Well-established, regular exercise interventions for older people living with HIV (OPLWH) are beneficial. However, the fundamental principles of exercise prescription for this population have not been sufficiently explored. An expert panel of health care professionals engaged in a modified Delphi technique to explore their perceptions of, and gain their consensus on, an exercise prescription framework for OPLWH in a resource-poor South African setting. A high level of agreement among participants was determined using a priori threshold of 80% agreement and an interquartile range of ≤ 1. Expert consensus was reached on a structured, multifaceted exercise prescription and also fundamental principles, such as multidisciplinary engagement and team collaboration, pre-exercise health screening, and exercise supervision. These were viewed as necessary components of a framework to improve the integration of exercise rehabilitation in the treatment, care, and support for OPLWH.

Adolescent girls and young women ages 15-29 years (AGYW) living in Lesotho experience a disproportionate HIV burden. Using a household-based national survey in Lesotho, we conducted a three-step latent class analysis to identify typologies of AGYW most vulnerable to HIV infection. We first classified AGYW into HIV vulnerability groups based on self-reported sexual behaviors, then identified associations between typology and HIV diagnosis. HIV vulnerability behaviors included early sexual debut, condomless sex, multiple sexual partners in the past year, sex with partners they do not know the status of or are living with HIV, age disparate sex, use of contraceptives, and having children. Across all age groups, we found that HIV vulnerability typologies could be described as low vulnerability, high vulnerability, and parous. As AGYW age, they engage in more types of higher vulnerability sexual behaviors; interventions to reduce this risk should start at a younger age. Our findings emphasize the importance of implementing and scaling up biomedical strategies such as pre-exposure prophylaxis.

Our study was designed to update the HIV Knowledge Questionnaire by incorporating pre-exposure prophylaxis (PrEP) knowledge questions, as previous HIV knowledge tools lack this focus. Four rounds of Delphi surveys were conducted with 47 expert participants, each with extensive HIV-related expertise (mean experience: 18.94 years). Expert participants rated item relevance on a scale of 0-3 and provided feedback. An item was removed if over 70% scored it two or less. The process continued until consensus was reached, defined as 80% of items scoring above two by more than 70% of expert participants, with no new suggestions. The final measure included 31 items covering general HIV knowledge, transmission modes, treatment, risk, and PrEP definitions, types, and dosages. Future research is essential to validate this tool for research and clinical settings, ensuring it accurately measures patients' diverse knowledge levels.

Chronic diseases such as osteoporosis and low bone mineral density (BMD) are significant public health concerns for people living with HIV (PLWH), especially with the increased life expectancy because of antiretroviral therapy (ART). This study evaluated the prevalence and associated factors of low BMD among 94 PLWH in Kerman, Iran, from September 2021 to February 2022. Using dual-energy X-ray absorptiometry, BMD was measured, with low BMD defined by specific T-scores and Z-scores. Predictors were assessed through interviews, medical records, and blood tests. Bivariable and multivariable logistic regression models identified associations between low BMD and various factors. The study found a 51.1% prevalence of low BMD, with significant associations with hypogonadism (adjusted odds ratio [aOR]: 3.19), longer ART duration (aOR per month: 1.02), and lower body mass index (aOR per unit: 0.83). The findings highlight the need for regular screening and timely intervention for low BMD among PLWH, particularly with prolonged ART use.

Effective antiretroviral treatment means that people with HIV are living for longer. This includes Black African women, who represent a large proportion of people aging with HIV in the United Kingdom. Despite this, the impact of living and aging with HIV on the well-being of Black African women aging with HIV has not been investigated. Interpretative phenomenological analysis of interviews with eight Black African women ages 50 years and older living with HIV developed six superordinate themes. Findings demonstrated how experiences of HIV-related stigma negatively affected social, occupational, and psychological well-being. Perspectives on living and aging with HIV into the future included experiences of acceptance, uncertainty, anxiety, and hope. Recommendations are made, including developing clinical practice to consider needs relating to social and psychological well-being, as well as physical well-being, for women aging with HIV.

HIV screening is not routinely offered to acutely ill, hospitalized patients. For some patients a hospitalization represents a crucial opportunity to identify undiagnosed HIV infection and interrupt HIV transmission chains. Among people who inject drugs, a hospitalization for infective endocarditis may be one of the only touchpoints they have with a health care provider. Nurse-led HIV screening initiatives in the acute care and emergency medicine settings are being trialed across the United States. Nurses and nurse practitioners are uniquely poised to establish universal, comprehensive HIV testing protocols for people who inject drugs hospitalized for the management of infective endocarditis.

Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in people with HIV (PWH) and increases the risk of hepatic fibrosis and hepatocellular carcinoma. We sent an online survey to providers of the American Academy of HIV Medicine. Of respondents (n = 214, 8% response rate), 65% reported screening for NAFLD in PWH, with 28% routinely screening all patients. Most respondents refer patients to hepatology if workup suggests another coexisting liver disease or cirrhosis, with the primary goals of referral being additional diagnostic testing (60%) or specific treatments (75%). The most common barriers to screening were feeling unsure of what tests to order (28%) and how to conclusively diagnose NAFLD (29%). Most respondents were interested in society guidelines (73%) and NAFLD education for patients (57%) and providers (55%). Our findings support the development of NAFLD clinical practice guidelines for HIV providers and the inclusion of PWH in clinical trials of novel agents.

Adherence to preexposure prophylaxis (PrEP) is lower among high-risk populations, including youth experiencing homelessness (YEH). This study determined the feasibility of urine PrEP adherence biomarker testing and examined the barriers and facilitators to PrEP uptake and adherence among YEH. YEH were recruited from a randomized control trial conducted in a large urban setting in southern United States. Interviews (N = 40) were conducted to identify barriers and facilitators to PrEP uptake and adherence. PrEP urine-based adherence testing feasibility was conducted among those who started on PrEP. Twenty-two participants obtained a prescription and 15 youth completed at least one adherence test. Facilitators and barriers were categorized as individual, interpersonal and community, and structural among PrEP starters and nonstarters. PrEP uptake and adherence were low for eligible YEH. Enriching the understanding of the challenges and facilitators experienced with accessing PrEP for YEH can improve engagement in HIV prevention among YEH.

The intersections of HIV with aging, incarceration, and racial disparities have been well studied, but little is known about the lived incarceration experiences of older African American persons living with HIV. This phenomenological study examined the fear of HIV disclosure among older African Americans living in Kentucky who have experienced incarceration. Based on the interviews analyzed, five main themes were identified: experiences with fear, experiences pertaining to confidentiality, experiences with disclosure, experiences with stigma, and the desire to be accepted. These themes demonstrate HIV disclosure fear within incarceration settings and the desire for support and services. Findings suggest that there should be more efforts to increase HIV knowledge and awareness within incarceration settings. Participants shared that having a support network alleviates isolation. We recommend that correctional settings implement policies to protect confidentiality violations and facilitate groups to help foster a more supportive environment for individuals living with HIV.

Although exercise supports the physical function and health of older people living with HIV (PLWH), less than half of PLWH globally achieve recommended levels of activity. A qualitative descriptive design was used to determine what motivates sedentary PLWH, 50 years and older, to participate in an exercise trial. Interviews were conducted with PLWH who participated in an exercise trial (n = 30) and PLWH who declined enrollment in the same exercise trial (n = 4). The theory of planned behavior (TPB) guided a directed content analysis of the interviews. Data analysis identified four themes: (a) intention or motivation (perceived benefits, maintaining the exercise behavior over time), (b) attitudes (goals and preferences), (c) perceived behavioral control (barriers, facilitators, and self-efficacy), and (d) subjective norms (pressure from health care providers and social networks). Findings from our study contribute to informing the development of future exercise interventions or trials and to planning care to encourage a physically active lifestyle.

Men who have sex with men (MSM) experience intimate partner violence (IPV) and are at an elevated risk of HIV acquisition. Preexposure prophylaxis (PrEP) is an effective preventative measure against HIV. However, its adoption and consistent use among MSM, especially those experiencing IPV, is low. This scoping review summarizes literature relevant to HIV PrEP, focusing on MSM who experience IPV. Of the 110 studies identified, eight eligible studies met the inclusion and exclusion criteria. Most of these were conducted in the United States, focusing exclusively on adult MSM. Most studies evaluated daily oral PrEP. The studies assessed the impact of IPV on respondent's knowledge, willingness, preference, and PrEP use and revealed varying levels of association between IPV and PrEP. Future research is essential to develop practice guidelines and policy to enhance PrEP uptake in this vulnerable population.

Older adults account for one in every five new HIV infections in the United States yet are often overlooked in tailored pre-exposure prophylaxis (PrEP) messaging. The aim of this study was to evaluate the original PrEP messaging source and its influence on PrEP use among a cohort of older adults. The Columbus Health Aging Project data (N = 794) were used to examine the initial PrEP information source and PrEP use in the past 6 months, adjusting for demographics and sexually transmitted infection (STI) status. Forty-six percent reported an STI, and 11.5% used PrEP. The main sources of PrEP information were peers (42.2%) and health care providers (40.2%); media (17.6%) sources were less common. Compared with those who received PrEP information from their health care provider, those informed by peers (adjusted odds ratio [aOR] = 0.58; 95% confidence interval [CI]: 0.34-0.99) or media (aOR = 0.17; 95% CI: 0.07-0.42) were less likely to use PrEP. Adjusting for STI-, media-informed remained less likely to have used PrEP compared with those informed by providers (aOR = 1.14; 95% CI: 0.55-2.35). These findings highlight the importance of tailored PrEP messaging for older adults for Ending the HIV Epidemic efforts. Media appears less impactful as a messaging approach for older adults.

There is a decreasing HIV care workforce in the United States, whereas the need for HIV care and prevention continues to increase. To better understand this issue, a quantitative, anonymous, one-time, self-administered survey was conducted. The survey was completed by 1,004 prescribing clinicians currently providing HIV-related health care. Clinicians of younger age and Black race, advanced practice registered nurses, and family medicine physicians were more likely to report continuing with the same number of patients or increasing the number of patients in their HIV practice in the next 5 years. The need for more prescribing HIV care clinicians is paramount because 17.8% reported plans to stop HIV clinical care wholly or to decrease the number of people living with HIV in their practice over the next 5 years. The most common reasons for leaving include retirement, administrative burden, and burnout.

People living with HIV (PLWH) may experience premature physical deficits, including walking, mobility, and balance problems. The purpose was to measure deficits in walking, mobility, balance, and dual tasking in PLWH. The secondary objective was to make recommendations regarding the use of rehabilitation outcome measures. CINAHL, PubMed, and SPORTDiscus databases were searched. Two independent reviewers screened titles/abstracts and full-text articles, extracted data, and performed a quality assessment. Fifty-six articles with 14,053 PLWH and 8,454 uninfected controls were included. A meta-analysis revealed significantly worse performance among PLWH on the five times sit to stand mobility test versus controls (Cohen d = 0.68, 95% confidence interval [CI 0.08-1.29], p = .03). Meta-analyses revealed no differences between PLWH and controls for usual gait speed (Cohen d = -0.47, 95% CI [-1.10 to 0.15], p = .14) and fast gait speed (Cohen d = -0.39, 95% CI [-0.87 to 0.08], p = .10). Ten of 12 studies comparing PLWH with controls found differences in balance outcomes. PLWH have significantly worse mobility than uninfected controls.

There is a shortage of health-related questionnaires developed specifically for African countries' cultural contexts and local languages. Researchers have translated some tools to the target local languages. However, poor quality translation, or even high-quality translation, can lead to an instrument that is not comparable to the original language if linguistic nuances and cultural differences are not considered. This can affect the validity and reliability of the research data. The objective of this commentary is to highlight limitations of the commonly accepted forward-backward translation approach and the importance of more rigorous cultural and linguistic adaptation processes in social and behavioral research related to HIV.

At the onset of the COVID-19 pandemic, clinicians and researchers were concerned about its impact on the health of people living with HIV (PLWH). Although mitigation measures during the early part of the pandemic used telehealth, it was uncertain whether PLWH would be amenable to this type of care and whether health outcomes would be affected. PLWH actively seeking treatment at a large urban outpatient practice in Essex County, New Jersey, were interviewed from October 2020 to June 2021 about their health-related experiences during COVID-19. The sample was dichotomized by age (< 55 and ≥ 55). In all, participants (69.2%, n = 92) used telehealth during this period, 85.0% ( n = 113) actively tested for COVID-19, with only 7% ( n = 8) testing positive at the time of interview. Our findings demonstrate that PLWH who engaged with health care before the COVID-19 pandemic continued doing that and had relatively favorable health outcomes with few differences by age.

Stress and HIV disproportionately affect Latinx adults in the United States, contributing to numerous health inequities. Among people living with HIV (PLWH), increased stress is associated with decreased medication adherence, effectiveness, and higher rates of immunosuppression and comorbidities. Our study ( N = 126) examined the relationship between perceived stress and HIV-related health among Latinx ( n = 83) and non-Latinx White ( n = 43) PLWH. Latinx PLWH reported better HIV-related health outcomes than non-Latinx White PLWH, despite higher viral load (all p 's < .05). An interaction effect showed that higher perceived distress was associated with worse health outcomes and lower CD4+ T cell count only in Latinx PLWH ( p 's < .05). Our findings highlight the consequences of stress on HIV-related health. Notably, higher stress may be especially detrimental among Latinx PLWH, underscoring the need for more culturally tailored interventions in HIV-related care. Future research should include additional sociocultural factors and longitudinal assessment in a larger sample.