Because a cure and a vaccine for the human immunodeficiency virus (HIV) are not expected for at least several years, prevention of AIDS is the only means of reducing the spread of the disease. While education, informatio...Because a cure and a vaccine for the human immunodeficiency virus (HIV) are not expected for at least several years, prevention of AIDS is the only means of reducing the spread of the disease. While education, information, and persuasion may be changing the HIV-related attitudes and even behaviors of some individuals, without a theoretical framework, the reasons why some individuals have changed and why other individuals have not changed are elusive. Three social-psycho logical models that have been applied to health-related behavior-the Health Belief Model (HBM), the Ajzen-Fishbein attitude-behavior model (AFM), and Leventhal et al.'s Self-Regulatory Model (SRM)-are tested in this study. The extent to which each model's variables are related to self-reported behavior change related to HIV and current HIV-related behavior are compared. Results indicate that the SRM and AFM contributed significantly to predicting risk behavior change, and that the HBM and AFM contributed significantly to predicting current risk behavior, after controlling for risk behavior change. Significant predictors of risk behavior change included timeline, identity, and self-efficacy from the SRM; sexual impulse (a barrier) from the HBM; and attitudes about the behaviors from the AFM. Significant predictors of current risk behavior included several barriers from the HBM and negative attitude about risk-reducing behaviors from the AFM.
A sexual health curriculum has been incorporated into our university's freshman seminar. The effectiveness of this program in changing sexuality-related knowledge, attitude, and behavior in college freshmen was studied....A sexual health curriculum has been incorporated into our university's freshman seminar. The effectiveness of this program in changing sexuality-related knowledge, attitude, and behavior in college freshmen was studied. Seven hundred eighty-six freshmen students enrolled in 37 randomly selected English classes were surveyed at baseline and at 3 months. Survey outcome measurements included: knowledge regarding sexually transmitted diseases (STDs), attitudes about sexual behavior, and behaviors including the frequency of barrier contraceptive use, abstinence, and the number of sexual partners. At postintervention, mean knowledge, attitude, and behavior scores were significantly higher for those simultaneously enrolled in the freshman seminar than for those not enrolled. Abstinence among males in the seminar increased. White males in the seminar were more likely to be abstinent or to use a condom than nonwhites. Females not participating in the intervention reported increased frequency of "never" using condoms and decreased frequency of condom use at last intercourse. Students participating in a sexual health curriculum in a college freshman seminar report less frequent high-risk sexual behaviors than students not participating in the seminar.
This study examined whether common reactions to AIDS are consistent with operation of the "magical law of contagion," a traditional belief that describes the transfer of properties, whether moral or physical, harmful or...This study examined whether common reactions to AIDS are consistent with operation of the "magical law of contagion," a traditional belief that describes the transfer of properties, whether moral or physical, harmful or beneficial, through contact. Three features of magical contagion, explored in previous work, were re-examined. These features sometimes contrast with microbial contamination as described by modern germ theory. They are: permanence of effects; dose-insensitivity; and potential for effects to act backwards (i.e., from recipient back onto source). A fourth characteristic, previously unaddressed, was also explored: "moralgerm conflation," i.e., the tendency to incompletely distinguish illness from evil. Three hundred and ninety-nine college students completed a survey assessing each feature with regard to AIDS-related scenarios. Also assessed was general AIDS knowledge. Subjects were very well-informed about AIDS, yet a significant subset showed "magical" features of thinking. Consistent with moral-germ conflation, degree of worry about getting AIDS was better predicted by guilt than by risk behaviors and knowledge that they are risky. Implications are discussed.
Maticka-Tyndale E, Kiewying M, Haswell-Elkins M
… +9 more, Kuyyakanond T, Anursornteerakul S, Chantapreeda N, Choosathan R, Sornchai S, Theerasobhon P, Supornpun A, Siriwattanametanont J, Elkins D
Results of knowledge, attitudes, beliefs, and practices (KABP) interviews ( = 330) and focus groups (12 groups, 80 participants) addressing human immunodeficiency virus (HIV) and AIDS conducted with women living in rural...Results of knowledge, attitudes, beliefs, and practices (KABP) interviews ( = 330) and focus groups (12 groups, 80 participants) addressing human immunodeficiency virus (HIV) and AIDS conducted with women living in rural villages in Khon Kaen province, Thailand, from November 1991 to January 1992 are reported. Women had obtained most of their information from television and radio. No AIDS health promotion programs had been targeted specifically to rural women. General knowledge regarding modes of transmission and prevention were good. The majority of women (85.5%) identified at least one known mode of transmission. Prostitution and contaminated needles were seen as the predominant sources of risk by these women. This knowledge, however, had not been applied to personal life circumstances in such a way that would facilitate avoidance of HIV infection. For example, few women considered themselves to be at risk for HIV infection even when they recognized that their husbands had engaged in risk-related behaviors (e.g., contracting for the services of commercial sex workers). Focus group discussions clarified the relationship between knowledge about HIV/AIDS, assessment of personal risk, use of condoms, and prevention strategies in general. Areas of misperception and confusion were identified, as well as potential vehicles for and content of AIDS health promotion initiatives. Results are currently being used to design health promotion interventions to reduce the spread of HIV.
AIDS Educ Prev
· 2025 Oct · PMID 41086046
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We tested the Appalachian Access Project, a bilingual, HIV status-neutral, social network, peer navigation, and mHealth intervention aimed at increasing use of HIV, STI, hepatitis C virus, and mpox prevention and care se...We tested the Appalachian Access Project, a bilingual, HIV status-neutral, social network, peer navigation, and mHealth intervention aimed at increasing use of HIV, STI, hepatitis C virus, and mpox prevention and care services among gay, bisexual, queer, and other men who have sex with men (GBQMSM) and transgender and nonbinary persons in Appalachia. The intervention also aimed to support use of medically supervised gender-affirming hormone therapy among participants desiring such care. Trial participants were recruited and randomized by social network to the intervention ( = 7 networks including 56 individuals) or delayed-intervention waitlist control group ( = 7 networks including 57 individuals). At follow-up, relative to control participants, intervention participants reported slight, but nonsignificant, increases in an HIV status-neutral service-use outcome, PrEP use, and HIV testing; and significant increases in HIV and STI knowledge. This intervention provides a foundation for future initiatives to reduce disparities in rural Appalachia; further research with larger sample sizes is warranted.
AIDS Educ Prev
· 2025 Oct · PMID 41086045
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Sexual and gender minorities experience disproportionately higher rates of depression and anxiety than cisgender heterosexual peers due to intersectional stigma. We conducted latent profile analyses to characterize parti...Sexual and gender minorities experience disproportionately higher rates of depression and anxiety than cisgender heterosexual peers due to intersectional stigma. We conducted latent profile analyses to characterize participants' intersectional stigma experiences and examined associations with mental health outcomes. Among 750 diverse participants, we identified high and low intersectional stigma (IS) profiles for cisgender men ( = 666) and gender-diverse participants ( = 84). Cisgender men and gender-diverse participants with high IS had significantly higher anxiety, depression, and social isolation than cisgender men with low IS. Gender-diverse participants with high IS had significantly higher social isolation than those with low IS. Cisgender men with high IS had significantly higher anxiety, depression, and social isolation than gender-diverse participants with low IS. These findings underscore the need for mental health interventions that explicitly account for compounded effects of racism, cissexism, and heterosexism affecting multiply marginalized sexual and gender minority youth.
AIDS Educ Prev
· 2025 Oct · PMID 41086044
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Pre-exposure prophylaxis (PrEP) for HIV infection has been shown to be highly effective in preventing infection. Although the overall use of PrEP has increased since its licensure in 2012, substantial disparities in its...Pre-exposure prophylaxis (PrEP) for HIV infection has been shown to be highly effective in preventing infection. Although the overall use of PrEP has increased since its licensure in 2012, substantial disparities in its uptake continue to be documented, especially among Black and Hispanic Americans. Achieving HIV elimination in the U.S. requires scale-up of culturally competent and linguistically appropriate PrEP services in both traditional and non-traditional settings. This commentary examines how recent actions undertaken by the U.S. federal government are likely to impede PrEP uptake and exacerbate existing disparities, thereby interfering with efforts to end the HIV epidemic in America.
AIDS Educ Prev
· 2025 Oct · PMID 41086043
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This study identified the preferred features of HIV/STI prevention mobile health (mHealth) apps among rural sexual minority men (SMM) in the southern U.S. and examined preference differences by HIV risk factors. Particip...This study identified the preferred features of HIV/STI prevention mobile health (mHealth) apps among rural sexual minority men (SMM) in the southern U.S. and examined preference differences by HIV risk factors. Participants ( = 406) completed an online cross-sectional survey. A series of multiple logistic regression models were used to examine differences. The top three preferred features included ordering at-home STI testing kits, ordering at-home HIV testing kits, and providing a list of local sexual health providers and professionals. HIV risk factor differences were found in participants who had engaged in condomless anal sex and who had been diagnosed with an STI being more likely to prefer the app to have the ability to synchronously or asynchronously talk to a sexual health professional, young adults being less likely to prefer various features, and racial/ethnic minority participants being more likely to prefer various features than non-Hispanic White participants.
Esquivel-Mendoza JA, Weinstein ER, Bharat B
… +8 more, Cardenas N, Puccinelli M, Mimiaga MJ, Psaros C, Doblecki-Lewis S, Krakower D, Mayer K, Safren SA
AIDS Educ Prev
· 2025 Oct · PMID 41086042
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Self-efficacy may influence several stages of the PrEP care continuum, yet most validated measures capture only one component rather than a comprehensive approach. To address this gap, this study validated the PrEP Use S...Self-efficacy may influence several stages of the PrEP care continuum, yet most validated measures capture only one component rather than a comprehensive approach. To address this gap, this study validated the PrEP Use Self-Efficacy (PrEP-USE) scale. Sexual minority men ( = 300) prescribed daily oral PrEP completed a baseline assessment including sociodemographics, the PrEP-USE scale, self-reported adherence, and PrEP-related variables (attitudes, stigma, subjective and descriptive norms) as part of a larger randomized controlled trial. Exploratory factor analysis identified a three-factor model (Challenges, Management, Routine) with acceptable fit. Overcoming challenges was associated with PrEP adherence ( = 1.09, < .01) and correlated with all PrEP-related variables ( < .05). Management correlated with all variables ( < .05) but not adherence. Routine was associated with adherence ( = 2.42, < .001) and only with PrEP attitudes ( < .05). Integrating the PrEP-USE scale into intervention frameworks may strengthen self-efficacy measurement.
Santos J, Baier V, Hunter A
… +7 more, Politt A, Bordeaux S, Sears G, Wheeler D, Baldwin J, Alexander SC, Hubach RD
AIDS Educ Prev
· 2025 Aug · PMID 40900189
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HIV and STI incidence are disproportionately elevated among sexual minority men (SMM) and Native American (NA) men in rural Oklahoma. The present study is a formative assessment of the Ending the HIV Epidemic in Rural Ok...HIV and STI incidence are disproportionately elevated among sexual minority men (SMM) and Native American (NA) men in rural Oklahoma. The present study is a formative assessment of the Ending the HIV Epidemic in Rural Oklahoma (e-HERO) project, which is part of the Ending the HIV Epidemic (EHE) initiative. EHE has an overarching goal of reducing incidence rates of HIV and STIs in rural Oklahoma. Semistructured focus groups were conducted with 16 men who self-identified as a sexual minority, Native American, or a combination of both who reside in Oklahoma to: (1) assess needs related to HIV/STI prevention and testing, (2) determine facilitators and barriers to resource access, and (3) assess preferences for mobile health intervention programming. Two overarching themes emerged: (1) HIV program participation barriers and (2) HIV service access preferences. There is an inherent need to advance integrated care in rural Oklahoma, with services that foster affirming environments for both SMM and NA men.
AIDS Educ Prev
· 2025 Aug · PMID 40900188
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Our community-based participatory research partnership developed and tested the bilingual Appalachian Access Project, a peer navigation and mHealth intervention designed to promote HIV, sexually transmitted infection, he...Our community-based participatory research partnership developed and tested the bilingual Appalachian Access Project, a peer navigation and mHealth intervention designed to promote HIV, sexually transmitted infection, hepatitis C virus, and mpox prevention and care among gay, bisexual, queer, and other men who have sex with men and transgender and nonbinary persons in Appalachia and to support medically supervised gender-affirming hormone therapy (GAHT) access among those desiring it. Although the intervention did not achieve its intended behavioral outcomes (e.g., increased use of HIV testing, preexposure prophylaxis [PrEP], HIV care, and GAHT), we identified ten critical lessons for future intervention research, including needs for: increased contact between study team members and peer navigators, more streamlined health outcome priorities, minimum intervention dose requirements for peer navigators, formal group activities, smaller catchment areas, and provider and organizational capacity-building interventions. Deeper understanding of intervention implementation can strengthen future efforts to reduce health disparities in Appalachia.
Sison O, Hernandez L, Caser AP
… +7 more, Baluscang JD, Laguing T, Sun S, Casison A, Moodley R, Restar A, Operario D
AIDS Educ Prev
· 2025 Aug · PMID 40900187
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The Philippines has one of the fastest-growing HIV epidemics in the Asia-Pacific region. Transgender women (TW) in the Philippines face considerable obstacles in accessing HIV testing. HIV self-testing (HIVST) is a promi...The Philippines has one of the fastest-growing HIV epidemics in the Asia-Pacific region. Transgender women (TW) in the Philippines face considerable obstacles in accessing HIV testing. HIV self-testing (HIVST) is a promising strategy to improve testing uptake, but there is limited information regarding how TW in the Philippines perceive this approach. We interviewed 25 adult HIV-negative TW from Metro Manila about their experiences, concerns, and recommendations for enhancing the implementation of HIVST within their community. We found four key themes: (1) Empowerment and autonomy as advantages of HIVST; (2) Person-level concerns related to the administration of self-tests, encompassing emotional readiness and concerns about accuracy; (3) Potential for expanding HIVST initiatives through community engagement and access to real-time support; and (4) Possible links between HIVST and other HIV prevention and health promotion services. The findings of this study offer strategies for implementing HIVST among TW in the Philippines.
AIDS Educ Prev
· 2025 Aug · PMID 40900186
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Adolescents face heightened vulnerability to reproductive health risks, including premarital sex, HIV, and substance abuse. This quasi-experimental study assessed the effectiveness of an animated video intervention in im...Adolescents face heightened vulnerability to reproductive health risks, including premarital sex, HIV, and substance abuse. This quasi-experimental study assessed the effectiveness of an animated video intervention in improving adolescent knowledge of these threats. Using an equivalent time-series design, 75 adolescents from Bojongloa Kidul District, Bandung, Indonesia, viewed an 8-minute animated video on premarital sex, HIV, and drug use for three consecutive days (April-June 2024). Knowledge was measured at baseline and three post-intervention points. The proportion with "good" knowledge rose from 17.3% at pre-test to 89.3% at the third post-test (p =.001). Findings demonstrate that short animated videos are an effective medium for enhancing reproductive health knowledge among adolescents and hold potential for integration into school- and community-based HIV prevention initiatives. The wide age range of participants may have influenced knowledge gains, suggesting the need for age-tailored content in future interventions.
Shrader CH, Robinson C, Hassan M
… +7 more, Brown B, Lee JY, Smith M, Latkin C, Schneider JA, Ompad DC, Duncan DT
AIDS Educ Prev
· 2025 Aug · PMID 40900185
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INTRODUCTION: Black, Latine, and Caribbean (BLC) sexual and gender minorities (SGM) face structural HIV inequities. Sociocentric interventions may address these barriers, but it is unclear if respondent-driven sampling (...INTRODUCTION: Black, Latine, and Caribbean (BLC) sexual and gender minorities (SGM) face structural HIV inequities. Sociocentric interventions may address these barriers, but it is unclear if respondent-driven sampling (RDS) can recruit existing BLC SGM friendship groups or if sociocentric HIV prevention interventions are feasible. METHODS: Using an exploratory mixed-methods design (August/2022-January/2024, New York, NY), we recruited participants into a sociocentric RDS group (sRDS) or an individual-level peer referral (PR) group, with qualitative interviews drawn from quantitative participants. RESULTS: We enrolled 29 participants in sRDS (seeds = 6) and 30 in PR; 18 completed qualitative interviews. Most were Black or Caribbean; half were US-born; over half were living with HIV. PR was viewed as feasible, while sRDS and sociocentric interventions were seen as inappropriate. Participants suggested social media and influencers for recruitment. DISCUSSION: Sociocentric approaches may be less acceptable to BLC SGM; recruitment should account for intersectional identities and offer fair compensation.
Luc CM, Levy JA, Jonbekov J
… +1 more, Mackesy-Amiti ME
AIDS Educ Prev
· 2025 Jul · PMID 40577396
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The program Migrants' Approached Self-Learning Intervention in HIV/AIDS for Tajiks (MASLIHAT) trains male Tajik migrants who inject drugs in delivering HIV prevention information within their diaspora social networks. Th...The program Migrants' Approached Self-Learning Intervention in HIV/AIDS for Tajiks (MASLIHAT) trains male Tajik migrants who inject drugs in delivering HIV prevention information within their diaspora social networks. This analysis examines the indirect effect of the intervention on HIV testing among the participants' regular female sex partners. Modified mixed-effects Poisson regression analyses compared the proportions of participants with a regular female sex partner in the MASLIHAT versus the TANSIHAT control condition who reported that their partner had been tested for HIV. Of the 420 participants, 108 (26%) reported having a regular female sex partner. Regression analyses indicated that HIV partner testing increased significantly in both conditions over the follow-up period, with MASLIHAT participants reporting a higher rate at 12 months than the TANSIHAT control group (IRR = 1.66, 95% CI [1.21, 2.28]). The MAS-LIHAT intervention increased female partner HIV testing over 12 months when compared to a non-HIV focused health education intervention.
This study examines the impact of a nurse-led sexual and reproductive health (SRH) intervention on the knowledge and attitudes of adolescents living with HIV (ALHIV). Using a randomized controlled trial design, 50 partic...This study examines the impact of a nurse-led sexual and reproductive health (SRH) intervention on the knowledge and attitudes of adolescents living with HIV (ALHIV). Using a randomized controlled trial design, 50 participants (25 control, 25 intervention) were recruited, with 47 completing the study between October 2023 and April 2024. The intervention group received four interactive sessions covering personal hygiene, contraceptive use, STI prevention, and risky behaviors. Baseline assessments showed no significant difference between groups (t =-1.411, = .300). However, post-intervention analysis revealed a significant improvement in SRH knowledge and attitudes in the intervention group ( = 5.467, < .001). Participants also showed increased comfort discussing SRH with nurses (χ = 22.17, < .001), greater willingness to disclose HIV status (χ = 7.69, = .021), and better understanding of STI testing importance (χ = 18.694, < .001). These findings support integrating nurse-led SRH programs into adolescent HIV care to improve outcomes.
Schnall R, Radix A, Kuhns LM
… +3 more, Janulis P, Paredes C, Garofalo R
AIDS Educ Prev
· 2025 Jul · PMID 40577394
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Transgender youth in the U.S. have unique health needs but often face barriers to accessing and receiving health care services, which contribute to disparate health outcomes including high risk for HIV acquisition. This...Transgender youth in the U.S. have unique health needs but often face barriers to accessing and receiving health care services, which contribute to disparate health outcomes including high risk for HIV acquisition. This article reports on a pilot randomized clinical trial of MyPEEPS Mobile for young transgender men (YTM) versus delayed intervention on condomless receptive anal and vaginal acts at 3 and 6 months after baseline. Participants rated the app as highly usable. Retention rates at 3 and 6 months were 89%. There were lower rates of condomless anal or vaginal sex acts during the intervention periods, but this reduction was not significantly different versus nonintervention periods. There was a higher likelihood of nPEP and PrEP use and HIV/STI testing during intervention periods, but this increase was not significantly different than nonintervention periods. Findings from the study support the feasibility of MyPEEPS Mobile for HIV prevention in YTM.
Oleas DS, Arentoft A, Aghvinian M
… +10 more, Savin MJ, Stiver J, Summers A, Slaughter A, Breen E, Talavera S, Cham H, Byrd D, Robinson Papp J, Rivera Mindt M
Acculturation is related to neurocognitive functioning in Latina/o/e PWH, however, little is known about the effects of stigma and nativity status. U.S.-born PWH ( = 44) and PWH born outside the U.S. ( = 22), = 45.33 (7...Acculturation is related to neurocognitive functioning in Latina/o/e PWH, however, little is known about the effects of stigma and nativity status. U.S.-born PWH ( = 44) and PWH born outside the U.S. ( = 22), = 45.33 (7.67), 71.2% male, = 12.33 (2.47) completed a neurocognitive battery, neuromedical evaluation, and sociodemographic questionnaires. Hierarchical regressions predicted neurocognitive T-scores from acculturation, perceived stigma, and nativity status. After accounting for acculturation, nativity status significantly predicted attention/working memory ( = .006), processing speed ( = .03), and executive function ( = .002), and the interaction between nativity status and stigma predicted English language verbal fluency ( = .001). Higher stigmatization was associated with higher English language fluency among those born outside the U.S. but lower English language fluency in U.S.-born participants. Nativity status should be considered when interpreting neurocognitive performance within Latina/o/e PWH.
Rhodes SD, Villafuerte-Sandoval HA, Aguilar-Palma SK
… +6 more, Mann-Jackson L, Alonzo J, Peña Flores VH, Cheley-Ortigoza PR, Davis DA, Romero-Sandoval EA
Guatemalan gay, bisexual, and other men who have sex with men (GBMSM) and transgender women experience profound HIV disparities, with prevalence rates far exceeding those of the general population. Limited access to and...Guatemalan gay, bisexual, and other men who have sex with men (GBMSM) and transgender women experience profound HIV disparities, with prevalence rates far exceeding those of the general population. Limited access to and suboptimal use of HIV prevention and treatment services hinder progress towards the Joint United Nations Programme on HIV and AIDS goal to end the epidemic by 2030. Our binational community-based participatory research partnership developed a blueprint of twelve recommendations to reduce HIV disparities in Guatemala. Recommendations include enhancing HIV surveillance, increasing research, combatting stigma, bolstering provider training, addressing social determinants of health, improving sexual health literacy and mental health services, and partnering with LGBTQ+ communities. The blueprint aims to advance HIV prevention and treatment among populations most affected by the epidemic in Guatemala and may serve as a model for other countries to respond to the urgent need for approaches to end the HIV epidemic globally.
Despite the proven effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), its use remains low in high-incidence areas. This study examined knowledge and barriers to PrEP among individuals at...Despite the proven effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), its use remains low in high-incidence areas. This study examined knowledge and barriers to PrEP among individuals at risk in Southern California. From September 2022 to April 2023, we recruited adult men who have sex with men, residing in San Bernardino and Riverside counties, who were not living with HIV and not using PrEP. Recruitment occurred through targeted online advertisements and clinic-distributed materials. Statistical analyses explored associations between demographic factors and barriers to PrEP. While 81% had heard of PrEP, nearly half were unaware of HIV testing requirements or of its availability for uninsured individuals. Uninsured participants were significantly less comfortable discussing sexual health with providers (OR: 0.19, 95% CI [0.05, 0.68]). Addressing misinformation, reducing provider stigma, and expanding access for uninsured individuals are essential for increasing PrEP use.