Enhancing societal tolerance towards people living with HIV/AIDS (PLWHA) is crucial for curbing the spread of the disease. We investigate the impact of Internet exposure on netizens' tolerant attitudes toward PLWHA. We analyzed data from 11,927 netizens surveyed in the Chinese Social Survey (CSS) conducted in 2017, 2019, and 2021. An ordered probit model was employed to examine the direct association between Internet exposure and netizens' tolerant attitudes toward PLWHA. During this period, Chinese netizens' tolerant attitudes toward PLWHA have increased. Internet exposure enhances netizens' tolerant attitudes toward PLWHA. Social participation mediates the positive impact of Internet exposure on netizens' attitudes toward PLWHA. Additionally, subjective social status amplifies the beneficial influence of Internet exposure and social participation on these attitudes. Male netizens derive greater benefits from social participation in fostering tolerance toward PLWHA compared to female netizens. Additionally, Internet exposure exhibits a double-edged sword effect on netizens' tolerant attitudes toward PLWHA. This study represents the first systematic investigation into the impact of Internet exposure on netizens' tolerant attitudes toward PLWHA, which is conducive to improving the social status and health welfare of PLWHA.

Differentiated service delivery (DSD) models for pregnant and postpartum women living with HIV (WLH) are lacking despite guidelines recommending DSD for this population. We used human-centered design (HCD) to develop a DSD model for pregnant and postpartum WLH at the Academic Model Providing Access to Healthcare (AMPATH) in Kenya. We conducted co-creation workshops with 11 postpartum women, 9 male partners and 9 providers from three AMPATH-affiliated facilities to develop a DSD model, refined by program/county health officials. The workshops used WHO building blocks for DSD to determine eligibility criteria and strategies for clinical encounters, antiretroviral therapy (ART) distribution, and psychosocial support. We used nominal group techniques and thematic analyses to identify DSD attributes, themes and preference heterogeneity. Workshops yielded a facility-based DSD model with these attributes: eligibility criteria including age ≥18 years, not primigravida, retention in care, viral load <50 copies/mL, no active maternal/child comorbidities; monthly clinical encounters during pregnancy and 6 months postpartum, then every 2-3 months aligned with immunization/HIV testing schedules; flexible ART refills every 1-6 months; psychosocial counseling by mentor mothers as needed. This model was acceptable to stakeholders with perceived feasibility/scalability. Engaging end-users through HCD generated a person-centered DSD model for integrated MCH clinics in Kenya.

The African kinship system facilitates the movement of children and adults between households to mitigate hardship, yet few studies have documented membership changes in rural African households over time and addressed the effects of these household dynamics on the developmental outcomes of children. We used a household inventory instrument to document the number of changes in household membership experienced by 93 households in rural Zambia between two timepoints (∼2 years apart). We then used multilevel models to evaluate the effects of migration and household change on the academic learning of the children affected by HIV residing in these households, positing migration between households as a proxy for household connectivity and a potential protective factor for children. Our inventoried households experienced on average 4.12 changes in membership over the measured period. About half of these changes were due to children under 10 moving between relatives' households. No effects of these migration-related variables were found on children's academic progress at the family level. Household connectivity, as operationalized by the movement of individuals between households, may be typical to these children's home life and were not shown to be detrimental to their academic learning.

Different definitions of late HIV diagnosis are used to represent people diagnosed at an advanced stage of their illness. How well varying definitions represent those at risk for poor outcomes is unclear. Our aim was to examine proportions of late, delayed and timely HIV diagnoses in Florida and identify factors associated with diagnosis status. Using the first laboratory test in the Enhanced HIV/AIDS Reporting System, we determined annual proportions of late (CD4 < 200 cells/μL), delayed (200 ≤ CD4 < 350 cells/μL) and timely (CD4 ≥ 350 cells/μL) diagnoses in Florida between 2015 and 2021 and assessed characteristics associated with diagnosis status using multinomial logistic regression models. Among 30,411 individuals (20% female, 39% non-Hispanic Black, 34% Hispanic, mean age 37.1 years), 22% had a late and 17% had a delayed diagnosis. Non-Hispanic Black race, older age, and diagnosis at an inpatient facility were associated with greater odds of having a late or delayed diagnosis compared with having a timely diagnosis. There was no change in the prevalence of late, delayed, and timely diagnoses each year during the study period. Nearly 40% of HIV diagnoses in Florida were late or delayed. Given those with late and delayed diagnoses were similar, strategies to improve timeliness of diagnosis among these groups are needed.

Human Immunodeficiency Virus (HIV) infection is stigmatizing, especially for key populations, who are disproportionately affected by Sexually Transmitted Infections (STIs). The stigma and discrimination suffered by these groups are among the main obstacles to HIV prevention, treatment and care, which is why the World Health Organization recommends the use of self-tests to increase HIV testing and achieve the 95-95-95 target by 2030 proposed by the United Nations. We conducted an overview of systematic reviews and meta-analyses, searching for free and indexed terms in nine databases, and using the acronym PICO as an inclusion criterion. Two independent reviewers performed the selection in two stages, and disagreements were resolved by consensus with a third reviewer. Quality analysis was performed using the Assessing the Methodological Quality of Systematic Reviews, version 2 (AMSTAR 2) tool. Four studies were included, one evaluating men who have sex with men (MSM), one evaluating MSM and another key population, and two evaluating MSM and transgender women (TGW). HIVST was effective in increasing testing frequency and uptake and was considered as good as or better in detecting new HIV infections. However, the presence of more than one critical weakness and multiple non-critical flaws reduced the overall confidence.

Given the current organ shortage crisis, organ transplantation among people with HIV (PWH) has become a reality. To effectively implement this practice, understanding the attitudes and beliefs about organ donation among PWH in Canada is imperative. PWH receiving care at the McGill University Health Centre were recruited to participate in a survey between October 2023-June 2024. The questionnaire assessed knowledge of organ donation and willingness to donate or receive organs from donors with HIV. Descriptive statistics were performed. Of 100 participants, 33.0% knew that PWH can undergo organ transplantation in Canada, and 26.0% knew that PWH in Canada can donate their organs to PWH. Additionally, 74.5% would consider accepting an organ from a deceased donor with HIV, 78.0% would consider accepting an organ from a living donor regardless of HIV status, 78.0% would be willing to be deceased donors, and 44.0% would be willing to be a living organ donor. Female-identifying and African, Caribbean or Black participants showed higher awareness about organ donation, whereas male-identifying and White participants demonstrated higher willingness to donate and receive organs from donors with HIV. While willingness among PWH was high, knowledge of organ transplantation was suboptimal, highlighting the need for increased awareness efforts.

HIV has become a rising healthcare issue in Pakistan in recent years with new outbreaks and spillover to traditionally low-risk groups. We studied the stigma around HIV, its relation to psychiatric comorbidities such as depression and anxiety, and adherence to treatment in people living with HIV (PLHIV). A hospital-based cross-sectional study was conducted over six months at a tertiary care hospital in Karachi, Pakistan. Self-administered digital questionnaires containing basic demographics, PHQ9, GAD7, HSS12, and GMAS scales were used to assess depression, anxiety, stigma, and medical adherence respectively. A total of 66 participants were included, with a mean age of 39.97 ± 14.32 years. The mean stigma score was 25.67 ± 9.46, with 9 participants (13.85%) experiencing severe stigma. Among the different stigma components, disclosure concerns had the highest mean score (7.91 ± 2.91). Most participants had no depression and a no-to-low risk for anxiety. No relationship was found between medical adherence and either stigma scores or psychiatric comorbidities. Patients identified as from key populations ( = 35) had significantly increased risk of depression ( = 0.0493), anxiety ( = 0.023), and HIV-associated stigma ( = 0.0166). Stigma continues to affect mental well-being and hinders early diagnosis and treatment of PLHIV. A comprehensive approach, cannot be complete without addressing this stigma and its effect on disease burden, diagnosis, and treatment.

Social norms, particularly those pertaining to gender equity, can shape attitudes and behaviors that contribute to adolescent sexual violence (SV). This study examines personal attitudes and perceived peer norms regarding gender equity and associations with perpetration of SV among 100 South Africans aged 13-17 in 2019. We assessed: (1) sexual activity and SV behaviors and (2) personal attitudes and perceived peer norms around gender equity. Descriptive statistics, t-tests, and logistic regressions examined associations between attitudes, norms, and SV, adjusting for demographics. Findings reveal that 59% of sexually active adolescents reported perpetrating SV behaviors, though only 8% classified their actions as "rape". Adolescents endorsed more gender equitable personal attitudes compared to their perceptions of peers, highlighting a misperception of social norms. Differences in gender equitable attitudes by biological sex and perpetration status were minimal, however, males and those reporting perpetration were more likely to endorse specific inequitable gender attitudes. Number of lifetime sexual partners was significantly associated with SV perpetration, particularly among males. An age-sex interaction revealed opposing trends - older age was associated with reduced odds of SV perpetration among males but increased odds among females. Correcting misperceived norms is a promising strategy for SV prevention among South African adolescents.

Older people with HIV (OPWH) have an increased risk of type 2 diabetes mellitus (T2DM). Understanding this is important to screen and initiate treatments. This study explored awareness of T2DM, perceived risk, and willingness to receive T2DM preventive education. OPWH were recruited from an academic health center in Chicago, Illinois between November 2022 and January 2023. Staff used interview guides for qualitative data collection and administered a sociodemographic survey. Qualitative data was analyzed using the Framework Method; survey data was analyzed descriptively. A total of 19 participants were enrolled; the mean age was 59 years, and 37% were female. Thematic analysis revealed: (1) although participants were familiar with T2DM, they were largely unaware of the increased risk among individuals with HIV; (2) participants had divergent views regarding their own T2DM risk perception; (3) health maintenance was a motivator for T2DM prevention, yet participants noted lifestyle improvements may be difficult to implement; (4) participants were open to receiving diabetes prevention materials via the patient portal. Despite a general lack of awareness of T2DM risk among older adults with HIV, participants were willing to receive T2DM prevention information. Future research should develop plain language materials for OPWH and determine appropriate delivery procedures.

Men who have sex with men (MSM) face a heightened risk of HIV, presenting a significant public health issue. This meta-analysis evaluates the effectiveness of HIV health education for MSM by examining changes in knowledge, attitudes, and behaviors across different cultures and regions. The study also explores heterogeneity sources through subgroup and sensitivity analyses to guide future research. Searches were conducted in databases including China Knowledge, Wipo, Wanfang, PubMed, and Web of Science, covering studies up to December 1, 2023. Included were controlled pre-post trials on HIV education's impact on MSM. Independent data extraction and analysis were completed by two researchers using RevMan 5.7. Pre-registration was done with PROSPERO. Twenty-seven studies met criteria. Post-intervention, significant improvements were noted in HIV knowledge (OR: 0.49; 95% CI: 0.44-0.56), condom use over six months (OR: 0.47; 95% CI: 0.38-0.58), and condom use in recent same-sex encounters (OR: 0.44; 95% CI: 0.29-0.66). Larger samples (>500) or long-term interventions (>1 year) enhanced homogeneity (I = 0%). In conclusion, these interventions significantly boost knowledge and condom use, identifying sample size and intervention duration as primary heterogeneity influences, guiding future strategy optimization.

In Brazil, pre-exposure prophylaxis (PrEP) is freely available to individuals at high risk of HIV infection. However, knowledge and perception of PrEP can act as barriers to its access and use. This study evaluated PrEP knowledge and perception among healthcare workers in the Unified Health System in a Brazilian capital. This cross-sectional study collected data through interviews with healthcare workers from 72 Primary Health Care (PHC) units and 5 Specialized Care (SC) services in Campo Grande, Mato Grosso do Sul. Binomial logistic regression models were used to analyze factors associated with PrEP knowledge and perception. A total of 372 professionals were interviewed. The majority were PHC professionals (93.0%), female (76.1%), aged between 30 and 39 years (41.4%), heterosexual (83.3%), and non-white (51.9%). PrEP knowledge was higher among LGBTQIA + professionals, those with less than one year of healthcare work experience, those with a positive perception of PrEP, and those attending more patients per day. A positive perception of PrEP was significantly higher among professionals who care for people living with HIV and lower among those with limited knowledge about PrEP. Identifying factors influencing PrEP access may help develop strategies to improve knowledge and perception, particularly in high-impact areas.

Before national guidelines related to infant feeding among people living with HIV (PLHIV) in the United States were changed in 2023, PLHIV were discouraged from breastfeeding due to the potential risk of perinatal HIV transmission. Potential health benefits to both mother and child coupled with the ability to mitigate HIV transmission risk with modern treatments now make feeding decisions more complex for PLHIV. This study examined personal and social determinants of feeding choice among PLHIV in the Philadelphia area just prior to the change in national guidelines. In 2022 and 2023, we conducted in-depth interviews with 28 PLHIV between the ages of 18-50 years old that had previously given birth, 22 while living with HIV. Participants who gave birth while living with HIV expressed that they had not been given the choice to breastfeed. When probed about how they would consider choice in a hypothetical future pregnancy in the new guidelines era, participants' own knowledge and beliefs about what was best for their babies and themselves were consistently raised as the most influential factors. They relied strongly on their health providers for up-to-date knowledge. Advice from partners, family, and community was considered less influential for most.

Given the significant syndemic of HIV and substance use in the U.S., this study sought to examine substance use patterns (consistent user, former user, recent adopter, and abstainers) and identify sociodemographic disparities among people with HIV (PWH). Using 2015-2019 National Survey on Drug Use and Health data ( = 212,411), we estimated prevalence rates and conducted multinomial logistic regression to assess associations between HIV status and (1) substance use and (2) sociodemographic factors. Results show PWH have higher rates of consistent and former use of a range of substances, including inhalants, methamphetamine, cocaine, and heroin. Younger PWH are more likely to use cannabis and hallucinogens, while middle-aged PWH show elevated methamphetamine use. Male and urban-residing PWH face higher risks for inhalants and cocaine. These findings underscore the need for targeted interventions addressing substance use disparities among PWH, particularly for high-risk subgroups and substances. Integrated care models emphasizing harm reduction and relapse prevention are critical. Policy reforms should expand Medicaid and Ryan White Program coverage to include comprehensive substance use treatment for PWH. Future research should explore longitudinal patterns of substance use transitions and the impact of structural factors such as stigma on these disparities to inform effective prevention and treatment strategies.

People who inject drugs (PWID) and men who have sex with men (MSM) in India are disproportionately affected by HIV and experience challenges achieving sustained viral suppression. We evaluated probabilities of suppression over time and characteristics associated with persistent viremia and viral rebound among MSM and PWID living with HIV (PLHIV) using 12 months of data collected between 2017-2019 from a cluster-randomized trial across 16 cities in India. To assessprobabilities of suppression, we fit logistic transition models with generalized estimating equations. To assess correlates of persistent viremia and viral rebound, we fit multivariable multilevel logistic regression models. Of 750 PWID, 88% were male and 14% completed high school. Of 850 MSM, 29% completed high school and 54% were married. 46% of PWID and 67% of MSM maintained viral suppression once achieved. Probabilities of viral rebound decreased over time. The probability of newly achieving suppression decreased, from 33%-12% after six months among PWID and 60%-13% among MSM. Among PWID, correlates of persistent viremia included lower education, employment, homelessness, and active injection. Among MSM, hazardous alcohol use was associated with viremia and viral rebound. Treatment engagement and support efforts need to be intensified to encourage PLHIV to achieve life-long suppression.

Pre-exposure prophylaxis (PrEP) is offered to pregnant HIV-uninfected women in serodiscordant relationships in Mozambique, yet uptake is still low. We conducted a randomized feasibility trial of PrEP education and psychosocial support to serodiscordant expectant couples via three storytelling sessions in two districts within Zambézia Province. Data were collected between December 2020 and December 2022. We recruited 64 couples (31 control and 33 intervention) from two health facilities. We assessed the intervention's effect on psychosocial metrics related to PrEP (stigma, treatment self-efficacy, treatment expectations, relationship satisfaction, social support), retention in clinical services, and participants' acceptability of each storytelling session. Among couples randomized to the intervention, 24 (73%) completed all three sessions. No impact was seen on median medication possession ratio (among women: 74.0% and 73.8% [ = 0.514]; among men: 78.3% and 75.4% [ = 0.543] for control and intervention groups, respectively). Surveys revealed no change in PrEP stigma, treatment self-efficacy, treatment expectations, or relationship satisfaction. In interviews, participants reported increased PrEP knowledge, improved trust, capacity, and motivation to remain adherent to their medications. Some described low PrEP awareness within their communities and suggested community-based educational sessions. In-person narrative-style storytelling could be an acceptable method of conveying PrEP information to serodiscordant couples in rural areas in Mozambique.

In South Africa, people living with HIV (PWH) often relocate for work and family obligations, which creates unique challenges for continuous HIV care. We explored the experiences of mobile individuals living with HIV navigating clinic transfers without formal letters. A qualitative study was conducted with PWH on antiretroviral therapy (ART) from two clinics in KwaZulu-Natal. Participants, who had not disclosed their HIV treatment history at registration, were interviewed in-depth between March and October 2023. Content and thematic analyses, informed by Andersen's behavioral model and self-management domains, were used. This study presents two case studies of individuals who faced challenges with accessing ART after relocating to new areas: a 37-year-old female worker and a 47-year-old male construction worker. Both faced difficulties accessing ART after relocation. When they presented at new clinics, they were told they could not access care without transfer letters. Unable to return to previous clinics, they sought treatment at a third clinic as treatment-naive, changing their names to avoid detection. To cover ART gaps, they also purchased or borrowed ART from others. These individuals developed strategies to overcome barriers. Educating clinic staff on the challenges faced by migrants could help improve transfers.

This study assessed the feasibility and acceptability of using global positioning systems (GPS) to evaluate food insecurity among older people living with HIV (PLWH), including those with criminal justice involvement. Approximately 25 PLWH participants were recruited via community engagement from September 2023 to January 2024. Bivariate analyses identified demographic characteristics, and chi-square tests investigated the association between arrest/incarceration history and food security. Spatial analysis examined patterns, calculated distances traveled and determined the frequency of visits to specific locations over seven days. Around 20.8% ( = 5) of participants had a CD4 count of ≤299 cells/mm³, indicating possible advanced HIV status. Food insecurity was higher among participants with lower education levels (61.5%;  = 8) and incomes ≤$20,000 annually (69.2%;  = 9). Those with arrest histories had slightly higher food insecurity rates (54.5%;  = 6) compared to those never arrested (45.5%;  = 5), though differences were not statistically significant. Most participants successfully charged and carried their GPS devices and retained food receipts. GPS compliance was higher at the start and middle of the study period but declined toward the end. Findings support that integrating geospatial technology is both feasible and acceptable for assessing food insecurity among older PLWH.

The expanding ageing population increases the importance of understanding frailty and related impacts on health. Our objectives were to examine the sexual function and its association with frailty among sexually active older adults aged 50+ living with HIV (OALHIV). A multi-centre cross-sectional study was conducted between September 2021 and July 2022. We enrolled OALHIV from specialized infectious disease hospitals providing HIV care in four cities in China. Data were collected through an investigator-administered questionnaire. Logistic regression was used to assess correlates of lower sexual function. 239 sexually active OALHIV (40 women and 199 men) were included in the present analyzes. 53 (22.2%) participants had frailty. About two-fifths (37.7%) reported at least one sexual difficulty lasting 3 months or more in the past year. Lack of interest in having sex was the most commonly reported sexual response problem (27.2%). 29.7% expressed satisfaction with their sex life. 49 participants were categorized as having a low sexual function. Frailty (aOR 3.03, 95%CI 1.22-7.53) was associated with low sexual function. OALHIV with frailty should be screened for sexual function problems. More efforts should be made to integrate sexual health services into geriatric services, ensuring comprehensive care that addresses their specific sexual concerns.

"Opt-out" Emergency Department (ED) blood-borne-virus screening enables early diagnosis, improving outcomes. Whereas some EDs encourage verbal reminders at blood draw, others emphasise "implied consent". Associations between these approaches and screening equity have not been explored. This retrospective cohort evaluation quantified demographic disparities in screening in two EDs following "reminder model" screening rollout. Staff attitudes were explored, identifying screening barriers. ED attendees from July-October 2022 were identified electronically. Associations between age, sex, self-identified ethnicity, attendance time and admission status on screening were analysed using odds ratios (ORs). Twenty ED staff underwent semi-structured interviews. There were 33,388 eligible ED attendances (54.8% female; median age 53y). 58.9% of attendees received screening. In unadjusted analysis, the screening rate was higher in men (OR 1.05; 95%CI 1.00-1.10) and in non-admitted attendees. People of Black, Asian or Other ethnic backgrounds had lower rates compared to White ethnicity. Attendees between 5pm-11pm had lower rates and 11pm-9am higher rates compared to 9am-5pm. All associations persisted in multivariable models. Interviews revealed low confidence in follow-up discussion in attendees who opted out and a high workload precluding screening. Demographic disparities were seen in this "reminder model" context. Simplifying processes and emphasising implied consent may improve equitable screening.

Pregnancy can be associated with excitement at the thought of adding a new member to a family. Many occurrences may as well accompany it, some of which are expected physical changes. However, an HIV diagnosis while pregnant may hinder the psychosocial health outcome of the pregnant mother and affect her response to the pregnancy as a result of the HIV test. To that effect, the psychosocial needs of the pregnant mother post HIV-positive test must be catered for. This paper explored the psychosocial support needs of pregnant women diagnosed with HIV during pregnancy. A qualitative, exploratory, and descriptive design was followed. Data were collected using an interview guide from 20 purposefully sampled women at a clinic in the Thembisile-Hani district municipality. Five themes emerged and findings indicated the need for psychosocial support from groups, family and healthcare professionals. A lack of post-result counselling also emerged with the results. The study exposed gaps between what HIV-positive mothers require as support and what they receive from the healthcare facilities. This indicated the need to implement adequate post-testing education and counselling fit for the psychosocial needs of pregnant HIV-positive women.

Mental health disorders contribute to a lack of HIV care retention and adherence. Pharmacotherapy for mental health treatment may increase retention and adherence. However, there is often a lack of pharmacotherapy services for mental health treatment available in HIV care. The current study explores the extent to which people living with HIV find the integration of pharmacotherapy for mental health treatment into HIV care acceptable and appropriate. We conducted in-depth interviews with ten patients living with HIV and comorbid mental health or substance use challenges. We used rapid qualitative analysis to analyze the transcript data. Patients cited several barriers to mental health treatment, including having to coordinate and establish rapport with other providers. Participants' perspectives about whether HIV care providers should provide pharmacotherapy for mental health treatment varied. However, most respondents agreed that it would be beneficial for HIV care providers to maintain existing regimens or address lapses in mental health care. Patients also cited benefits to integration, including the ability to receive care from a trusted provider and increased access. These findings add to previous literature and demonstrate the nuanced nature of the acceptability of receiving pharmacotherapy for mental health treatment from an HIV care provider.

Young adults living with perinatally acquired HIV (PAH) face many stressors. Sharing one's status may help with coping with these challenges but there are no rigorously evaluated interventions to support HIV status sharing in this population. The aim of this study was to explore the experiences of participants in a novel HIV status-sharing intervention guided by motivational interviewing. We used a cross-sectional, qualitative design. Ten young adults from Uganda (20-25 years; 6 female), nine from the UK (19-29 years; 7 female) and five therapists (2 UK; 3 Uganda) participated in individual semi-structured interviews. The data were analysed using thematic analysis. Seven theoretical themes were identified. Participants reported positive experiences of the intervention, a desire for more support and the importance of peer interaction. This study provides evidence for the acceptability of a novel HIV-sharing intervention for young adults with PAH. The intervention could inform HIV sharing guidance and clinical practice.

Methamphetamine use among sexual minority men (SMM) has been associated with poor ART adherence, and reduced initiation and adherence to PrEP. From May 2021 to May 2023, 226 SMM were enrolled in , a culturally responsive smartphone application to reduce methamphetamine use and improve sexual health. Using a status-neutral approach, an ordinal variable reflected participants' placement on the HIV Prevention/Care Continuum, from HIV-positive, not taking ART, to HIV-negative, currently taking PrEP. An ordinal logistic model was structured to identify factors associated with participants' placement on the Continua. Of the 99 SMM at risk of HIV, 57.6% had an HIV test within three months. The majority ( = 77; 77.8%) had heard of PrEP, among whom only 28 (36.4%) were currently on PrEP. Among the 127 (56.2%) participants with HIV, 61 (48.0%) had viral load testing in the last three months, and 48 (37.8%) were virally suppressed. With demographics, social determinants of health, and substance use/sexual risk behaviors controlled, those with post-graduate education were more likely to have higher placement in the Continua (OR = 2.12,  = 0.011). STI in the past 12 months was correlated with lesser placement (OR = 0.57;  = 0.045). Neither methamphetamine use disorder nor readiness to change was correlated with Continua placement.

Eliminating stigmas that harm sexual and gender minorities (SGM) with HIV is necessary to end the epidemic; however, few validated stigma-reducing interventions for healthcare settings exist, and even fewer have been evaluated in Spanish-speaking contexts. Finding Respect and Ending Stigma around HIV (FRESH) is a healthcare setting stigma-reduction intervention that was adapted and tested to address HIV and intersectional stigmas that harm SGM with HIV in the Dominican Republic. Herein, we detail the intervention adaptation process and present feasibility, acceptability, and pre-post preliminary effectiveness results ascertained via paired t-tests. Twenty healthcare workers at HIV clinics and sixteen SGM with HIV received the intervention (N = 36). Among healthcare workers, intervention receipt was associated with reductions in negative opinions about people with HIV (PWH,  = 0.01); among SGM PWH there were significant improvements in healthcare empowerment ( < 0.05) and awareness of clinic-based stigma ( < 0.05). Nearly 100% rated the intervention, content, or quality of information as excellent; 95% reported they would recommend FRESH to friends or colleagues. All participants felt the intervention helped them to "better understand and deal with stigma." The Spanish-language FRESH intervention is a promising stigma-reducing intervention for SGM PWH and healthcare workers. Future directions include intervention full-scale testing in Spanish-language settings.

Stigma toward homosexuality plays an important role in the increased risk of acquiring or transmitting HIV among men who have sex with men (MSM). This study describes associations between three dimensions of homosexuality-related stigma (enacted, perceived and internalized) and HIV risk behaviors among HIV-negative MSM in Hanoi, Vietnam. A total of 1675 HIV-negative MSM were recruited from the baseline of a cohort study from 2017 to 2019 through respondent-driven, time-location and internet-based sampling strategies. Stigma was measured by a locally validated instrument, with a higher score indicated a higher level of stigma (from 1 to 4). Enacted stigma (mean = 2.10), perceived stigma (mean = 2.62) and internalized stigma (mean = 2.55) were found. About 25% of participants reported group sex and 6.3% reported drug use before or during group sex in the last 6 months. Enacted stigma was significantly associated with group sex (adjusted OR = 1.48; 95% CI 1.20-1.84) and drug use before or during group sex (adjusted OR = 1.68; 95% CI 1.19-2.36). Internalized stigma was significantly associated with group sex (adjusted OR = 1.27; 95% CI 1.05-1.53) and drug use before or during group sex (adjusted OR = 1.44; 95% CI 1.04-1.99). The results highlight the need for multifaced interventions at a multiple socio-ecological levels to reduce stigma toward homosexuality.

Daily oral HIV pre-exposure prophylaxis (PrEP) is highly effective when taken consistently, but its uptake remains low among mobile fishermen in Kenya. This study explored barriers and facilitators to PrEP uptake in three Lake Victoria beach communities. In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with 65 fishermen, purposively sampled by community, age and study arm. IDIs and FGDs examined PrEP knowledge, perceptions and experiences and were conducted in Swahili or Dholuo, transcribed and translated into English. Data were analyzed using a framework approach. Most participants were >35 years old (56%), married (83%) and half (48%) had completed primary education or higher. Although most had heard of PrEP, some confused it with post-exposure prophylaxis, and many were unsure of correct dosing and eligibility. Barriers to uptake included anticipated partner conflict, confusion with HIV treatment medications and stigma associated with PrEP use, leading to fear of disclosing use to sexual partners. Facilitators included a preference for PrEP over condoms and its perceived protection in sero-different partnerships. Despite free availability in clinics, misconceptions may hinder uptake. Educational interventions are needed to improve PrEP knowledge and reduce stigma, especially among mobile populations like fishermen.

This systematic review assessed the success rates of endodontic treatment in HIV-positive (HIV+) patients. Registered in PROSPERO (CRD42020216495), the study addressed whether success rates differ between HIV+ and non-HIV patients. Two reviewers searched Medline-PubMed, Scopus, Web of Science, EMBASE, and Lilacs. Eligibility criteria included studies evaluating primary endodontic treatment success with at least 12 months of follow-up. Risk of bias was assessed using the Newcastle-Ottawa scale, and evidence certainty was measured with the GRADE approach. From 252 studies, four case-control studies (282 individuals) met the criteria. Three studies focused on teeth with pulp necrosis and chronic apical periodontitis, while one included pulp necrosis and irreversible pulpitis. The success rate was 89.67% for HIV+ patients and 94.13% for non-HIV patients, with no significant differences between groups. The evidence had a very low certainty level. Findings suggest similar endodontic treatment success rates in HIV+ and non-HIV individuals, but the low certainty of evidence must be considered. PROSPERO - CRD42020216495.

HIV antiretroviral drugs used as pre-exposure prophylaxis (PrEP) are effective for HIV prevention. This study evaluated determinants of PrEP uptake among HIV-negative spouses in HIV-serodiscordant heterosexual relationships in Nairobi City County, Kenya. Of the 424 participants, 114 reported current PrEP use, resulting in a PrEP uptake of 27% (23-31%). The top reason for current PrEP use was to achieve pregnancy ( = 69; 61%). Of the 424 participants, 209 (49%) had never used PrEP, and the leading reasons for never using PrEP were lack of PrEP information (38%) and self-perceived low risk for HIV (36%). Factors associated with decreased likelihood of PrEP use included: low level of education ( = 0.026), self-perception of being at low-to-no risk for HIV ( = 0.021), lack of desire for more children ( = 0.005) and lack of knowledge that PrEP is offered free ( = 0.004). Female sex (aOR = 2.3; 95% CI: 1.4-4.0) and lack of condom use (aOR = 2.5; 95% CI: 1.4-4.5) were associated with increased odds of taking PrEP. Uptake of PrEP among HIV-serodiscordant couples in Nairobi City County was low, and PrEP use was driven by desire to fulfill pregnancy intentions. Aggressive educational campaigns to address self-HIV-risk perceptions and increase PrEP knowledge are necessary for increased PrEP demand.

This study aims to investigate how comprehensive HIV knowledge, stigma and sociodemographic factors relate to sexual risk behaviors among sexually active young women in the Philippines. Using the 2022 Philippine National Demographic and Health Survey data, a cross-sectional quantitative approach analyzed 2494 sexually active young women aged 15-24 years. Logistic regression models examined associations, controlling for sociodemographic factors. Sexual risk behaviors included STI symptoms, multiple sexual partners and non-condom use. Findings revealed 26.6% reported sexual risk behaviors. Significant associations were found with secondary or lower educational attainment (AOR = 0.56, 95% CI 0.42-0.76) reducing the odds and daily internet access (AOR = 1.63, 95% CI 1.18-2.23) and recent alcohol consumption (AOR = 1.82, 95% CI 1.30-2.54) increasing the odds of sexual risk behavior. Knowing one's HIV test result was protective (AOR = 0.33, 95% CI 0.21-0.51), while comprehensive HIV/AIDS knowledge and stigma showed no significant associations. Overall, one in four sexually active young women in the Philippines is at risk of HIV infection. Thus, targeted interventions are crucial to address risk factors identified among young women. This study informs public health strategies, emphasizing proactive HIV testing to empower informed decision-making and reduce risky sexual behaviors.

Retrospective cohort aimed to analyze viral resistance mutations to integrase in people living with HIV/Aids (PLWHA) in Brazil. Patients receiving first-line therapy with a three-drug antiretroviral (ART) regimen containing dolutegravir (DTG), with HIV-1 genotypic resistance test available after starting treatment, were included. Data from three national databases related to antiretroviral dispensing, LT CD4+ cell count and HIV viral load (VL), and genotyping resistance testing were linked. Ideal adherence was defined as the proportion of days covered (PDC) ≥ 80%. Thirty (7.0%) of the 430 participants had resistance to DTG; five had high and 11 had moderate resistance levels. The N155H ( = 9) and E138K ( = 7) mutations were the most prevalent. DTG mutations were significantly more prevalent among males, whites, and those with HIV-VL count > 100,000 copies/mL, switching to alternative regimens or with resistance mutations to other classes of antiretroviral drugs ( < 0.05). Ideal ART adherence was observed in 52.8% of the participants and it was associated with DTG mutations ( < 0.001). This study described the resistance mutations to DTG in individuals starting treatment with this drug and the characteristics of such individuals. Understanding such a profile is crucial to regions where a DTG-containing regimen is the recommended first-line therapy.