Public Health, HIV Care and Prevention, Human Rights and Democracy at a Crossroad in Brazil
AbstractOn January 2019, Brazil ’s new far-right president Jair Bolsonaro was sworn into office. Bolsonaro’s administration supports downsizing the Brazilian Unified Health System (SUS), while increasing the size of the private health sector. The new administration might leave millions of Brazilians without medical care, inclu ding hundreds of thousands of people living with HIV/AIDS. Bolsonaro’s administration, allied with a highly conservative Congress and sharp decreases in federal funding for public health, education and research, could jeopardize key health and human rights strategies focused on wome...
Source: AIDS and Behavior - March 22, 2019 Category: Infectious Diseases Source Type: research

Awareness and Understanding of HIV Non-disclosure Case Law and the Role of Healthcare Providers in Discussions About the Criminalization of HIV Non-disclosure Among Women Living with HIV in Canada
AbstractIn 2012, the Supreme Court of Canada ruled that people with HIV are legally obligated to disclose their serostatus before sex with a “realistic possibility” of HIV transmission, suggesting a legal obligation to disclose unless they use condoms and have a low HIV viral load (
Source: AIDS and Behavior - March 21, 2019 Category: Infectious Diseases Source Type: research

Emotional Communication in HIV Care: An Observational Study of Patients ’ Expressed Emotions and Clinician Response
AbstractEmotional support is essential to good communication, yet clinicians often miss opportunities to provide empathy to patients. Our study explores the nature of emotional expressions found among patients new to HIV care, how HIV clinicians respond to these expressions, and predictors of clinician responses. Patient-provider encounters were audio-recorded, transcribed, and coded using the VR-CoDES. We categorized patient emotional expressions by intensity (subtle ‘cues’ vs. more explicit ‘concerns’), timing (initial vs. subsequent), and content (medical vs. non-medical). Emotional communication...
Source: AIDS and Behavior - March 20, 2019 Category: Infectious Diseases Source Type: research

Measuring Antiretroviral Adherence Among Young People Living with HIV: Observations from a Real-Time Monitoring Device Versus Self-report
This report compares self-report (SR) antiretroviral (ARV) adherence data to adherence data collected via Wisepill, a real-time electronic monitoring (EM) device, among young people living with HIV (YPLH) in the southern United States. Participants (n  = 66; ages 16 to 26) were followed for 14 weeks. Descriptive analyses were used to compare SR to EM data. Correlations and a linear regression were conducted to explore factors possibly associated with SR-EM discrepancies. We also examined associations between various levels of SR and EM adher ence and viral suppression/non-suppression at 14 weeks. Ra...
Source: AIDS and Behavior - March 19, 2019 Category: Infectious Diseases Source Type: research

Examining the Impact of a Psychosocial Syndemic on Past Six-Month HIV Screening Behavior of Black Men who have Sex with Men in the United States: Results from the POWER Study
AbstractSyndemic production theory has been used to explore HIV transmission risk or infections but has not been used to investigate prevention behavior, or with large samples of non-Whites. This analysis is the first to explore the impact of syndemic factors on previous six-month HIV screening behavior among US Black MSM. Data from Promoting Our Worth, Equality and Resilience (POWER) were analyzed from 3294 participants using syndemic variable counts and measures of interaction/synergy. Syndemic variables included: past three-month poly-drug use, depression, last year intimate partner violence, HIV risk and problematic bi...
Source: AIDS and Behavior - March 18, 2019 Category: Infectious Diseases Source Type: research

A Pilot Randomized Trial of Intervention Components Addressing Drug Use in Couples HIV Testing and Counseling (CHTC) with Male Couples
This study developed and examined the efficacy of two adjunct components to couples HIV testing and counseling (CHTC)—communication training (CT) videos and a substance use module (SUM)—to reduce drug use and sexual HIV transmission risk in MSM couples. Parti cipants included 70 male couples randomized into one of four conditions: CHTC, CHTC + CT videos, CHTC + SUM, and CHTC + CT videos + SUM. Participants completed a survey pre-intervention and 1-, 3-, and 6-months later. Completion of the SUM in the absence of CT videos was associated w ith significant i...
Source: AIDS and Behavior - March 18, 2019 Category: Infectious Diseases Source Type: research

Physician Mistrust, Medical System Mistrust, and Perceived Discrimination: Associations with HIV Care Engagement and Viral Load
This study examined both types of mistrust among 801 substance-using individuals with uncontrolled HIV infection. The aims were to determine how physician mistrust, medical system mistrust, and discrimination experiences were ass ociated with engagement in HIV primary care. Findings indicated higher levels of physician mistrust, but not medical system mistrust, were associated with a longer time since the last visit to an HIV provider. Longer time since seeing an HIV care provider was associated with higher viral load. This study refines our understanding of the relationship between mistrust and HIV care engagement for a l...
Source: AIDS and Behavior - March 16, 2019 Category: Infectious Diseases Source Type: research

A Randomized Controlled Trial of a Rapid Re-housing Intervention for Homeless Persons Living with HIV/AIDS: Impact on Housing and HIV Medical Outcomes
AbstractWe conducted a randomized controlled trial to determine whether, for homeless persons living with HIV/AIDS (PLWHA), rapid re-housing can improve housing and HIV viral suppression more than standard housing assistance. We recruited 236 PLWHA from HIV emergency housing in New York City (NYC) and randomized them to: (1) Enhanced Housing Placement Assistance (EHPA), i.e., immediate assignment to a case manager to rapidly re-house the client and provide 12  months of case management or (2) usual services, i.e., referral to an NYC housing placement program for which all HIV emergency housing residents were eligible....
Source: AIDS and Behavior - March 16, 2019 Category: Infectious Diseases Source Type: research

Implementing an Updated “Break the Cycle” Intervention to Reduce Initiating Persons into Injecting Drug Use in an Eastern European and a US “opioid epidemic” Setting
AbstractWe tested the hypothesis that an updated “Break the Cycle” (BtC) intervention, based in social cognitive theory and motivational interviewing, would reduce the likelihood that current persons who inject drugs (PWID) would assist persons who do not inject drugs (non-PWID) with first injections in Tallinn, Estonia and Staten Island, New York City. 402 PWID were recruited, a baseline interview covering demographics, drug use, and assisting non-PWID with first drug injections was administered, followed by BtC intervention. 296 follow-up interviews were conducted 6 months post-intervention. Percentages ...
Source: AIDS and Behavior - March 16, 2019 Category: Infectious Diseases Source Type: research

High Rates of Unprotected Receptive Anal Intercourse and Their Correlates Among Young and Older MSM in Brazil
AbstractThe aim of this study was to estimate the prevalence and factors associated with unprotected receptive anal intercourse (URAI), stratified by age (18 –24 or 25 + years old), in a sample of 4,129 MSM recruited by respondent driven sampling in 12 Brazilian cities in 2016. The prevalence of URAI was higher among younger MSM (41.9% vs 29.7%) (p 
Source: AIDS and Behavior - March 16, 2019 Category: Infectious Diseases Source Type: research

Depression Symptom Trajectories Among Mothers Living with HIV in Rural Uganda
AbstractThe aim was to identify latent class trajectories of depression symptoms among HIV+ women in Uganda. Depression was assessed at four time points using the Hopkins Symptom Checklist among 288 women caring for a child 2 –5 years old. Mixture modeling was used to estimate the number and nature of classes defined by trajectories of depressive symptoms over time. Maternal and child characteristics were explored as predictors of class. Three trajectories of symptoms of depression were identified; (1) stable-low, (2) moderate-subclinical, and (3) chronic-high. About 8% of women reported moderately or highly ele...
Source: AIDS and Behavior - March 15, 2019 Category: Infectious Diseases Source Type: research

A Mixed-Methods Study Examining Adherence to and Acceptability of Intravaginal Rings for HIV Prevention: Behavioral Results of MTN-027
AbstractIntravaginal rings (IVR) containing antiretroviral drugs are a promising method for HIV prevention. We triangulated quantitative and qualitative assessments to evaluate the acceptability of four IVRs used continuously for 28  days as part of a Phase I trial (N = 48 HIV-negative women; ages 18–45). Adherence was high throughout the trial, yet 30% of participants reported involuntary IVR expulsions followed by re-insertion. Most participants (93.6%) felt comfortable with the IVR being inside their body. Participant s reported liking the IVR more (36.2%) or the same amount (55.3%) since starti...
Source: AIDS and Behavior - March 15, 2019 Category: Infectious Diseases Source Type: research

Using a Social Support Framework to Understand How HIV Positive Kenyan Men Engage in PMTCT/EID Care: Qualitative Insights From Male Partners
AbstractGreater male partner involvement in Prevention of Mother to Child Transmission (PMTCT) and Early Infant Diagnosis (EID) is associated with improved outcomes. Perceived low social support for the mother can negatively impact the uptake of PMTCT/EID services. Most research relies on women ’s reports of the types and quality of male partner support received versus what is desired. This qualitative study examines Kenyan male partners' reported social support provision pre- and post-partum from their own perspective. The study was embedded within intervention development studies in K enya designed to develop ...
Source: AIDS and Behavior - March 15, 2019 Category: Infectious Diseases Source Type: research

Antiretroviral Concentration in Hair as a Measure for Antiretroviral Medication Adherence: A Systematic Review of Global Literature
AbstractThis review aims to validate hair antiretroviral concentration (HAC) as a measure for antiretroviral medication adherence. This review included 31 studies that analyzed a total of 11 ARV drugs in four different drug classes. The associations between HAC and non-pharmacokinetic measures were generally lower than the association between HAC and other pharmacokinetic measures: the correlation coefficients (r) ranged from − 0.20 to 0.38 for self-report or pill counts and 0.20 to 0.85 for electronic drug monitoring; HAC and other pharmacokinetic measures were positively correlated with the correlation coeff...
Source: AIDS and Behavior - March 15, 2019 Category: Infectious Diseases Source Type: research

Racial and Ethnic Disparities in HIV Pre-exposure Prophylaxis Awareness Among Men Who have Sex with Men
AbstractRacial and ethnic disparities exist in HIV pre-exposure prophylaxis (PrEP) awareness and care. We evaluated how racial and ethnic disparities in PrEP awareness among MSM presenting to a sexually transmitted disease clinic changed from 2013 to 2016. Among 1243 MSM (68% non-Hispanic White, 22% Hispanic, and 10% non-Hispanic Black), PrEP awareness increased overall, but awareness was lower among Hispanic and non-Hispanic Black MSM relative to non-Hispanic White MSM. Awareness converged among non-Hispanic Black and White MSM by 2016, but remained consistently lower among Hispanic MSM. Improved efforts are needed to add...
Source: AIDS and Behavior - March 14, 2019 Category: Infectious Diseases Source Type: research

Barriers to Accessing Sexual Health Services for Transgender and Male Sex Workers: A Systematic Qualitative Meta-summary
AbstractAccess to safe and effective sexual healthcare services for transgender and male sex workers (TMSW) is a human right. Globally, TMSW experience a higher prevalence of human immunodeficiency virus (HIV) and sexually transmitted infections than the general population or other sex workers, suggesting the existence of unique challenges for this group when accessing healthcare. A systematic database search identified 22 qualitative papers addressing barriers to accessing sexual healthcare services for TMSW. These papers were critically evaluated for adherence to best practice standards for qualitative research and resea...
Source: AIDS and Behavior - March 13, 2019 Category: Infectious Diseases Source Type: research

A Latent Class Analysis of the Social Determinants of Health Impacting Heavy Alcohol Consumption Among Women Living with HIV in Canada: The Canadian HIV Women ’s Sexual and Reproductive Health Cohort Study
AbstractWe used longitudinal data from the 2013 –2017 Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (N = 1422) to assess the clustered impact of social determinants of health (SDoH) on hazardous drinking. Two measures of alcohol use were defined: (i) weekly alcohol use, with >  7 drinks/week as heavy drinking, and (ii) monthly binge drinking (≥ 6 drinks at one sitting), with ≥ 1/month as frequent binging. Twelve SDoH indicators were classified using latent class analysis: no/least adversities, discrimination/stigma, economic hardship, ...
Source: AIDS and Behavior - March 12, 2019 Category: Infectious Diseases Source Type: research

Which Gay and Bisexual Men Attend Community-Based HIV Testing Services in Australia? An Analysis of Cross-Sectional National Behavioural Surveillance Data
This study aimed to compare the socio-demographic and behavioural characteristics of GBM whose last HIV test was conducted at a community-based service to GBM whose last test was at a traditional clinical setting. We analysed behavioural surveillance data collected from 5988 participants in seven states and territories in the period 2016 –2017. We found that non-HIV-positive GBM who attended community-based services were largely similar to men attending clinic-based settings, particularly in terms of sexual practice and risk of HIV. However, non-HIV-positive GBM who were younger, born in Asia, more socially engaged w...
Source: AIDS and Behavior - March 12, 2019 Category: Infectious Diseases Source Type: research

HIV Disclosure to Family Members and Medication Adherence: Role of Social Support and Self-efficacy
AbstractAlthough antiretroviral therapy (ART) is vital to people living with HIV (PLWH) by suppressing the virus and in turn preventing onward HIV transmission and reducing AIDS-related morbidity and mortality, the rates of optimal ART adherence continuously remain low. Disclosure of HIV status is considered to be a critical predictor of ART adherence. However, few studies have explored the mechanisms underlying the association between disclosure and medication adherence. The current study aims to examine the mediating role of social support and self-efficacy underlying the relationship between HIV disclosure to family mem...
Source: AIDS and Behavior - March 12, 2019 Category: Infectious Diseases Source Type: research

Sexual Risk and Criminal Justice Involvement Among Women Who Use Drugs
This study examined associations between arrest, probation, and jail incarceration on the number of sexual partners, sexual concurrency, and consistent condom use for drug-using women (n  = 631) in Oakland, California. We used logistic and negative binomial regression and adjusted for demographics, sex exchange and drug use. Probation was associated with higher rates of sexual partnership and concurrency (IRR 1.87, 95% CI [1.11, 3.15]; OR 3.64, 95% CI [1.08, 12.20]). Incarcerati on lasting over 12 weeks was associated with higher rates of sexual partnership (IRR 2.23, 95% CI [1.41, 3.51]). Women incarcer...
Source: AIDS and Behavior - March 11, 2019 Category: Infectious Diseases Source Type: research

HIV Care Trajectories as a Novel Longitudinal Assessment of Retention in Care
AbstractConsistent engagement in care is associated with positive health outcomes among people living with HIV (PLWH). However, traditional retention measures ignore the evolving dynamics of engagement in care. To understand the longitudinal patterns of HIV care, we analyzed medical records from 2008 to 2015 of PLWH  ≥ 18 years-old receiving care at a public, hospital-based HIV clinic (N = 2110). Using latent class analysis, we identified five distinct care trajectory classes: (1) consistent care (N = 1281); (2) less frequent care (N = 270); (3) return to care...
Source: AIDS and Behavior - March 9, 2019 Category: Infectious Diseases Source Type: research

Effects of a Mobile Health Intervention to Promote HIV Self-testing with MSM in China: A Randomized Controlled Trial
This study tested a mobile health (mHealth) intervention program entitledWeTest, delivered via the WeChat mobile app, to promote oral HIV self-testing (HIVST) among MSM in Hefei, China. A total of 100 MSM participants enrolled, completed baseline assessment, were randomly assigned to intervention or control, and completed 6-month follow-up surveys. Intervention participants (n  = 50) received two oral HIVST kits and access toWeTest, a private WeChat group which provided app-based messages and referrals to health services related to HIV. Control participants (n  = 50) received two oral HIVST kits...
Source: AIDS and Behavior - March 9, 2019 Category: Infectious Diseases Source Type: research

Adolescent HIV Healthcare Providers ’ Competencies in Motivational Interviewing Using a Standard Patient Model of Fidelity Monitoring
AbstractThe goal of this project is to describe adolescent HIV care providers ’ competence in Motivational Interviewing (MI) using a standard patient interaction model of fidelity assessment. Providers (N = 151) at 11 clinics completed monthly MI role plays. The MI Coach Rating Scale was utilized to assess MI skill. Despite mean differences in baseline MI ability by pro vider type (medical providers, psychologists/social workers, other), when examined together, only clinic had a significant main effect. Aspects of the clinic environment may have a greater impact on providers’ baseline MI ability t...
Source: AIDS and Behavior - March 7, 2019 Category: Infectious Diseases Source Type: research

Barriers and Facilitators of Rapid HIV and Syphilis Testing Uptake Among Filipino Transnational Migrants in China
This study estimated the point prevalence of HIV/syphilis and examined correlates of HIV/syphilis testing uptake among female migrant domestic workers in Macao, China. Data was obtained from 1363 female Filipino domestic workers who were offered free rapid HIV and syphilis testing. A mixed methods analysis was undertaken to examine correlates of testing and themes about reasons for not testing. Among 1164 women tested, there were no cases of HIV/syphilis observed and 199 (14.6%) refused HIV/syphilis testing. Greater social integration (aOR 1.12; 95% CI 1.02 –1.24), having more than one sexual partner (aOR 1.65; 95% C...
Source: AIDS and Behavior - March 6, 2019 Category: Infectious Diseases Source Type: research

Role of Social Network Sexual Norms and Behaviors on the HIV Sexual Risk Behaviors of People Who Inject Drugs in HPTN 037
This study examined the effect of social network descriptive sexual norms and behaviors on the sexual behaviors of people who inject drugs (PWID). Data from HPTN037 of 232 PWID (egos) and 464 network members (alters) were used in multilevel multivariate logistic regression models. Egos whose alters reported multiple sex partners had greater odds of multiple sex partners (aOR 2.20, 1.13 –4.29). Egos’ norms of condomless sex with primary (aOR 2.67, 1.15–6.17) and casual (aOR 2.38, 1.01–5.59) partners and egos’ norms of giving (aOR 5.52, 1.87–16.25) and receiving (aOR 7.38, 1.34–40.66...
Source: AIDS and Behavior - March 2, 2019 Category: Infectious Diseases Source Type: research

Risk Factors Associated with HIV, Sexually Transmitted Infections (STI), and HIV/STI Co-infection Among Youth Living in the Slums of Kampala, Uganda
AbstractThe purpose of this analysis was to examine the associated factors of self-reported HIV/STI co-infection among youth living in the slums of Kampala. The study sample consists of a cross-sectional survey. Participants comprised a convenience sample (N  = 1134) of youth living on the streets or in the slums (age 12–18). Multinomial logistic regression analyses were used to determine the association between hypothesized risk factors and levels of HIV/STI co-infection, adjusting for sociodemographic variables. Among the sample of youth who wer e sexually active (n = 586), 9.9% (n&thins...
Source: AIDS and Behavior - March 1, 2019 Category: Infectious Diseases Source Type: research

HIV and Sexuality Stigma Reduction Through Engagement in Online Forums: Results from the HealthMPowerment Intervention
In this study, we explored whether engaging in stigma-related discussions was associated with changes in YBMSM’s stigma-related scores throughout the trial. YBMSM (ages 18–30; N = 238) pa rticipating in HMP completed surveys at baseline, and 3 and 6 month follow-ups that included a series of scales focused on HIV and sexuality (internalized homophobia; sexual prejudice) stigma. Sixty-two participants contributed to the forums (1497 posts). We coded instances where YBMSM’s conversa tions were stigma related (915 posts, 61.1%), including discussions of anticipated (74/915, 8.1%), experien...
Source: AIDS and Behavior - March 1, 2019 Category: Infectious Diseases Source Type: research

Physical Activity Intensity is Associated with Symptom Distress in the CNICS Cohort
AbstractSymptom distress remains a challenging aspect of living with HIV. Physical activity is a promising symptom management strategy, but its effect on symptom distress has not been examined in a large, longitudinal HIV-infected cohort. We hypothesized that higher physical activity intensity would be associated with reduced symptom distress. We included 5370 people living with HIV (PLHIV) who completed patient-reported assessments of symptom distress, physical activity, alcohol and substance use, and HIV medication adherence between 2005 and 2016. The most frequent and burdensome symptoms were fatigue (reported by 56%), ...
Source: AIDS and Behavior - March 1, 2019 Category: Infectious Diseases Source Type: research

Prevalence and Correlates of PrEP Awareness and Use Among Black Men Who Have Sex with Men and Women (MSMW) in the United States
AbstractMen who have sex with men and women (MSMW), including those who are Black, experience HIV-related disparities compared to men who have sex with men only (MSMO). Few studies have assessed the prevalence and correlates of pre-exposure prophylaxis (PrEP) awareness and use among Black MSMW. We recruited MSM  ≥ 18 attending Black Gay Pride events between 2014–2017. We conducted multivariable logistic regressions to assess differences in PrEP awareness and use among HIV-negative Black MSM (n = 2398) and within Black MSMW (n = 419). MSMW were less likely than MSMO to repo...
Source: AIDS and Behavior - February 28, 2019 Category: Infectious Diseases Source Type: research

Impaired Neurocognitive Performance and Mortality in HIV: Assessing the Prognostic Value of the HIV-Dementia Scale
This study examined whether  global HIV-associated neurocognitive impairment (NCI), assessed with the HIV-Dementia Scale (HDS), predicted mortality in an ethnically diverse sample of 209 HIV-positive adults. Participants were predominantly in the mid-range of illness at baseline, and followed over 13-years. At baseline, 31 (1 5%) participants scored in the NCI range (HDS ≤ 10); 58 (28%) died during follow-up. Baseline NCI was significantly associated with earlier mortality (HR  =  2.10, 95% CI [1.10–4.00]) independent of sociodemographic and HIV disease-related covariates. Less errors ...
Source: AIDS and Behavior - February 28, 2019 Category: Infectious Diseases Source Type: research

Microfinance Interventions and HIV Treatment Outcomes: A Synthesizing Conceptual Framework and Systematic Review
ConclusionGreater emphasis should be placed on assessing theeffect mechanisms and intermediate behaviors to generate a sound theoretical basis for microfinance interventions. (Source: AIDS and Behavior)
Source: AIDS and Behavior - February 25, 2019 Category: Infectious Diseases Source Type: research

Gender Disparities in Traumatic Life Experiences and Antiretroviral Therapy Adherence Among People Living with HIV in South Carolina
AbstractPeople living with HIV are at increased risk for experiencing trauma, which may be linked to reduced adherence to antiretroviral therapy (ART), making it more difficult to achieve and maintain viral suppression. The current study sought to assess whether traumatic life experiences were associated with lower ART adherence among a diverse sample of people living with HIV in South Carolina. A cross-sectional survey was completed by 402 individuals receiving HIV care from a large immunology center. Principal component analysis revealed three primary categories of trauma experience (extreme violence/death-related trauma...
Source: AIDS and Behavior - February 23, 2019 Category: Infectious Diseases Source Type: research

Selecting Evidence-Based HIV Prevention Behavioral Interventions for HIV-Negative Persons for National Dissemination
AbstractThis paper describes the development of a formula to determine which evidence-based behavioral interventions (EBIs) targeting HIV-negative persons would be cost-saving in comparison to the lifetime cost of HIV treatment and the process by which this formula was used to prioritize those with greatest potential impact for continued dissemination. We developed a prevention benefit index (PBI) to rank risk-reduction EBIs for HIV-negative persons based on their estimated cost for achieving the behavior change per one would-be incident infection of HIV. Inputs for calculating the PBI included the mean estimated cost-per-...
Source: AIDS and Behavior - February 23, 2019 Category: Infectious Diseases Source Type: research

Engagement in Mental Health Care is Associated with Higher Cumulative Drug Exposure and Adherence to Antiretroviral Therapy
AbstractMental health (MH) disorders are more prevalent among persons living with HIV compared to the general population, and may contribute to suboptimal adherence to antiretroviral therapy (ART). Tenofovir-diphosphate (TFV-DP), the phosphorylated anabolite of tenofovir (TFV), is a biomarker with a 17-day half-life in red blood cells. TFV-DP can be measured in dried blood spots (DBS) using liquid chromatography/tandem mass spectrometry (LC-MS/MS) to assess adherence and cumulative drug exposure to tenofovir disoproxil fumarate (TDF)-based ART. From a larger clinical cohort (N  =  807), TFV-DP concentrations ...
Source: AIDS and Behavior - February 23, 2019 Category: Infectious Diseases Source Type: research

Using a Multi-level Framework to Test Empirical Relationships Among HIV/AIDS-Related Stigma, Health Service Barriers, and HIV Outcomes in KwaZulu-Natal, South Africa
AbstractHIV/AIDS-related (HAR) stigma is an ongoing problem in Sub-Saharan Africa  that is thought to impede HIV preventive and treatment interventions. This paper uses a systematic sample of households (Level 1) nested within near-neighbor clusters (Level 2) and communities (Level 3) to examine multilevel relationships of HAR stigma to health service barriers (HSBs) and HIV out comes in KwaZulu-Natal, South Africa, thereby addressing methodological and conceptual gaps in the literature from this context. Findings suggest differential patterns of prediction at Level 1 when examining two different dimensions of stigma:...
Source: AIDS and Behavior - February 23, 2019 Category: Infectious Diseases Source Type: research

Data-Driven Goals for Curbing the U.S. HIV Epidemic by 2030
AbstractProgress in reducing HIV infections has been suboptimal despite availability of effective prevention and treatment interventions and national strategies to bring them to scale. As part of a community-driven process, we expanded previous epidemiologic models using updated surveillance data from the Centers for Disease Control and Prevention to estimate quantitative parameters for ambitious but attainable national HIV prevention goals. We estimated new HIV infections could be reduced by up to 67% and prevalence could begin to decline by 2030 if 95% targets for diagnosis, care retention, and viral suppression are met ...
Source: AIDS and Behavior - February 22, 2019 Category: Infectious Diseases Source Type: research

Effect of Patient Navigation on Transitions of HIV Care After Release from Prison: A Retrospective Cohort Study
In this report we describe baseline characteristics and 6-month post-incarceration HIV care outcomes for 170 individuals in Wisconsin. Overall, 114 (67%) individuals were linked to outpatient HIV care within 180  days of release from prison, and of these, 90 (79%) were observed to have HIV viral suppression when evaluated in the community. The strongest predictor of linkage to care in this study was participation in a patient navigation program: Those who received patient navigation were linked to care 84% of the time, compared to 60% of the individuals who received only standard release planning (adjusted OR 3.69, 95...
Source: AIDS and Behavior - February 21, 2019 Category: Infectious Diseases Source Type: research

Changes Over Time in HIV Prevalence and Sexual Behaviour Among Young Female Sex-Workers in 14 Sites in Zimbabwe, 2013 –2016
AbstractYoung female sex-workers (FSW) aged 18 –24 are at high risk of HIV due to high numbers of sexual partners, difficulty negotiating condom use, increased risk of gender-based violence, and limited access to services. Here we describe changes in sexual behaviours among young FSW across Zimbabwe between 2013 and 2016, and risk factors for prevalent HIV in 2013 and 2016. FSW ≥ 18 years were recruited using respondent-driven sampling in 14 sites across Zimbabwe in 2013 and 2016 as part of the SAPPH-IRe trial. We collected data on socio-demographics and sexual behaviour and offered HIV testing. Statis...
Source: AIDS and Behavior - February 20, 2019 Category: Infectious Diseases Source Type: research

Association of Adolescent- and Parent-Reported Relationship Functioning with HIV Sexual Risk Among Adolescents in Botswana
AbstractGlobally, adolescents in sub-Saharan Africa are the youth most affected by HIV. Parent –adolescent relationships can be protective in child and adolescent development and may be implicated in lowered adolescent HIV sexual risk. However, the importance of parental and adolescent perceptions of their relationship and assessing the implications of family functioning in adolescents’ risk for HIV or other sexually transmitted infections are not well established in the research literature. This dyadic study simultaneously assessed both parents’ and adolescents’ perceptions of family...
Source: AIDS and Behavior - February 19, 2019 Category: Infectious Diseases Source Type: research

Health Literacy and Health Outcomes in Persons Living with HIV Disease: A Systematic Review
AbstractLow health literacy is associated with challenges for those living with HIV including medication non-adherence and poorer health outcomes. The aim of this study was to systematically review the literature on health literacy and health outcomes in persons living with HIV. The extended guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, as well as A Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist were utilized to guide the approach to the review. A variety of electronic databases including PubMed, CINAHL, PsychInfo, and Cochrane Library were search...
Source: AIDS and Behavior - February 19, 2019 Category: Infectious Diseases Source Type: research

Self-reported Cannabis Use and Changes in Body Mass Index, CD4 T-Cell Counts, and HIV-1 RNA Suppression in Treated Persons with HIV
AbstractCannabis use is prevalent among HIV-positive persons, but evidence regarding the impact of cannabis in HIV-positive persons is limited. We conducted a retrospective cohort study of HIV-positive adults initiating their first antiretroviral therapy (ART) regimen. A dedicated intake form assessed self-reported cannabis use in the preceding 7  days at each visit. The relationships between time-varying cannabis use and body mass index (BMI), CD4+ T-cell count, and HIV-1 RNA levels were assessed using random effects models adjusted for age, sex, race, and other reported substance use. 4290 patient-visits from 2008 t...
Source: AIDS and Behavior - February 18, 2019 Category: Infectious Diseases Source Type: research

Characteristics of Persons Who Inject Drugs with Recent HIV Infection in the United States: National HIV Behavioral Surveillance, 2012
AbstractWe evaluated characteristics associated with recent HIV infection among persons who inject drugs (PWID) from 19 U.S. cities who participated in 2012 National HIV Behavioral Surveillance. Recent infection was defined as having a reactive HIV test, a Bio-Rad Avidity index cutoff  ≤ 30%, no reported HIV diagnosis ≥ 12 months before interview, and no evidence of viral suppression. Of 8667 PWID, 50 (0.6%) were recently HIV infected. Having a greater number of sex partners (≥ 2 partners vs. 0) [prevalence ratio (PR) 4.7, 95% confidence interval (CI) 1.3–17.8] , injec...
Source: AIDS and Behavior - February 18, 2019 Category: Infectious Diseases Source Type: research

Effects of a Short Message Service  (SMS) Intervention on Reduction of HIV Risk Behaviours and Improving HIV Testing Rates Among Populations located near Roadside Wellness Clinics: A Cluster Randomised Controlled Trial in South Africa, Zimbabwe and Mozambique
AbstractShort Message Service (SMS) offers an innovative method of promoting sexual health to key and vulnerable populations who are users of mobile phones and are at high risk of HIV infection. This cluster randomised control trial tests the effectiveness of a SMS intervention in reducing HIV risk behaviours and improving HIV testing behaviours among truck drivers, sex workers and community residents located near Roadside Wellness Clinics (RWCs)  in three southern African countries. The SMS arm received 35 HIV risk reduction and HIV testing SMSs over a 6-month period. The SMS intervention had no significant impact on...
Source: AIDS and Behavior - February 15, 2019 Category: Infectious Diseases Source Type: research

Mozambique ’s Community Antiretroviral Therapy Support Group Program: The Role of Social Relationships in Facilitating HIV/AIDS Treatment Retention
We report on qualitative findings from this evaluation from the patient perspective on the role of social relationships (as facilitated through CASG) in conferring time, financial, educational and psychosocial benefits that contribute to improved patient rete ntion. These findings may be helpful in informing what aspects of social relationships are critical to foster as CASG is implemented within a greater number of Mozambican health facilities, and as other countries design and implement related models of care and treatment with a support group componen t. (Source: AIDS and Behavior)
Source: AIDS and Behavior - February 15, 2019 Category: Infectious Diseases Source Type: research

Influence of Rurality on HIV Testing Practices Across the United States, 2012 –2017
This study examines the isolated influence of rurality on HIV testing and identifies specific US areas where future efforts to increase HIV testing sho uld be directed to. (Source: AIDS and Behavior)
Source: AIDS and Behavior - February 14, 2019 Category: Infectious Diseases Source Type: research

Psychosocial Correlates of HIV Testing Frequency Among Men Who Have Sex with Men in Guangzhou, China
We examined sociodemographic and psychosocial factors associated with HIV testing patterns in the past 2  years among 492 HIV-negative men who have sex men (MSM) at an HIV testing center in Guangzhou, China. MSM who tested for HIV frequently were more likely to be older, reside in Guangzhou, and have higher monthly income. Compared with MSM who tested frequently, MSM who never tested were less likely to report that their sexual partner(s) had ever received HIV tests or that their good friends had ever received HIV tests, and were less likely to report having an HIV-positive gay friend or ever discussing HIV with sexua...
Source: AIDS and Behavior - February 14, 2019 Category: Infectious Diseases Source Type: research

Acceptability and Preliminary Efficacy of an Online HIV Prevention Intervention for Single Young Men Who Have Sex with Men Seeking Partners Online: The myDEx Project
AbstractPrevention of new cases of HIV among young gay, bisexual and other men who have sex with men (YGBMSM; ages 18 –24) remains a priority. We developed and pilot tested an online intervention (myDEx) using a pilot randomized trial design with 180 online-recruited single YGBMSM who reported recent unprotected anal intercourse, self-reporting as HIV negative or status-unaware, and who met sexual partners throug h online dating applications. myDEx participants reported higher overall satisfaction (d = 0.46) and willingness to recommend the intervention to friends (d = 0.48) than controls....
Source: AIDS and Behavior - February 14, 2019 Category: Infectious Diseases Source Type: research

Community Levels of PrEP Use Among Men Who Have Sex with Men by Race/Ethnicity, San Francisco, 2017
AbstractEfforts in San Francisco are maximizing the use of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) where high levels of use are needed to maximize reducing new HIV infections. National HIV Behavioral Surveillance surveys MSM in San Francisco. Demographics, health care and risk behaviors are assessed. PrEP use is measured for 12  month, 6 month and 30 day periods. Of 399 HIV uninfected men sampled in 2017, 43.4% used PrEP in the past 12 months. Proportions of men using PrEP by race/ethnicity were not significant at any time point. Decreases between 6 month and 30 d...
Source: AIDS and Behavior - February 13, 2019 Category: Infectious Diseases Source Type: research

Consent for HIV Testing Among Adolescent Sexual Minority Males: Legal Status, Youth Perceptions, and Associations with Actual Testing and Sexual Risk Behavior
AbstractThis brief report presents a preliminary investigation of the relations between minor consent laws for HIV testing/treatment and testing behavior among adolescent sexual minority males (ASMM;N = 127; ages 14–17). Most participants had legal capacity to consent without parental/guardian permission (HIV testing: 79%; HIV testing/treatment: 65%). Despite having this legal right, few (15%) had ever tested. Capacity to consent was not associated with HIV testing in this sample; neverthe less, those who had not disclosed their sexual activity to parents/guardians were less likely to have tested. Confi...
Source: AIDS and Behavior - February 12, 2019 Category: Infectious Diseases Source Type: research

If You Build It, Will They Use It? Preferences for Antiretroviral Therapy (ART) Adherence Monitoring Among People Who Inject Drugs (PWID) in Kazakhstan
This study examines preferences for ART adherence monitoring among people who inject drugs (PWID) in Kazakhstan. In-depth interviews were conducted with 20 HIV-positive PWID, 18 of their intimate partners, and 7 AIDS Center healthcare providers in Almaty, Kazakhstan. Results indicated that patients varied in their preferences of which strategies would be most effective and acceptable to use in monitoring their adherence. Overall, patients were highly enthusiastic about the potential use of pharmacokinetic testing. Many participants supported the use of EMDs, though some were concerned about having their adherence tracked. ...
Source: AIDS and Behavior - February 11, 2019 Category: Infectious Diseases Source Type: research