Managing multimorbidity together: relationship dynamics and dual medication adherence for hypertension and HIV in Malawi.

Background: Cardiometabolic disorders are highly prevalent among people living with HIV, complicating the medication management of both conditions. Primary partners provide key sources of support for antiretroviral therapy; however, little research has considered their role in the context of comorbidities.

Purpose: Using baseline data from the Healthy Hearts cohort study, we investigated associations between relationship dynamics and dual medication adherence for HIV and hypertension (HTN) in Malawi.

The association of food insecurity with hepatic steatosis in women with and without HIV.

Objective: Food insecurity is a risk factor for metabolic dysfunction-associated steatotic liver disease in the general population. However, little is known about the impact of food insecurity on hepatic steatosis among women with (WWH) and without HIV (WWOH).

Design: We assessed hepatic steatosis by controlled attenuated parameter (CAP) in decibels/meter (dB/m) and food security status using the U.

How Does Poverty Stigma Affect Depression Symptoms for Women Living with HIV? Longitudinal Mediating and Moderating Mechanisms.

Purpose: In a sample of women living with HIV, we examined whether individual traits fear of negative evaluation and resilience moderate the internalization of poverty stigma that these women experience from others. We also examined the downstream effects of these processes on depression symptoms using moderated serial mediation analyses.

Methods: Data were collected annually for 4 years (2016-2020; T1, T2, T3, and T4) from 369 women living with HIV at 4 US cities using validated measures.

Cluster randomised controlled trial of a household-level, group preconception nutrition awareness and norm intervention (SUMADHUR) combined with multiple micronutrient supplements (MMS) for newly married households: a protocol.

Introduction: Micronutrient deficiencies remain prominent drivers of adverse maternal and child health outcomes in Nepal. Gender-based inequalities and norms around women's status and access to nutrition exacerbate poor nutritional status. Many newly married, preconception women lack adequate nutrition due to delayed engagement with the health system and limited autonomy to prioritise their own health.

Exploring Allostatic Load as an Objective Measure of Stress Among U.S. Women With and Without HIV: A Pilot Study.

Stress has been found to be linked to adverse health outcomes. Having an objective measure of stress to complement validated self-reported stress measures is helpful for assessing the impact of interventions aimed at reducing stress and measuring its associations with health outcomes. Allostatic load is an objective measure that summarizes stress's impact on multiple physiological systems.

Prevalence and predictors of intimate partner violence against men in Kisumu slums, Kenya.

Background: Men in sub-Saharan Africa experience intimate partner violence, with few reporting their cases to the legal authorities or coming out for assistance. Consequently, data on the prevalence and drivers of intimate partner violence in different parts of sub-Saharan Africa are inadequate. Therefore, this study was designed to investigate the prevalence and predictors of intimate partner violence against men in Kisumu slums, Kenya.

Effect of a climate-smart intervention on agriculture and nutrition of people with HIV.

Objective: To evaluate impacts of Shamba Maisha , a climate-smart agriculture intervention, on agricultural and nutrition outcomes of people with HIV.

Design: Secondary analysis of a parallel, nonblinded cluster-randomized controlled trial.

Setting: Western Kenya.

Associations Between Internalized HIV Stigma and Cognitive Function Among Older Women With HIV.

Objectives: Internalized HIV stigma refers to the negative beliefs, feelings, and attitudes that people with HIV (PWH) adopt about themselves due to societal HIV stigma. Internalized HIV stigma negatively affects mental health but less is known about this factor on cognitive function in PWH. This study examines associations between internalized HIV stigma and cognition among women aged 50+ with HIV.

Associations of inflammatory markers with post-acute clinical findings among survivors of Ebola virus disease with and without viral RNA shedding in the semen in Liberia: a nested case-control study.

Background: A high proportion of survivors of Ebola virus disease (EVD) have post-acute sequelae of EVD (PASE), but the relationship between inflammation and PASE pathogenesis is poorly understood. This study tests the hypothesis that inflammation is associated with PASE among survivors with and without viral RNA shedding in the semen.

Methods: This was a case-control study nested in a longitudinal cohort that recruited confirmed survivors of EVD and their uninfected contacts from the 2013-16 EVD epidemic in Liberia, starting on June 1, 2015.

Spillover Effects of an Agricultural Livelihood Intervention Among People Living with HIV on Community Empowerment in Kenya.

Food insecurity and HIV are closely intertwined and together have compounded effects on morbidity and mortality. Additionally, food insecurity and HIV have combined effects on weakening communities, including causing decreased economic capacity, decreased ability of families to care for children, and intergenerational transfer of poverty. Livelihood interventions that improve food security are promising approaches for improving the quality of life of people living with HIV, and they may also have profound effects on the strength and stability of communities.

Spatial Variation in the Association between Extreme Heat Events and Warm Season Pediatric Acute Care Utilization: A Small-Area Assessment of Multiple Health Conditions and Environmental Justice Implications in California (2005-2019).

Background: The increasing frequency and severity of extreme heat events due to climate change present unique risks to children and adolescents. There is a lack of evidence regarding how heat's impacts on pediatric patients vary spatially and how structural and sociodemographic factors drive this heterogeneity.

Objectives: We examined the association between extreme heat events and pediatric acute care utilization in California for 19 distinct health conditions.

Association of experienced stigma in healthcare settings with health outcomes among Black women living with HIV: Mediating roles of internalized stigma, anticipated stigma, and trust in HIV care.

Background: Black women living with HIV (WLHIV) often have suboptimal ART adherence due to a multitude of social and structural barriers, including HIV-related stigma. Trust in healthcare providers plays a significant role in adhering to ART and is likely lower among Black WLHIV compared to their White counterparts. This study examined the relationship between experienced stigma in healthcare settings and ART adherence and viral suppression through anticipated stigma in healthcare settings, internalized stigma, and medical mistrust.

Brief Report: Internalized Poverty-Related Stigma and Interpersonal Violence Among Women Living With HIV in the United States.

Background: Interpersonal violence (IPV) affects half of women living with HIV (WLHIV) in the United States and has important consequences for mental health and HIV outcomes. Although different types of stigmas (eg, HIV- or sexual identity-related) are associated with increased risk of IPV, the relationship between poverty-related stigma and IPV is unclear, even though poverty frequently co-occurs with IPV.

Methods: Data from up to 4 annual visits (2016-2020) were collected from 374 WLHIV enrolled in a substudy of the Women's Interagency HIV Study (now known as Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study) at 4 sites across the United States.

Longitudinal associations between intersectional stigmas, antiretroviral therapy adherence, and viral load among women living with HIV using multidimensional latent transition item response analysis.

Background: In the US, Women, especially Black and Latina women living in disadvantaged environments, are disproportionally affected by HIV. Women living with HIV (WLHIV) have higher rates of suboptimal antiretroviral therapy (ART) adherence, and detectable viral load (VL). Experiences of intersectional poverty, HIV, gender, and racial stigmas may increase the rates of detectable VL through suboptimal ART adherence.

Effect of improving food security on parenting practices and caregiver-adolescent relationships: qualitative findings of an income-generating agricultural intervention in rural Kenya.

Background: Despite the recognised links between food insecurity and parenting, few studies have evaluated the perceived impacts of livelihood or food security interventions on parental practices, intra-household functioning, adolescent behaviour and psychosocial outcomes in HIV-affected households in sub-Saharan Africa.

Aims: The study aimed to understand the perceived effects of food security on parenting practices and how this was experienced by both adolescent girls (aged 13-19 years) and their caregivers in rural Kenya.

Method: We conducted semi-structured, individual interviews with 62 caregiver-adolescent dyads who were participants in the adolescent (NCT03741634), a sub-study of adolescent girls and caregivers with a household member participating in the agricultural and finance intervention trial (NCT01548599).

Defining what Matters: Use of Q Methodology to Identify Food Values among People Living with HIV Affected by Food Insecurity.

Objectives/background: To inform the development of a "food is medicine" (FIM) intervention, the present study aimed to describe how people living with HIV (PLWH) prioritize daily food choices in the context of food insecurity.

Methods: Interviews with PLWH experiencing various levels of food insecurity (n=24) were conducted using Q-Methodology. Participants ranked 57 food-choice value statements from "most like me" to "least like me" in a process called forced distribution.

The Impact of Wildfire Smoke on Asthma Control in California: A Microsimulation Approach.

Wildfire smoke exposure leads to poorer health among those with pre-existing conditions such as asthma. Particulate matter in wildfire smoke can worsen asthma control, cause acute exacerbations, and increase health resource utilization (HRU) and costs. Research to date has been retrospective with few opportunities to project changes in underlying asthma control and HRU given exposure to wildfire smoke.

The health benefits of reducing micro-heat islands: A 22-year analysis of the impact of urban temperature reduction on heat-related illnesses in California's major cities.

This study investigates the relationship between temporal changes in temperatures characterizing local urban heat islands (UHIs) and heat-related illnesses (HRIs) in seven major cities of California. UHIs, which are a phenomenon that arises in the presence of impervious surfaces or the lack of green spaces exacerbate the effects of extreme heat events, can be measured longitudinally using satellite products. The two objectives of this study were: (1) to identify temperature trends in local temperatures to characterize UHIs across zip code tabulation areas (ZCTAs) in the seven observed cities over a 22-year period and (2) to use propensity score and inverse probability weighting to achieve exchangeability between different types of ZCTAs and assess the difference in hospital admissions recorded as HRIs attributable to temporal changes in UHIs.

Exploring the role of motherhood in healthcare engagement for women living with HIV in the USA.

Mothers living with HIV are faced with managing their own complex healthcare and wellness needs while caring for their children. Understanding the lived experiences of mothers living with HIV, including grandmothers and mothers with older children - who are less explicitly represented in existing literature, may guide the development of interventions that best support them and their families. This study sought to explore the role of motherhood and related social/structural factors on engagement with HIV care, treatment-seeking behaviour, and overall HIV management among mothers living with HIV in the USA to inform such efforts.

The influence of an agricultural intervention on social capital and water insecurity coping strategies: Qualitative evidence from female smallholder farmers living with HIV in western Kenya.

Background: Greater social capital is associated with positive health outcomes and better HIV management. The ways by which social capital may influence household water insecurity (HHWI), a critical determinant of health among persons living with HIV, remain underexplored. Further, despite the importance of reliable water access and use for health and agricultural productivity, few studies have described the strategies smallholder farmers living with HIV use to manage water insecurity.

A race to net zero-early lessons from healthcare's decarbonization marathon.

Climate change poses a threat to healthcare systems; at the same time, healthcare systems contribute to a worsening climate. Climate-induced disasters are predicted to increase both the demand for healthcare services while also posing a threat to the integrity of healthcare systems' infrastructures and supply chains. Many healthcare organizations have taken initiatives to prepare for such disasters through implementing carbon emission-reduction practices and infrastructure reinforcement, through globally recognized frameworks and strategies known as Scopes 1, 2, and 3, and decarbonization.

Distinct patterns of cigarette smoking intensity and other substance use among women who experience housing instability.

Background: Recent insights into substance use cessation suggest that outcomes short of long-term abstinence are clinically meaningful and may offer more realistic incremental goals, particularly for highly vulnerable individuals. With the goal of informing tobacco treatment programs, we examined distinct patterns of cigarette smoking and their association with the ongoing use of other substances in women who experience housing instability.

Methods: We recruited participants from a longitudinal study of women experiencing housing instability.

An agricultural livelihood intervention is associated with reduced HIV stigma among people with HIV.

Objective: HIV stigma undermines antiretroviral treatment (ART) adherence and viral suppression. Livelihood interventions may target drivers of negative attitudes towards people with HIV (PWH) by improving their health and strengthening their economic contributions. We examined the effects of a multisectoral agricultural livelihood intervention on HIV stigma among PWH in western Kenya.

Food Is Medicine for Human Immunodeficiency Virus: Improved Health and Hospitalizations in the Changing Health Through Food Support (CHEFS-HIV) Pragmatic Randomized Trial.

Background: Policy support for "food is medicine"-medically tailored meals or groceries to improve health-is rapidly growing. No randomized trials have heretofore investigated the benefits of medically tailored food programs for people with human immunodeficiency virus (PWH).

Methods: The CHEFS-HIV pragmatic randomized trial included PWH who were clients of Project Open Hand (POH), a San Francisco-based nonprofit food organization.