Pre-exposure Prophylaxis Prescription Differences at Two Federally Qualified Health Centers.

Background: Pre-exposure prophylaxis (PrEP) are medications that prevent HIV infection. However, PrEP is not equally used by all who would benefit. We examined PrEP disparities by comparing the number of sexually transmitted infections (STIs) and PrEP prescriptions across sex, race, and ethnic groups from two federally qualified health centers (FQHCs) in Pinellas County, Florida and Chicago, Illinois.

Rapid ART, Rapid PrEP, and Status Neutral Implementation in Ryan White-Funded Clinics: Results From a Multisite Survey.

Background: Ending the HIV Epidemic strategies include rapid ART Initiation (R-ART), rapid pre-exposure prophylaxis (R-PrEP), and status neutral approaches (status neutral), but implementation across heterogeneous settings in the United States is not well characterized.

Setting: Ryan White (RW)-funded HIV treatment clinics located in select Ending the HIV Epidemic priority areas in the United States.

Methods: Clinics were sent a survey to assess experiences offering R-ART, R-PrEP, and status neutral (collectively called "rapid START").

Improving Community-Engaged Implementation Science: Perspectives From "Ending the HIV Epidemic" Supplement Award Cases in the United States.

Background: Community-engaged research (CEnR) is fundamental to effective HIV prevention and treatment implementation, although limited in practice. We describe CEnR lessons learned by researchers in HIV-related implementation science to improve future CEnR.

Setting: Academic-community research partnerships funded by the 2019-2021 National Institutes of Health Ending the HIV Epidemic (EHE) supplement awards.

Progress and Priorities to End the HIV Epidemic by 2030: Combined Lessons From 120 US Implementation Research Projects.

Five years into the US national Ending the HIV Epidemic (EHE) plan, it is a critical time to examine what has been learned and what still needs to be studied to achieve its 2030 goals of reducing new HIV infections by 90%. While much has already been gained from the 250+ individual National Institutes of Health-funded implementation research projects and the capacity building provided by the Implementation Science Coordination Initiative (ISCI) and 9 regional consultation hubs (RCHs), identifying generalizable implementation science lessons requires the synthesis of findings across multiple sites, studies, and/or contexts. This supplemental issue of JAIDS emphasizes collaborative papers that summarize shared HIV implementation knowledge from multiple EHE-funded research projects.

Mapping Implementation Strategies to Address Barriers to Pre-Exposure Prophylaxis Use Among Women Through POWER Up (Pre-Exposure Prophylaxis Optimization Among Women to Enhance Retention and Uptake): Content Analysis.

Background: Black cisgender women (hereafter referred to as "women") experience one of the highest incidences of HIV among all populations in the United States. Pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention option, but uptake among women is low. Despite tailored strategies for certain populations, including men who have sex with men and transgender women, Black women are frequently overlooked in HIV prevention efforts.

Increasing providers' PrEP prescription for Black cisgender women: A qualitative study to improve provider knowledge and competency via PrEP training.

Background: Awareness and uptake of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) remains low among Black/African American cisgender women, partly due to low self-reported PrEP knowledge and comfort among primary care providers. Ensuring providers are trained on PrEP is crucial, as increased PrEP knowledge is associated with higher rates of PrEP prescription.

Objective: We aimed to develop a PrEP training for providers to improve their self-efficacy in discussing and prescribing PrEP for Black women, with the ultimate goal of increasing PrEP awareness and utilization among Black women.

Factors Associated with HIV Pre-Exposure Prophylaxis Use Among Transmasculine People Who Have Sex with Cisgender Men, at a Federally Qualified Health Center in Chicago, Illinois.

Transmasculine individuals who have sex with cisgender men (TMSM) remain an understudied population regarding pre-exposure prophylaxis (PrEP). We used electronic medical record data to assess PrEP eligibility and initiation in TMSM in a large LGBTQ+ focused federally qualified health center in Chicago, Illinois. We examined a sample of 430 TMSM from January 1, 2015 to December 31, 2019, and used logistic regression to model PrEP eligibility and initiation.

Filling in the Gaps: Updates on Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections.

Over the past two decades, cases of sexually transmitted infections (STIs) due to syphilis, gonorrhea, and chlamydia have been rising in the United States, disproportionately among gay, bisexual, and other men who have sex with men (MSM), as well as racial and ethnic minorities of all genders. In this review, we address updates about the evidence on doxycycline post-exposure prophylaxis (doxy-PEP) for prevention of bacterial STIs, including efficacy, safety, antimicrobial resistance (AMR), acceptability, modeling population impact, and evolving guidelines for use. Equitable implementation of doxy-PEP will require evaluation of who is offered and initiates it, understanding patterns of use and longer-term STI incidence and AMR, provider training, and tailored community education.

Adapting Provider Training and Pre-Exposure Prophylaxis Advertising to Increase Pre-Exposure Prophylaxis Awareness and Uptake Among Black Cisgender Women.

Black cisgender women (hereafter referred to as "women") have disproportionately high rates of HIV infection yet low rates of pre-exposure prophylaxis (PrEP) utilization. Barriers to PrEP uptake exist at the system, provider, and individual/client level. To learn how existing training and advertising can be adapted to address race- and sex-based gaps within PrEP service delivery, we conducted focus groups with providers and Black women.

A Systematic Review of Implementation Research on Determinants and Strategies of Effective HIV Interventions for Men Who Have Sex with Men in the United States.

Men who have sex with men (MSM) are disproportionately affected by HIV, accounting for two-thirds of HIV cases in the United States despite representing ∼5% of the adult population. Delivery and use of existing and highly effective HIV prevention and treatment strategies remain suboptimal among MSM. To summarize the state of the science, we systematically review implementation determinants and strategies of HIV-related health interventions using implementation science frameworks.

The Relationship between Substance Use Stigma and COVID-19 Vaccine Hesitancy.

Two parallel public health epidemics affecting the United States include the COVID-19 pandemic and a rise in substance use disorders (SUDs). Limited research has examined the potential relationship between these two epidemics. Our objective was therefore to perform an exploratory study in order to examine the association between public stigma toward people with a past history of opioid, methamphetamine, cocaine, and alcohol use disorder and COVID-19 vaccine hesitancy.

PrEP Persistence Support and Monitoring in Areas of High HIV Burden in the Midwestern United States.

Monitoring pre-exposure prophylaxis (PrEP) metrics can guide service delivery yet does not occur routinely. We developed a survey to understand current practices for monitoring PrEP at PrEP-providing organizations in Illinois and Missouri. The survey was distributed from September through November 2020; 26 organizations participated.

Changes in HIV Prevention and Sexual Experiences During the COVID-19 Pandemic: A Mixed-Methods Study.

Background: STI and HIV services and infection rates were affected during the COVID-19 pandemic, because of changes in access to health care and individual behavior. Understanding how individuals made decisions around prevention and sexual activities during different phases of the pandemic is useful to addressing the rising rates of STIs and HIV.

Setting: Federally-qualified health center focused on sexual and gender minority health, Chicago IL, 2021.

Temporary changes in STI & HIV testing & diagnoses across different phases of the COVID-19 pandemic, Chicago IL.

Introduction: While the U.S. has seen a sustained rise in STI cases over the past decade, the impact of the COVID-19 on STIs and HIV is unclear.

POWER Up-Improving pre-exposure prophylaxis (PrEP) uptake among Black cisgender women in the Southern United States: Protocol for a stepped-wedge cluster randomized trial (SW-CRT).

Background: HIV disproportionately affects Black/African American cisgender women (hereafter women) in the United States. Despite its proven effectiveness, pre-exposure prophylaxis (PrEP) for HIV prevention remains vastly under-prescribed to women based on their need. Increasing PrEP uptake and persistence among women is crucial to reducing HIV transmission; however, there have been few studies designed specifically for women.

PrEP Use and Adherence among Transgender Persons in Chicago, IL (SHIPP Study, 2014-2018, USA).

Few studies investigating daily oral preexposure prophylaxis (PrEP) focus on transgender persons. The Sustainable Health Center Implementation PrEP Pilot (SHIPP) Study included a large observational cohort of transgender persons with implications for PrEP in the United States. We examined data from SHIPP's observational cohort and its Medication Adherence Substudy (MAS) to understand adherence among transgender participants in Chicago, IL.

HIV prevention metrics: lessons to be learned from contraception.

Introduction: As the range of effective HIV prevention options, including multiple biomedical tools, increases, there are many challenges to measuring HIV prevention efforts. In part, there is the challenge of varying prevention needs, between individuals as well as within individuals over time. The field of contraception faces many similar challenges, such as the range of prevention methods and changing contraceptive needs, and has developed many metrics for assessing contraceptive use at the program level, using frameworks that move beyond the HIV prevention cascade.

Trajectories of Oral PrEP Adherence Among Young Kenyan Women: Implications for Promoting Effective PrEP Use.

Using data from a 2-year study of young women at high HIV risk in Thika and Kisumu, Kenya, we identified group-based trajectories of PrEP adherence based on electronic pillcap-monitoring and assessed potentially associated demographic and socio-behavioral factors. Among 348 women, we selected a three-trajectory adherence model: low and declining (N = 211, 61%), moderate but declining (N = 119, 34%) and steady high adherers (N = 18, 5%). We also identified a two-trajectory HIV risk model based on self-perceived risk in the past week: high and increasing (N = 28, 8%) and steady low (N = 320, 92%) risk.

Provider Perspectives on Factors Affecting the PrEP Care Continuum Among Black Cisgender Women in the Midwest United States: Applying the Consolidated Framework for Implementation Research.

Background: To End the HIV Epidemic and reduce the number of incident HIV infections in the United States by 90%, pre-exposure prophylaxis (PrEP) uptake and persistence among cisgender women, particularly racial and ethnic minority women, must be increased. Medical providers play a pivotal role across the PrEP care continuum.

Methods: In this qualitative study, guided by the Consolidated Framework for Implementation Research, we explored health care provider perspectives on facilitators and barriers to PrEP implementation strategies for Black cisgender women in the Midwest United States.

Lifetime sexual violence exposure in women compromises systemic innate immune mediators associated with HIV pathogenesis: A cross-sectional analysis.

Objectives: Violence and HIV/AIDS syndemic highly prevalent among women impairs HIV prevention efforts. Prolonged exposure to violence results in physical trauma and psychological distress. Building on previous findings regarding genital immune dysregulation following sexual abuse exposure, we investigate here whether systemic changes occur as well.

Support for evidence-informed opioid policies and interventions: The role of racial attitudes, political affiliation, and opioid stigma.

Political affiliation, racial attitudes, and opioid stigma influence public support for public health responses to address opioid use disorders (OUD). Prior studies suggest public perceptions of the opioid epidemic are less racialized and less politically polarized than were public perceptions of the crack cocaine epidemic. Analyzing a cross-sectional, nationally representative sample (n = 1161 U.

Moving toward equity: fostering transdisciplinary research between the social and behavioral sciences and implementation science to end the HIV epidemic.

Purpose Of Review: Since the beginning of the HIV epidemic, social and behavioral scientists have developed interventions to stem the spread of the virus. The dissemination of these interventions has traditionally been a lengthy process; however, implementation science (IS) offers a route toward hastening delivery of effective interventions. A transdisciplinary approach, wherein IS informs and is informed by social and behavioral sciences (SBS) as well as community participation, offers a strategy for more efficiently moving toward health equity and ending the HIV epidemic.

COVID-19 Testing Results by HIV Status, March-July 2020, Chicago, USA.

The role of HIV in coronavirus disease 2019 acquisition is not yet understood. Among 1862 patients, including 349 people with HIV-with most of these being virally suppressed and 308 having recently used pre-exposure prophylaxis-we compared rates of positive polymerase chain reaction results. Positivity was higher among people with HIV (10.