AIDS And Behavior[JOURNAL]
Sun
200 papers
Misinformation, Social Media, and Myths About Injectable ART: Communication Barriers to HIV Care Among Transgender Women in India.
Peerbhoy Z, Rawat S, Singh J … +4 more , Ponugoti I, Mimiaga MJ, Biello KB, Lodge W
AIDS Behav · 2026 May · PMID 42151704 · Publisher ↗
Effective health communication is vital for engagement in HIV care, especially for transgender women (TGW), who often encounter misinformation. This issue is worsened by lower literacy levels and stigma. Despite efforts...
Effective health communication is vital for engagement in HIV care, especially for transgender women (TGW), who often encounter misinformation. This issue is worsened by lower literacy levels and stigma. Despite efforts like providing free antiretroviral therapy (ART), misinformation persists, and little is known about the specific rumors and misconceptions that influence TGW's engagement with HIV services. This study aims to fill these gaps and identify key intervention points to enhance HIV communication and care outcomes for TGW living with HIV. We conducted 30 in-depth interviews from July to September 2023 in Mumbai and New Delhi, India, in English, Hindi, and Marathi. Using thematic analysis with both deductive and inductive coding, we found that despite 80% of participants reporting ART adherence above 90%, misinformation remained a major barrier. Three main themes emerged: (1) misinformation about cures spread by traditional healers caused some TGW to delay or doubt ART; (2) social media, especially YouTube, served as a support source but also spread misinformation, leading to confusion; and (3) injectable ART was widely misunderstood, with some believing it to be a cure. These findings highlight the strong influence of misinformation and the need for targeted, accurate health messaging for TGW in India. Misinformation hampers HIV care by promoting unproven cures, reliance on traditional healers, and misconceptions about injectable ART. Recognizing these sources and effects offers valuable insights for developing targeted communication strategies and policies that support correct health information and sustained HIV care for TGW.
Patterns of Sexual Behaviors and Sexual Partner Characteristics as Predictors of Perceived HIV Risk and HIV Status Among Adolescent Girls and Young Women in Kenya.
Laterra A, Yellman MA, Salazar LF … +3 more , Maloney KM, Luo R, Masyn KE
AIDS Behav · 2026 May · PMID 42151703 · Publisher ↗
Adolescent girls and young women (AGYW) in Kenya remain at disproportionate risk of HIV acquisition. While individual risk factors are well-documented, fewer studies examine how these factors co-occur in distinct profile...
Adolescent girls and young women (AGYW) in Kenya remain at disproportionate risk of HIV acquisition. While individual risk factors are well-documented, fewer studies examine how these factors co-occur in distinct profiles or how such profiles relate to perceived HIV risk and HIV status. We analyzed data from 2,810 AGYW (aged 15-24) reporting ≥ 1 male sex partner in the prior 12 months in the 2018 Kenya Population-based HIV Impact Assessment (KENPHIA). Latent class analysis identified patterns of condom use, transactional sex, alcohol use, partner type, age disparity, and partner HIV status. Associations between class membership, perceived HIV risk, and HIV status were estimated. Three classes emerged: Married without Condoms (55%) was characterized by low condom and alcohol use and cohabitating partners; Dating with Condoms (42%) featured higher condom use, moderate transactional sex, low alcohol use, and similarly aged, non-cohabiting partners; and Older Husband (4%) was defined by higher alcohol use and older cohabitating partners of positive or unknown HIV status. Members of the Older Husband class had much higher odds of HIV positivity compared to the Married without Condoms class (aOR = 83.33, 95% CI 21.74-333.33) and the Dating with Condoms class (aOR = 54.36, 95% CI 18.51-159.58). Despite similarly low HIV prevalence (1%) in the Married without Condoms and Dating with Condoms classes, the latter perceived higher HIV risk. Distinct profiles exist among Kenyan AGYW. Tailored prevention is needed, especially for AGYW with older partners of unknown status, alongside efforts to improve risk recognition across profiles.
Structures and Processes Associated with Integrating Pharmacy Claims Data into Antiretroviral Adherence Support Programs: a Collaboration with Pharmacies, Prescribers, Payers, and Public Health Agencies (AdhereP4).
Onukwugha E, Johnson A, Lee TY … +2 more , Cassidy-Stewart H, Pandit NS
AIDS Behav · 2026 May · PMID 42151702 · Publisher ↗
A multidisciplinary collaboration is needed to improve antiretroviral (ARV) therapy adherence among people with HIV (PWH) to ensure adequate patient outcomes. The AdhereP4 program was a collaboration among pharmacies, pr...
A multidisciplinary collaboration is needed to improve antiretroviral (ARV) therapy adherence among people with HIV (PWH) to ensure adequate patient outcomes. The AdhereP4 program was a collaboration among pharmacies, prescribers, payers, and public health agencies that identified PWH with a ≥30-day gap in ARV access using pharmacy claims data. While pharmacy claims data are useful for identifying adherence gaps, limited guidance exists on structures and processes needed to integrate such data in pharmacy and clinical services to better provide adherence support. The AdhereP4 program identified key programmatic structures and processes for a successful collaboration of pharmacy claims data with dispensing pharmacy and clinical patient data. Structures include staffing, data, and procedures while programmatic processes include adherence assessment, adherence intervention, and training/communication. AdhereP4 implementation required support from an information technologist, database managers, programmers, pharmacists, clinicians, social workers/case managers, and a public health specialist. Key lessons learned from the development and implementation of the AdhereP4 program were identified through monthly collaborator meetings and informal collaborator interviews. Lessons identified included (1) develop support and training for all collaborators; (2) develop a data dictionary for each site prior to data collection; (3) develop a standard operating procedure manual related to data management; and (4) complete periodic review of data to address any concerns early. Monthly pharmacy claims data can be successfully used by pharmacy and clinic staff to identify and address ARV adherence gaps. Successful implementation requires collaboration across stakeholders and a clear data management plan.
Geospatial Accessibility Factors Influencing HIV Care Continuum Outcomes in South Carolina.
Utaka EN, Yang X, Xia H … +5 more , Wang S, Shi F, Li Q, Olatosi B, Li X
AIDS Behav · 2026 May · PMID 42151701 · Publisher ↗
Ending the HIV epidemic in the U.S. requires access to comprehensive care. Traditional measures of service access have focused on distance and time. This study used the enhanced two-step floating catchment area (E2SFCA)...
Ending the HIV epidemic in the U.S. requires access to comprehensive care. Traditional measures of service access have focused on distance and time. This study used the enhanced two-step floating catchment area (E2SFCA) method to measure geospatial accessibility and its association with HIV care continuum outcomes. Data from South Carolina's 2020 enhanced HIV/AIDS reporting system (eHARS) were used to calculate aggregated county-level percentage linkage to care (LTC), retention in care (RIC), and viral suppression (VS) among adult people living with HIV (PLWH). E2SFCA was used to measure geospatial accessibility, using the 60-min index as the threshold. County-level mean percentage of dependent variables and covariates were calculated. A linear regression model (LRM) was used to evaluate the association between accessibility index and LTC, RIC, and VS after adjusting for covariates. Accessibility index ranged from 17.9 to 198 across the 46 counties (mean = 67.5, SD = 36.5). Counties with better accessibility were more likely to have a higher percentage of LTC (β = 5.07, 95% CI = 0.83, 9.31) but a lower percentage of VS (β = -2.85, 95% CI= -4.60, -1.10). The negative association between accessibility index and VS was moderated by the percentage of household without vehicle ownership (β = 2.00, 95% CI = 0.02, 4.00). No association was found between the accessibility index and RIC. Counties with lower uninsured rates (β= -3.11, 95% CI= -5.35, -0.87) had higher % LTC. Suboptimal geographic accessibility to HIV care is an important structural barrier in South Carolina. Targeted policies and interventions are needed to address this challenge.
Housing and Water Insecurity as Structural Predictors of Intimate Partner Violence: A Cross-Sectional Study of People Living with HIV.
Gyan SE, Owuor P, Naidoo K … +1 more , Boateng GO
AIDS Behav · 2026 May · PMID 42143646 · Publisher ↗
Intimate partner violence (IPV) remains a major public health concern globally, particularly among people living with HIV (PLHIV). While prior research has focused on individual and interpersonal factors, less attention...
Intimate partner violence (IPV) remains a major public health concern globally, particularly among people living with HIV (PLHIV). While prior research has focused on individual and interpersonal factors, less attention has been given to structural determinants such as housing and water insecurity. This study examines associations between these insecurities and emotional, physical, and sexual abuse among PLHIV in Kenya. Data were drawn from a cross-sectional study (N = 1,132), with 515 participants aged ≥ 16 years completing IPV measures. Descriptive, bivariate, and multivariable generalized linear models were used. Overall, 40.6% reported emotional abuse, 19.6% physical abuse, and 7.6% sexual abuse. Greater water insecurity was associated with increased odds of emotional abuse (AOR = 1.03, 95% CI: 1.01–1.05) and physical abuse (AOR = 1.04, 95% CI: 1.01–1.07), but not sexual abuse. Housing insecurity was associated only with emotional abuse (OR = 1.45, 95% CI: 1.21–1.73). Addressing structural inequities may reduce IPV and improve health outcomes.
Multi-method Analysis of Implementation Determinants and Strategies to Support the Implementation of Contingency Management for Methamphetamine Use in an HIV Care Setting.
Prescott MR, Chentsova V, Delgado J … +6 more , Dung D, Shoptaw S, Aarons GA, Moore DJ, Grelotti D, Montoya J
AIDS Behav · 2026 May · PMID 42126510 · Publisher ↗
Methamphetamine use is prevalent among people with HIV (PWH) and complicates HIV care. Integrated substance use and HIV care services are recommended, yet rarely available. Contingency management (CM) is an evidence-base...
Methamphetamine use is prevalent among people with HIV (PWH) and complicates HIV care. Integrated substance use and HIV care services are recommended, yet rarely available. Contingency management (CM) is an evidence-based treatment for methamphetamine use, but its implementation within HIV primary care is limited. This study identified determinants and strategies to support CM implementation in HIV care. Key informants from an HIV clinic at an academic medical center (n = 15 patients; n = 15 providers) completed semi-structured interviews and a survey. A rapid qualitative analysis guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework identified implementation determinants, and potential strategies were classified using the Expert Recommendations for Implementing Change (ERIC) compilation. Both patient and provider participants rated CM as acceptable (M = 3.72 and 4.55/5) and appropriate (M = 3.85 and 4.54/5). Providers also rated CM as feasible (M = 4.08/5) and reported strong support for integrating CM into HIV care, citing the high priority of addressing methamphetamine use. Facilitators included the clinic's person-centered culture and providers' familiarity with substance use treatment. Barriers included perceptions that reinforcer values in standard CM protocols were low, limited staffing, and competing provider demands. Suggested implementation strategies included adapting CM (e.g., increasing reinforcer value), patient-directed outreach/advertisements, and provider education and support (e.g., reminders about CM availability and referral processes). Findings indicate strong support for integrating CM into HIV primary care, while noting challenges to implementation. Addressing these determinants through targeted multi-level implementation strategies may enhance CM adoption and sustainment in HIV care settings.
Barriers and Enabling Factors for Taking PrEP: The Lived Perspectives of Female, Male and Transgender Sex Workers in Thailand.
Vannakit R, Janyam S, Phaengnongyang C … +8 more , Manopaiboon C, Suya I, Beney T, Girault P, Mills S, Cassell M, Wolf RC, Ananworanich J
AIDS Behav · 2026 May · PMID 42118230 · Publisher ↗
Despite Thailand's goal of ending AIDS by 2030, pre-exposure prophylaxis (PrEP) uptake remains very low among sex workers (SWs) as they are effectively excluded from programming. This qualitative study explores PrEP pere...
Despite Thailand's goal of ending AIDS by 2030, pre-exposure prophylaxis (PrEP) uptake remains very low among sex workers (SWs) as they are effectively excluded from programming. This qualitative study explores PrEP pereceptions, decision-making and long-acting injectable (LAI)-PrEP potential among 113 female, male and transgender SWs across seven high-burden provinces. Utilizing 13 focus group discussions and thematic analysis guided by the Health Belief Model, findings revealed uneven and limited PrEP awareness, with many female SWs encountering PrEP for the first time. Key barriers identified by SWs included HIV-related stigma, lack of appropriate information and issues regarding eligibility. Among transgender women sex workers, there are concerns about hormone therapy interactions. Conversely, high perceived risk and family responsibilies motivated interest in taking PrEP. Participants strongly preferred LAI-PrEP for its discretion and compatibility with irregular sex work schedules. Enhancing equitable access requires decentralized, community-led delivery that addresses structural vulnerabilities including criminalization, stigma and discrimination. While LAI-PrEP addresses adherence challenges, its success depends on intensified awareness and targeted information provision, affordability and integration with existing community-led or key population-led health services to ensure culturally appropriate, stigma-free and sustainable HIV prevention for sex workers.
Living in Fear: Severe HIV-Associated Stigma Persists in Senegal, West Africa.
Benzekri NA, Diagne A, Diouf M … +8 more , Diallo MB, Fall B, Lam HA, Ngom NF, Jaquet A, Seydi M, Bernard C, IeDEA West Africa Collaboration
AIDS Behav · 2026 May · PMID 42105082 · Publisher ↗
Dedicated studies to understand and explore HIV-related stigma among PWH in Senegal are essential for the development and implementation of effective stigma reduction strategies. The goals of this study were to understan...
Dedicated studies to understand and explore HIV-related stigma among PWH in Senegal are essential for the development and implementation of effective stigma reduction strategies. The goals of this study were to understand the current challenges confronted by newly diagnosed PWH in Senegal and to explore the manifestations of HIV-related stigma using a mixed methods approach. We conducted a convergent mixed methods study among participants ≥ 18 years of age, newly diagnosed with HIV and enrolled in the IeDEA West Africa NEWDiag cohort in Dakar, Senegal. A subset of individuals who had been diagnosed with HIV within the preceding 12 months participated in in-depth interviews. For the quantitative strand, sociodemographic data were collected using a structured questionnaire, clinical data were captured using chart review, and HIV-related stigma was assessed using the 12-item HIV Stigma Scale. Multivariable linear regressions were used to evaluate the associations between sociodemographic and clinical characteristics and HIV-related stigma. Qualitative data collection and analysis were guided by the Classic Grounded Theory approach, which included the use of theoretical sampling and the constant comparative method. Among 107 individuals enrolled in the quantitative strand, 49 (46%) were female. The median HIV-related stigma score was 29 (IQR 23-33); 65% experienced personalized stigma, 100% experienced disclosure concerns, 73% reported concerns with public attitudes, and 61% reported negative self-image. In the multivariable linear regression model, time elapsed since HIV diagnosis was associated with higher stigma scores (β: 0.22; 95% CI 0.06-1.60) and any amount of formal education was protective (β: - 0.21; 95% CI - 10.15 to - 0.20). In-depth interviews were conducted with 23 participants of which 10 (43.5%) were women. The core concept that emerged from the qualitative strand was "living in fear". Living with HIV involves living with ongoing and pervasive fear, including fear of death, fear of infecting others, and fear of rejection as a result of one's HIV status. This fear exists within a societal context characterized by profoundly negative perceptions regarding the morality of PWH and a lack of understanding regarding the transmission and treatment of HIV, which leads to the rejection, isolation, and avoidance of PWH. The perceived moral implications associated with contracting HIV can contribute to feelings of extreme shame, loss of self-worth, and suicidality. The strategy employed by PWH to minimize the risk of rejection is "status-concealing", which is the active effort to conceal one's HIV status. Attending HIV clinic appointments and taking ART may act as stimuli that contribute to the re-experiencing of the initial trauma of learning one's HIV diagnosis. HIV continues to be highly stigmatized in Senegal. Newly diagnosed PWH live with a pervasive fear that they will be rejected if their HIV status is disclosed and they employ numerous strategies to conceal their status. Future research is needed to develop, evaluate, and implement interventions to reduce HIV-related stigma in the region.
Cross-sectional and Longitudinal Association Between Sleep and HIV Prevention and Care Behaviors Among Transgender Women of Color: The TURNNT Cohort Study.
Duncan DT, Furuya A, Radix A … +4 more , Whalen A, Merriman J, Callander D, Makarem N
AIDS Behav · 2026 May · PMID 42101533 · Publisher ↗
We investigated the association between sleep health and HIV care and prevention outcomes among transgender women of color (TWOC). We used data from TWOC living in New York City collected from 2020 to 2022. Our exposures...
We investigated the association between sleep health and HIV care and prevention outcomes among transgender women of color (TWOC). We used data from TWOC living in New York City collected from 2020 to 2022. Our exposures of interest were short sleep (sleeping for less than seven hours per night), poor-quality sleep (self-rated quality of sleep as “very bad” or “fairly bad”), and long sleep onset latency (taking at least 30 min to fall asleep). We asked participants about their HIV care and prevention outcomes, including HIV/STI testing, condom use, PrEP use, and HIV viral load suppression. We used Targeted Maximum Likelihood Estimation to estimate the association between sleep and these outcomes and included age, education, income, US-born nativity, and hormone replacement therapy use as potential confounders. Among the 314 participants, 54.5% had short sleep, 35.0% had poor-quality sleep, and 24.8% experienced long sleep onset latency. Among people living with HIV (51.6%), those who had short amounts of sleep were less likely to always use a condom (Adjusted Prevalence Ratio [aPR]: 0.67; 95% CI: 0.51–0.87) and be virally suppressed (aPR: 0.87; 95% CI: 0.79–0.96), and those who had poor-quality sleep were less likely to be virally suppressed (aPR: 0.83; 95% CI: 0.72–0.96). Among people living without HIV (46.2%), experiencing long sleep onset latency decreased the likelihood of always using condoms (aPR: 0.36; 95% CI: 0.15–0.85). Improving sleep health among TWOC could improve HIV care and prevention outcomes and reduce health inequities.
Associations Between Extreme Weather Events, Resource Insecurities, and HIV Vulnerabilities Among Adolescent Girls and Young Women in Kenya: Latent Profile Analysis Findings.
Logie CH, Admassu Z, MacNeil A … +11 more , Hasham A, Kagunda J, Evelia H, Gachoki C, Omondi B, Chege M, Mwanga M, Gittings L, Dorea C, Turan JM, Mbuagbaw L
AIDS Behav · 2026 May · PMID 42084840 · Publisher ↗
Extreme weather events (EWE) may elevate HIV risk across Sub-Saharan Africa by worsening resource insecurities, yet limited research has included adolescent girls and young women (AGYW). We examined associations between...
Extreme weather events (EWE) may elevate HIV risk across Sub-Saharan Africa by worsening resource insecurities, yet limited research has included adolescent girls and young women (AGYW). We examined associations between EWE exposure, resource insecurities, and HIV vulnerabilities among AGYW in Kenya. We conducted a community-based cross-sectional survey with a purposive sample of AGYW aged 16-24 in Nairobi and Kisumu. We used latent profile analysis (LPA) to identify resource insecurity profiles based on food, water, and sanitation access; multinomial logistic regression to assess associations between past-year EWE exposure and profile membership; and multivariable regression to assess associations between profile membership and HIV vulnerabilities (transactional sex, intimate partner violence [IPV], adolescent sexual and reproductive health stigma [ASRH-S], sexual relationship power [SRP]). LPA categorized participants (n = 597; mean age: 20.13 years) into three profiles: mild, moderate, and severe insecurity. Multiple EWE exposure (vs. 1 EWE) was associated with increased odds of moderate (2-4 EWEs: Adjusted Relative Risk Ratio [aRRR]: 1.71, 95% Confidence Interval [CI] = 1.03-2.83; > 5 EWEs: aRRR: 2.24, 95%CI: 1.10-4.53) and severe insecurity (≥ 5 EWEs: aRRR: 6.55, 95%CI: 1.78-24.05). The severe resource insecurity group reported increased transactional sex (aOR = 4.72; 95%CI: 2.45-9.07), IPV (aOR = 3.02; 95%CI: 1.22-7.48), and ASRH-S (aβ = 1.88; 95%CI: 0.45-3.30), and lower SRP (aβ = -3.16; 95%CI: -5.85, -0.47), than those with mild insecurity. EWE exposure is associated with heightened resource insecurities, which are linked to HIV vulnerabilities among AGYW in Kenya. Findings highlight the need for climate-responsive, gender and youth-tailored interventions to address multiple resource insecurities and strengthen HIV prevention with climate-affected Kenyan AGYW.
Correlates of HIV and STI Testing in Rural Southern Substance Using-Men who have Sex with Men: A Behavioral Model for Health Services Use Approach.
Owens HA, Montemayor BN, Gilreath TD … +1 more , Owens C
AIDS Behav · 2026 May · PMID 42084839 · Publisher ↗
While research shows rural men who have sex with men (MSM) are less likely to get HIV and STI tested compared to urban MSM, research has not identified which groups of rural MSM are more or less likely to get tested. The...
While research shows rural men who have sex with men (MSM) are less likely to get HIV and STI tested compared to urban MSM, research has not identified which groups of rural MSM are more or less likely to get tested. There is a dearth of literature of within-group differences of HIV/STI testing among rural MSM, especially among substance using-MSM who are more vulnerable to HIV/STI infections. This study examined factors associated with HIV and STI testing among rural substance-using MSM in the South, guided by the Andersen's Behavioral Model of Health Services Use. Participants (N = 284) completed an online cross-sectional questionnaire, and two logistic regressions examined associations of predisposing, enabling, and need factors with past-year HIV and STI testing. For HIV testing, significant factors were education level, having a primary care provider, past-year sexualized drug use, and past-year STI diagnosis. For STI testing, significant factors were education level, sexualized drug use, and drug-related transactional sex. Findings highlight the importance of educational and risk perception campaigns to increase rural MSM accessing services, provider trainings for providers to identify behavioral risk factors and offer testing services, and at-home testing services.
SeCuRE Pilot Trial: A Community-Engaged HIV Status-Neutral Microeconomic Intervention in the United States.
Gamarel K, Mayo-Wilson LJ, Ubong IA … +10 more , Jadwin-Cakmak L, Correll-King W, Monro D, Harris H, Poindexter J, Riser C, Stephenson J, Reyes L, Neilands TB, Poteat T
AIDS Behav · 2026 May · PMID 42084838 · Full text
Transgender women of color in the United States experience inequities across the HIV prevention and care continua shaped by intersectional oppression and economic marginalization. We evaluated the "Strengthening Communit...
Transgender women of color in the United States experience inequities across the HIV prevention and care continua shaped by intersectional oppression and economic marginalization. We evaluated the "Strengthening Community Responses to Economic Vulnerability" (SeCuRE) intervention, an HIV status-neutral, multicomponent program comprising financial assistance, peer-facilitated group sessions focused on economic empowerment, gender affirmation, community support, individualized mentorship, and microgrants, in a two-arm pilot mixed-methods randomized waitlist-controlled trial with transgender women of color in Detroit, Michigan. The intervention included 12 peer-led group sessions adapted from a prior microenterprise program and individualized mentoring with a microgrant. Primary outcomes were feasibility, acceptability, and fidelity. Enrollment was 97.5% (39/40), retention ranged from 84.6 to 87.2%, and group attendance averaged 90.3%. Acceptability was high and fidelity benchmarks were achieved. Exploratory analyses showed significant improvements in financial self-efficacy at 3 months (B = 0.67, 95% CI 0.16-1.17, z = 2.60, p = 0.009) and reductions in condomless sex at 6 months (OR = 0.05, 95% CI 0.002-0.86, z = - 2.06, p = 0.040). Qualitative exit interviews indicated high acceptability and highlighted themes of financial empowerment, community connection, and affirming environments. SeCuRE was feasible, acceptable, delivered with fidelity, and showed preliminary efficacy. Findings underscore the urgent need for larger trials of community-driven, status-neutral interventions embedded within community partnerships that provide housing, food, and financial supports.
Reach of Mpox Vaccination One Year After the Start of the Epidemic: Results of a Community-Based Survey of Men Who Have Sex with Men, San Francisco, USA.
Rojo E, Haider MR, Suprasert B … +2 more , Wilson EC, McFarland W
AIDS Behav · 2026 May · PMID 42084837 · Publisher ↗
Our survey of venue-attending men who have sex with men (MSM) in San Francisco (N=545) found that one year after the first reported case of mpox, 76% (95% CI 72-79%) self-reported receiving at least one vaccine dose and...
Our survey of venue-attending men who have sex with men (MSM) in San Francisco (N=545) found that one year after the first reported case of mpox, 76% (95% CI 72-79%) self-reported receiving at least one vaccine dose and 58% (95% confidence interval [CI] 54-62%) received two doses. Vaccination was higher among MSM born outside the US (adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.12-3.39), with some college or higher education (aOR 1.90, 95% CI 1.10-3.28), and seeing a healthcare provider in the last year (aOR 2.75, 95% CI 1.56-4.85). No differences in vaccination were found by race/ethnicity, age, and HIV status. Findings show rapid mpox vaccination uptake among MSM in San Francisco, although lagging behind among US-born MSM and those with lower education.
Identifying Implementation Gaps in the HIV Prevention Cascade among Peruvian Men Who Have Sex with Men.
Gallardo-Cartagena JA, Oliveros D, Cabello R … +5 more , Benites C, Buchbinder S, Konda KA, Altice FL, Sanchez J
AIDS Behav · 2026 May · PMID 42084836 · Publisher ↗
Despite expansion of publicly funded HIV pre-exposure prophylaxis (PrEP) in Peru, uptake remains limited. We conducted a cross-sectional online survey (June-August 2023) among 463 men who have sex with men eligible for P...
Despite expansion of publicly funded HIV pre-exposure prophylaxis (PrEP) in Peru, uptake remains limited. We conducted a cross-sectional online survey (June-August 2023) among 463 men who have sex with men eligible for PrEP to examine progression across the PrEP cascade and identify implementation-relevant determinants of PrEP seeking and initiation. Although 78.6% reported readiness to start PrEP, only 30.5% had sought PrEP and 17.3% had ever initiated. Exploratory factor analysis identified five implementation-related constructs, including actionable PrEP knowledge, self-efficacy, action planning, social support, and cost concerns. In stage-specific multivariable models, higher actionable PrEP knowledge was strongly associated with seeking PrEP (aOR 4.01, 95% CI 2.61-6.33) and initiation (aOR 3.17, 95% CI 1.52-7.01). Higher income was also associated with initiation. Substantial implementation gaps exist between readiness and uptake. Multi-level strategies that strengthen meaningful knowledge delivery and reduce structural barriers may improve PrEP cascade progression in Peru.
An Examination of Perceptions and Usage of Dried Blood Spot Biosampling Technology for HIV Viral Load Collection Among Youth with HIV.
Gurung S, MacDonell K, Sizemore KM … +2 more , Ferraris CM, Naar S
AIDS Behav · 2026 May · PMID 42070204 · Publisher ↗
Dried blood spot (DBS) biosampling holds promise for expanding routine viral load (VL) monitoring for youth with HIV (YWH), particularly those at highest risk for HIV medication non-adherence. This mixed methods study pi...
Dried blood spot (DBS) biosampling holds promise for expanding routine viral load (VL) monitoring for youth with HIV (YWH), particularly those at highest risk for HIV medication non-adherence. This mixed methods study piloted home-based DBS collection with YWH, aged 15-24 years. We enrolled 34 YWH with suppressed VL from April 22, 2020, to December 15, 2021, a subset of a fully virtual, nationwide decentralized clinical trial (ATN 144 SMART). Participants were mailed a HemaSpot-HF kit and asked to complete a computer-assisted self-interview (CASI) with an instructional DBS video. Surveys and semi-structured interviews provided quantitative and qualitative data to assess feasibility, appropriateness, and acceptability of home-based DBS for VL monitoring. Of 239 total screener attempts, 134 individuals were eligible and 115 provided contact information/completed the screener; 34 enrolled and returned DBS kits. Descriptive analyses showed a positive relationship between perceived suitability, feasibility, and acceptability. Perceived suitability was negatively associated with age, and feasibility differed significantly by health insurance coverage. Qualitative findings identified facilitators such as clinic/provider support, awareness of DBS innovation, insurance coverage, and streamlined mailing processes. Barriers included living environment challenges, cost concerns, and mail delivery issues. This pilot supports a self-management model and provides preliminary evidence that home-based DBS collection is feasible and acceptable among YWH. Scaling up this method through clinic and provider promotion could transform YWH HIV care by enabling remote VL monitoring. Findings also underscore the value of DBS as a practical biospecimen collection strategy for decentralized research models.
Impact of a Trauma-Informed Intervention on Psychosocial and HIV Treatment Outcomes Among Older Adults Living with HIV: A Pilot Study.
Brown MJ, Addo PNO, Owiredu D … +6 more , Kaur A, Adeagbo O, Haider MR, Hardin JW, Weissman S, Hansen NB
AIDS Behav · 2026 Apr · PMID 42056642 · Publisher ↗
A childhood sexual abuse (CSA) history is more prevalent among people living with HIV and may have lingering effects among older adults living with HIV (OALH). However, studies examining the impact of trauma-informed int...
A childhood sexual abuse (CSA) history is more prevalent among people living with HIV and may have lingering effects among older adults living with HIV (OALH). However, studies examining the impact of trauma-informed interventions among OALH are scant. The aim of the study was to determine the preliminary effect of the Coping with Childhood Sexual Abuse, HIV, and Aging (CoSHA) intervention on depressive symptoms, coping and ART adherence among OALH. Data were obtained from 28 OALH recruited from an immunology clinic and an AIDS service organization in South Carolina. Generalized estimating equation (GEE) models were used to determine the preliminary effect of the intervention on depressive symptoms, coping and ART adherence among OALH from baseline to 6-week, 3- and 6- month follow-up using intention-to-treat analysis. The intervention reduced depressive symptoms over the 6-month period (B=-9.13, 95% CI: -10.3, -8.00). There were also positive changes in planning coping (B = 0.73, 95% CI: -0.08, -1.54) and religious coping (B = 1.13, 95% CI: -0.08, 2.34), and ART adherence (B = 15.2, 95% CI: -0.95, 31.3) but these were borderline statistically significant. Future research should determine the impact of the CoSHA intervention in a full randomized controlled trial.
Multi-level Risks Associated with Partner and Client Violence Among Trans Women Who Do Sex Work in San Francisco, 2023-2024.
O'Neal IR, Palafox E, Suprasert B … +5 more , Baguso GN, Chritton SE, Ruiz R, McFarland W, Wilson EC
AIDS Behav · 2026 Apr · PMID 42053906 · Publisher ↗
Syndemic conditions of sex work and violence are associated with elevated HIV risk for trans women. Less is known about the types of violence experienced by trans women who engage in sex work. We examined the prevalence...
Syndemic conditions of sex work and violence are associated with elevated HIV risk for trans women. Less is known about the types of violence experienced by trans women who engage in sex work. We examined the prevalence of types of violence for trans women engaged in sex work and correlates of interpersonal violence (IPV). Data were from National HIV Biobehavioral Surveillance among trans women in San Francisco, 2023-2024. Demographic characteristics, substance use, sex work, and IPV were selfreported. Multivariable logistic regression identified factors associated with IPV among trans women engaged in sex work. Of 117 trans women engaged in sex work, over half were aged 18-39 (50.4%), Hispanic/Latina (54.3%), US-born (58.1%), had a high school education or less (59.0%), and earned < $40,000 USD/year (80.8%). Trans women engaged in sex work were more likely to experience sexual assault by steady partners (6.8% vs. 1.4%, X = 7.25, p = 0.019), physical attack by casual partners (6.0% vs. 0.9%, X = 7.56, p = 0.010), and physical attack by steady partners (12.1% vs. 3.2%, X = 10.08, p = 0.001) than those not engaged in sex work. Among trans women engaged in sex work, those aged 18-39 years (vs. ≥ 40, aOR 9.38, p < 0.001) and those using methamphetamine (vs. none, aOR 4.82, p = 0.004) had higher odds of IPV. Results point to an unmet need for IPV and trauma services focused on trans women who engage in sex work. Economic interventions that reduce reliance on sex work for income may present the best opportunity for violence prevention.
Suitability and Acceptability of Decentralised Care for People Living with HIV.
Dixon B, Yap SZK, Baek M … +5 more , Boyle N, Lynch D, Bergin C, Fleming C, Townsend L
AIDS Behav · 2026 Apr · PMID 42053905 · Publisher ↗
HIV management is evolving, with improved long-term survival and patient health. However, the model of care for people living with HIV (PLWHIV) in Ireland has remained unchanged, with care focused in tertiary sites in ur...
HIV management is evolving, with improved long-term survival and patient health. However, the model of care for people living with HIV (PLWHIV) in Ireland has remained unchanged, with care focused in tertiary sites in urban centres. We explored the acceptability of decentralised HIV care at local hospitals, community healthcare settings, or with primary care providers (PCP), and the acceptability of receiving antiretroviral therapy (ART) locally. HIV attendees at two tertiary referral centres were invited to complete a questionnaire recording demographics, transit time to clinic, engagement with PCP, satisfaction with current model of care and acceptability of alternative models on a Likert scale and provide written qualitative feedback. The relationship between acceptance of new models of care and sociodemographic factors were investigated. N = 511 (71% male) PLWHIV at two tertiary HIV centres participated. The median time spent traveling to and from clinic was 1 h 50 min. While the current model of care was convenient to the majority, decentralised care models were also acceptable to most participants. Longer travel time was associated with increased acceptance of care locally (β=-0.015, p < 0.001), while male sex was associated with acceptance of community-based care (β=-1.11, p = 0.007). Care in the community and receipt of ART locally was more acceptable to younger patients. Concerns regarding stigma and lack of local expertise were cited as barriers to changing the current care model. We identify a cohort of PLWHIV for whom an alternative model of care is preferable, and supports the development of a hybrid HIV care model in Ireland.
Factors Associated with Not Seeking Post-exposure Prophylaxis for HIV Among PrEP-Naive Men Who Have Sex with Men: An Analysis from the French ANRS-PREVENIR Study.
Jones JC, Costa M, Sagaon-Teyssier L … +10 more , Sow A, Beniguel L, Ben-Mechlia M, Assoumou L, Ghosn J, Costagliola D, Manda V, Protière C, Spire B, Michels D
AIDS Behav · 2026 Apr · PMID 42045640 · Publisher ↗
HIV post-exposure prophylaxis (PEP) uptake is low among men who have sex with men (MSM), even among those aware of it. We examined factors associated with not seeking PEP among MSM in the ANRS-PREVENIR cohort who were Pr...
HIV post-exposure prophylaxis (PEP) uptake is low among men who have sex with men (MSM), even among those aware of it. We examined factors associated with not seeking PEP among MSM in the ANRS-PREVENIR cohort who were PrEP-naive at enrollment, aware of PEP, and reported a potential need for it in the previous 12 months. Among 3,193 participants, 632 (19.8%) met these criteria, and 424 (67.1%) did not seek PEP. The most cited reasons were low perceived HIV risk, fear of judgment or stigmatization, and reluctance to seek hospital-based care. In multivariable analyses, living alone, perceived sexual risk, awareness of a partner's HIV status, high alcohol consumption, and engagement in 'hardcore sexual' practices were associated with higher odds of not seeking PEP, whereas frequent HIV testing and prior mental health consultation were associated with lower odds. These findings highlight the need to address individual and structural barriers to PEP uptake.
The HIV Pre-exposure Prophylaxis (PrEP) Initiation Cascade: Patient Experiences with Primary Care in a Health Care System Before Starting PrEP.
Lockhart E, Turner D, Alsultan A … +6 more , Berezin M, Guastaferro K, Pittiglio B, Torres Alzate H, Szalacha L, Marhefka S
AIDS Behav · 2026 Apr · PMID 42045639 · Full text
Pre-exposure prophylaxis (PrEP) for HIV prevention has been available since 2012; only 36% of people in the U.S. who would benefit from PrEP have been prescribed it. Primary care is an ideal location to initiate PrEP, as...
Pre-exposure prophylaxis (PrEP) for HIV prevention has been available since 2012; only 36% of people in the U.S. who would benefit from PrEP have been prescribed it. Primary care is an ideal location to initiate PrEP, as many people who may benefit from PrEP are seen in primary care annually. Yet, patients and providers face barriers to accessing and prescribing PrEP. It is unclear where disengagement from PrEP initiation occurs. We have defined the PrEP Initiation Cascade to include eight timepoints: (1) discussing sexual health with a provider, (2) interest in hearing about PrEP, (3) PrEP awareness, (4) PrEP willingness, (5) PrEP intentions, (6) speaking with a provider about PrEP, (7) being prescribed PrEP, (8) using PrEP. We surveyed patients (n = 278) from primary care in a large health system to understand where they disengaged from initiating PrEP. Multivariable logistic regression models examined patients' demographic characteristics associated with disengagement during the PrEP Initiation Cascade. Over 66% of patients wanted to hear about PrEP from their provider; less than 20% had. Of patients who spoke to their provider about PrEP, 60% were prescribed it. In regression analyses, we found that patients who were raised religious (vs. never religious), regardless of current religiosity, were more likely to have discussed sexual health with their provider, wanted to hear about PrEP from their provider, and had ever heard of PrEP. People who identified as bisexual (vs. heterosexual) and people who were diagnosed with an STI in the last 6 months (vs. no STI diagnosis) were more likely to have ever spoken to a doctor about PrEP, been prescribed PrEP, and ever used PrEP. Most patients in primary care have discussed their sexual health with their provider in the past year and are interested in hearing about PrEP from their provider, yet few spoke with their provider about PrEP. Multi-level interventions for patients and providers in primary care should be developed to increase PrEP initiation. Future research should focus on keeping patients engaged with the PrEP Initiation Cascade, particularly those in demographic groups shown to disengage in the PrEP Initiation Cascade prematurely.
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