Human Immunodeficiency Virus Prevention Research Articles

HIV Infection and Associated Factors Among Out-of-School MSM Aged 16-24 Years - 6 Cities and Tianjin Municipality, China, 2022-2023.

Approximately 80% of newly diagnosed human immunodeficiency virus (HIV) cases among individuals aged 15-24 years in China are attributed to out-of-school youth. This study presents findings on HIV prevalence and comprehensive insights into HIV service utilization, risky behaviors, and prevention knowledge among young out-of-school men who have sex with men (MSM) aged 16-24 years in China. This population exhibits a disproportionately high burden of HIV, with only 51.6% of HIV cases previously diagnosed. HIV services should be expanded to include these key populations. Tailored interventions are needed to remove barriers to regular HIV services faced by young key populations.

B Cell Dynamics in HIV Pathogenesis: Insights and Implications

Human Immunodeficiency Virus (HIV) infection remains a global health challenge, with intricate interactions between the virus and the immune system, particularly B cells, significantly influencing disease progression. This review aims to provide a comprehensive examination of B cell dynamics during HIV pathogenesis, offering insights into the implications for therapeutic interventions, vaccine design, and the broader understanding of HIV-associated immune dysfunction. The review begins by outlining the epidemiology of HIV and emphasizing the critical impact of the virus on the immune system, with a specific focus on B cells. It explores the alterations in B cell subpopulations, including memory B cell depletion and dysregulation, highlighting their implications for immune function during HIV infection. This review consolidates current knowledge on B cell dynamics in HIV pathogenesis, providing a foundation for advancing our understanding of the intricate host-virus interactions. The insights gained from this exploration hold significant implications for the development of targeted therapeutic strategies and informed approaches to HIV prevention and treatment.

Disclosure Concerns and the Correlation Among Gay, Bisexual, and Other Men Who Have Sex With Men Living With HIV Receiving Antiretroviral Therapy in Taiwan.

Gay, bisexual, and other men who have sex with men (GBMSM) are associated with the widespread human immunodeficiency virus (HIV) transmission in Taiwan. Additionally, little is known about disclosure patterns and rates, as well as factors influencing disclosure, among GBMSM living with HIV in the country. HIV prevention for GBMSM is effective when HIV status is disclosed. For instance, GBMSM disclosing their HIV status can result in early pre-exposure prophylaxis with a serodiscordant partner. In this cross-sectional study of 200 GBMSM living with HIV conducted from June to November 2020, we assessed internalized homophobia (IHP Scale) and social support (Multidimensional Scale of Perceived Social Support), as well as self-reported disclosure and non-disclosure. Among the participants, 75.5% revealed their HIV status within 3 months of diagnosis. Younger age, occupation type, and number of sexual partners were some factors associated with disclosure. Those receiving more social support and who experienced less IHP were more likely to reveal their HIV status. On the contrary, older GBMSM and GBMSM living with HIV who worked in educational enterprises still experienced severe IHP. Policymakers and healthcare practitioners should be aware of the problems faced by GBMSM living with HIV and offer practical assistance to improve their mental health.

Extended Postexposure Protection Against Vaginal Simian/Human Immunodeficiency Virus Infection With Tenofovir Alafenamide Fumarate/Elvitegravir Inserts in Macaques.

Vaginal inserts that can be used on demand before or after sex may be a desirable human immunodeficiency virus (HIV) prevention option for women. We recently showed that inserts containing tenofovir alafenamide fumarate (TAF, 20 mg) and elvitegravir (EVG, 16 mg) were highly protective against repeated simian/human immunodeficiency virus (SHIV) vaginal exposures when administered to macaques 4 hours before or after virus exposure (93% and 100%, respectively). Here, we show in the same macaque model that insert application 8 hours or 24 hours after exposure maintains high efficacy (94.4% and 77.2%, respectively). These data extend the protective window by TAF/EVG inserts and inform their clinical development for on-demand prophylaxis in women.

PSYCHOSOCIAL CORRELATES OF PREVENTION, CARE, AND WELL-BEING AMONG OLDER WOMEN LIVING WITH HIV

Abstract There are over 4.2 million older adults (ages 50+ years) living with human immunodeficiency virus (HIV) globally. Older women continue to make up a significant proportion of this population. Advances in antiretroviral therapy treatments have allowed HIV+ individuals to live longer, healthier lives. However, compared to all persons living with HIV, women have lower viral suppression rates and are less likely to be retained in care. While older women living with HIV (WLWH) face unique challenges with HIV prevention and care, such as caregiving responsibilities, gender discrimination, and ageism, there is a dearth of research focusing on their experiences. As the population of older WLWH continues to increase, understanding barriers and facilitators to HIV prevention and care among this population is a public health priority. This symposium will provide insight into psychosocial factors that influence HIV prevention, care, and well-being among older WLWH. Our first presentation highlights a qualitative study identifying sources of strength and concerns about aging with HIV among older women. Our second presentation examines social support networks and interpersonal strain in relation to loneliness among older WLWH. Our third presentation highlights the impact of patient-provider communication regarding HIV/AIDs on sexual health communication between older WLWH and their partners. Our fourth presentation examines mental health vulnerabilities and strengths of older WLWH during the humanitarian crisis in Ukraine. Discussant Dr. Anna Rubtsova will contextualize these findings and offer suggestions for future research to enhance well-being of older women across the continuum of HIV prevention and care.

Legislation expanding pharmacist scope of practice to furnish Human Immunodeficiency Virus pre‐exposure prophylaxis: A content analysis

AbstractIntroductionApproximately 1.2 million persons in the United States have indications for human immunodeficiency virus (HIV) pre‐exposure prophylaxis (PrEP) yet utilization remains low. Alternative models for PrEP access, such as community pharmacy programs where pharmacists may prescribe and dispense HIV PrEP medications, may help improve rates of utilization. Individual states have begun to pass laws governing expanded pharmacist practice for provision of PrEP.MethodsAn internet search was conducted from January 2022 to June 2023 to identify United States legislative bills which support the independent provision of PrEP by pharmacists. A content analysis was conducted of the bill text to conceptualize key components, compare these across states, and hypothesize implications for implementation and pharmacy practice.ResultsTwelve states (Arkansas, California, Colorado, Nevada, Utah, New Mexico, Virginia, Oregon, Illinois, Maine, Rhode Island, and Connecticut) with legislation supporting pharmacist‐furnished HIV PrEP were identified. Content analysis revealed differences in required pharmacist training, conditions for furnishing PrEP, total amount of PrEP permitted for dispensing, and discussions of pharmacist‐provided laboratory testing and reimbursement.ConclusionPharmacist‐furnished PrEP is rapidly gaining support as a means to expand access to HIV prevention tools. State‐to‐state differences in legislation will have an impact on implementation and scalability of these models. It will be important to observe states that were early adopters of this type of legislation and who experienced challenges in implementing such programs in order to refine the new legislation being presented in other states.

Examination of Incidence of Sexually Transmitted Infections in the Ending the HIV Epidemic Priority Counties of the United States, 2005-2019.

The incidence of sexually transmitted infections (STIs) has been increasing in the United States, and this trend has continued alongside expanding/changing human immunodeficiency virus (HIV) prevention strategies, moving from reliance solely on behavioral interventions like condoms to biomedical methods like oral and injectable antiretroviral preexposure prophylaxis (PrEP). In 2019, the Ending the HIV Epidemic (EHE) initiative was released to prioritize resource allocation to the 50 jurisdictions in the United States with the highest HIV incidence, providing an opportunity to monitor STI incidence in a national group of discrete, geographic units and identify trends and differences across jurisdictions. Using existing data from the US CDC and Census Bureau, a retrospective analysis was conducted to examine the incidence of STIs in 49 of the 50 EHE priority counties between 2005 and 2019. This timeframe was divided into 2 periods representing a before and after entry into the biomedical era of HIV prevention: P1 (2005-2011) and P2 (2012-2019). A total of 49 EHE counties were included in this analysis, representing 27.4% of the total US population. Entry into the biomedical HIV prevention era was associated with an increase in STI incidence in 28 EHE counties and a decrease in 14 EHE counties. The greatest percent increase in total STI incidence was in the District of Columbia (+12.1%; incidence rate ratio = 1.121 [1.115, 1.127]; P < 0.001) and the greatest percent decrease was identified in Orleans Parish, LA (-8.7%; incidence rate ratio = 0.913 [0.908, 0.919]; P < 0.001). Rising STI rates in the biomedical era of HIV prevention represent missed opportunities for comprehensive sexual and preventive healthcare. County-level data provide actionable insight for reducing STI incidence. The EHE counties that have experienced decreases in STI incidence while being in the biomedical era may provide models of best practice, which may be scaled in other jurisdictions.

Measures to improve participation of registered nurses in HIV and AIDS research.

Registered nurses are crucial in lowering the complications of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Nigeria. Human immunodeficiency virus infects individuals and impairs the immune system, impairing the body's capacity to fight bacteria, viruses, and other pathogens. Therefore, registered nurse-led initiatives are beneficial in promoting HIV and AIDS research development. However, these evidence-based treatments and professional expectations for registered nurse research creation do not represent contemporary research development on HIV and AIDS by registered nurses. This study aimed to explore measures to improve the participation of registered nurses in HIV and AIDS research in Nigeria. The study was conducted at a general hospital in Ijebu Ode, Ogun State, Nigeria. A qualitative approach design was employed. Participants of the study comprised 31 registered nurses in three focus groups. This study demonstrated the importance of research in effectively reducing HIV and AIDS transmission and maintaining good practices in a hospital setting in Nigeria. However, this understanding did not translate into knowledge creation through autonomous research productivity in this context. The study discovered that registered nurses were primarily involved in data collection and validation, which did not result in publications. The study found that registered nurses in Nigeria are typically worried about ways to promote nurses' engagement in research in Nigeria. These results might be utilised to improve the supply of research services and act as a baseline for future research linked to HIV and AIDS transmission prevention in Nigeria.

Assessment of community pharmacies readiness to dispense antiretroviral medicines in Rwanda.

Since the introduction of the 'Test and treat' approach in the Human Immunodeficiency Virus (HIV) management, various strategies have been devised and implemented by countries to relieve public health facilities of the large numbers of people coming for medicine refills and clinical follow-up. One of the strategies is the dispensing of antiretroviral medicines through community pharmacies. In Rwanda, community pharmacies are not yet involved in antiretrovirals (ARVs) dispensing, and no study has assessed their readiness to provide this service. This study aimed to assess the readiness of community pharmacy staff and infrastructure to implement a decentralised model of antiretroviral medicines dispensing. This cross-sectional study included data from 262 community pharmacies sampled across all districts of Rwanda. Primary data were collected using a structured questionnaire, from February to March 2023. Responses were received for 262 community pharmacies, representing the total sample size. Data analysis was done using quantitative descriptive and inferential statistical approaches. Frequency tables and graphs were produced using STATA15 and the outputs were exported to MS Excel as well as MS Word to allow document framing and designing. The research has shown a high proportion of community pharmacy staff trained in HIV prevention (82.4% trained on HIV testing), but a low level of training in treatment (30.5%) and psychosocial support of people living with HIV (29.8%). Infrastructure and storage conditions were found to be adequate, with 99.6% of surveyed Pharmacies having sufficient storage space. Majority (93.9%) expressed their willingness to dispense ARVs in the pharmacy premises. A large number of respondents (92.4%) felt that dispensing of antiretroviral medicines through community pharmacies would lead to an increase in sales of over the counter and other non-HIV related medicines. The main anticipated challenge that should be addressed to ensure effective implementation is the lack of interoperability between reporting systems used by community pharmacies and those used by health facilities providing HIV services (76.7% of respondents). Community pharmacies in Rwanda have majority of staff trained in various areas of HIV prevention, but a small proportion have been trained in HIV care and treatment. Community pharmacies have the necessary infrastructure to dispense ARVs, and those with shortcomings, such as the lack of a separate room for individual patient counselling, are willing to obtain such a room if they are authorised to dispense ARVs. Staffs are willing to dispense ARVs in community pharmacies if the model is recommended by policymakers. The model could have several benefits for community pharmacies and the public health system in general, but there are also challenges that should be mitigated to ensure effective implementation. The staff willingness and expected benefits constitute enabling factors that the Ministry of Health and the national HIV control programme may leverage to prepare for introducing the model of ARVs distribution through community pharmacies.

Young people’s attitudes to Pre-Exposure Prophylaxis for HIV Prevention – a qualitative exploratory study

Abstract Introduction Young people aged 18-24 years old are a key demographic target for eliminating human immunodeficiency virus (HIV) transmission globally. Pre-exposure prophylaxis (PrEP), a prevention medication which reduces HIV transmission, is emerging as a key tool to reduce HIV transmission. Despite largely good uptake by gay and bisexual men who have sex with men, hesitancy to use PrEP has been observed in other socio-cultural groups, such as young people, heterosexuals, people from ethnic minority backgrounds and females. Aim The aim of this study was to explore young peoples’ perceptions and attitudes to using PrEP. Methods A convenience sample of young people were recruited from England aged between 18 and 24 using a social media invitation posted by two authors which include details about the study with a registration link. Data was collected using semi-structured one-to-one interviews with graphic elicitation about current experiences of HIV care, awareness of using PrEP and decision making about accessing PrEP. Thematic analysis was used to identify codes and themes to describe participants’ experiences. Institutional ethical approval was obtained. Results Twenty-four young people took part. The sample was 58% female, 100% cisgendered, 54% had or were completing undergraduate study, 58% were straight, 58% had previously had a HIV test, 17% had previously used PrEP and a broad range of ethnicity were included. Key findings found young people had good levels of knowledge about HIV but had a poor understanding of using PrEP. In this information vacuum, negative stigma and stereotypes about HIV were transferred to using PrEP, which were reinforced by information on social media, television, and film - such as an association between using PrEP and being a promiscuous, white, gay males. In addition, young people from ethnic ethnicity communities appeared to have particularly negative attitudes to PrEP use, compared to ethnic majority counterparts. This meant the young people in our study were unable to make decisions about when to access and use PrEP. Discussion/Conclusion The findings indicate an information vacuum for young people regarding PrEP. A strength of the study is that theoretical data saturation was reached. A limitation of the study is that participants were all cisgendered and therefore the experiences of young trans people were not accounted for. Further work is needed to explore what information young people need, when and how this can be delivered to support informed decision-making about using PrEP. Pharmacists have a key role in supporting sexual health and further work should explore community pharmacies readiness to provide this information to young people.

Spatial heterogeneity in relationship between district patterns of HIV incidence and covariates in Zimbabwe: a multi-scale geographically weighted regression analysis.

A study was conducted to investigate the district-level patterns of incidence of the human immunodeficiency virus (HIV) in Zimbabwe in the period 2005-2015 and explore variations in the relationship between covariates and HIV incidence across different districts. Demographic health survey data were analysed using hotspot analysis, spatial autocorrelation, and multi-scale geographically weighted regression (MGWR) techniques. The analysis revealed hotspots of the HIV epidemic in the southern and western regions of Zimbabwe in contrast to the eastern and northern regions. Specific districts in Matabeleland South and Matabeleland North provinces showed clusters of HIV incidence in 2005-2006, 2010-2011 and 2015. Variables studied were multiple sex partners and sexually transmitted infections (STI) condom use and being married. Recommendations include implementing targeted HIV prevention programmes in identified hotspots, prioritising interventions addressing the factors mentioned above as well as enhancing access to HIV testing and treatment services in high-risk areas, strengthening surveillance systems, and conducting further research to tailor interventions based on contextual factors. The study also emphasizes the need for regular monitoring and evaluation at the district level to inform effective responses to the HIV epidemic over time. By addressing the unique challenges and risk factors in different districts, significant progress can be made in reducing HIV transmission and improving health outcomes in Zimbabwe. These findings should be valuable for policymakers in resource allocation and designing evidence-based interventions.

Perception and Uptake of HIV/AIDS Voluntary Counselling and Testing Among Women in Akinyele Local Government Area, Ibadan.

Introduction: At the end of 2020, there were reportedly 37.7 million HIV-positive individuals. HIV testing has been marketed as a crucial first step method to diagnose, treat, and prevent human immunodeficiency virus (HIV) infection. It is the cornerstone of all HIV prevention initiatives. The study's main aim was to ascertain the degree of HIV and HIV VCT (voluntary counselling and testing) awareness among women in Akinyele Local Government Area, Ibadan, as well as their attitudes towards HIV VCT and the rate at which they adopted the treatment. Method: This study employed a descriptive study design aimed at assessing the perception and uptake of HIV VCT among women residing in Akinyele Local Government Area, Ibadan, Oyo state. The total population of the women was 410. The sample size was determined using the Taro Yamane formula and the sample size was 220 women which was allocated proportionally to each primary health care center. The research instrument used for the study is a self-administered questionnaire. Results: The results showed that more than 75% of respondents had good understanding of HIV and HIV VCT, and that 65% had positive perceptions of HIV VCT. The study found that there is no significant association between women's level of education and their level of knowledge on HIV and HIV VCT and conclude that there is no significant association between women's perception of HIV and HIV VCT and HIV VCT uptake. Conclusion: In conclusion, the result revealed like other related studies that the attitude of women in Akinyele local government towards HIV Voluntary Counselling and Testing is just a little above average which means quite a number of the respondents are still not willing to take HIV VCT. Hence, the women need more sensitization on the importance and benefits of HIV VCT.

Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis

BackgroundMen who have sex with men (MSM) and transgender women (TGW) have a disproportionately higher risk of human immunodeficiency virus (HIV) infection than other groups. Oral HIV pre-exposure prophylaxis (PrEP) is an effective prevention tool and should be offered to those at higher risk. Identifying demand creation strategies (DCS) and retention strategies (RS) to improve PrEP persistence is essential to control the HIV epidemic.AimWe aimed to identify the (DCS and RS with higher proportions among MSM and TGW.MethodsA systematic review and meta-analysis of prospective studies were conducted, with studies retrieved from five databases until November, 2022 following the Cochrane and PRISMA guidelines. The study protocol was registered in PROSPERO (CRD42022323220). The outcomes were DCS and RS for PrEP use among MSM and TGW. Strategies used for users enrolled in the PrEP-recruited (DCS) were classified as face-to-face (peer educator recruitment at social venues, nongovernmental organizations, and parties; direct referrals by health services; friends and/or sexual partners); online (chatbot or peer educator recruitment on social media [e.g., , Instagram or Facebook] or dating/hook-up apps [e.g., Grindr, Tinder, Badoo, and Scruff]); and mixed (face-to-face and online). RS was classified as provider counseling (face-to-face by a health professional; prevention of HIV risk counseling, distribution of condoms, lubricants, and testing for HIV or other sexually transmitted infections); online counseling (text messages, chatbots, telephone calls, social media, and peer educators); and mixed (all previous strategies). Subgroup analyses were conducted for each treatment strategy. Meta-analyses were performed using the R software version 4.2.1.ResultsA total of 1, 129 studies were retrieved from the five databases. After eligibility, 46 studies were included. For MSM, most DCS and RS were online at 91% (95% CI: 0.85–0.97; I2=53%), and 83% (95% CI: 0.80–0.85; I2=17%) respectively. For TGW, mixed DCS and RS were the most frequent at85% (95% CI: 0.60–1.00; I2=91%) and online counseling at 84% (95% CI: 0.64–0.95) compared to other strategies.ConclusionCritical issues play. Pivotal role in increasing PrEP awareness among MSM and TGW, minimizing access gaps, and ensuring retention of PrEP services. Offering oral PrEP using online DCS and RS can reach and retain high numbers of MSM and TGW, and reduce HIV incidence in these populations.

Comparison of the Performance of Logistic Regression Model in the Presence and Absence of Mediation

Over the last decade major global efforts mounted to address the HIV epidemic has realized notable successes in combating the pandemic. Sub Saharan Africa (SSA) still remains a global epicenter of the disease, accounting for more than 70% of the global burden of infections. Despite wide spread use of various intervention strategies that act as mediation factors in Human Immunodeficiency Virus (HIV) prevention, HIV prevalence still remains a challenge especially in some geographic areas and populations. Therefore, how mediation factors interact with the prevailing HIV risk factors to cause an impact on its prevalence remains a question not answered. This study considered Exposure to HIV related media as a mediator variable in the relationship between HIV risk factors and HIV prevalence. Two logistic regression models, one in presence of mediation and another in absence of mediation were formulated and compared to establish the best performing model. Models were fitted to real data from the Kenya Population-based HIV Impact Assessment survey-2018 and model parameters were estimated using Maximum Likelihood Estimation in R. Results based on both Akaike’s Information Criterion and the McFadden’s R2 value revealed that the model formulated in presence of mediation performed better compared to that without mediation.

Prevalence of risk factors for human immunodeficiency virus among sexually active women in Rwanda: a nationwide survey

BackgroundThe Human Immunodeficiency Virus (HIV) remains a global health burden, and despite the advancements in antiretroviral therapy and various strategies employed to curb HIV infections, the incidence of HIV remains disproportionately high among women. Therefore, this study aimed to determine the prevalence of the risk factors for the acquisition of HIV among sexually active women in Rwanda.MethodsSecondary data from the 2020 Rwanda Demographic Health Survey, comprising 10,684 sexually active women, was used. Multistage stratified sampling was employed to select the study participants. Multivariable logistic regression was conducted to determine the associated risk factors using the SPSS (version 25).ResultsOf the 10,684 sexually active women, 28.7% (95% confidence interval (CI): 27.5–29.4) had at least one risk factor for HIV acquisition. Having no education (AOR = 3.65, 95%CI: 2.16–6.16), being unmarried (AOR = 4.50, 95%CI: 2.47–8.21), being from female-headed households (AOR = 1.75, 95%CI: 1.42–2.15), not having health insurance (AOR = 1.34, 95%CI: 1.09–1.65), no HIV test history (AOR = 1.44, 95%CI: 1.01–2.08), being from the poorest wealth quintile (AOR = 1.61, 95%CI: 1.14–2.27) and lack of exposure to mass media (AOR = 1.30, 95%CI: 1.07–1.58) were associated with higher odds of exposure to at least one HIV acquisition risk factor. In contrast, age groups of 25–34 (AOR = 0.56, 95%CI: 0.44–0.71) and 35–44 years (AOR = 0.62, 95%CI: 0.48–0.80), rural residence (AOR = 0.63, 95%CI: 0.49–0.81) and being from the western region (AOR = 0.67, 95%CI: 0.48–0.94) were associated with less odds of exposure to at least one HIV acquisition risk factor.ConclusionMore than a quarter of sexually active women in Rwanda had exposure to at least one risk factor for HIV acquisition. There is a need to maximize the use of mass media in disseminating HIV prevention and behavioral change messages. Engagement of religious leaders and promotion of HIV testing, especially among the never-testers, may be vital strategies in successful HIV prevention programs.

Same-Day Initiation of Oral Pre-Exposure Prophylaxis is High Among Adolescent Men Who Have Sex With Men and Transgender Women in Brazil

PurposeThis study analyzed the sociodemographic and behavioral characteristics of adolescent men who have sex with men (aMSM) and transgender women (aTGW) initiating oral pre-exposure prophylaxis (PrEP) in human immunodeficiency virus (HIV) prevention clinics. MethodsPrEP1519 is a prospective, multicenter, open-label PrEP demonstration cohort study of aMSM and aTGW aged 15–19 years living in three large Brazilian capital cities. For this analysis, we included adolescents who enrolled in PrEP1519 from February 2019 to August 2021. Adolescents who visited PrEP clinics were classified into four groups based on PrEP eligibility and on their decision to use PrEP: (1) ineligible for same-day PrEP initiation; (2) eligible for same-day PrEP initiation, initiated PrEP at first visit; (3) eligible for PrEP initiation, initiated PrEP after the first visit; and (4) eligible for same-day PrEP initiation but declined. The groups that were eligible for same-day PrEP initiation were compared using the Chi-square and Fisher’s exact tests. ResultsOf the 1,254 adolescents enrolled in the PrEP1519 study, 61 (4.9%) were considered ineligible for same-day PrEP initiation. Of the 1,193 eligible for same-day PrEP initiation, 1,113 (93.3%) initiated PrEP [1,054 initiated PrEP in the first visit (88.3%) and 59 in subsequent visits (4.9%)] and 80 (6.7%) did not. Despite 90% of the PrEP decliners reporting a low risk of HIV infection, most reported condomless anal sex in the past six months (70%). DiscussionSame-day PrEP initiation among aMSM and aTGW was high, highlighting that this strategy was important to promote PrEP initiation among adolescents with increased vulnerability to HIV in Brazil.

Mental Health Needs of Adolescent and Young Adult PrEP Users in South Africa: Implications for Sexual and Reproductive Health Programming

PurposePoor mental health is associated with sexual and reproductive health (SRH) risks, including human immunodeficiency virus (HIV) and pre-exposure prophylaxis discontinuation. Adolescents and young people (AYP) are vulnerable to HIV and depression. This paper describes the prevalence and severity of depression and associated factors in AYP accessing SRH services in South Africa. MethodsA cross-sectional analysis of enrollment data (January 2019 to December 2021) from a cohort of individuals receiving pre-exposure prophylaxis services at eight clinics in three provinces in South Africa was conducted. Females (n = 1,074) and males (n = 231) aged 15–24 years were included. Interviewer-administered questionnaires were conducted, and the prevalence and severity of depression assessed using the Patient Health Questionnaire-9. Multivariate analysis was used to identify factors associated with depression. ResultsOver 40% of participants had experienced any depression symptoms (43.7% of females, 38.5% of males). For males, experiencing intimate partner violence was the only predictor of depression symptoms (adjusted odds ratio (AOR) 8.81, 95% confidence intervals (CI) 1.03–75.44). For females, living with both parents (AOR 1.70, 95% CI 1.15–2.51), having transactional sex (AOR 1.63, 95% CI 1.00–2.65), experiencing any intimate partner violence (AOR 1.96, 95% CI 1.34–2.89), and using drugs (AOR 1.78, 95% CI 1.03–3.11) were all positively associated with depression symptoms. Resilience was a protective factor against depression symptoms for both sexes (males: AOR 0.96, 95% CI 0.93–0.98; females: AOR 0.96, 95% CI 0.95–0.97). DiscussionThere is a high burden of depression among AYP accessing SRH services in South Africa. Mental health screening should be integrated into SRH and HIV prevention programs for AYP.

Culturally Targeted Video Intervention to Increase PrEP Use Intentions Among Latinx Sexual Minority Men: A Pilot Randomized Controlled Trial.

Background: Latinx sexual minority men experience the greatest human immunodeficiency virus (HIV) burden in the United States. Pre-exposure prophylaxis (PrEP) is the most effective HIV prevention tool available, however, PrEP uptake remains low among this group. Methods: This two-arm pilot randomized controlled trial study aimed to assess the feasibility and preliminary efficacy of delivering an online culturally targeted video intervention that aims to increase PrEP uptake intentions among Latinx sexual minority men. The intervention group received a culturally targeted video that contained the same PrEP information as the control group and incorporated positive aspects of Latinx masculinity (i.e., caballerismo). Participants were recruited through Amazon's MTurk crowd-sourcing platform. A total of twenty-five participants met the study inclusion criteria (N = 25). Results: The control group had a higher mean PrEP intentions score (M: 3.3, 95% CI: 2.7-3.9) when compared with the intervention group. A moderate, negative, linear correlation was observed between machismo and PrEP intention scores (r = -.34). In contrast, a small, positive correlation was found between caballerismo and PrEP intentions (r = .19). Conclusions: While the culturally targeted video intervention did not increase PrEP use intentions, the study highlights the importance of understanding and addressing cultural factors such as Latin masculinity.

Perspectives on HIV pre-exposure prophylaxis (PrEP) implementation in Mississippi among Black women and clinical staff: Recommendations for clinical trauma-informed programs

Intimate partner violence (IPV) can constraint Black women’s ability to prioritize and access Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP) services. Recent research has called for the development of trauma-informed PrEP implementation programs to improve the delivery of PrEP to Black cisgender women; however, many PrEP-prescribing settings do not reflect this recommendation. The current study sought to identify key components to develop a trauma-informed PrEP implementation program for Black cisgender women and clinical staff. We conducted focus groups with PrEP-eligible Black cisgender women (February-June 2019), and semi-structured interviews with clinical staff offering HIV prevention and treatment services (October-November 2020) in community healthcare clinics in Mississippi. Seven themes were identified as needed to facilitate integration of trauma-informed approaches into existing PrEP programs, including defining intimate partner violence (IPV), appropriate IPV screening and response, HIV prevention in abusive relationships, staff training needs, and creating supportive clinic environments. PrEP-eligible Black women and clinical staff generally agreed on how to best operationalize IPV screening and response, the importance of trauma-informed staff training, and the need for Black women-specific informational campaigns. However, Black women highlighted the need for providers to discuss HIV prevention in controlling relationships, and to respond to IPV disclosure. HIV pre-exposure prophylaxis has yet to achieve the potential impact observed in trials. Ultimately, realizing the HIV prevention potential of PrEP in the US necessitates centering the perspectives of Black cisgender women and staff to better integrate trauma-informed approaches.

Two into one does go: Formulation development of a multipurpose combination vaginal ring releasing dapivirine and metronidazole for prevention of HIV infection and treatment of bacterial vaginosis

Bacterial vaginosis (BV) is a common but often asymptomatic dysbiosis of the human vagina characterized by an imbalance in the normal vaginal microbiota due to loss of lactobacilli and an overgrowth of certain anaerobic bacteria. While BV itself is not a sexually transmitted infection, it is associated with an increased risk in women of various sexually acquired infections, including human immunodeficiency virus (HIV) infection. There is, therefore, a strong rationale for pursuing new multipurpose products that seek to treat or prevent BV alongside preventing HIV infection. With the dapivirine-releasing vaginal ring for HIV prevention now approved in several African countries, here we report formulation development of a next-generation ring product that releases both dapivirine (DPV) and the antibiotic drug metronidazole (MET). Following thermal analysis studies to characterize the phase behaviour of DPV-MET mixtures and rheological analysis to assess the cure characteristics of the active silicone elastomer mixes, matrix-type rings were manufactured containing 25 or 200 mg DPV in combination with 100, 250, 500, 1000 or 2000 mg MET. The results for drug content, in vitro release, mechanical testing, and Gardnerella vaginalis time-kill experiments demonstrate the feasibility of incorporating both DPV and MET in a matrix-type ring formulation and indicate that clinically effective release rates may be possible.