AIDS And Behavior[JOURNAL]
Sun
200 papers
30 Years of AIDS and Behavior: The Times They are A-Changin'.
Kalichman SC
AIDS Behav · 2026 Jun · PMID 41968264 · Publisher ↗
Abstract loading — click title to view on PubMed.
Persistent HIV Transmission Misconceptions Among People Who Inject Drugs in Massachusetts, USA.
Shaw LC, Jimenez YS, Sproesser DM … +8 more , Hayes E, Baumgartner K, Krakower DS, Bordeu M, Mimiaga MJ, Bositis CM, Bazzi AR, Biello KB
AIDS Behav · 2026 Apr · PMID 41964811 · Publisher ↗
Despite the widespread success of combination antiretroviral therapy in reducing overall HIV morbidity and mortality, people who inject drugs (PWID) continue to experience elevated risk of infection and suboptimal care o...
Despite the widespread success of combination antiretroviral therapy in reducing overall HIV morbidity and mortality, people who inject drugs (PWID) continue to experience elevated risk of infection and suboptimal care outcomes. Addressing knowledge gaps related to HIV acquisition and transmission is essential for reducing incident cases of HIV. We assessed HIV transmission misconceptions (e.g., HIV can be transmitted through sharing cigarettes, hugging an infected person) among HIV-negative PWIDs recruited through two syringe service programs in Massachusetts between 2020 and 2025. Participants completed 10 items adapted from the International AIDS Questionnaire, with responses categorized into three groups: 'many misconceptions' (0-7 questions answered correctly), 'few misconceptions' (8-9 correct), and 'no misconceptions' (10 correct). Of 185 participants, 79% held at least one misconception. The most common misconception was that HIV could be transmitted through mosquitoes (55% incorrect). The least prevalent misconceptions related to condom use, drug injection "works" (e.g., cookers, cottons), and hugging (≥ 90% answered correctly). We also observed misconceptions related to syringe sharing (13% incorrect) and mother-to-child transmission (17% incorrect; no difference between women and men). Sociodemographic characteristics did not differ significantly across misconception categories. Participants who reported a recent overdose represented 27% of the full sample but 45% of the 'no misconceptions' subgroup. Misconceptions present since the early era of the HIV epidemic remain prevalent among PWID in this region, despite access to robust harm reduction and HIV prevention services. Findings highlight the importance of dispelling long-standing myths, strengthening education about preventive perinatal transmission, and reinforcing knowledge of injection-specific transmission.
PrEP Use Willingness and Perceptions Among Young Female Sex Workers in Kisumu, Kenya: Implications for HIV Prevention.
Omollo D, Murnane P, Ayallo J … +2 more , Onyango J, Weiser SD
AIDS Behav · 2026 Apr · PMID 41964810 · Publisher ↗
Female sex workers (FSW) are disproportionately burdened with HIV. Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV transmission, yet determinants of willingness to use PrEP among young FSW is less u...
Female sex workers (FSW) are disproportionately burdened with HIV. Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV transmission, yet determinants of willingness to use PrEP among young FSW is less understood. We assessed factors associated with willingness to use PrEP, using data from a cross-sectional study on PrEP adherence strategies, among HIV-negative FSW aged 18-24 years living in Kisumu City, Kenya. We characterized differences in demographics and sexual history by awareness of PrEP using Pearson's chi-square test. Among FSW aware of PrEP, we further assessed factors associated with willingness to use PrEP. We enrolled 200 FSW, of whom 83% reported being aware of PrEP. Among those aware of PrEP, 16% had previously taken PrEP. On average, for each additional day or night spent away from the neighborhood in the past month, FSW had 12% decreased odds (AOR = 0.88, 95%CI: 0.77, 0.99) of willingness to use PrEP. While most FSW in Kisumu City were aware of PrEP and perceived it positively, uptake was hindered by stigma, discomfort with health services, and lifestyle factors like mobility. To close the gap between awareness and actual use of PrEP, there is need for flexible and mobile PrEP delivery models tailored to the unique lifestyles of FSW, such as community-based outreach, peer delivery, or digital health interventions that support care continuity despite mobility.
Perceptions About the Relationship Between HIV, Antiretroviral Therapy (ART), and Fecundity in Sub-Saharan Africa: Findings from a Systematic Scoping Review.
Sedlander E, El Ayadi AM, Wairimu N … +5 more , Ackernecht J, Velloza J, Cedars MI, Ngure K, Gandhi M
AIDS Behav · 2026 Apr · PMID 41964809 · Full text
Advances in antiretroviral therapy (ART) enable women living with HIV to safely conceive and give birth without vertical transmission. However, in sub-Saharan Africa, 1 in 6 people experience infertility and women living...
Advances in antiretroviral therapy (ART) enable women living with HIV to safely conceive and give birth without vertical transmission. However, in sub-Saharan Africa, 1 in 6 people experience infertility and women living with HIV face even higher rates. Research shows that ART and virologic suppression improve fertility/fecundity, yet this benefit is often overlooked in ART adherence education. To map the literature on people's understandings and beliefs about the relationship between HIV, ART, and fecundity, a systematic scoping review of the English and French literature in sub-Saharan Africa was conducted. After iterative search strategy development and implementation in PubMed, three independent reviewers screened texts, read a subset of full texts, and used a charting table to summarize results and identify emerging themes. Of 1,981 sources identified, only 12 met the inclusion criteria uncovering the following themes: (1) Beliefs that HIV and PrEP cause infertility exist but have not been widely documented; (2) Perceptions that ART improves health before pregnancy motivates women to adhere and provides hope about future pregnancy; (3) Stigma from providers discourage women living with HIV from seeking preconception care; and (4) Lack of awareness among providers and patients about the impact of HIV on pregnancy, highlights the need for provider training. Research on perceptions of HIV, ART, and fecundity in sub-Saharan Africa is sparse. Future research is needed to determine whether addressing this gap in understanding could improve ART adherence and help couples living with HIV build their families.
Human Papillomavirus Vaccine Hesitancy and Uptake Among Adolescent Girls Living with HIV in Sierra Leone: A Call for Integration of Cervical Cancer Services.
Jiba DF, Turay P, Baldeh M … +19 more , Kamara MN, Kanu S, Farma-Grant LML, Barrie U, Awonuga WO, Baio MM, Sesay D, Shehab D, Sinnah R, Namanga ES, Johnson PMD, Brima MT, Sandy SFF, Saccoi EJ, Kamara JB, Smith M, Kamara MS, Andrew Dykens J, Lakoh S
AIDS Behav · 2026 Apr · PMID 41964808 · Publisher ↗
Human papillomavirus (HPV) vaccination is critical for preventing cervical cancer among women living with HIV. Yet, uptake among adolescent girls needed to prevent cervical cancer remains understudied in low-income count...
Human papillomavirus (HPV) vaccination is critical for preventing cervical cancer among women living with HIV. Yet, uptake among adolescent girls needed to prevent cervical cancer remains understudied in low-income countries. This cross-sectional study examined HPV vaccination rates among adolescent girls (aged 10-18 years), sociodemographic predictors and perceptions related to HPV vaccination among their caregivers. A total of 249 caregivers of these adolescents, all attending antiretroviral therapy clinics in Sierra Leone, were included. This cross-sectional study assessed HPV vaccination rates among adolescent girls with HIV. We collected data using structured surveys and employed logistic regression models to identify factors associated with vaccine initiation (≥ 1 dose). Only 13.3% (n = 33/249) of adolescents had received the HPV vaccine, with significant disparities by age: older adolescents (18 years) had higher uptake (27.8%, 10/36) compared to younger peers (10-13 years) (5.3%, 5/94). Caregiver relationship strongly predicted vaccination: extended family caregivers had 1.84-fold higher odds of initiating vaccination than grandparents (adjusted OR = 1.84, 95% CI:1.09-3.12, p = 0.022). Misconceptions were prevalent: 16.8% (n = 41/243) of caregivers believed HPV vaccination promotes premarital sex, and 4.5% (n = 11/243) feared infertility, with none in the latter group vaccinating their child. Despite 80.7% (n = 196/243) expressing intent to vaccinate, only 6.6% (n = 13/196) had done so, highlighting a critical intention-action gap. Structural barriers, such as inconsistent access and cultural myths, likely mediate low uptake. These findings underscore the need for multifaceted interventions, including community-led education to dispel myths, integration of HPV vaccination into HIV care platforms, and targeted engagement of extended family decision-makers.
What, how, and when matters: acceptability and preferences for HIV pre-exposure prophylaxis among people who inject drugs in New Delhi, India.
McFall AM, Kant A, Bell J … +7 more , Mohapatra S, Kaptchuk RP, Srikrishnan AK, Zook KJC, Mehta SH, Clipman SJ, Solomon SS
AIDS Behav · 2026 Apr · PMID 41954809 · Full text
HIV pre-exposure prophylaxis (PrEP), particularly long-acting injectable formulations (LAI PrEP), has the potential to reduce the number of new infections among people who inject drugs (PWID), especially in low resource...
HIV pre-exposure prophylaxis (PrEP), particularly long-acting injectable formulations (LAI PrEP), has the potential to reduce the number of new infections among people who inject drugs (PWID), especially in low resource settings in the context of low coverage of harm reduction services, high HIV incidence, and substance use and instability. Few studies have examined PrEP perceptions, preferences, and service delivery models among these populations. We aimed to characterize acceptability, perceptions, preferences, and barriers/facilitators of different PrEP options, including LAI PrEP, among a cohort of PWID in New Delhi, India. This mixed methods study (March 2024-March 2025) included focus group discussions (FGDs) followed by cross-sectional survey data covering PrEP awareness, acceptability, and preferences and a discrete choice experiment (DCE) on LAI PrEP. FGDs indicated there was little prior awareness of and interest in PrEP, with concerns about what PrEP medications may do to their body or how it would make them feel. Hesitation surrounding PrEP was also driven by low personal HIV risk perception. Among 389 surveyed, 96% had no prior knowledge of PrEP; 72% indicated they would rather not take PrEP, with 20% preferring LAI PrEP, 5% weekly pills, 3% undecided, and no one preferred daily pills. Preferred characteristics of LAI PrEP were less frequent injections, delivery at existing healthcare clinics, and payment or incentives. PrEP programs of any modality aiming to build demand and deliver PrEP to PWID should consider how these populations often differ substantively in knowledge, needs, and preferences from other populations that have so far been the focus of PrEP campaigns.
HIV-Stigmatizing Beliefs and Attitudes as a Barrier to Early PrEP Care Continuum Engagement Among People Who Inject Drugs.
Walters SM, Do H, Jaiswal J … +11 more , Khezri M, Ivasiy R, Friedman SR, Ompad DC, El Shahawy O, Lim S, Schneider JA, Bouris A, Bluthenthal RN, Earnshaw VA, Huh J
AIDS Behav · 2026 Apr · PMID 41954808 · Publisher ↗
HIV pre-exposure prophylaxis (PrEP) is a highly effective prevention strategy, yet awareness, knowledge, and willingness to use it among people who inject drugs (PWID) remains inadequate despite widespread eligibility. S...
HIV pre-exposure prophylaxis (PrEP) is a highly effective prevention strategy, yet awareness, knowledge, and willingness to use it among people who inject drugs (PWID) remains inadequate despite widespread eligibility. Stigma, particularly HIV-stigmatizing beliefs and attitudes, may be a key barrier to engagement at early stages of the PrEP care continuum. We examine how HIV-stigmatizing beliefs and attitudes affect PrEP awareness, knowledge, and willingness among PWID. We surveyed 262 HIV-negative PWID in Los Angeles and Denver (2021-2023) and used structural equation modeling to examine associations between HIV-stigmatizing beliefs and attitudes (11-item validated scale with α = 0.899 and 1-factor structure) and three early PrEP outcomes: awareness, knowledge, and willingness, while controlling for race/ethnicity, gender, housing status, and conducted sub-analyses on willingness to use long-acting injectable PrEP. HIV-stigmatizing beliefs and attitudes were significantly associated with lower PrEP awareness (β - 0.212, p < 0.001) and less accurate knowledge (β - 0.179, p = 0.006). Accurate knowledge was associated with greater willingness to use PrEP (β 0.175, p = 0.027). Black, Indigenous, and Other Persons of Color (BIPOC) participants reported higher HIV-stigmatizing beliefs and attitudes than non-Hispanic White participants (β 0.196, p = 0.003). Over half (56%) of participants were willing to take daily oral PrEP once informed, and many were interested in long-acting injectable PrEP. HIV-stigmatizing beliefs and attitudes are associated with lower PrEP care continuum engagement among PWID, particularly through limiting awareness and understanding of PrEP. BIPOC participants reported higher levels of stigmatizing attitudes, suggesting that broader structural and intersectional stigma may shape PrEP engagement, consistent with prior research. Interventions to increase PrEP uptake should address both individual- and structural-level stigma and consider leveraging peer networks and community supports to foster resilience and improve equitable access to HIV prevention tools.
Predictive Models to Identify Factors Associated with a High One-Time Sexual Partnership Rate Among U.S. Men Who Have Sex with Men.
Anderson EJ, Gandhi NR, Sanchez TH … +2 more , Enns EA, Jenness SM
AIDS Behav · 2026 Apr · PMID 41934601 · Publisher ↗
One-time sexual partnerships have the potential to generate densely connected sexual networks. The distribution of one-time partnerships among MSM is often right-skewed, wherein a small proportion of MSM have a high numb...
One-time sexual partnerships have the potential to generate densely connected sexual networks. The distribution of one-time partnerships among MSM is often right-skewed, wherein a small proportion of MSM have a high number of partners. Identifying a set of covariates to predict who these individuals are can aid in developing and deploying STI prevention interventions and contribute to our understanding of STI transmission dynamics. We fit several negative binomial models to estimate the count of one-time partnerships among US MSM using data from a web-based egocentric network survey. Penalized logistic models were fit to evaluate predictors of MSM with high partnership counts at different binary cut points. Several covariates were significant predictors of a high one-time partnership rate in every model, including the number of main (partner considered a boyfriend, significant other, or life partner) and casual (an ongoing relationship, but not a main partner) partners, engaging in exchange sex, mobile app or internet use to meet men, and non-injection drug use. In the negative binomial models, the rate of one-time partnership formation was lower for those having one main partner compared to none, and higher for those with > 1 main partner, or any casual partners. Logistic models for partnership rates with a cut point at 6 partners per year considered as a high count had the overall best predictive performance. Overall, risk factors for HIV tend to occur together. We identified a set of covariates that were consistent predictors of high partnership rates. These models and predictors could be used as indicators for HIV/STI prevention interventions, such as partner-based services, and to aid in the parameterization of transmission models.
A Content Analysis of Digital Crowdsourced Messages to Reduce HIV Stigma and Promote Testing Among Adolescents and Young Adults in Kazakhstan.
Landers SE, Sun Y, Tolegenova A … +10 more , McNabb K, Zhao Y, Kuskulov A, Nyblade L, Tucker JD, Balabekova O, Gryazev D, Mergenova G, Davis A, JasSpark Study Team
AIDS Behav · 2026 Apr · PMID 41934600 · Publisher ↗
In Kazakhstan, almost a quarter of HIV infections are estimated to be among adolescents and young adults (AYA). However, AYA have low testing rates, partially due to stigma. A nationwide digital crowdsourcing open call i...
In Kazakhstan, almost a quarter of HIV infections are estimated to be among adolescents and young adults (AYA). However, AYA have low testing rates, partially due to stigma. A nationwide digital crowdsourcing open call invited AYA ages 13-29 years old to create media content that could reduce HIV stigma in order to promote testing among peers. This study examines the format and content of entries to the open call, exploring whether AYA address key points about stigma and testing identified by public health professionals. The content analysis framework was informed by Nyblade et al.'s concept of immediately actionable drivers of stigma: awareness of stigma, fear of HIV acquisition, attitudes, and institutional environment. Additional codes examined content type, tone, AYA-specific appeal, social support, and testing messages. The open call received 96 entries, representing almost all provinces in Kazakhstan. AYA submitted more videos/images (67%) compared to other types of content. Most content was emotive in tone (60%) and included features with AYA-specific appeal (80%). Nearly a third of entries referenced the impact of social support. Eighty-eight percent included at least one driver of stigma; most addressed them in a positive way, but some perpetuated stigmatizing ideas. Finally, 60% explained the importance of HIV testing, mainly focusing on health implications. Findings suggest AYA are willing to submit to open calls and can produce creative, relevant content to address HIV stigma and promote testing. A minority of entries included potentially stigmatizing content, highlighting the importance of a structured, multi-phase judging process in crowdsourcing.
Intersectional Stigma and Health of People Living with HIV on ART Who Use Alcohol in Southwestern Uganda.
Gutin SA, Atukunda E, Khorassani FS … +10 more , Fatch R, So-Armah K, Tumwegamire A, Emenyonu NI, da Silva CE, Ngabirano C, Lunze K, Adong J, Muyindike W, Hahn JA
AIDS Behav · 2026 Apr · PMID 41931222 · Full text
HIV, TB, and alcohol use are stigmatized conditions that lead to poor care engagement and health outcomes. Stigmatized traits can operate independently or be intersectional. We examined the relationships between intersec...
HIV, TB, and alcohol use are stigmatized conditions that lead to poor care engagement and health outcomes. Stigmatized traits can operate independently or be intersectional. We examined the relationships between intersectional HIV-, TB-, and alcohol-related stigma on poorer perceived health among people with HIV (PWH) receiving antiretroviral therapy in a study examining TB infection risk among PWH in HIV care in southwestern Uganda (2022-2023). We used proportional odds models to examine associations between high intersectional HIV, TB, and alcohol stigma (defined as above median scores on validated scales) and the outcome of poorer perceived health. Among 379 PWH, 12% described their health status as fair/poor. High intersectional HIV and alcohol stigma was associated with increased odds of poorer perceived health (adjusted odds ratio [aOR] = 1.62; 95% CI: 1.04-2.52), but we found no associations between other HIV, TB, and alcohol stigma intersections and this outcome. We found a significant interaction between intersectional HIV and alcohol stigma and marital status (Wald χ = 5.02, p = 0.03), and upon stratification, high intersectional HIV and alcohol stigma was associated with an increased odds of poorer perceived health among unmarried participants (aOR = 2.54; 95% CI: 1.33-4.86; p < 0.01) but not among married participants (aOR = 1.05; 95% CI: 0.56-1.95; p = 0.88). High intersectional HIV and alcohol stigma was associated with poorer perceived health among PWH in care, particularly among unmarried persons. Given the possible benefits of partner support, interventions that strengthen social support for unmarried persons may help mitigate the negative health impact of intersectional stigma.
A Scoping Review Assessing the Relationship Between Structural, Functional, and Perceived Social Support with Antiretroviral Therapy (ART) in the Last Decade.
Poudyal A, Thapa A, Sikkema KJ
AIDS Behav · 2026 Apr · PMID 41931221 · Publisher ↗
Antiretroviral Therapy (ART) adherence is a complex outcome influenced by individual, interpersonal, and structural factors. Social support can improve adherence, yet studies report inconsistent associations between soci...
Antiretroviral Therapy (ART) adherence is a complex outcome influenced by individual, interpersonal, and structural factors. Social support can improve adherence, yet studies report inconsistent associations between social support and ART adherence, potentially resulting from differences in operationalization and measurement. We conducted a scoping review of articles published between 2014 and 2024 using Arksey and O'Malley's framework to (a) identify how social support and adherence are operationalized and measured, (b) explore relationships between social support and ART adherence, and (c) compare associations across different measures. We identified 118 articles; 87 (74%) reported positive associations between social support and adherence, 28 (24%) found no association, and three reported negative associations. Associations varied by support source (children, spouses, family members, and healthcare providers), type (instrumental, emotional, informational), and nature (same-gender ties). Four ART measures were identified: self-report, indirect measures, biological markers, and composite measures. Most studies (109) assessed perceived or functional social support, while only six examined structural support and network relationships (e.g., the respondent and their partners). Significant variations existed in adherence measures and benchmarks. Social support measures also varied substantially, with limited theoretical justification for selection. Mixed findings reflect measurement variations and the multifaceted nature of social support. Future studies should investigate both constructs comprehensively and systematically, using composite measures with objective biomarkers where feasible, and accounting for measurement differences and literature gaps.
National HIV Behavioral Surveillance Among Women of Transgender Experience and Transfeminine People in Nine Cities in the United States, 2023-2024.
Al-Tayyib A, Glick SN, Wilson EC … +7 more , Olsson T, Rivera AV, Ma Y, Leonard CM, Nassau T, Barak N, McFarland W
AIDS Behav · 2026 Apr · PMID 41920471 · Publisher ↗
Women of transgender experience and transfeminine people (WTE/TFP) are disproportionately impacted by HIV. Between July 2023 and May 2024, a total of 2059 eligible WTE/TFP across nine project areas participated in the Na...
Women of transgender experience and transfeminine people (WTE/TFP) are disproportionately impacted by HIV. Between July 2023 and May 2024, a total of 2059 eligible WTE/TFP across nine project areas participated in the National HIV Behavioral Surveillance (NHBS-Trans) project. Among the 1993 participants with valid HIV test results, 35.7% were living with HIV. Detrimental social and economic factors were common, including low income (57.0%), unemployment (35.4%), homelessness (31.8%), physical abuse and harassment (25.1%), and avoiding seeking healthcare due to discrimination (22.4%). Continued efforts to increase access to HIV testing and prevention strategies are vital to decrease the number of new infections to end the HIV epidemic. However, without increased access to economic opportunities and stable housing and decreases in discrimination and harassment, existing HIV prevention and care services may not address the HIV epidemic among women of transgender experience and transfeminine people.
Increases in Hepatitis C Virus (HCV) Treatment and Cure Among People Who Inject Drugs in the Seattle Area Between 2018 and 2022.
Ebersberger JL, Tsui JI, Corcorran MA … +1 more , Glick SN
AIDS Behav · 2026 Apr · PMID 41920470 · Publisher ↗
This study aimed to describe the current hepatitis C virus (HCV) continuum of care and characterize the prevalence of HCV among Seattle-area people who inject drugs (PWID), including an assessment of changes between 2018...
This study aimed to describe the current hepatitis C virus (HCV) continuum of care and characterize the prevalence of HCV among Seattle-area people who inject drugs (PWID), including an assessment of changes between 2018 and 2022. Cross-sectional data from the 2018 and 2022 Seattle-area National HIV Behavioral Surveillance (NHBS) surveys of PWID was included in this study. All participants completed a biobehavioral survey and were offered rapid HIV and HCV antibody testing. Among those who screened HCV antibody-positive, we estimated proportions for steps along the HCV care continuum, including proportions of PWID who had previously been told they had HCV, were treated, and cured. The 2018 and 2022 NHBS-PWID surveys included 533 and 495 participants, respectively. In 2022, 61% (303/495) of PWID tested HCV antibody-positive, compared with 71% (376/533) in 2018. Among those who were HCV antibody-positive, prior HCV testing was common in both years [94% (95% CI: 91%-96%) in 2018; 92% (95% CI: 89%-95%) in 2022]. The proportion reporting prior HCV diagnosis increased from 68% (95% CI: 63%-72%) in 2018 to 71% (95% CI: 66%-76%) in 2022. Among those diagnosed, treatment rose from 26% (95% CI: 20%-31%) in 2018 to 47% (95% CI: 40%-54%) in 2022, and cure increased from 18% (95% CI: 14%-23%) in 2018 to 33% (95% CI: 27%-40%) in 2022. Compared to 2018, in 2022 the proportion of PWID with HCV in the Seattle area who had been treated and cured nearly doubled. Sustained investment in HCV diagnosis and treatment is needed to strengthen the HCV continuum of care.
Changes in Stimulant Use Over Time Among Men Who Have Sex with Men in Philadelphia, Baltimore, and Washington, DC, 2008-2023.
German D, Nassau T, Yenokyan K … +8 more , Li X, Bornstein S, Drezner K, Hoj T, Gribbin M, Flynn C, Brady KA, Kuo I
AIDS Behav · 2026 Mar · PMID 41915291 · Full text
Stimulant use among men who have sex with men (MSM) can contribute to HIV risk and care challenges. Monitoring and responding to local trends are critical for Ending the HIV Epidemic (EHE) initiatives. We assessed stimul...
Stimulant use among men who have sex with men (MSM) can contribute to HIV risk and care challenges. Monitoring and responding to local trends are critical for Ending the HIV Epidemic (EHE) initiatives. We assessed stimulant use patterns in Baltimore, Philadelphia, and Washington, DC from 2008 to 2023 using National HIV Behavioral Surveillance data. We collected cross-sectional data in each city using venue-based sampling in 2008, 2011, 2014, 2017, and 2023. We estimated average predicted probabilities of methamphetamine, powder cocaine, and crack cocaine use, and evaluated differences in prevalence of stimulant use overall and by race/ethnicity. In DC, stimulant use was stable or declined. Methamphetamine use remained stable overall (8%), with observed decreases among Hispanic MSM (13% to 4%). In Baltimore, methamphetamine use increased (2% to 5%) overall, while powder cocaine slightly declined overall (15% to 13%), with decreases among Black MSM but increases among White and Hispanic MSM. Crack cocaine decreased slightly (12% to 11%). In Philadelphia, methamphetamine use rose substantially (3% to 10%), with the largest increase among White MSM (3% to 19%). Powder cocaine use was highest in Philadelphia, reaching 41% among White MSM in 2023. Trends in stimulant use among MSM differed across these three EHE-funded cities. Philadelphia showed pronounced increases, particularly among White MSM, while DC and Baltimore exhibited more modest or stable patterns. Comparable local data sources are essential for identifying city- and subpopulation-specific trends to inform focused, equitable prevention strategies within EHE.
Evaluation of a Clinic-Level Intervention to Increase Anxiety and Depression Screening in an Urban HIV Clinic.
Zimmer D, Staab EM, Mehra G … +6 more , Zhu M, Ridgway JP, Schmitt J, Franco-Galicia MI, Hunter S, Laiteerapong N
AIDS Behav · 2026 Mar · PMID 41910683 · Full text
Anxiety and depression are common in people living with HIV and associated with low antiretroviral treatment adherence, elevated HIV viral load, and increased mortality. Yet, anxiety and depression are underdiagnosed and...
Anxiety and depression are common in people living with HIV and associated with low antiretroviral treatment adherence, elevated HIV viral load, and increased mortality. Yet, anxiety and depression are underdiagnosed and undertreated in this population. Implementing a system for routine anxiety and depression screening may overcome barriers to diagnosis. To improve the identification and management of anxiety and depression within an HIV clinic, we engaged HIV clinicians in the design of the workflow, created electronic health record reminders for screening, and trained medical assistants to deliver the screening questions at clinic visits. We evaluated this 24-month quality improvement project using electronic health record data and clinician surveys. From November 2020 to October 2022, 747 patients had 1166 appointments during which anxiety and/or depression screening was due. During year one, anxiety and depression screening were completed at 75% (311/416) and 77% (362/469) of eligible encounters, respectively. During year two, screening was completed at 85% of encounters for anxiety (425/502) and depression (446/524). On average, anxiety screening increased by 2.2% per month (t = 4.24, p < 0.001), and depression screening increased by 1.2% per month (t = 2.82, p = 0.01) after intervention implementation. Patients who screened positive received follow-up. Clinician satisfaction with screening processes increased from baseline to 6 months. Findings suggest that screening for anxiety and depression can improve detection and management in an HIV clinic, while also being acceptable to HIV clinicians.
Displacement Stressors and Sexual and Reproductive Health Challenges for Internally Displaced Young Adults in Northern Mozambique: A Qualitative Study Using the Socio-ecological Framework for Refugee Distress.
Chantre CL, Suleman A, Dos Santos PF … +7 more , Dos Santos K, Xaria M, Khoshnood K, Wainberg ML, Mello M, Wessels M, Mootz JJ
AIDS Behav · 2026 Mar · PMID 41903025 · Publisher ↗
An ongoing insurgency in Cabo Delgado, Mozambique, has displaced over one million people since 2017. Young adults in Mozambique have the greatest risk for HIV. Young adults can be impacted by a host of sexual and reprodu...
An ongoing insurgency in Cabo Delgado, Mozambique, has displaced over one million people since 2017. Young adults in Mozambique have the greatest risk for HIV. Young adults can be impacted by a host of sexual and reproductive health (SRH) challenges and poor access to care yet less is understood about how exposure to conflict and forced displacement affects SRH. Our qualitative study facilitated focus groups and stakeholder interviews to query urban internally displaced persons, including young adults, and stakeholders involved in the humanitarian response to understand views on the impact of displacement stressors on internally displaced young people's SRH. Using an adapted socio-ecological model of refugee distress, we examined how displacement stressors due to the insurgency shaped SRH outcomes among internally displaced youth in Nampula, Mozambique. We conducted a thematic analysis to interpret themes and organize them by level of the model. Participants (n = 53; 30.2% women, ages 19-80, mean age = 44.5, SD = 18.3), reported that stressors like food insecurity, limited housing, integration challenges such as school discontinuation and perceived discrimination, and cultural changes were related to increased instances of transactional sex, early pregnancy, early marriage, gender-based violence, disinterest in SRH services, and changing cultural norms related to sexual practice. Results showed that internally displaced young adults in Mozambique faced multiple displacement stressors and struggled attending to their SRH needs due to challenges experienced in their new environment. Findings indicate that efforts to address displacement stressors should be prioritized in work to improve SRH outcomes among displaced Mozambican young adults.
Dyadic Internalized Stigma, Resilience, and Psychological Distress Among People with HIV and their Family Members: An Actor-Partner Interdependence Mediation Model Analysis.
Shi F, Yang X, Qiao S … +4 more , Tam CC, Liu S, Zhou Y, Li X
AIDS Behav · 2026 Mar · PMID 41886241 · Full text
Despite robust evidence showing the mediation role of psychological resilience in the impacts of HIV-related stigma on psychological distress, most studies were conducted from an intrapersonal perspective. Limited studie...
Despite robust evidence showing the mediation role of psychological resilience in the impacts of HIV-related stigma on psychological distress, most studies were conducted from an intrapersonal perspective. Limited studies have examined the dyadic effects of HIV-related stigma and resilience on psychological distress for people with HIV (PWH) and their family members. This study aimed to explore the actor-partner effect and the mediation role of resilience in the relationship between internalized stigma and psychological distress among PWH and family members dyads. Between October 2023 and December 2023, a total of 800 PWH-family member dyads were recruited from two urban cities and nine rural counties in Guangxi, China. All participants completed validated questionnaires capturing demographic characteristics, internalized stigma, resilience, and psychological distress. This study employed the actor-partner interdependence mediation model to examine both individual (actor) and dyadic (partner) pathways, along with resilience as a mediator. For actor effects, resilience partially mediated the relationship between internalized stigma and psychological distress in PWH (β = 0.08, SE = 0.01, p < 0.001) but not in their family members (β = -0.00, SE = 0.01, p = 0.68). Regarding partner effects, indirect effects were significant in the association between family members' internalized stigma and PWH's psychological distress through PWH's resilience (β = 0.03, SE = 0.01, p < 0.01). This study underscores the complex interplay between internalized stigma, resilience, and psychological distress in PWH-family member dyads. Psychological health promotion programs would benefit from adopting family-centered strategies that attend to stigma reduction and resilience improvement for both PWH and family members.
Effects of Sociodemographic Characteristics, Menstrual (Health) Literacy and Contraception Literacy on Sexual Abstinence Among Never-Married Chadian and Cameroonian Adolescents and Young Adults: Results from Population-Based Surveys.
Laoungang AM, Wamba A, Soh G
AIDS Behav · 2026 Mar · PMID 41880083 · Publisher ↗
Sexual abstinence has been recognized as one of the strategies to prevent unwanted pregnancies, sexually transmitted diseases, including HIV/AIDS among adolescents and young adults in the Sub-Saharan Africa. However, fac...
Sexual abstinence has been recognized as one of the strategies to prevent unwanted pregnancies, sexually transmitted diseases, including HIV/AIDS among adolescents and young adults in the Sub-Saharan Africa. However, factors associated with youth decisions to abstain are understudied. This study aimed to examine how demographic factors, menstrual (health) literacy, contraception literacy, sociocultural factors are associated with sexual abstinence among Chadian and Cameroonian adolescents and young adults (AYAs). We used data from the Chadian and Cameroonian Demographic and Health Surveys. The study included 10,644 single AYAs aged 15-24. We used logistic regression to identify factors associated with sexual abstinence. The models explained 37% of variance in sexual abstinence among both Chadian and Cameroonian AYAs. At the individual level, age, gender, education, employment status, menstrual literacy, and contraception literacy were associated with abstinence. At the interpersonal level, gender, and age of the head of household were associated, and at the sociocultural level, religion, household socioeconomic status, place of residence, and exposure to media showed significant associations. The study suggests a need for a multifaceted approach, including educational reforms and public health policies that address structural inequalities and reduce sexual vulnerability among AYAs.
Water Insecurity is Associated with Intimate Partner Violence Among Women Living with HIV in Western Kenya.
Odak JJ, Young SL, Frongillo EA … +7 more , Cohen CR, Burger RL, Sheira LA, Weke E, Wekesa P, Bukusi EA, Weiser SD
AIDS Behav · 2026 Mar · PMID 41880082 · Publisher ↗
Water insecurity is a pervasive problem in sub-Saharan Africa that co-occurs with other challenges like food insecurity and intimate partner violence (IPV), which may intersect to worsen HIV/AIDS outcomes. However, littl...
Water insecurity is a pervasive problem in sub-Saharan Africa that co-occurs with other challenges like food insecurity and intimate partner violence (IPV), which may intersect to worsen HIV/AIDS outcomes. However, little is known about its association with IPV among women living with HIV (WLWH) who are vulnerable to both. We assessed the prevalence of IPV among WLWH in western Kenya and whether water insecurity was associated with a higher likelihood of IPV. We analyzed baseline data for WLWH enrolled in the Shamba Maisha cluster randomized controlled trial, a multisectoral intervention designed to reduce food insecurity and improve HIV/AIDS outcomes among people living with HIV (PLWH) in western Kenya. Water insecurity was assessed using a validated scale for this region; dichotomously and across four levels of severity. IPV (physical, sexual and emotional) was assessed using an adapted WHO instrument on women's health. Mixed effects regression models were used to assess associations between water insecurity and IPV (lifetime and recent), adjusting for covariates. Among 395 WLWH, 58.5% reported lifetime IPV and 18.5% reported recent IPV. Any water insecurity was associated with higher odds of lifetime (AOR = 2.1; 95% CI: 1.22, 3.60) and recent IPV (AOR = 2.3; 95% CI: 1.06, 5.16). Severe water insecurity was associated with about fivefold greater odds of lifetime (AOR = 4.9; 95% CI: 2.02, 11.81) and recent IPV (AOR = 5.2, 95% CI: 1.78, 15.38). These findings demonstrate water insecurity as a critical structural driver of IPV among WLWH, with potentially important implications for HIV/AIDS.
Correction: Mental Health and ART Adherence in a Multisite International Study: The Mediating Roles of Social Support and Substance Use in People with HIV : Salud mental y adherencia a la TAR en un estudio internacional multicéntrico: el papel mediador del apoyo social y el consumo de sustancias en personas con VIH.
Awad J, Sun W, Maria DS … +15 more , Schnall R, Apiruknapanond P, Wang T, Valencia CP, Davey CH, Baez SS, Iwu E, Sabone M, Makhado L, Cuca YP, Phillips JC, Corless IB, Shaibu S, Dawson-Rose C, Chen WT
AIDS Behav · 2026 Mar · PMID 41874902 · Publisher ↗
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