AIDS And Behavior[JOURNAL]
Sun
200 papers
Facilitators and Barriers to Home-Based Long-Acting Injectable Antiretroviral Therapy: Clinician Perspectives from the INVITE-Home Study.
Bolton AT, Bourdeau B, O'Shea J … +9 more , Rebchook G, Van Nuys J, Moore E, Harris OO, Johnson MO, Shade SB, Palomares M, Buchacz K, Saberi P
AIDS Behav · 2026 Jan · PMID 41604045 · Full text
The Innovative Administration of Long-Acting Injectables for HIV Treatment Enhancement at Home (INVITE-Home) study is the first to examine the implementation of home-based long-acting injectable antiretroviral therapy (L...
The Innovative Administration of Long-Acting Injectables for HIV Treatment Enhancement at Home (INVITE-Home) study is the first to examine the implementation of home-based long-acting injectable antiretroviral therapy (LAI-ART) administered by a trained treatment buddy, such as a family member, partner, or friend. We conducted semi-structured qualitative interviews with 19 clinicians from four HIV clinics in the San Francisco Bay Area between June and December 2024 to explore perceived facilitators, barriers, and training needs related to home-based LAI-ART. Participants included physicians (n = 7), pharmacists (n = 4), nurses (n = 4), nurse practitioners (n = 2), and social workers (n = 2). Using an Implementation Research Logic Model to guide analysis, clinicians identified anticipated benefits of home-based administration, including reduced transportation and scheduling barriers, increased convenience and flexibility, and greater privacy. They emphasized the potential for home administration to foster patient-centered care, reduce stigma, and support treatment in familiar environments. Empowerment and autonomy were viewed as central to enhancing patient engagement and adherence, while some noted the opportunity to improve clinic efficiency by alleviating capacity constraints and freeing up provider time. Reported barriers included concerns about injection accuracy, the complexity of insurance and billing systems, communication gaps between clinical teams and patients or buddies, and the availability and reliability of treatment buddies. These findings highlight the need for comprehensive planning, structured training for treatment buddies, and sustained clinical support to address logistical and interpersonal challenges. Successful implementation will require balancing these challenges while maximizing the benefits of convenience, patient-centered care, and expanded access to LAI-ART.
The Role of Healthcare-Related Experiences in Willingness and Preference for Long-Acting Injectable PrEP (LAI-PrEP) Among Transfeminine People in the United States.
Glick JL, Nestadt DF, Sanchez T … +12 more , Lucas IL, Caldwell JA, Valentine-Graves M, Winter S, Islek D, Murray SM, Baral S, Brown K, Ragone L, de Ruiter A, Sarkar S, Vannappagari V
AIDS Behav · 2026 Jan · PMID 41591691 · Publisher ↗
Transgender women and transfeminine people (TWTFP) experience disproportionately high HIV prevalence, low HIV pre-exposure prophylaxis (PrEP) coverage, and negative healthcare experiences. Long-acting injectable PrEP (LA...
Transgender women and transfeminine people (TWTFP) experience disproportionately high HIV prevalence, low HIV pre-exposure prophylaxis (PrEP) coverage, and negative healthcare experiences. Long-acting injectable PrEP (LAI-PrEP) and daily oral-PrEP are delivered under different healthcare interaction protocols. We examined the role of healthcare-related experiences on willingness and preference for LAI-PrEP among a U.S. nationwide sample of sexually active TWTFP aged 15+. Recruitment occurred between 6/2022 and 10/2023 via social media advertisements for a cross-sectional online sexual health survey. Analyses included past-year PrEP naïve TWTFP with no prior HIV diagnosis (N = 1648). Participants reported LAI-PrEP willingness and ranked PrEP modality preferences; recent healthcare-related experiences were explored as correlates, using adjusted multivariable Poisson regression with robust variance estimation. Among respondents, 26.3% were willing to use LAI-PrEP (n = 433/1648). Among participants willing to use LAI-PrEP and another modality (n = 390/433; 90.1%), 45.6% (n = 178/390) preferred LAI-PrEP. Discussing sexual health with a healthcare provider (HCP) was associated with increased LAI-PrEP willingness (adjusted prevalence ratio [aPR] = 1.34; 95% confidence interval [CI] = 1.12-1.60; p = 0.001); use of oral prescription medication (non-hormonal) was associated with decreased LAI-PrEP willingness (aPR = 0.60; 95% CI = 0.38-0.93; p = 0.022). No significant associations were found between healthcare-related experiences and LAI-PrEP preference. Given that most TWTFP who were willing to use LAI-PrEP were also willing to use oral-PrEP, but nearly half preferred LAI-PrEP, offering multiple PrEP modalities is essential to meet their needs. Associations between sexual health discussions and increased LAI-PrEP willingness highlight the importance of HCP engagement; initiatives which encourage HCPs to initiate LAI-PrEP conversations in supportive ways are crucial. Associations between oral prescription use and decreased LAI-PrEP willingness, coupled with null findings related to injection use, highlight the need for further investigation.
The Syndemic Effects of Food Insecurity, Depression, and Gender-Based Violence on HIV Treatment Outcomes Among People with HIV in Zimbabwe.
Lee JS, Mawere T, Nyanda R … +11 more , Nyamayaro P, Stanton AM, McKetchnie SM, Bere T, Jopling R, Gulbicki L, Goldsmith K, May J, Mangezi W, Abas M, O'Cleirigh C
AIDS Behav · 2026 Jun · PMID 41591690 · Full text
The effects of food insecurity (FI) on mental health and HIV treatment outcomes among people with HIV (PWH) in Zimbabwe are not well understood, despite its high prevalence and links to poor health. We examined associati...
The effects of food insecurity (FI) on mental health and HIV treatment outcomes among people with HIV (PWH) in Zimbabwe are not well understood, despite its high prevalence and links to poor health. We examined associations between FI and self-reported health quality, viral load, CD4 count, antiretroviral therapy (ART) adherence, depression diagnosis and symptoms, and gender-based violence (GBV) among PWH in Zimbabwe. Participants were 484 PWH receiving HIV care in Mashonaland East Province who were assessed for enrollment in a randomized controlled trial for depression. Associations were estimated using linear or logistic regression, controlling for gender and income type. We also tested an interaction between FI and depression on ART adherence. In the past 12 months, 51% reported having skipped a meal (moderate FI) and 29% reported having skipped an entire day of eating (severe FI). Moderate FI was associated with poorer overall perceived health quality (b = -8.48, 95%CI[-12.86 to -4.10], p < .001), increased likelihood of depression diagnosis (OR = 2.13, 95%CI[1.47-3.11], p < .001), greater depression severity (b = 0.89, 95%CI[0.27-1.51], p = .005), and being a woman who experienced GBV (OR = 2.35, 95%CI[1.43-3.93], p = .001). Severe FI was associated with poorer overall perceived health (b = -8.02, 95%CI[-12.89 to -3.16], p = .001), increased likelihood of depression diagnosis (OR = 2.91, 95%CI[1.92-4.43], p < .001), greater depression symptom severity (b = 1.36, 95%CI[0.68-2.04], p < .001), and poorer medication adherence (b = -3.90, 95%CI[-7.58 to -0.22], p = .038). There was an interaction between moderate FI and depression diagnosis on ART adherence (b = -8.88, 95%CI[-15.71 to -2.05], p = .011). Screening and targeted interventions are needed to address FI among PWH in Zimbabwe.
Couch-Surfing and HIV Risk Behavior Among Young Adults Experiencing Homelessness.
Petry L, Onasch-Vera L, Vayanos P … +2 more , Henwood B, Rice E
AIDS Behav · 2026 Jun · PMID 41591689 · Full text
Young adults experiencing homelessness (YAEH) are significantly more likely to engage in HIV risk-related sexual behavior relative to their stably housed peers, and their social support networks can influence their engag...
Young adults experiencing homelessness (YAEH) are significantly more likely to engage in HIV risk-related sexual behavior relative to their stably housed peers, and their social support networks can influence their engagement in these behaviors. However, few studies have investigated HIV risk behaviors among YAEH who are "couch-surfing," a highly prevalent network-based survival strategy that involves cycling through temporary, informal housing arrangements. The current study utilizes survey data collected from 461 YAEH accessing drop-in center services in Los Angeles, California, between September 2016 and October 2018. Egocentric network analysis was used to examine associations among couch-surfing, sources of social support, and HIV risk and prevention behaviors. The potential moderating effect of social support on the relationship between couch-surfing and specific sexual risk behaviors was also tested. Compared to street- and shelter-based youth, couch-surfing YAEH reported the highest rates of recent transactional sex (18.0%) and concurrent or serial sexual partners (38.2%). Relative to residing in emergency shelter or transitional housing programs, couch-surfing was associated with over twice the odds of engaging in recent transactional sex (OR = 2.52, p = .023, 95% CI 1.13-5.62)-as was living unsheltered (OR = 2.06, p = .029, 95% CI 1.08-3.95). While social support was individually associated with several HIV risk-related sexual behaviors, its effect was ultimately eclipsed by homeless situation in the final model. Findings underscore the need for individual- and structural-level interventions that attend to the unique socioenvironmental contexts of couch-surfing YAEH.
Using the Framework for Reporting Adaptation and Modifications-Expanded (FRAME) to Adapt an Evidence-Based HIV-Prevention Intervention for Zambian Adolescent Girls and Young Women.
Sissoko GD, Kanguya T, Mwenge M … +7 more , Sharma A, Chhun N, Yu SH, Emerson E, Hosek S, Bolton-Moore C, Donenberg GR
AIDS Behav · 2026 Jan · PMID 41591688 · Publisher ↗
Despite substantial global efforts, adolescent girls and young women (AGYW) in Southern Africa remain disproportionately affected by HIV. In Zambia, the HIV prevalence among AGYW is nearly three times that of their male...
Despite substantial global efforts, adolescent girls and young women (AGYW) in Southern Africa remain disproportionately affected by HIV. In Zambia, the HIV prevalence among AGYW is nearly three times that of their male peers. The Informed Motivated Aware and Responsible Adolescents and Adults (IMARA) program, an evidence-based HIV/STI prevention intervention initially developed in the United States and later adapted in South Africa, demonstrated promising reduction in HIV risk through culturally tailored, mother-daughter-focused strategies. This paper outlines the process of adapting IMARA for Zambian AGYW by utilizing the Framework for Reporting Adaptations and Modifications-Expanded (FRAME). The adaptation process consisted of four phases: (1) Assessment through stakeholder meetings and focus groups involving adolescents and caregivers; (2) Intervention Delivery Decisions guided by community feedback; (3) Curriculum Adaptation through iterative revisions and collaborative input from Zambian and U.S.-based researchers; and (4) Theater Testing with adolescent-caregiver dyads to refine the content. All modifications were documented using FRAME. Eight key modifications, covering content, context, and training, were implemented to create ZAIMARA (Zambian Informed Motivated Aware and Responsible Adolescents and Adults). These changes were proactively planned, occurred pre-implementation, and were deemed fidelity-consistent. Examples include translating materials into a local language and changing intervention terms and scenarios to reflect cultural norms. Applying FRAME to adapt IMARA in Zambia provided a transparent, systematic method to maintain cultural relevance with fidelity to an evidence-based intervention. Our study demonstrates the utilization of the FRAME for future adaptations of HIV prevention programs in diverse global contexts.
Educational Attainment and HIV Prevalence by Age Among Pregnant Women in South Africa.
Babalola CM, Gopalkrishnan K, Mdingi MM … +7 more , Mukomana F, Gqirana M, Muzny CA, Taylor CM, Peters RPH, Medina-Marino A, Klausner JD
AIDS Behav · 2026 Jan · PMID 41591687 · Publisher ↗
We examined the association between educational attainment and HIV positivity among pregnant women in a high HIV-prevalence setting and assessed how this relationship varies by age to inform targeted prevention strategie...
We examined the association between educational attainment and HIV positivity among pregnant women in a high HIV-prevalence setting and assessed how this relationship varies by age to inform targeted prevention strategies. This cross-sectional study included 2003 pregnant women aged 21-44 years attending their first antenatal visit (<27 weeks' gestation) at four public health facilities in East London, South Africa, between March 2021 and May 2024. Educational attainment was categorized as pre-high school (< grade 10), high school (grades 10-12), diploma (post-high school), or degree (associate's or bachelor's). Age was categorized into four groups (21-24, 25-29, 30-34, and 35-44 years). HIV status was determined through routine antenatal testing. We used logistic regression to assess associations between educational attainment and HIV positivity, adjusting for age, partner's HIV status, and participant sexually transmitted infection (STI) status. Overall HIV prevalence was 31.0% (95% CI, 28.9%-33.0%). Compared with women with less than a high school education, the odds of HIV infection were lower among women who attained high school education (adjusted odds ratio [AOR], 0.59; 95% CI, 0.40-0.87), a diploma (AOR, 0.40; 95% CI, 0.24-0.67), or a degree (AOR, 0.21; 95% CI, 0.09-0.43). However, this inverse association was not observed among women aged 35-44 years. In conclusion, higher educational attainment was associated with lower HIV prevalence among pregnant women, but this protective association diminished with increasing age. HIV prevention strategies should account for both socioeconomic factors and age-related interpersonal dynamics influencing HIV vulnerability.
Chemsex Practice Among PrEP Users in Buenos Aires, Argentina.
Pastor I, Kundro MA, Alonso Serena M … +7 more , Viloria GA, Zorz MB, Cardozo F, Cecchini D, Barletta J, Altclas I, Losso MH
AIDS Behav · 2026 Jan · PMID 41591686 · Publisher ↗
Chemsex, defined as the intentional use of psychoactive substances to enhance sexual activity, has been associated with a higher frequency of sexually transmitted infections (STIs) diagnosis among HIV pre-exposure prophy...
Chemsex, defined as the intentional use of psychoactive substances to enhance sexual activity, has been associated with a higher frequency of sexually transmitted infections (STIs) diagnosis among HIV pre-exposure prophylaxis (PrEP) users. Evidence from Latin America remains limited. This research aims to characterize the practice of chemsex and STIs prevalence in PrEP users in Buenos Aires, Argentina. We conducted a descriptive, cross-sectional study using clinical records and a self-administered ad-hoc questionnaire among PrEP users attending four public hospitals. Between February to October 2024, 165 PrEP users were included. The prevalence of chemsex, during the previous year, was 32%. The drugs used, in order of frequency, were MDMA 21%; cocaine 14%; gamma-hydroxybutyrate 12%; ketamine 10%; methamphetamine 6%; mephedrone 2%; and gamma-butyrolactone 1%. Additionally, 48% reported concurrent use of two or more drugs during the practice. A multivariate logistic regression analysis showed that engaging in chemsex was significantly associated with higher odds of reporting an STI in the past year [aOR 3.67 (95% CI 1.67 - 8.42) p 0.001). Age, time on PrEP, number of sexual partners, and engagement in group sex were not independently associated with STI diagnosis. In conclusion, chemsex was common among PrEP users in Buenos Aires and independently associated with recent STI diagnosis, highlighting the importance of integrating behavioral assessments and harm reduction strategies into PrEP and sexual health policymaking.
Violence Exposure, Affect and ART Use Among Young Black and Latinx Men Who have Sex with Men: An Ecological Momentary Assessment Analysis.
Bogard MX, Tieu HV, Rendina J … +5 more , Nandi V, Walcott M, Bianco M, Soler J, Frye V
AIDS Behav · 2026 Jan · PMID 41586972 · Publisher ↗
Black and Latinx gay, bisexual and other men who have sex with men (BLMSM) face disproportionate HIV burdens due to structural racism and homonegativity which manifest as multiple forms of violence that disrupt consisten...
Black and Latinx gay, bisexual and other men who have sex with men (BLMSM) face disproportionate HIV burdens due to structural racism and homonegativity which manifest as multiple forms of violence that disrupt consistent HIV care engagement. This study examined pathways linking interpersonal, community and structural violence exposure to antiretroviral therapy (ART) use among young adult BLMSM and explored the mediating roles of substance use and negative affect. Participants (N = 41; ages 18-34) living with HIV in New York City completed a 90-day ecological momentary assessment (EMA) between May 2021 and March 2023. Multilevel logistic regression with Bayesian estimation assessed within- and between-person differences in ART use. Both witnessing and directly experiencing violence were associated with lower odds of same-day ART use, an effect mediated by negative affect. Violence exposure increased negative affect, which reduced same-day ART use by 50%, independent of race/ethnicity, violence exposure type, housing support and substance use. Cannabis use was linked to higher odds of same-day ART use but lower long-term maintenance. Non-Hispanic Black men and those receiving HIV/Services Administration (HASA) housing support demonstrated greater ART engagement, highlighting the critical role of housing stability in improving HIV-related health outcomes. Negative affect emerged as the strongest predictor of daily ART use, underscoring the need to integrate trauma-informed mental health support into HIV care for BLMSM. Additional research is needed to clarify the temporal and differential impacts of violence exposure and cannabis use on ART engagement.
Exploring the Interest and Intention to Use Long-Acting Injectable PrEP (LAI-PrEP) Among Gay, Bisexual and Other Men Who Have Sex with Men (GBMSM) in the Netherlands.
Kolstee J, Wang H, Zimmermann H … +5 more , Schroeder M, Appiah A, Sarkar S, Milinkovic A, Jonas K
AIDS Behav · 2026 Jan · PMID 41579236 · Publisher ↗
Long-acting injectable PrEP (LAI-PrEP) provides opportunities to expand HIV prevention coverage in the Netherlands. Understanding which Dutch gay, bisexual and other men who have sex with men (GBMSM) are interested in us...
Long-acting injectable PrEP (LAI-PrEP) provides opportunities to expand HIV prevention coverage in the Netherlands. Understanding which Dutch gay, bisexual and other men who have sex with men (GBMSM) are interested in using LAI-PrEP when available can support HIV prevention efforts. Survey data was collected online via the PROTECT survey from 1,447 GBMSM in the Netherlands between October 2023 and March 2024. Multivariable logistic analysis was conducted to determine variables associated with GBMSM who intend to use LAI-PrEP when available. Interest and intention to use LAI-PrEP among Dutch GBMSM is high (76.1% and 73.9%) and among those currently on oral PrEP even higher (80.8% and 79.5%). GBMSM who intend to use LAI-PrEP have more sexual partners in the past 6 months (11-50 partners (aOR = 3.24; 95%CI: 1.54-6.85), 51-100 partners (aOR = 3.10; 95% CI: 1.20 to 8.30), more than 150 partners (aOR = 3.86; 95% CI: 1.74 to 8.67)), engage more in chemsex (aOR = 1.41; 95% CI: 1.00 to 2.01), are less likely to fear LAI-PrEP side effects (aOR = 0.83; 95% CI: 0.74 to 0.94;) or injection pain (aOR = 0.68; 95% CI: 0.61 to 0.75) and more likely to believe they are at risk of acquiring HIV (aOR = 1.23; 95% CI: 1.05 to 1.45). If made available in the Netherlands, many GBMSM are likely to commence using LAI-PrEP, particularly current oral PrEP users or discontinued users. Sexually active Dutch GBMSM, who are already protecting themselves, may be the first group to use LAI-PrEP.
Outcomes of a Pilot Mobile App Just-in-Time-Adaptive-Intervention Supporting Coping Skills in Trauma Affected People with HIV.
Gasik RE, Skeen SJ, Tokarz S … +2 more , Theall KP, Clum GA
AIDS Behav · 2026 Jan · PMID 41575709 · Full text
People with HIV (PWH) experience trauma and mental health burdens at higher rates than seronegative individuals. Psychosocial interventions have shown promise for improving mental health and coping among PWH, but relativ...
People with HIV (PWH) experience trauma and mental health burdens at higher rates than seronegative individuals. Psychosocial interventions have shown promise for improving mental health and coping among PWH, but relatively few trauma-informed, coping-focused mobile health (mHealth) interventions exist. This pilot study evaluates the preliminary outcomes of NOLA Gem, a just-in-time adaptive intervention (JITAI)-based mHealth app designed to support real-time coping among people living with HIV (PWH) in the New Orleans area. Participants were assigned to either a control or intervention group; the intervention group received access to the NOLA Gem app, which delivered psychoeducation modules and just-in-time skill suggestions based on daily diary responses over a three-week period. Both groups completed brief daily diary surveys over the 3-week period to assess stress, emotion regulation, and coping outcomes. Analyses demonstrated positive changes in treatment compared to control, particularly in the final week. From week 1 to week 3, participants in the treatment group experienced significant reductions in maladaptive coping, rumination, and PTSD symptoms compared to the control group, along with increased feelings of control over stress at both timepoints. These effects were especially pronounced among high completers, who demonstrated greater improvements in maladaptive coping, rumination, and stress control compared to both low completers and controls. High completers also showed significant decreases in overall stress and self-reported alcohol use. These preliminary findings suggest that NOLA Gem is a promising intervention for improving coping and reducing trauma-related symptoms among PWH, particularly for those who actively engage with the app.Trial Registration: ClinicalTrials.gov NCT05784714; https//clinicaltrials.gov/ct2/show/NCT05784714.
PrEP as a "Hidden Message": The Impact of Partner Dynamics on Oral PrEP Adherence Among Cisgender Women in Serodiscordant Relationships.
Phuntsog TD, Stockman JK, Amico KR … +6 more , Kofron R, Morris S, Landovitz RJ, Strathdee S, Moore DJ, Blumenthal J
AIDS Behav · 2026 Jun · PMID 41575708 · Full text
BACKGROUND: Heterosexual sex accounts for 87% of new HIV diagnoses among cisgender women. We sought to explore the intersection of partner dynamics and oral preexposure prophylaxis (PrEP) adherence among cisgender women...
BACKGROUND: Heterosexual sex accounts for 87% of new HIV diagnoses among cisgender women. We sought to explore the intersection of partner dynamics and oral preexposure prophylaxis (PrEP) adherence among cisgender women in heterosexual serodiscordant relationships. METHODS: From June 2017-August 2018, we conducted semi-structured in-depth interviews using a social ecological model framework. Twenty cisgender women in serodiscordant relationships, who participated in a PrEP demonstration project to evaluate adherence and retention in San Diego and Los Angeles, participated in in-depth interviews. Interviews were audio-recorded and transcribed, and transcripts were analyzed using thematic analysis. RESULTS: Among the 20 participants, the median age was 37.5 years (IQR 32, 48), with n = 6 (30%) identifying as Black and n = 5 (25%) as Hispanic. Sixty-five percent of women had protective drug levels based on real-time tenofovir-diphosphate drug level assays at the study visit prior to their interviews. Some partners played a significant role in PrEP adherence, often showing support by vocalizing encouragement and appreciation, offering reminders to take PrEP, and sometimes administering PrEP. Other partners were unsupportive and discouraged PrEP use, which may have hindered adherence. HIV and PrEP stigma were identified as potential barriers for women to take PrEP and disclose their PrEP use to others. CONCLUSIONS: Within the context of this PrEP demonstration project, partner dynamics impacted PrEP adherence for HIV-negative cisgender women in serodiscordant relationships. We urge further investigation of relationship dynamics and PrEP adherence and persistence specifically among US-based cisgender women.
Understanding Patient Barriers and Facilitators Throughout the PrEP Care Continuum: an Analysis of Qualitative Interviews with PrEP Navigators in the United States.
Casimir T, Brin M, Veihman P … +7 more , Fontalvo S, Garofalo R, Radix A, Kuhns LM, Naar S, Janulis P, Schnall R
AIDS Behav · 2026 Jan · PMID 41575707 · Publisher ↗
Pre-exposure prophylaxis (PrEP) is a medication that significantly reduces the risk of HIV infection when taken as prescribed, however, less than 36% of the 1.2 million eligible-for-PrEP Americans are currently prescribe...
Pre-exposure prophylaxis (PrEP) is a medication that significantly reduces the risk of HIV infection when taken as prescribed, however, less than 36% of the 1.2 million eligible-for-PrEP Americans are currently prescribed it. PrEP navigators can help reduce barriers to PrEP uptake and increase access to care for those vulnerable to HIV. As part of formative work for designing an e-peer navigation tool, MyPEEPS Mobile Plus, twenty PrEP navigators were interviewed about barriers and facilitators to PrEP options, delivery, and peer navigation. We analyzed our findings using the nine-step PrEP care continuum as a framework. Participants described how medical mistrust, cultural competency, patient assistance programs, availability of PrEP options, prescriber knowledge and availability, housing insecurity, and rapport contribute to uptake and adherence of PrEP and retention in care. In summary, our study highlights the crucial role of PrEP navigators in facilitating access to HIV prevention services and demonstrates strategies to overcome individual and structural barriers in a clinical setting. These findings will improve the design of the MyPEEPS Mobile Plus intervention and may inform future e-peer navigation strategies.
Effectiveness of Integrating HIV Oral Pre-exposure Prophylaxis (PrEP) and Family Planning: A Systematic Review of Initial Implementation Efforts in Low- and Middle-Income Countries.
O'Reilly KR, Yeh PT, Fonner V … +2 more , Kennedy C, Sweat MD
AIDS Behav · 2026 Jan · PMID 41575706 · Full text
Oral pre-exposure prophylaxis (PrEP) and family planning (FP) share key characteristics. Both are preventive, both have high efficacy but effectiveness which can be diminished by inconsistent use and both are particularl...
Oral pre-exposure prophylaxis (PrEP) and family planning (FP) share key characteristics. Both are preventive, both have high efficacy but effectiveness which can be diminished by inconsistent use and both are particularly beneficial for adolescent girls and young women (AGYW) in certain lower- and middle-income countries. When the efficacy of PrEP was proven in field trials, an effort to implement PrEP programs for the populations that would most benefit from it was launched. For AGYW, making PrEP available through existing FP services was seen as a natural opportunity for integration and was the primary effort and until recently, only experience in implementation of PrEP for AGYW. In this systematic review, we attempted to discover whether the integrated delivery of PrEP and FP results in the uptake and consistent use of either or both interventions. We found that no studies that met our inclusion criteria as no valid comparison for a PrEP/FP integration was discovered. Nonetheless, valuable information on the feasibility and acceptability of PrEP was gleaned from some of these studies, much less on the impact of PrEP promotion on FP acceptance and use. Providing PrEP to eligible individuals is an urgent public health priority. Doing so while enhancing uptake and use of FP is equally important. Future studies would benefit from a more encompassing view of this important integration.
Mental Health and ART Adherence in a Multisite International Study: The Mediating Roles of Social Support and Substance Use in People with HIV.
Awad J, Sun W, Santa Maria D … +15 more , Schnall R, Apiruknapanond P, Wang T, Valencia CP, Horvat Davey C, Solis Baez S, Iwu E, Sabone M, Makhado L, Cuca YP, Phillips JC, Corless IB, Shaibu S, Dawson-Rose C, Chen WT
AIDS Behav · 2026 Jan · PMID 41571948 · Publisher ↗
ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study i...
ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental health-adherence link. Cocaine, Amphetamine-type stimulants, inhalants, and opioids directly influenced adherence but did not mediate this relationship. In contrast, no significant effects were observed for tobacco, alcohol, cannabis or sedatives. This large-scale, nurse-led, international study offers critical insights into the roles of social support and substance use as psychosocial influencers in the cascade of care for PLHIV. Clinical implications include prioritizing educative, preventative, and harm-reductive approaches to specific substances that impact ART adherence. Findings may also inform interventions that emphasize strengthening social support to improve adherence in ART and care while addressing substance use as a barrier to care and well-being.
Telehealth to Enhance PrEP Awareness Among Women Who Sell Sex: A Community-Embedded Approach.
Zemlak JL, Keegan J, Singer RB … +5 more , Jonhson G, Aguero J, Miller D, Lerret S, John SA
AIDS Behav · 2026 Jan · PMID 41559449 · Publisher ↗
Women who sell sex (WSS) experience a disproportionate burden of HIV due to various structural barriers and social inequities. While pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV acquisition, awar...
Women who sell sex (WSS) experience a disproportionate burden of HIV due to various structural barriers and social inequities. While pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV acquisition, awareness and uptake among WSS remains low. Telehealth offers the opportunity to address common barriers to care by embedding PrEP services within trusted community spaces. This study evaluates the acceptability and preliminary effectiveness of a community-embedded telehealth approach to engage WSS in the PrEP care continuum, with a specific focus on expanding awareness. Participants were recruited from two community-based drop-in centers in a Midwestern U.S. city from November 2023 to January 2024. Pre-visit surveys were obtained to assess baseline PrEP knowledge and intention to use PrEP, followed by a 15-30-min telehealth visit with a PrEP provider. Post-visit surveys and qualitative interviews assessed changes in PrEP knowledge, telehealth acceptability, intention to use PrEP, and barriers and facilitators to PrEP uptake. PrEP knowledge and intention to use PrEP increased post-intervention compared to baseline. Qualitative findings highlighted high community-embedded telehealth acceptability, low baseline PrEP awareness, a desire to share new PrEP information with peers, and the need for innovative PrEP outreach strategies. This study supports telehealth as a strategy to increase awareness of PrEP among WSS. Targeted public health messaging and expanded integration of PrEP into community and primary care settings is warranted. Future research is needed exploring strategies for sustained engagement and linkage to long-term PrEP care.
Transactional Sex, HIV Testing and Receipt of Results Among Adolescents and Young Women: A Comparative DHS Analysis of the Four Major Regions in Uganda.
Amuge GE, Ariho P, Kisaakye P … +1 more , Scarpa G
AIDS Behav · 2026 Jan · PMID 41557062 · Publisher ↗
Transactional sex, and HIV remain significant public health concerns in Uganda, necessitating increased HIV testing and results receipt among young females who engage in transactional sex. This study aimed at examining r...
Transactional sex, and HIV remain significant public health concerns in Uganda, necessitating increased HIV testing and results receipt among young females who engage in transactional sex. This study aimed at examining regional variations and factors associated with transactional sex, HIV testing, and receipt of results among young women in the four major regions of Uganda. Stata version 15 was used to analyze the 2016 UDHS data set. The study applied a binary logistic regression model to examine the predictors of HIV testing and receipt of results at multivariate level. Overall, 13.5% of the young women reported engaging in transactional sex. The prevalence of HIV testing and receipt of results was highest amongst respondents who had been involved in transactional sex within Eastern Uganda (24.0%), and lowest among those in Central Uganda (7.2%). The study revealed significant predictors across regions: transactional sex, marital status, and distance to the health facility in the North; age, marital status and frequency of reading newspapers in Central; and age, working status, frequency of reading newspaper and watching television, and stigmatizing attitude in Eastern and Western regions. This study underscores the importance of region-specific programming and the need for an all-encompassing strategy to address the intricate factors driving HIV transmission among young women in Uganda. It is paramount that well designed peer education interventions tailored towards life skills development for young women engaged in transactional sex are implemented.
"It's Not Secret-It's Not Advertised" - Content, Format, and Platform Preferences to Promote PrEP Use in the Southern United States.
Gravett RM, Tucker JD, Matthews LT … +5 more , Van Der Pol B, McCollum G, Ong JJ, Marrazzo J, Elopre L
AIDS Behav · 2026 Jan · PMID 41549223 · Publisher ↗
Gay, bisexual, and other men who have sex with men (GBM) in the Southern United States (US) experience high HIV incidence yet have relatively lower HIV pre-exposure prophylaxis (PrEP) uptake, especially among GBM of colo...
Gay, bisexual, and other men who have sex with men (GBM) in the Southern United States (US) experience high HIV incidence yet have relatively lower HIV pre-exposure prophylaxis (PrEP) uptake, especially among GBM of color. Despite awareness, PrEP use remains insufficient to meaningfully impact the HIV epidemic in the Southern US. PrEP promotions largely focus on PrEP messaging, especially product awareness. Theory-based health promotion research has not explored how to develop promotions that drive PrEP uptake. To close this gap, we explored preferences among GBM in the Southern US for promotion content, format, and platform. Grounded in Andersen's Model, we conducted semi-structured interviews with HIV-negative GBM, aged 18-39 years, and used inductive and deductive coding for thematic analysis to develop themes and sub-themes to understand promotion preferences. Forty GBM (68% Black, 10% Latino, 53% not using PrEP) completed interviews. Three major themes emerged: (1) content beyond promoting PrEP awareness, (2) using digital devices and media access for promoting PrEP, and (3) platforms for PrEP promotion. GBM in this study preferred digital promotion of PrEP, focusing on access, safety, and effectiveness that is delivered discreetly; promotion in the non-digital space could normalize PrEP use. Creating promotions that address these themes will make promotions more relevant to drive uptake of PrEP in the Southern US.
Accelerating HIV Prevention in Cameroon: Factors Associated with Sexual Risk Behaviours and Increased HIV Exposure Among 15-19-Year-Old Adolescent Girls.
Baruwa OJ, Toska E, Banougnin BH … +6 more , Tamambang R, Sekgobela D, Nyamukondiwa P, Ferguson J, Yates R, Maughan-Brown B
AIDS Behav · 2026 Jan · PMID 41549222 · Publisher ↗
Adolescent girls in Cameroon face substantial sexual and reproductive health vulnerabilities that heighten their risk of HIV exposure. Using data from 2,586 adolescent girls aged 15-19 years from the 2017-18 Cameroon Pop...
Adolescent girls in Cameroon face substantial sexual and reproductive health vulnerabilities that heighten their risk of HIV exposure. Using data from 2,586 adolescent girls aged 15-19 years from the 2017-18 Cameroon Population-based HIV Impact Assessment, we examined factors associated with multiple sexual partnerships, age-disparate sex, inconsistent condom use, transactional sex, and a composite measure of high-risk sex. Overall, 4.31% reported multiple partners, 25.18% engaged in age-disparate sex, 27.06% reported inconsistent condom use, 3.91% engaged in transactional sex, and 19.61% exhibited high-risk sexual behaviours. In multivariable analyses, marriage or cohabitation was strongly associated with age-disparate sex (aOR = 8.57, 95% CI = 5.84-12.56; p < 0.001) and inconsistent condom use (aOR = 10.07, 95% CI = 6.98-14.53; p < 0.001). Adolescent motherhood was associated with high-risk sex (aOR = 1.71, 95% CI = 1.14-2.55; p = 0.011). School non-enrolment was associated with inconsistent condom use (aOR = 1.76, 95% CI = 1.31-2.37; p = 0.001). Predicted probabilities showed that unmarried, non-mothers who initiated sex later had the lowest probability of high-risk sex (8%), whereas married adolescent mothers with early sexual debut had the highest (72%). These findings underscore the need for combination HIV prevention programming that prioritises married adolescents, adolescent mothers, out-of-school girls, and those initiating sex early. Delaying sexual debut, preventing adolescent motherhood and child marriage, and strengthening age-appropriate, context-specific interventions may substantially reduce HIV exposure among adolescent girls in Cameroon.
Sexual Relationship Typologies, Multilevel Determinants, and HIV Among Adolescent Mothers in Eastern and Southern Africa: A Multilevel Latent Class Analysis.
Gebrekristos LT, Groves AK, Stoner MCD … +2 more , Ezeh A, Lê-Scherban F
AIDS Behav · 2026 Jan · PMID 41543669 · Publisher ↗
In Eastern and Southern Africa (ESA), there is heterogeneity within adolescent mothers' (AMs') sexual relationships. However, existing studies focus on single relationship characteristics, even though these characteristi...
In Eastern and Southern Africa (ESA), there is heterogeneity within adolescent mothers' (AMs') sexual relationships. However, existing studies focus on single relationship characteristics, even though these characteristics do not operate in isolation. Moreover, no studies have examined multilevel predictors of AMs' relationships. Identifying and characterizing typologies by multilevel factors can inform targeted interventions to lower HIV risk. Data are from the Population-based HIV impact Assessment (PHIA) Project on AMs (15-19 years) from 9 ESA countries (N = 2,761). We conducted multilevel latent class analysis to identify relationship typologies at the AM and community (PHIA cluster) levels, multinomial logistic regression to characterize typologies by multilevel predictors, and multivariable generalized estimating equations (GEE) log-binomial regression to calculate prevalence ratios of HIV for relationship typologies. There were 3 typologies: married with minimal transactional sex (61%), unmarried peer partnership (30%), and working and high transactional sex (9%). Individual-level (i.e., age, school enrollment, low-wealth household, number of sexual partners) and community-level factors (i.e., urbanicity and proportion of low-wealth households) were associated with typologies. Married with minimal transactional sex was associated with a 51% lower HIV prevalence compared to the unmarried peer partnership (adjusting for multilevel factors). We also identified 2 PHIA cluster-level classes: high age-disparate marriage (49%) and low marriage (51%). Low-wealth communities had higher odds of being high age-disparate marriage communities. Results suggest that AMs' relationships fall into 3 distinct typologies and 2 community-level classes. Further, HIV prevalence varies across relationship typologies. Utilizing tailored approaches could optimize interventions that reduce AMs' HIV risk in ESA.
Effectiveness of Telehealth in HIV Management for People Living with HIV and Key Populations: A Systematic Review of Models, Adherence, Viral Suppression, and Behavioral Outcomes.
Chandra IN, Raistanti SRS, Maulana MA … +1 more , Anita A
AIDS Behav · 2026 Jan · PMID 41543668 · Publisher ↗
Human Immunodeficiency Virus (HIV) is a global health problem that causes many deaths, especially in low- and middle-income countries (LMICs). Most HIV cases occur in sub-Saharan Africa and Asia. In efforts to manage HIV...
Human Immunodeficiency Virus (HIV) is a global health problem that causes many deaths, especially in low- and middle-income countries (LMICs). Most HIV cases occur in sub-Saharan Africa and Asia. In efforts to manage HIV, technologies such as telehealth have begun to be considered as an effective solution, both in high- and low-income countries. This study aims to identify telehealth models used in low-, middle-, and high-income countries and to evaluate their impact on treatment adherence, viral load, and HIV disease management. This study answers the question: "What telehealth models are used in countries with different income levels, and how do they impact HIV/AIDS patients?" This literature review was conducted between February and April 2025 by searching five databases: PubMed, Sage, ProQuest, Scopus, and ScienceDirect, covering the last 10 years, from January 2015 to January 2025. Articles that met the inclusion criteria were original articles on the use of telehealth in HIV patients. Article selection was conducted using the PRISMA flowchart, and quality assessment was conducted using the Quality Assessment of Risk of Bias (RoB 2.0). Of the 4739 articles found, 11 articles met the criteria with four main themes: telehealth models, improving treatment adherence, reducing viral load, and the impact of telehealth on HIV management. The results of this study indicate that telehealth models vary, but their benefits have been proven significant in HIV management, especially in resource-limited countries, and they can improve treatment adherence and reduce viral load.
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