Anticipated protection overcomes vaccine hesitancy and mistrust among women enrolled in the DC MACS/WIHS Combined Cohort Study.

Background: Despite efficacy of COVID-19 vaccines in preventing severe complications of infection there remains vaccine hesitancy. We examined COVID-19 vaccine uptake and vaccine hesitancy among persons living with HIV (PWH).

Methods: A nested survey was administered to women in the District of Columbia MACS-WIHS Combined Cohort Study (10/01/2020-9/30/2022).

Partner Violence and Substance-Related Service Use: Differences by HIV Status Among Women.

Introduction: Substance use disorders are prevalent among women living with HIV and women experiencing intimate partner violence. The study aimed to examine the association between intimate partner violence and substance-related service utilization among women living with and without HIV.

Methods: Utilizing Women's Interagency HIV Study (2013-2019) data, linear regression models in 2023-2024 estimated the association between recent and lifetime intimate partner violence and drug- and alcohol-related service utilization among women reporting substance use.

UnPrEPed for HIV prevention services: Hesitancy among US primary care providers.

Provision of HIV prevention services by primary care (PCP) healthcare providers is critical to reduce the number of new HIV infections. We examined the performance of HIV risk assessments and provision of HIV prevention services by PCPs. In our cohort, less than one-half of respondents asked about sex and drug use all or most of the time, and among those that did not routinely ask about sex and drug use only 66% and 59%, respectively, would ask given more time.

HIV Related Stigma among Healthcare Providers: Opportunities for Education and Training.

HIV-stigma can influence engagement in care and viral suppression rates among persons living with HIV (PLWH). Understanding HIV-provider level stigma and its associated factors may aid in development of interventions to improve engagement in care. We assessed HIV-related stigma, provider knowledge, and practices and beliefs among healthcare providers using an online survey tool.

Psychosocial stress and neuroendocrine biomarker concentrations among women living with or without HIV.

Objective: Women living with HIV (WLWH) experience psychosocial stress related to social-structural vulnerabilities. To investigate neuroendocrine pathways linking stress and increased cardiovascular disease risk among WLWH, we evaluated associations between psychosocial stress (i.e.

High Provider Trust Associates with High HIV Antiretroviral Adherence Among Women Living with HIV in a Metropolitan Washington, DC Cohort.

Trust in providers and health care systems (HCSs) has been associated with higher HIV antiretroviral (ART) adherence; however, most previous studies enrolled primarily men and did not concurrently assess provider trust, HCS distrust, and clinical/biological outcomes. We enrolled 239 Washington, DC Women's Interagency HIV Study (WIHS) women: 167 with HIV (WWH) and 72 without HIV. In 2006 and 2017-2018, women completed surveys on provider trust and HCS distrust.

Long-Acting Injectable ART and PrEP Among Women in Six Cities Across the United States: A Qualitative Analysis of Who Would Benefit the Most.

Long-acting injectable (LAI) modalities have been developed for ART and PrEP. Women face unique barriers to LAI use yet little research has examined women's perceptions of potential LAI HIV therapy candidates. We conducted 89 in-depth interviews at six Women's Interagency HIV Study (WIHS) sites with women living with HIV (n = 59) and HIV-negative women (n = 30) from 2017 to 2018.

Patient Health Literacy and Communication with Providers Among Women Living with HIV: A Mixed Methods Study.

In this mixed-methods study, we examine the relationship between provider communication and patient health literacy on HIV continuum of care outcomes among women living with HIV in the United States. We thematically coded qualitative data from focus groups and interviews (N = 92) and conducted mediation analyses with quantitative survey data (N = 1455) collected from Women's Interagency HIV Study participants. Four qualitative themes related to provider communication emerged: importance of respect and non-verbal cues; providers' expressions of condescension and judgement; patient health literacy; and unclear, insufficient provider communication resulting in diminished trust.

"I Haven't Been Ill, I Know It's There": a Case Study Examination of the Social, Behavioral, Clinical, and Structural Factors that Contribute to Sustained Viremia Among Women Living with HIV.

Compared to their HIV-seropositive male counterparts, HIV-seropositive women are less likely to achieve and retain viral suppression (VS). Data regarding the social, behavioral, clinical, and structural factors that facilitate or impede viral suppression among HIV-seropositive women is needed. This study aims to examine HIV-seropositive women's perceptions regarding factors that contribute to their HIV treatment decisions.

Viral Suppression Is Associated with HIV Treatment Self-Efficacy in a Cohort of Women in Washington, DC.

The goal of HIV treatment is viral suppression as it is linked with improved health outcomes and decreased risk of viral transmission. We assessed the sociodemographic, behavioral, and patient-provider interaction associations with viral suppression with an administered survey to HIV-seropositive women in the metropolitan Washington, DC, site of the Women's Interagency HIV Study (WIHS) between 2017 and 2018. Logistic and mixed models were used to explore related factors between HIV viral suppression groups and HIV treatment self-efficacy, respectively.

Perspectives of Women Who Forgo Post-mastectomy Breast Reconstruction: A Mixed Methods Analysis.

Unlabelled: Despite a growing body of evidence suggesting improved psychosocial well-being and survival after post-mastectomy breast reconstruction (PMBR), rates remain stagnant at approximately 40%. Although PMBR access and utilization have been well reported, there is much less known from the point of view of women who decide not to undergo PMBR. This study uses a mixed methods approach to fill that gap by investigating the patient-level decisions that lead to foregoing PMBR.

A Qualitative Exploration of Women's Interest in Long-Acting Injectable Antiretroviral Therapy Across Six Cities in the Women's Interagency HIV Study: Intersections with Current and Past Injectable Medication and Substance Use.

Medications for antiretroviral therapy (ART) and preexposure prophylaxis (PrEP) are currently daily pill regimens, which pose barriers to long-term adherence. Long-acting injectable (LAI) modalities have been developed for ART and PrEP, but minimal LAI-focused research has occurred among women. Thus, little is known about how women's history of injection for medical or nonmedical purposes may influence their interest in LAI.

Interest in Long-Acting Injectable Pre-exposure Prophylaxis (LAI PrEP) Among Women in the Women's Interagency HIV Study (WIHS): A Qualitative Study Across Six Cities in the United States.

Long-acting injectable (LAI) pre-exposure prophylaxis (PrEP) has the potential to facilitate adherence and transform HIV prevention. However, little LAI PrEP research has occurred among women, who face unique barriers. We conducted 30 in-depth interviews with HIV-negative women from 2017-2018 across six sites (New York; Chicago; San Francisco; Atlanta; Washington, DC; Chapel Hill) of the Women's Interagency HIV Study.

Multisite Study of Women Living With HIV's Perceived Barriers to, and Interest in, Long-Acting Injectable Antiretroviral Therapy.

Background: Adherence to antiretroviral therapy (ART) is imperative for viral suppression and reducing HIV transmission, but many people living with HIV report difficultly sustaining long-term adherence. Long-acting injectable (LAI) ART has the potential to transform HIV treatment and prevention. However, little LAI ART-related behavioral research has occurred among women, particularly outside of clinical trials.

Health Disparities and the Digital Divide: The Relationship between Communication Inequalities and Quality of Life among Women in a Nationwide Prospective Cohort Study in the United States.

: Communication inequalities can affect health-seeking behaviors yet the relationship between Internet use and overall health is inconclusive. Communication-related inequalities vary by race/ethnicity and SES but existing research primarily includes middle-class Whites. We therefore examined the relationship between communication-related inequalities-measured by daily Internet use-and health-related quality of life (QOL) using a nationwide prospective cohort study in the United States that consists of primarily low income, minority women.

Brief Report: PrEP Eligibility Among At-Risk Women in the Southern United States: Associated Factors, Awareness, and Acceptability.

Background: Among women in the United States, non-Latina black women in the South have disproportionately high rates of new HIV infections but low use of pre-exposure prophylaxis (PrEP). Effective strategies to identify factors associated with PrEP eligibility could facilitate improved screening, offering, and uptake of PrEP among US women at risk of HIV.

Setting And Methods: We applied 2014 CDC criteria for PrEP use to at-risk HIV-negative women enrolled in the Southern US sites (Atlanta, Chapel Hill, Birmingham/Jackson, Miami) of the Women's Interagency HIV Study from 2014 to 2015 to estimate PrEP eligibility and assess PrEP knowledge and acceptability.

Healthcare Empowerment and HIV Viral Control: Mediating Roles of Adherence and Retention in Care.

Introduction: This study assessed longitudinal relationships between patient healthcare empowerment, engagement in care, and viral control in the Women's Interagency HIV Study, a prospective cohort study of U.S. women living with HIV.

Stigma, Partners, Providers and Costs: Potential Barriers to PrEP Uptake among US Women.

Background: Pre-Exposure Prophylaxis (PrEP) use has remained low among US women while significantly increasing among men who have sex with men. Besides lack of awareness, women face several social and structural barriers in gaining access to and using PrEP.

Methods: Four focus group discussions with 20 HIV-negative women who live in the Washington DC metropolitan area.

Change in patterns of HIV status disclosure in the HAART era and association of HIV status disclosure with depression level among women.

Whether widespread use of HAART changed patterns of HIV status disclosure among women living with HIV is largely unknown. In addition, the association between time to first HIV disclosure and depression has not been fully explored among women. A retrospective cross-sectional survey was conducted among HIV-infected women from the Washington, DC site of the Women's Interagency HIV Study to collect detailed information about their HIV status disclosure behavior.

Life begins at 60: Identifying the social support needs of African American women aging with HIV.

HIV chronicity has resulted in increased life expectancy for many African American women who acquired the disease during the epidemic's peak years. As these women live longer and age, their social support needs may increase. Five focus groups were conducted in Washington, DC with 23 HIV-positive African American women aged 52-65 to explore women's perceptions about how aging and HIV chronicity affects their social support needs.

"The Pleasure Is Better as I've Gotten Older": Sexual Health, Sexuality, and Sexual Risk Behaviors Among Older Women Living With HIV.

There is limited research examining the sexual health and well-being of older women living with HIV (OWLH). Most studies focus on sexual dysfunction, leaving aside the richer context of sexuality and sexual health, including the effect of age-related psychosocial and interpersonal changes on sexual health behaviors. Guided by the integrative biopsychosocial model and the sexual health model, this study explored the importance of sex and sexuality among OWLH to identify their sexual health and HIV prevention needs for program planning.