Adolescents and young adults aged15 and 25 have the highest rates of STIs and HIV, yet they often do not seek testing or treatment. This study examined the factors influencing HIV and STI testing among sexually active high school students using data from the 2019 and 2021 Youth Risk Behavior Surveys (YRBS), which sampled students across all 50 states and the District of Columbia. Key variables included HIV and STI testing, sex, race/ethnicity, sexual identity, age of first sexual intercourse, and substance use during sex. Chi-square tests and multinomial logistic regression were used to identify predictors of testing. Results showed that only 14.4% of students were tested for HIV and 16.3% for other STIs. Factors associated with testing included age, number of sexual partners, and substance use. This study highlights the need for alternative methods of STI and HIV testing to improve screening rates among this at-risk age group.

The attitudes of People Living with HIV (PLWH) towards frailty and maintaining quality of life (QOL) whilst ageing is largely unknown. This study examines how PLWH perceive being assessed for frailty and ageing, and the importance of QOL as they age. 40 semi-structured interviews were conducted. Many of the participants voiced that ageing was unexpected and were unprepared for this. Main themes for ageing included self-determination and loss of independence; concern for the future including care provision, services required for ageing and fear of admission into aged care. Themes associated with frailty were, future loss of physical function and the assessment process reflecting both positive (proactive) and negative (confronting) responses regarding ageing and frailty as many participants felt they were too young to be considered frail. Themes for quality of life included the importance of self-expression and independence; connection to others, having adequate finances to enjoy life, having baseline needs met such as housing and having a positive outlook on the future. This study highlighted the importance of talking about ageing and how frailty is framed in discussions to develop individualised strategies for PLWH to decrease risk factors for frailty.

People living with HIV (PLWH) have a higher prevalence of mental ill health compared to the general population. We aimed to understand the impact of the COVID-19 pandemic and omitting routine HIV appointments on the mental health (MH) of PLWH. Between April 2020 and March 2021, routine appointments for "stable" PLWH were replaced by virtual consultations. MH assessments using standardised questionnaires were compared before and during the pandemic. Full data were available for 426 individuals after excluding those with incomplete data and those requiring early review for non-MH-related issues. The results showed that 277 (65%) experienced no/minimal MH symptoms throughout, indicating robust MH. For depression, scores worsened in 59 (13.8%), improved in 62 (14.6%) and remained stable in 305 (71.6%). For anxiety, scores worsened in 55 (12.9%), improved in 64 (15%) and remained stable in 307 (72.1%). A total of 98.4% of individuals remained virally suppressed, with 7 developing a detectable viral load. One person stopped antiretroviral treatment secondary to an MH crisis. Findings suggest that the COVID-19 pandemic did not significantly impact the overall MH in our cohort of PLWH. It also demonstrates an effective implementation of virtual consultations. The complex nature of MH in PLWH highlights the need for individualised MH care.

The most significant progress in addressing the HIV/AIDS epidemic has been the development of antiretroviral therapy (ART). However, ensuring a high degree of treatment adherence is necessary to prevent resistance and disease progression. We conducted a cross-sectional study to evaluate adherence to ART through the calculation of the medication possession ratio (MPR) and to identify risk factors for suboptimal adherence in a cohort of HIV-positive patients receiving care at a Colombian healthcare institution across 16 cities. Records of 12,145 users were analyzed, and a multivariate logistic regression model was performed, considering optimal adherence (MPR > =  95%) versus suboptimal adherence (MPR < 95%) as the reference. Suboptimal adherence to ART was identified in 29% of users. Residence region, presence of HIV-defining illnesses, chronic kidney disease (CKD), co-infections such as hepatitis C, tuberculosis, and sexually transmitted infections, treatment duration of more than 5 years, and non-suppressed viral load were identified as risk factors for non-adherence. This underscores the need to identify interventions for those vulnerable groups to minimize the likelihood of non-adherence and to intervene in care models focused on the medical needs of these patients.

Violence experience, interpersonal and community-level, is commonly reported by people living with HIV (PLWH). Understanding the impact of the various forms of violence on HIV outcomes is critical for prioritizing violence screening and support resources in care settings. From February 2021 to December 2022, among 285 PLWH purposively sampled to attain diversity by gender, race/ethnicity, and HIV care retention status in Atlanta, Georgia, we examined interpersonal and community violence experiences and proxy measures of violence (post-traumatic stress disorder (PTSD), anxiety, depression) and their associations with HIV outcomes (engagement and retention in care and HIV viral suppression) using multivariable analysis. Participants commonly reported lifetime intimate partner violence (89%), non-partner violence (97%), hate crimes (93%), and moderate-to-severe adverse childhood events (59%). Lifetime violence experiences were not significantly linked to HIV care engagement, retention, nor durable viral suppression, but were each individually associated with PTSD, which in turn, was significantly associated lower odds of durable viral suppression (AOR 0.35, CI 0.14-0.86). Thus, the high prevalence and multiplicity of interpersonal and community-level violence experienced among PLWH in Atlanta underscores the need for universal trauma-informed approaches and supports implementation of PTSD screening to identify patients at greatest need for trauma support services.

The advent of effective antiretroviral treatments has led to the reclassification of HIV as a chronic disease for those on an effective treatment plan. However, the well-being of individuals with HIV is adversely affected by a number of factors, including stigma and discrimination, which hinder access to healthcare. To address this issue, it is first necessary to understand the current levels of knowledge and stigma surrounding HIV, and consequently, HIV Outcomes Italy has created a survey with the aim of assessing these levels.A total of 914 healthcare professionals, comprising clinicians, obstetricians, nurses and LPNs (licensed practical nurses) participated in an anonymous online survey with questions pertaining to knowledge on HIV, stigma, and training on STIs (sexually transmitted infections). The survey was conducted in Italy between August 2022 and February 2023.The results show a reasonable level of knowledge regarding HIV-related topics among healthcare workers. However, a notable minority exhibited deficiencies. The findings indicate the presence of stigma, both in the form of observed discriminatory practices and in the form of personal enactment of discriminatory behaviour.The results of the survey indicate an inverse relationship between knowledge and stigma, emphasising the need for ongoing and specific education on HIV.

The aim of this systematic review was to summarize the dietary intake of children and adolescents living with HIV and its association with cardiovascular risk factors. PubMed/MEDLINE, Scopus, Web of Science, BIREME and LILACS were searched for original observational studies. The studies were extracted between June and August 2021, in addition to a manual search of references. Twelve studies involving 1,805 participants aged 6.5 to 17.3 years were included. An association between energy intake, low sugar and fat intake and the presence of lipodystrophy syndrome was reported in 1 of the 12 (8.3%) studies, between fat intake and plasma lipid levels in 1 (8.3%), and between low fiber intake and high -scores for BMI in 1 (8.3%); there was a positive correlation between cholesterol intake and plasma triglyceride levels in 1 study (8.3%). In conclusion, a dietary pattern of low consumption of fruits and vegetables was identified, but few studies have reported associations between dietary intake and cardiovascular risk factors. Thus, there is a need for nutritional guidance strategies aimed at changing inappropriate eating habits in order to reduce cardiovascular risk factors in this population.

Although HIV is more prevalent among transgender and gender-diverse individuals than cisgender people, a dearth of research has compared the HIV-related care engagement of these populations. Using 2008-2017 Medicare data, we identified TGD (trans feminine and non-binary [TFN], trans masculine and non-binary [TMN], unclassified gender) and cisgender (male, female) beneficiaries with HIV and explored within and between gender group differences in the predicted probability of engagement in the HIV Care Continuum. Transgender and gender-diverse individuals had a higher predicted probability of every HIV-related care outcome vs. cisgender individuals, with TFN individuals showing the highest probability of HIV care visit engagement, sexually transmitted infection screening, and antiretroviral treatment receipt and persistence. Notably, except for sexually transmitted infection screening, cisgender females and TMN people had a slightly lower probability of engaging in HIV-related care than TFN people and cisgender males. Although transgender and gender-diverse beneficiaries living with HIV had better engagement in the HIV Care Continuum than cisgender individuals, findings highlight disparities in engagement for TMN individuals and cisgender females, though engagement was still low for Medicare beneficiariesof all genders. Interventions are needed to reduce HIV care engagement barriers for all Medicare beneficiaries.

Oral healthcare settings can be a challenging environment for people with HIV. Combined with problematic insurance policies, insufficient health literacy, and higher treatment fees, HIV stigma contributes to barriers when accessing oral healthcare. We conducted a descriptive study via an online survey with open-ended questions to understand the experiences of people with HIV in oral healthcare settings. The survey was administered by non-governmental organizations. Thematic analysis was used to analyze the data via a critical realist approach. Seventy-five participants responded to survey between August and September 2023. Thematic analysis yielded three main themes: occurrences of stigma in healthcare, coping with HIV stigma and anxiety, and barriers beyond stigma. Participants reported a problematic understanding of HIV literature and stigma among dentists, which was manifested as excessive precaution measures, denial of care, unnecessary referrals, gossiping, discriminatory remarks and disclosure of HIV status without consent. This was reflected in people with HIV as self-stigma, fear of healthcare workers and avoidance of healthcare services. Advancements in dental education and post-qualification training are needed in infection control and ethics, while people with HIV need health education to preserve their rights and sustain good health and well-being to prevent adverse outcomes.

WHO's 2013 PMTCT guidelines recommended lifelong antiretroviral therapy (ART) for HIV-infected pregnant and breastfeeding women, exclusive breastfeeding (EBF), nevirapine prophylaxis (NVP) and early infant diagnosis (EID) for HIV-exposed-breastfed infants. We examined the association between knowledge and adherence to these guidelines among 550 HIV-infected pregnant women in Maharashtra, India. Knowledge of PMTCT guidelines was assessed using a structured-questionnaire during enrollment. Adherence to ART, NVP, and EBF was assessed using structured questionnaires during post-partum home visits at 2 weeks, 2, and 6 months respectively. EID adherence at 6 weeks was assessed by weekly infants' HIV testing clinical record review. We used Fisher's exact test to assess the association between correct knowledge and subsequent adherence and logistic regression to estimate the odds ratios. The results showed that women's correct responses to specific questions of each PMTCT guideline correlated with subsequent adherence. For instance, awareness of duration and place to obtain ART was associated with a higher likelihood of taking ART at delivery (aOR = 1.93,  = 0.02 and aOR = 3.91,  < 0.01 respectively). Similarly, women knowing only breastmilk should be given to infants for 6 months showed highest adherence to EBF (aOR = 2.59,  = 0.02). Women who correctly knew the reason for infant NVP administration were more adherent to it at 6 weeks (aOR = 1.77;  = 0.03). Women aware of mother-to-child HIV transmission during delivery had highest adherence to EID at 6 weeks (aOR 3.58,  = 0.01). Gaps were identified in women's detailed knowledge of and adherence to each PMTCT guideline. Suboptimal adherence to ART (n = 389, 71%), EBF (n = 179, 33%), NVP (n = 428, 78%), and EID at 6 weeks (n = 369, 67%) was found. Our study suggests providing a comprehensive knowledge of each guideline through the PMTCT program's education strategies can enhance adherence among HIV-infected women.

In the current study, we examine associations between exposure to violence and antiretroviral medication adherence in persons with HIV (PWH) in a southern city in the United States. We include investigation of a variety of violence exposures including childhood sexual abuse, physical abuse, witnessing family violence, lifetime violence exposures and current stress related to violence experiences, as well as neighborhood violence exposure. We examined associations between violence exposures and adherence and mediational pathways between these variables including mental health symptoms - specifically depressive, anxiety, and posttraumatic stress symptoms - as well as coping strategies. Results suggest that physical abuse in childhood was associated with ART non-adherence, no other reported violence experiences were associated with adherence. Of the mediational paths analyzed between violence and ART adherence, only coping with substance use was significant. In post hoc analyses, we examined the mental health symptoms of depression, PTSD and anxiety as mediators between violence exposures and substance use coping. Depressive symptoms were the only significant mediational pathway. Implications for interventions to address histories of violence, depressive symptoms, coping with substance use and adherence are discussed.

By consistently taking medication, people with HIV (PWH) can attain viral suppression, improving their health and reducing transmission risk. PositiveLinks (PL) is a clinic-deployed mobile platform designed to improve engagement in care for PWH by enabling them to track their medications, connect with peers, and communicate with providers. This project investigated the experience of PL users who had recent periods of viral non-suppression to understand how these high-risk episodes can be predicted and prevented. Fifteen participants completed mental health measures and in-depth interviews. Two members of the study team independently coded interview transcripts and resolved any discrepancies. The codebook was developed iteratively until thematic saturation and intercoder reliability were achieved. Participants revealed mental health and substance use concerns. Frequent stressors highlighted were relationship challenges, financial difficulties, and unstable living situations. Relationship challenges were a common barrier to care, along with competing priorities, transportation and finances. In contrast, positive relationships, motivation, positive interactions with clinic staff, and social programs facilitated regaining viral suppression. Participants highlighted the importance of strong patient-provider relationships and social support in overcoming barriers to care. We identified factors that impact medication adherence, which will inform efforts to mitigate and prevent viral non-suppression and thus improve health outcomes.

HIV stigma remains a barrier to HIV prevention, testing, and treatment in sub-Saharan Africa. This study uses Zimbabwe Demographic and Health Survey data to examine how education reduces HIV stigma, focusing on two key initiatives: the 1992 AIDS Action Program, which enhanced HIV awareness, and the 1980 education reform, which expanded schooling access. By addressing gaps in the literature on external HIV stigma, the study highlights education's long-term impact on attitudes toward people living with HIV. Our findings show that the 1980 reform is associated with a 1.19-year increase in educational attainment and a 42.6% rise in secondary school attendance for children aged 2-7 years in 1980 compared to those aged 16 and older. Furthermore, each additional year of schooling after the AIDS Action Program is associated with a 12.1% reduction in the likelihood of stigmatizing people with HIV and a 12.8% increase in HIV knowledge. Stigma reduction is more pronounced among rural residents (13.3%) and women (5.9%) but is insignificant for men and urban dwellers. These results underscore the role of schools in improving public health knowledge and reducing HIV stigma, offering valuable insights for future educational and health strategies.

HIV and the consequences of HIV-associated neurocognitive disorders (HAND) disproportionally affect South African women. Longitudinal neurocognitive data on women with HIV are limited. We tracked longitudinal neurocognitive profiles of South African women with HIV (baseline = 140) compared to women without HIV (baseline = 156). We determined if lifetime and childhood trauma were significantly correlated with global deficit scores (GDS). We assessed neurocognitive performance at baseline, 1-year, and 5-years. We used mixed linear models to determine between-group differences and neurocognitive profiles over time. We used Pearson's correlations to assess correlations with GDS. There were no significant between-group differences in GDS. Both groups showed a significant decline in GDS (i.e., improved cognition) between baseline and 1-year follow-up ( < 0.01). There were significant group differences in learning ( = 0.02) and attention/working memory ( = 0.01) at baseline, with HIV + status associated with higher deficit scores. Childhood neglect was correlated with baseline GDS among women with HIV. Our results support the use of antiretroviral treatment to improve and/or maintain neurocognition in women with HIV. Future research should focus on the specific types of trauma exposure, specifically neglect and its association with HAND.

The purpose of this study was to investigate the effects of aromatherapy and acupoint herbal patching on fatigue and sleep disorders in people living with HIV (PLWH). Aromatherapy and acupoint herbal patching are ancient alternative therapies in traditional Chinese medicine. We randomly selected 90 patients from the Nanjing Public Health Medical Center in China and divided them into three groups: aromatherapy group, acupoint herbal patching group and control group. They were supposed to fill in the Pittsburgh Sleepiness Index Scale (PSQI), the Piper Fatigue Scale (PFS), and the Liver Depression and Spleen Deficiency Insomnia Symptoms Scale (LDSSIPS) before and after the intervention. The results showed that the difference between the PSQI score and fatigue score of the aromatherapy group and acupressure group before and after the intervention was statistically significant ( < 0.05), and the difference between the scores of the three groups after the intervention was statistically significant ( < 0.05). This study found that aromatherapy and acupoint herbal patching could effectively alleviate fatigue of PLWH and improve the quality of sleep, and that the therapeutic effect of the aromatherapy group was comparable with that of the acupoint herbal patching group.

Perinatal women living with HIV face increased susceptibility to mental health challenges, including suicidal ideation (SI). This study aimed to determine the prevalence of SI among perinatal women with HIV and identify associated factors. A systematic search was done across PubMed, Embase, Scopus, ScienceDirect, and Google Scholar. Data analysis was executed using R software. Publication bias was assessed via funnel plot and Egger's test, while heterogeneity was investigated using the I2 statistic. A total of 11 studies involving 4329 participants were included. The pooled prevalence of SI was 23.4% (95% CI: 16.3-32.4). Subgroup analysis showed higher prevalence in postnatal women (36.4%) than antenatal women (27.8%), although this difference was not statistically significant. Studies employing the Edinburgh Postnatal Depression Scale reported a higher prevalence (38.9%). Studies published between 2013-2017 showed a higher prevalence (37.6%) compared to those published between 2018-2022 (18.2%). Factors associated with SI included depression during pregnancy or postpartum, unplanned pregnancy, intimate partner violence, undisclosed HIV status, lack of social support, and recent diagnosis of sexually transmitted infections other than HIV. The high prevalence of SI emphasizes the need for mental health screening and interventions. Mental health assessments should be integrated into routine antenatal and postnatal care.

Transgender youth are disproportionately affected by HIV, particularly minoritized youth in the US south. To understand HIV service use among transgender youth, we interviewed 25 young racial and ethnic minority clients of four southern community-based HIV service organizations (CBOs), and CBO staff ( = 12), about service access and use. Participants were assigned male at birth and identified as female ( = 8), transgender ( = 11) or gender-fluid or nonbinary ( = 6). The majority were Black/African American or mixed race; four were Hispanic or Latino/a. Most were unemployed; nearly half were unstably housed or homeless during the prior year. Four service types were each used by approximately two-thirds of participants: counseling/support, HIV/STD testing/education, pre-exposure prophylaxis education/prescriptions, and transgender-related medical services (primarily hormone provision). Just over a quarter used social services (e.g., housing, employment). Key facilitators to service use included a non-stigmatizing CBO atmosphere, and easy and convenient access. Poor access (e.g., inconvenient hours, location), lack of transportation or parking, social service needs, and lack of money were barriers. Qualitative reports highlighted unmet social service needs, particularly housing, especially for those without HIV. To reduce disparities, HIV prevention for racial and ethnic minoritized transgender youth should simultaneously address hormone provision, HIV risk reduction and social service needs.

This study explored the challenges faced by, and resilience of First Nations, Métis, and Inuit women living with HIV in Manitoba and Saskatchewan during the COVID-19 pandemic. Through a decolonizing, community-based research approach, guided by a Community Guiding Circle (CGC), interviews were conducted with 45 Indigenous women living with HIV. Participants were recruited via community outreach, peer networks, and social media. Data collection and analysis utilized Indigenous storywork and inductive thematic analysis. The study revealed significant barriers related to housing instability, childcare, and access to healthcare, all exacerbated by systemic inequities rooted in colonialism, patriarchy, and capitalism. Despite these challenges, Indigenous cultural practices, ceremonies, community support, and family ties emerged as crucial sources of resilience, though often disrupted during the pandemic. The findings underscore the urgent need for culturally safe, women-centered care models that integrate Indigenous knowledge and practices. For health and social care practitioners, this research emphasizes the importance of advocating for systemic change to address the unique needs of Indigenous women living with HIV and calls for the development and implementation of culturally safe health and social care tailored to their unique needs and resilience.

Peer support services for people living with HIV (PLHIV) serve varying functions and are a unique resource for support. Peer support programs are considered an important strategy for achieving better quality of life (QoL) for PLHIV and there has been substantial investment in provision of such programs. The present study asks whether being connected to other PLHIV is associated with better QoL for PLHIV in Australia and; whether involvement in formal peer support programs is associated with QoL among people newly diagnosed with HIV. A sample of 816 PLHIV participated in a nationwide survey. Regression analyses showed that having a friend living with HIV who they could talk to about HIV was significantly associated with better QoL. However, a multiple regression analysis showed that use of peer advice/support and peer navigator programs was associated with lower QoL among PLHIV who had been living with HIV for more than five years. This suggests that people experiencing poorer QoL are more likely to access these programs long after diagnosis. It is therefore critical that peer support continue to be available and accessible to PLHIV beyond initial diagnosis and treatment as a means of ongoing HIV-related care.

People living with HIV (PLWH) in Canada experience high rates of interpersonal violence which may lead to adverse health outcomes that require hospitalization. Using self-reported data on experiences of violence linked to administrative health data on hospitalizations, we used Poisson regression modelling to examine and compare the associations between experiences of violence (recent [in the past 6 months], non-recent [>6 months ago], or none) and hospitalization rates, among a sample of PLWH in British Columbia, Canada. Of 984 PLWH included in this study, 60.0% reported experiencing non-recent violence, and 14.8% experienced recent violence. Those who experienced non-recent violence had a higher rate of hospitalization than those who never experienced violence (adjusted Rate Ratio [aRR]: 1.41; 95% Confidence Interval [CI]: 1.05-1.87). There was no difference in hospitalization rates between those who experienced recent violence and those who never did (aRR: 1.08; 95% CI: 0.74-1.60). PLWH who experienced recent violence had the highest proportion of hospitalizations attributed to mental, behavioural, or neurodevelopmental disorders. Efforts are needed to provide violence-aware care that recognizes violence and its impacts on PLWH experiencing multiple sociostructural inequities. Further studies should evaluate the impacts of violence on other types of healthcare utilization in generalizable samples of PLWH in Canada.

Research on incarcerated men indicates low PrEP access even though HIV disproportionately affects them. Intersecting attributes - urban, incarcerated, Black, heterosexual men with substance use diagnoses (SUDs) - improves the odds of HIV transmission/acquisition. It is crucial to determine, among "key populations," who might be eligible to take PrEP. PrEP eligibility criteria have been used inconsistently in research. This exploratory, quantitative, study uses criteria from the United States Centers for Disease Control and Prevention to determine eligibility: HIV-negative test and sexually active plus a sexual partner living with HIV and/or diagnosed with an STI and/or inconsistent or no condom use for intercourse. We found a considerable percentage ( = 61; 32.8%) of PrEP-eligible individuals ( = 186) in a sample of urban, formerly incarcerated, Black, heterosexual men with SUDs. Most PrEP-eligible participants (78.7%) did not receive PrEP information from health service providers. Most participants (85.2%) reported they were "not likely" to contract HIV. This study demonstrates the accurate determination of PrEP eligibility and the need to assess individuals' awareness of their vulnerabilities to HIV acquisition - the first step needed before accessing PrEP. Interventions to improve PrEP access must focus on the accurate determination of PrEP eligibility, individuals' awareness of their vulnerability to HIV acquisition and how/when they receive information about PrEP.