AIDS And Behavior[JOURNAL]
Sun
200 papers
Rapid Identification of HIV Among People Who Inject Drugs: Tampa, FL, 2024.
McCoy B, Wilson J, Oxner A … +5 more , Mutchler A, Carlesso-Dager M, Fuchs E, Holbrook E, Henderson H
AIDS Behav · 2026 Mar · PMID 41795752 · Publisher ↗
Syringe Service Programs (SSPs) have proven effective in reducing HIV transmission among people who inject drugs (PWID). However, early HIV detection remains an underutilized opportunity for preventing transmission and c...
Syringe Service Programs (SSPs) have proven effective in reducing HIV transmission among people who inject drugs (PWID). However, early HIV detection remains an underutilized opportunity for preventing transmission and curbing outbreaks. This paper emphasizes the impact of implementing routine, opt-out HIV screening within SSPs as a strategy to enhance early detection and prevention efforts. In 2022, the IDEA Exchange Tampa, Florida's second legally sanctioned SSP, transitioned from an opt-in to a routine opt-out screening model. This shift identified six anonymous participants with acute and untreated HIV, including three confirmed seroconversions (within 59 days of a prior negative test), two individuals diagnosed during their first HIV screening at the SSP with 'unknown infection duration', and one previously diagnosed individual who had been out of care. Through a robust linkage-to-care framework, all six participants were linked to care within an average of 7.5 days (100% linkage rate). Clinical counseling sessions revealed that these individuals were part of an interconnected 26-person risk network involving needle-sharing and sex exchange behaviors. These findings underscore the critical role of systematic opt-out screening in SSPs for accelerating case detection and facilitating rapid linkage-to-care. Expanding routine, opt-out HIV screening at SSPs is essential to improving detection, curbing outbreaks, and advancing the goals of the Ending the HIV Epidemic (EHE) initiative.
Factors Associated with Mpox Vaccination Uptake Among Women of Transgender Experience and Transfeminine People in New York City, 2024.
Rivera AV, Rodriguez K, Shelton M … +1 more , Edelstein Z
AIDS Behav · 2026 Mar · PMID 41776118 · Full text
Women of transgender experience (WTE) have been disproportionately burdened by mpox. Using 2024 data from the New York City site of the National HIV Behavioral Surveillance study among WTE and transfeminine people (TFP),...
Women of transgender experience (WTE) have been disproportionately burdened by mpox. Using 2024 data from the New York City site of the National HIV Behavioral Surveillance study among WTE and transfeminine people (TFP), we identified factors associated with receiving at least one dose of the mpox vaccine. Of 103 WTE/TFP, most identified as Hispanic/Latina and being born outside of the United States with 40% receiving at least one dose. Participants who self-reported having HIV were more than twice as likely to have received a dose (PR: 2.31; 95% CI: 1.20-4.47). Mpox vaccine outreach efforts may benefit from status-neutral strategies.
Barriers and Facilitators Influencing PrEP Uptake Among Men Who Have Sex with Men and Transgender Women in the United States: A Systematic Review.
Dhir AM, Singh A, Clipman SJ … +1 more , Farley JE
AIDS Behav · 2026 Mar · PMID 41774306 · Publisher ↗
In the United States, men who have sex with men (MSM) and transgender women (TGW) have high HIV pre-exposure prophylaxis (PrEP) awareness, yet uptake rates remain extremely low. This signifies the presence of certain bar...
In the United States, men who have sex with men (MSM) and transgender women (TGW) have high HIV pre-exposure prophylaxis (PrEP) awareness, yet uptake rates remain extremely low. This signifies the presence of certain barriers not yet addressed in policy and practice and facilitators not yet utilized in designing effective interventions. This systematic review used the Gelberg and Andersen Model of Vulnerable Populations as a theoretical framework to explore barriers and facilitators to PrEP uptake among MSM and TGW in the US. We searched PubMed, Embase, CINAHL, and Web of Science in May 2025 to identify eligible studies exploring barriers and/or facilitators to PrEP uptake among MSM and TGW in the US. Studies published in 2012 onward in the English language and particularly focusing on uptake (initiation) met the eligibility criteria. We excluded studies focused on awareness, willingness, adherence, persistence, and other components of the PrEP care continuum. The review was conducted in accordance with the PRISMA 2020 Statement. Barriers and facilitators reported in studies were mapped into the domains of the Gelberg and Andersen model and then narratively synthesized using a thematic approach. Eleven studies (9 qualitative and two mixed methods) met the eligibility criteria. Utilizing the Gelberg and Andersen model, within the predisposing factors domain, three themes emerged, namely (a) PrEP knowledge, health beliefs, and misinformation, (b) stigma, discrimination, and trust, and (c) influence of social environment and lived realities. Within the enabling factors domain, three themes emerged, namely (a) financial access and insurance coverage, (b) healthcare provider and system factors, and (c) addressing specific community needs and systemic vulnerabilities. Finally, within the need factors domain, one theme emerged, namely perceived versus evaluated need for PrEP. Additionally, a sub-group analysis showed that Black and Latino TGW may experience additional barriers to PrEP uptake due to intersecting stigma related to race, sexuality, and HIV and scarcity of culturally competent and gender-affirming care. Also, rural MSM may experience additional barriers due to reliance on urban social networks for information and support because of lack of such networks and support tailored to their geographical location. The findings of this review reveal an intricate interplay between predisposing, enabling, and need factors, which aligning with the observations that although PrEP awareness among MSM and TGW has grown, significant gaps in knowledge and misinformation remain, and uptake remains extremely low. These factors extend beyond general awareness levels and hence must be addressed through policy and practice interventions to enhance HIV prevention efforts among this key population in the US.
Navigating Multifaceted Barriers: A Qualitative Exploration of Antiretroviral Therapy Adherence Among Hispanic People with HIV in Texas.
Garcia A, Radunsky AP, Naiman NE … +2 more , Dorough RJM, Jain MK
AIDS Behav · 2026 Jun · PMID 41774305 · Full text
HIV remains a significant public health concern, particularly among Hispanic individuals living with HIV (PWH) in Texas. Despite advancements in antiretroviral therapy (ART), adherence to medication regimens continues to...
HIV remains a significant public health concern, particularly among Hispanic individuals living with HIV (PWH) in Texas. Despite advancements in antiretroviral therapy (ART), adherence to medication regimens continues to be a challenge due to limited access to healthcare. This qualitative study aims to explore the multifaceted barriers that hinder ART adherence among Hispanic PWH in Texas, providing a comprehensive understanding of the challenges faced by this population and informing targeted interventions. We conducted semi-structured interviews, each lasting approximately 30 to 40 min, with 13 participants recruited from both outpatient and inpatient settings. Interviews were conducted by members of our bilingual research team. Data were analyzed using grounded theory to identify key themes related to adherence challenges, including stigma, healthcare navigation, and socioeconomic factors. The analysis revealed six major themes impacting adherence, with the following distribution based on the percentage of coded references: Health Management and Medication Effects (35.5%), Education and Empowerment (23.9%), Coping Strategies and Adjustment (17.5%), Stigma and Disclosure (10.1%), Social Support and Connection (7.2%), and Access and Affordability (5.8%). Participants highlighted the physical and emotional challenges of managing ART, the role of education in adherence, and the significant impact of stigma and financial barriers. The findings show the complexity of ART adherence among Hispanic PWH in Texas, revealing the need for culturally tailored interventions that address the stigma, healthcare access, and social support. Enhancing education, strengthening support networks, and reducing financial barriers are important steps toward improving ART adherence and health outcomes in this population.
Intersectional Minority Stress and Suicidal Thoughts and Behaviors among Black Sexual and Gender Minority Youth.
Quinn K, Schmitt M, Pearson B … +2 more , Curtis MG, Kohlbeck SA
AIDS Behav · 2026 Feb · PMID 41762329 · Publisher ↗
Black sexual and gender minority youth (SGMY) face significant disparities in suicidal thoughts and behaviors. Minority Stress Theory (MST) posits that the minoritized social statuses of sexual and gender minority indivi...
Black sexual and gender minority youth (SGMY) face significant disparities in suicidal thoughts and behaviors. Minority Stress Theory (MST) posits that the minoritized social statuses of sexual and gender minority individuals increases experiences of discrimination and victimization, which may increase poor mental health and lead to suicide. Such experiences are further complicated for racial and ethnic minority individuals who hold multiple marginalized positions and thus experience intersectional minority stress. Little research has examined how Black SGMY experience intersectional minority stressors and how these experiences impact suicidal thoughts and behaviors. In this phenomenological study, we explored experiences of minority stress at the intersection of race and sexual and/or gender identity and examined how such experiences can contribute to suicidal thoughts and behaviors. We conducted in-depth interviews with 22 Black SGMY ages 16-24 in Milwaukee, WI. We identified five themes surrounding the compounding minority stressors Black SGMY faced that contributed to poor mental health and suicidal thoughts and behaviors: (1) the journey of self-acceptance; (2) familial rejection; (3) societal marginalization; and (4) suicidal thoughts and behaviors as an escape from oppression. Our findings suggest effective suicide prevention strategies for Black SGMY should move beyond universal models and incorporate culturally responsive and identity-affirming strategies. In addition, peer-led support and community-based programming may be important avenues for affirming and protecting the lives of Black SGMY.
An Evaluation of Social Media and Geospatial Dating Apps for Recruitment of a National Sample of Young Men Who Have Sex with Men in the LITE-2 Study.
Bonnewit I, Schnall R, Garofalo R … +5 more , Duncan DT, Wood OR, Almodovar M, Xiao F, Kuhns LM
AIDS Behav · 2026 Feb · PMID 41758405 · Publisher ↗
In 2022, over two thirds of individuals diagnosed with HIV in the United States were people of color, half resided in the south, and 67% of new cases were attributed to male-to male sexual transmission (Centers For Disea...
In 2022, over two thirds of individuals diagnosed with HIV in the United States were people of color, half resided in the south, and 67% of new cases were attributed to male-to male sexual transmission (Centers For Disease Control, 2024). To combat these health disparities, the Ending the HIV Epidemic (EHE) initiative recommends that HIV prevention research focus on targeted populations and geographic regions with high rates of new HIV diagnosis. There are limited data on the relative efficiency of social media and dating apps for the recruitment of key EHE populations to HIV prevention studies. The LITE-2 Study aimed to recruit a national sample of approximately 3,000 young men who have sex with men (YMSM), at least 30% Black/African American and 30% Hispanic/Latino. This analysis compared the success of different social media platforms in relation to study goals, using descriptive statistics from the LITE-2 study (N = 2999) to assess enrollment count, eligibility rates, cost, and geographic distribution for each platform. Facebook had the highest enrollment rate, 45.38%, among eligible screeners. The cost per enrolled participant for Grindr, Sniffies, Scruff, Jack'd, and Adam4Adam was $118.02, $129.46, $220.59, $252.53, and $305.56 respectively. Jack'd had the highest proportion of Black participants, and Sniffies the highest proportion of Hispanic/Latino individuals. Use of Scruff resulted in enrollment of the highest proportion of participants in the rural EHE jurisdictions (47.1%). These findings inform digital recruitment strategies for future studies with similar racial/ethnic and geographic targets.
From PrEP-Related Mistrust to Trusted Prevention Ecosystems: Implementation Priorities Following Simon et al. and Jaiswal et al.
Vijayasimha M, Srikanth M
AIDS Behav · 2026 Jun · PMID 41758404 · Publisher ↗
PrEP-related medical mistrust is not simply a lack of trust; it is a relational, historically rooted and continuously reinforced response to perceived institutional betrayal, everyday discrimination, and inequitable prev...
PrEP-related medical mistrust is not simply a lack of trust; it is a relational, historically rooted and continuously reinforced response to perceived institutional betrayal, everyday discrimination, and inequitable prevention systems. Building on recent AIDS and Behavior articles by Simon et al. and Jaiswal et al. describing PrEP-related mistrust, distrust, and misinformation among Black sexual minority men and socioeconomically diverse young sexual minority men from multiple racial and ethnic groups in the United States, we argue that the field must move from documenting mistrust to engineering "trust-ready" prevention ecosystems that can be evaluated, scaled, and sustained. We synthesize converging evidence linking stigma, mistrust, and HIV testing behaviors and situate PrEP mistrust within broader HIV-care experience with antiretroviral therapy adherence and retention. We further highlight that public health narratives that foreground only past abuses can inadvertently obscure ongoing harms that shape lived experience and digital information practices today. We propose three implementation priorities: (1) institutionalize validated trust and fairness metrics within PrEP and HIV programme monitoring; (2) design trust-ready delivery models that embed stigma-reduction, accountability, and rights-based safeguards; and (3) align digital information ecosystems with trust-building by addressing mis- and disinformation, including institutionalized science denialism, while avoiding colonial or paternalistic messaging. These priorities are relevant beyond high-income settings, where overlapping criminalization, under-resourcing, and digital misinformation can compound inequity. Treating mistrust as an implementation outcome-and sometimes a survival-informed response-can accelerate equitable PrEP scale-up.
Association between Levels of Alcohol Use, Perceived HIV Risk, and Untreated HIV Among Persons at Alcohol-Serving Venues in Kenya and Uganda.
Beesiga B, Litunya J, Nakato JZ … +18 more , Agola JA, Marson K, Mugoma WE, Agaba P, Temple J, Camlin CS, Shade SB, Woolf-King SE, Hahn JA, Kakande E, Kabami J, Petersen ML, Havlir DV, Balzer LB, Ayieko J, Kamya MR, Chamie G, OPAL-East Africa trial team
AIDS Behav · 2026 Feb · PMID 41746468 · Full text
Alcohol-serving venues in East Africa are high-risk environments for HIV transmission but few studies in sub-Saharan Africa (SSA) have examined perceived HIV risk and sexual risk behaviors by alcohol use levels on a broa...
Alcohol-serving venues in East Africa are high-risk environments for HIV transmission but few studies in sub-Saharan Africa (SSA) have examined perceived HIV risk and sexual risk behaviors by alcohol use levels on a broader population of persons at alcohol-serving venues in the era of biomedical HIV prevention. We conducted a cross-sectional analysis of adults (≥ 18 years) at alcohol-serving venues in eight communities (~ 10,000 residents/community) in rural western Kenya and southwestern Uganda. We distributed recruitment cards to patrons and workers and invited them for free HIV screening at nearby health facilities, with same-day initiation of HIV pre- or post-exposure prophylaxis or antiretroviral therapy (ART) if eligible. Using generalized estimating equations with adjustment for age, sex, and country, we assessed whether increasing levels of alcohol use, as measured by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), categorized as no/low use (< 4 for men, < 3 for women), medium use (4-5 for men, 3-5 for women), high use (6-7), and very high use (≥ 8) were predictive of perceived HIV risk (current or anticipated in the next three months) and four HIV-risk factors (i.e., sex with a partner with HIV or unknown HIV status, multiple sexual partners, transactional sex, and sexually transmitted infections) among persons without HIV. We also evaluated the association between AUDIT-C levels and untreated HIV (defined as newly diagnosed or previously diagnosed but out of care for ≥ 6 months) among persons with HIV and between AUDIT-C levels and HIV-risk factors among persons with untreated HIV. We distributed 9,375 recruitment cards at 480 venues: 7,744 (83%) adults participated in screening at health facilities (median age 34 years; 38% women; 91% patrons). Overall, 4,107 (53%) reported unhealthy alcohol use: 26% medium, 11% high, 16% very high. Of 6,124 (79%) persons who tested HIV-negative, 2,285 (37%) reported perceived HIV risk. Increasing alcohol use was significantly associated with higher odds of perceived HIV risk (medium use: adjusted odds ratio (aOR) = 1.36, 95% CI: 1.17-1.58, p < 0.001; high: aOR = 2.06, 95%CI: 1.71-2.47, p < 0.001; and very high: aOR = 2.07, 95%CI: 1.74-2.47, p < 0.001; vs. no/low alcohol use) as well as sexual risk factors. Of 1,620 (21%) PWH, 219 (14%) had untreated HIV: 141 (9%) newly diagnosed; 78 (5%) previously diagnosed, not on ART. Increasing levels of alcohol use were not associated with untreated HIV. Our findings highlight the ongoing need for interventions to reduce alcohol use and improve engagement in biomedical HIV prevention and treatment among adults at alcohol-serving venues in East Africa.
Trends in HCV Prevalence and Risk Factors Among People who Inject Drugs in Los Angeles County, 2012-2024.
Ma Y, Sey EK, Santacruz H … +3 more , Kwon J, Chambers P, Chirumamilla S
AIDS Behav · 2026 Feb · PMID 41746467 · Publisher ↗
Evaluating trends in Hepatitis C virus (HCV) prevalence is critical for tracking the progress in HCV elimination efforts. We evaluated the changes in the prevalence of HCV infection (HCV antibody) among people who inject...
Evaluating trends in Hepatitis C virus (HCV) prevalence is critical for tracking the progress in HCV elimination efforts. We evaluated the changes in the prevalence of HCV infection (HCV antibody) among people who inject drugs (PWID) participating in the National HIV Behavioral Surveillance in Los Angeles County (LAC). Steady decreases in HCV antibody seroprevalence over time was observed among PWID from 81.2% in 2012 to 64.9% in 2015, 59.1% in 2018, 50.1% in 2022, and 34.2% in 2024. Chronic HCV infection (positive on both antibody and RNA tests) also declined from 37.1% in 2018 to 30.6% in 2022 and 18.2% in 2024. This downward pattern is further supported by multivariable analyses which showed a consistent reduction in HCV prevalence over time (aPR = 0.91, 95% CI 0.89-0.92). The largest decreases occurred among participants aged ≥ 30 years and among female PWID, with both decreasing 9.1% annually. HCV antibody positivity remained significantly higher among males, those with lower education, daily injectors, participants with incarceration history, and those engaging in receptive syringe sharing. Decreases in HCV antibody and RNA prevalence, alongside improved sterile injection practices, greater awareness of HCV status, and increases in treatment uptake, may reflect the impact of harm reduction efforts at reducing transmission among PWID in LAC. To achieve and sustain equitable progress, it remains essential to continue expanding HCV testing and treatment, particularly for communities that have not yet fully benefited from these interventions.
Unawareness of HIV-Positive Status among Men in Seven Sub-Saharan African Countries: Age, Behavioral, and Structural Determinants.
Farahani M, Farley SM, Hoos D … +10 more , Smart TF, Reid GA, Gudo ES, Kirungi WL, Nyirenda RK, Maile L, Mugurungi O, Njau PF, Dlamini S, El-Sadr WM
AIDS Behav · 2026 Feb · PMID 41735762 · Publisher ↗
Men in sub-Saharan Africa lag behind women in HIV testing and awareness. We pooled 2019-2023 Population-based HIV Impact Assessments from seven countries (Eswatini, Lesotho, Malawi, Mozambique, Tanzania, Uganda, Zimbabwe...
Men in sub-Saharan Africa lag behind women in HIV testing and awareness. We pooled 2019-2023 Population-based HIV Impact Assessments from seven countries (Eswatini, Lesotho, Malawi, Mozambique, Tanzania, Uganda, Zimbabwe). Among 59,293 men, HIV prevalence was 5.9% (95% CI 5.7-6.2). Of 5,394 HIV-positive men, 22.1% (95% CI 20.0-24.3) were unaware of their status (8.4% in Eswatini; 31.5% in Mozambique), declining with age (41.0% at 15-29 vs. 11.5% at ≥ 50). Survey-weighted Poisson regression identified independent correlates: condom-free last sex (aPR 2.5), hazardous drinking (aPR 1.3), infrequent/no prior testing (aPR 1.9), and higher wealth (lower 60% vs. upper 40%: aPR 0.8). Age amplified behavioral gaps in condom use. Among men classified as aware, 5.4% were identified solely through ARV biomarker detection despite self-reported unawareness. Youth-centered, behavior-tailored retesting strategies are essential to close the awareness gap.
HIV-Related Stigmatization of Thai Women Living with HIV during Pregnancy and Post-natal Period.
Phonphithak S, Hirunsuthikul N, Rattananupong T … +1 more , Bureechai S
AIDS Behav · 2026 Feb · PMID 41735761 · Publisher ↗
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A Stepped-Wedge Cluster Randomized Trial of PRIDE in HIV Care: A Crowdsourcing and Peer-Actuated Network Intervention to Increase Engagement in the HIV Care Continuum for Sexual Minority and Gender Expansive Men in Kazakhstan.
Wu E, Lee YG, Vinogradov V … +18 more , Zhakupova G, Mergenova G, Davis A, Paine EA, Hunt T, Reeder K, Primbetova S, Terlikbayeva A, Laughney C, Chang M, Baiserkin B, Abishev A, Tukeyev M, Abdraimov S, Denebayeva A, Kasymbekova S, Tazhibayeva G, Kozhakhmet M
AIDS Behav · 2026 Feb · PMID 41733746 · Publisher ↗
HIV transmission in Kazakhstan has increased among men who have sex with men (MSM) and transgender and nonbinary people who have sex with men (TSM), driven by low HIV testing rates. PRIDE in HIV Care is an intervention d...
HIV transmission in Kazakhstan has increased among men who have sex with men (MSM) and transgender and nonbinary people who have sex with men (TSM), driven by low HIV testing rates. PRIDE in HIV Care is an intervention designed to have a community-level effect of increasing HIV testing among MSM and TSM in Kazakhstan. The intervention was tested using a stepped-wedge, cluster-randomized controlled trial across three cities in Kazakhstan: Almaty, Astana, and Shymkent. The order of intervention implementation by city was randomly set to occur in 6-month increments. The PRIDE in HIV Care intervention is a theory-driven “crowdsourcing and peer-actuated network intervention” designed to amplify community members’ successes and resilience via “influencers” who can strengthen and impart benefit to their networks and community. We collected serial cross-sectional data where MSM and TSM (N = 629) among the study cities completed one assessment between 21 August 2018, and 30 March 2022. The primary outcome was whether they had received an HIV test in the prior six months. There was a statistically significant increase in odds of recent HIV testing for every additional month the intervention was implemented in a respondent’s city (AOR = 1.08, 95% CI = 1.05–1.12; p < .001). The PRIDE in HIV Care intervention appears to be efficacious in enacting a community wide increase—i.e., promoted HIV testing among those who did not go through the intervention itself—in HIV testing among MSM and TSM.Trial Registration.This trial is registered with clinicaltrials.gov (NCT02786615).
Tell or Not to Tell: Changes in Ukrainian Older Adults' HIV Status Disclosure Practices During Intersecting Covid-19 and War Crises.
Deac AA, Rich KM, Zaviryukha I … +6 more , Zeziulin O, Kiriazova T, Earnshaw VA, Bromberg DJ, Shenoi SV, Rozanova J
AIDS Behav · 2026 Jun · PMID 41733745 · Full text
Humanitarian crises exacerbate challenges to accessing HIV care. Older people with HIV (OPWH, aged ≥ 50 years) may seek additional support with HIV care, which often requires disclosing their HIV status to healthcare pro...
Humanitarian crises exacerbate challenges to accessing HIV care. Older people with HIV (OPWH, aged ≥ 50 years) may seek additional support with HIV care, which often requires disclosing their HIV status to healthcare providers, family, or friends. We sought to understand how crises, including COVID-19 and the war with the Russian Federation, have changed OPWH disclosure behaviours over time. We surveyed OPWH in Kyiv, Ukraine, by phone at four-time points: May-June 2020 (Wave 1), January-February 2021 (Wave 2), January-February 2022 (Wave 3) and May-June 2022 (Wave 4). Participants' responses were compared longitudinally. The primary outcome was new HIV status disclosure, and the independent variables were living conditions (living alone, not living alone) and HIV care support. Other variables analysed were age, gender, comorbidities, social support, depressive and anxiety symptoms, time since diagnosis, and history of addiction. A mixed-effects multivariable logistic regression model was used to assess the relationship between HIV status disclosure and independent variables. Of the 123 participants recruited, 90 OPWH completed the survey across all four-time points, of which 46 (51.1%) were women, and the mean age was 54.3 (SD = 6.38) in Wave 1 and 58.8 (SD = 6.64) in Wave 4. Men were less likely to disclose their HIV status (adjusted odds ratio [aOR] = 0.29; 95% CI [0.09, 0.94], p = 0.04) as were OPWH living alone (aOR 0.29, 95% CI [0.10 - 0.85], p = 0.02). Other variables were not statistically significant (p > 0.05). Findings underscore the pressing need for interventions that prioritise comprehensive, inclusive, and tailored to address key barriers to HIV disclosure, such as gender norms and social isolation. Future HIV care and support programs should integrate targeted strategies to foster community support, mitigate stigma, and promote disclosure as a pathway to adherence, overall health outcomes, and well-being of OPWH, particularly those living alone or within marginalised subgroups.
Undetectable = Untransmittable (U = U) Awareness and HIV Treatment Optimism Among Men Who Have Sex with Men in Mumbai, India.
Chaudary J, Rawat S, Dange A … +7 more , Golub SA, Kim RS, Mutyala N, Chakrapani V, Mayer KH, Arnsten J, Patel VV
AIDS Behav · 2026 Feb · PMID 41733744 · Publisher ↗
Little is known about Undetectable=Untransmittable (U = U) awareness among MSM in India. We analyzed baseline survey data from MSM (N = 1004) in an mHealth HIV testing trial in Mumbai and Thane, India. We assessed factor...
Little is known about Undetectable=Untransmittable (U = U) awareness among MSM in India. We analyzed baseline survey data from MSM (N = 1004) in an mHealth HIV testing trial in Mumbai and Thane, India. We assessed factors associated with U = U awareness and agreement (HIV treatment optimism) using multivariable Poisson regression. U = U awareness (29%) was associated with English survey completion, searching for sexual health information online, awareness of PrEP/PEP, and participation in MSM-focused HIV prevention programs (all P < 0.05). Overall, 50% of the participants agreed with HIV treatment optimism, which was associated with searching for sexual health information online, PrEP knowledge, and being out about their sexual orientation. Focused, culturally tailored U = U education is needed to improve awareness and treatment optimism among diverse Indian MSM.
Memory Strategy Use, Cognition, and Metacognition Among People Aging with HIV.
Vickers JK, Delgadillo JD, Haase SR … +4 more , Long AR, Domoyeri P, Vance DE, Fazeli PL
AIDS Behav · 2026 Feb · PMID 41733743 · Publisher ↗
Living with the HIV virus is a chronic health condition with life expectancies among treated people similar to seronegative individuals. However, older people living with HIV (PLWH) are at higher risk for comorbidities,...
Living with the HIV virus is a chronic health condition with life expectancies among treated people similar to seronegative individuals. However, older people living with HIV (PLWH) are at higher risk for comorbidities, including cognitive impairment, than their seronegative counterparts. Use of memory strategies has been shown to enhance memory performance among older PLWH, yet few studies have examined factors that drive memory strategy use as well as how impairments in metacognition may hinder the initiation of memory strategies. To address this gap, associations between cognitive function, locus of control and memory strategy use among PLWH with and without memory impairment were examined, followed by the association between metacognition and memory strategy use among PLWH. A secondary analysis was performed using cross-sectional data of 174 PLWH aged 40+ years. Spearman’s correlation was used to determine associations between memory strategy use (total, internal, and external), objective cognitive performance (seven domains and global), and locus of control (internal and external), and informed follow-up linear regression models. ANOVA was used to assess differences in memory strategy use between PLWH across metacognition groups (i.e., concordance between subjective and objective memory functioning yielding four groups: agree both normal, agree both impaired, over-estimators, under-estimators). Among PLWH with memory impairment, higher use of total memory strategies was associated with higher SES, White race, and higher external locus of control (powerful others subscale). Higher use of internal memory strategies was associated with higher SES, White race, older age, and higher external locus of control (powerful others and chance subscales). Higher external strategy use was associated with better executive function. Among PLWH without impairment, higher use of total memory strategies was associated with younger age. Higher use of internal memory strategies was associated with poorer global cognition, executive, and learning function. Higher external strategy use was associated with female sex, younger age, and higher SES. Higher internal locus of control was correlated with better function in all cognitive domains among PLWH without memory impairment. Among all PLWH, those who underestimated their cognitive ability used the most memory strategies, while those who overestimated their abilities used the least memory strategies. Those who correctly estimated their cognitive abilities as being normal or impaired fell in the middle with correct estimators of impaired cognition using the second most memory strategies. As PLWH get older, education around the use of effective memory strategies as well as social support to reinforce memory strategy use may be key to promoting improved confidence in cognitive abilities and quality-of-life as cognition declines. PLWH who overestimate their cognitive abilities and people from low socioeconomic status backgrounds may be less likely to use memory strategies and may benefit from being targeted for memory strategy education.
Estimating HIV Risk Among Individuals Released from Incarceration in Washington State: A Data-Driven Approach to Targeted Prevention.
Troupe D, Jack HE, Bagdon-Cox C … +2 more , Amiya RM, Erly S
AIDS Behav · 2026 Feb · PMID 41733742 · Publisher ↗
People being released from prison face a heightened risk of HIV acquisition, yet there is need for additional research to quantify that risk and identify which groups should be prioritized for prevention efforts. We perf...
People being released from prison face a heightened risk of HIV acquisition, yet there is need for additional research to quantify that risk and identify which groups should be prioritized for prevention efforts. We performed a population cohort study of people released from Washington State prisons to estimate the HIV acquisition risk post-release and applied machine learning methods to identify subpopulations at highest risk. We linked state prison release rosters (1/1/2010 and 12/31/2021) to HIV surveillance data to calculate HIV incidence post-release and used a decision tree to partition the population into risk strata using demographic variables, reason for incarceration, mental health, and substance use assessments. Among 58,026 individuals released from prison, 120 were diagnosed with HIV in the three years following release, corresponding to a rate of 32.5 per 100,000 person-years. Specific subgroups of people who use substances were found to have HIV diagnosis rates 24–38 times higher than the general population. People released from prison in Washington State are at a risk of HIV acquisition 6.1 times higher than the rate among individuals not released from prison. Routinely collected data can identify high-risk subgroups, enabling targeted prevention programs in prison and after release.
Using Dynamic Causal Bayesian Networks to Assess the Role of Patient-Centered Care and Individual-Level Barriers on Viral Suppression Changes Among a Cohort of People with HIV.
Trepka MJ, Gonzales S, Ward MK … +7 more , Fennie KP, Sheehan DM, Jean-Gilles M, Devieux J, Gray A, Ladner R, Yoo C
AIDS Behav · 2026 Feb · PMID 41723786 · Full text
To assess the impact of changes in barriers to HIV viral suppression and the moderating role of patient-provider relationships, we conducted a retrospective cohort study using dynamic causal Bayesian network analyses on...
To assess the impact of changes in barriers to HIV viral suppression and the moderating role of patient-provider relationships, we conducted a retrospective cohort study using dynamic causal Bayesian network analyses on the first two available needs assessments between May 2020 and December 2022 for clients of the Miami-Dade County Ryan White Program (RWP) Part A Program. A cohort of 1539 individuals was formed using data from the RWP medical case management dataset. These records were merged with summary patient-centered care measures of their provider that were obtained from an earlier survey of clients in the program. Of the 1539 individuals in the longitudinal cohort, 86.2% were virally suppressed at time point 1 and 87.5% at time point 2. At time point 2, 144 (9.4%) were newly suppressed, and 124 (8.1%) were newly non-suppressed. Of the modifiable factors assessed, drug use and tobacco use significantly predicted a low probability of viral load suppression, while provider rating and provider's Health Care Relationship Trust Score significantly predicted a high probability of viral load suppression, although the associations with drug use and tobacco use were stronger than those with any provider variables. Results highlight the need for interventions promoting strong patient-provider relationships and targeting reductions in tobacco and illegal drug use with priorities based on the prevalence of tobacco and illegal drug use within specific RWP client populations.
Social-Cognitive and Identity-Related Factors Promoting Pre-exposure Prophylaxis (PrEP) Uptake Among Bisexual Men.
Lake S
AIDS Behav · 2026 Feb · PMID 41719000 · Publisher ↗
Pre-exposure prophylaxis (PrEP) is the cornerstone of HIV prevention in the United States, yet uptake remains low among bisexual men compared to gay men. Theory-driven communication interventions have promise for address...
Pre-exposure prophylaxis (PrEP) is the cornerstone of HIV prevention in the United States, yet uptake remains low among bisexual men compared to gay men. Theory-driven communication interventions have promise for addressing this disparity. Prior research among gay and bisexual men has shown that the Reasoned Action Approach (RAA) can predict PrEP intentions through attitudes, norms, and perceived behavioral control, while other studies highlight the influence of sexual identity-related stressors on prevention behaviors. However, bisexual men remain underrepresented in this work. This study sought to address this gap by exploring modifiable socio-cultural influences on bisexual men's PrEP use that can inform the development of PrEP promotion messages. Through an online survey of N = 276 US bisexual men, this study examined the relative impact of RAA factors (e.g., attitudes, perceived norms, and control beliefs) and identity-related stressors (e.g., concealment, masculine consciousness, and identity conflict) on intentions to use PrEP. The results revealed that, in contrast to previous work, only experiential attitudes toward PrEP (e.g., worry over HIV risk) were significantly associated with intentions, while instrumental attitudes, norms, and control beliefs were not. Regarding identity-related stressors, concealment from family was negatively associated with intentions, but masculine consciousness and identity conflict were not. Findings suggest that bisexual men's PrEP decisions may be shaped less by the cognitive predictors and more by affective and concealment-related processes. The results underscore the risk of generalizing findings from studies of gay men to bisexual men and highlight the need for more research to understand bisexual men's PrEP use motivations.
Attitudes, Knowledge, and Worry About HIV in the U=U Era: A Campaign with Before-After Surveys Among HIV-Negative Men Who Have Sex with Men in Sweden.
Sjöland CF, Dennermalm N, Nilsson Schönnesson L … +4 more , Laine K, Kanon E, Suarez D, Ekström AM
AIDS Behav · 2026 Jun · PMID 41712054 · Full text
Despite evidence that undetectable equals untransmittable (U=U), negative attitudes toward people living with HIV persist among men who have sex with men (MSM). We examined HIV-related knowledge, attitudes and relationsh...
Despite evidence that undetectable equals untransmittable (U=U), negative attitudes toward people living with HIV persist among men who have sex with men (MSM). We examined HIV-related knowledge, attitudes and relationship willingness among Swedish MSM and evaluated an anti-stigma campaign. Repeated cross-sectional online surveys of MSM aged ≥ 18 years were conducted in Sweden (2020-2021) before and after an anti-stigma campaign. Participants were recruited via LGBTQIA+ media and dating or cruising platforms. Multivariable logistic regression adjusted for sociodemographic and behavioral factors. We analyzed 3100 pooled responses and 1132 post-campaign responses. Knowledge gaps were substantial: 72% had not encountered U=U messaging and only 53% knew that treatment prevents transmission. Nearly half expressed unwillingness to consider relationships with people living with HIV. Negative attitudes decreased with higher knowledge (adjusted odds ratio [aOR] 0.38; 95% confidence interval [CI] 0.28-0.53) and increased with greater worry (aOR 3.66; CI 2.75-4.90). Greater relationship willingness was associated with higher HIV knowledge (aOR 3.79; CI 2.67-5.41). Less negative attitudes and greater relationship willingness were also linked to openness about sexual orientation. Campaign exposure was significantly associated with higher knowledge, less negative attitudes, lower worry, and greater relationship willingness. U=U awareness remains limited and stigma persists. The interrelations between knowledge, worry, and attitudes highlight cognitive and emotional dimensions of stigma. Observed links with campaign exposure suggest potential value of concise, context-specific U=U-centered communication in addressing stigma among MSM.
Assessing Motivation for Condom Use Among MSM: Effort Discounting as a Novel Measure of Sexual Risk.
Luehring-Jones P, Palfai TP, Simons JS … +1 more , Maisto SA
AIDS Behav · 2026 Feb · PMID 41712053 · Publisher ↗
Among men who have sex with men (MSM), motivation for condom use in sexual situations varies as a function of trait-level characteristics and state-level contextual factors. To-date, however, condom use motivation has be...
Among men who have sex with men (MSM), motivation for condom use in sexual situations varies as a function of trait-level characteristics and state-level contextual factors. To-date, however, condom use motivation has been assessed in cross-sectional research designs by single use, questionnaire-based self-report measures. This study describes the development and validation of a novel sexual effort discounting task that was designed to rapidly assess individual differences in motivation for condom use by measuring how much effort a participant would invest into acquiring a condom prior to engaging in anal intercourse with a partner of unknown HIV and STI status. The task was repeatedly administered as part of an ecological momentary assessment (EMA) study of condom use motivation to a pilot group of 55 MSM who regularly engaged in risky sexual behavior. Results demonstrated good reliability across administrations, and validity was supported by significant longitudinal associations with daily fluctuations in motivation to use condoms, significant correlations with self-reported sexual behavior, condom use, and cognitions related to condom use (e.g., intentions to use condoms), and significant positive associations with performance on a newly-developed EMA version of the well-established Sexual Delay Discounting Task (Johnson and Bruner in Drug Alcohol Depend 123:15-21, 2012). Use of the novel sexual effort discounting task may allow for greater insight into how differing levels of motivation for condom use may impact sexual decision-making among MSM, both in terms of indexing individual differences in motivation for condom use and assessing the impact of changing contextual variables on motivation in repeated-measures research designs.
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