy Otwombe, Cecilia Morgan, Abby J Isaacs, Yunda Huang, Fatima Laher, James G Kublin, Glenda E Gray
Recall and social desirability bias undermine self-report of paper-and-pencil questionnaires. Mobile phone questionnaires may overcome these challenges. We assessed and compared sexual risk behavior reporting via in-clinic paper-and-pencil and mobile phone questionnaires. HVTN 915 was a prospective cohort study of 50 adult women in Soweto, who completed daily mobile phone, and eight interviewer-administered in-clinic questionnaires over 12 weeks to assess sexual risk. Daily mobile phone response rates were 82% (n = 3486/4500); 45% (n = 1565/3486) reported vaginal sex (median sex acts 2 (IQR: 1-3)) within 24 h and 40% (n = 618/1565) consistent condom...
March 29, 2018: AIDS and Behavior
Christine Tagliaferri Rael, Michelle Martinez, Rebecca Giguere, Walter Bockting, Caitlin MacCrate, Will Mellman, Pablo Valente, George J Greene, Susan Sherman, Katherine H A Footer, Richard T D'Aquila, Alex Carballo-Diéguez
Transgender women may face a disparate risk for HIV/AIDS compared to other groups. In 2012, Truvada was approved for daily use as HIV pre-exposure prophylaxis (PrEP). However, there is a dearth of research about barriers and facilitators to PrEP in transgender women. This paper will shed light on transgender women living in New York City's perceived and actual challenges to using PrEP and potential strategies to overcome them. After completing an initial screening process, four 90-min focus groups were completed with n = 18 transgender women...
March 27, 2018: AIDS and Behavior
Jeffrey T Parsons, Nadav Antebi-Gruszka, Brett M Millar, Demetria Cain, Sitaji Gurung
This study examined the effect of four syndemic conditions-namely, polydrug use, depression, childhood sexual abuse, and intimate partner violence-on rates of HIV transmission risk behavior (TRB) and separately, transactional sex among transgender women. TRB was defined as the number of condomless penetrative sex events with a casual or main partner of discordant or unknown HIV status. Using data from 212 transgender women in New York City, multivariable analyses revealed that, compared to those with no syndemic conditions, dramatically higher rates of recent HIV TRB events (ARR = 8...
March 27, 2018: AIDS and Behavior
Roman Shrestha, Frederick L Altice, Pramila Karki, Michael M Copenhaver
This study reports the feasibility, acceptability, and preliminary efficacy of the bio-behavioral community-friendly health recovery program-an integrated, HIV prevention intervention to improve pre-exposure prophylaxis (PrEP) adherence and HIV-risk reduction behaviors among high-risk people who use drugs. We used a within-subjects, pretest-posttest follow-up design to recruit participants, who were HIV-uninfected, methadone-maintained and reported HIV-risk behaviors and had initiated PrEP (n = 40; males: 55%)...
March 26, 2018: AIDS and Behavior
Jacklyn D Babowitch, Alan Z Sheinfil, Sarah E Woolf-King, Peter A Vanable, Shannon M Sweeney
Viral suppression, a critical component of HIV care, is more likely when individuals initiate antiretroviral therapy (ART) early in disease progression and maintain optimal levels of adherence to ART regimens. Although several studies have documented the negative association of depressive symptoms with ART adherence, less is known about how depressed mood relates to intentional versus unintentional lapses in adherence as well as the mechanisms underlying this association. The purpose of the current study was to examine the association of depressive symptoms with ART adherence, assessed as a multidimensional construct...
March 23, 2018: AIDS and Behavior
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