Latent class and time-to-event analyses of social determinants of health and COVID-19 vaccine uptake among Black women living with HIV.

Existing inequities are exacerbated during the COVID-19 pandemic. Similar to HIV, COVID-19 disproportionately affects Black and other communities of color. Among Black women living with HIV (BWLWH) this study examined the relationship between community level and individual level social determinants of health and time to COVID-19 vaccine uptake.

Treatment Goals of Sexual Minority Men in LGBTQ-Affirmative CBT.

Sexual minority men seek out mental health treatment at approximately twice the rate of the general population, with minority stress being the most likely explanation for this population's heightened mental and behavioral health concerns and associated treatment seeking. However, little research identifies sexual minority men's mental health treatment goals, thereby potentially hindering tailored treatment development and clinicians' preparation. The present study qualitatively identifies treatment goals among 94 ethnically diverse, majority cisgender sexual minority men who participated in a trial of LGBTQ-affirmative CBT.

Brief Post-Surgical Stress Management Intervention Effects on Positive Psychological Well-Being and Self-Efficacy in Women Being Treated With Adjuvant Endocrine Therapy for Hormone-Receptor Positive Breast Cancer.

Background: Women prescribed adjuvant endocrine therapy (AET) for nonmetastatic breast cancer may experience a decline in positive psychological well-being (PPWB) and self-efficacy. Brief cognitive behavioral therapy (CBT) and relaxation training (RT) interventions have shown short-term efficacy in reducing distress, but their impact on PPWB and self-efficacy over longer periods among women prescribed AET is unknown.

Aims: We aimed to investigate longitudinal effects of CBT and RT on PPWB and self-efficacy among women prescribed AET.

Multiple marginalized identities and internalized HIV stigma among people living with HIV in South Florida: An intersectional approach.

Internalized HIV stigma is associated with several adverse mental and physical health outcomes among people living with HIV (PLWH). PLWH and other marginalized identities may experience worse internalized HIV stigma due to minority stress and structural oppression. This study conceptualized intersectionality via a multiplicative approach and examined the associations between intersectional marginalized-group identities and internalized HIV stigma among a sample of PLWH in South Florida (N = 1343) using hierarchical linear regression models.

Integrated PTSD and Adherence Treatment for People with HIV: Main Findings of a Feasibility Pilot for Cognitive Processing Therapy-Lifesteps (CPT-L).

Background: Despite high PTSD prevalence and related detrimental health outcomes for persons with HIV (PWH) there are no established integrated interventions addressing co-occurring HIV and PTSD. Negative reinforcement conceptual models posit that avoidant behavior (a hallmark symptom of PTSD) demonstrated by PWH with co-occurring PTSD can contribute to poor antiretroviral therapy (ART) adherence. However, research evaluating the impact of evidence-based treatment for PTSD among HIV positive populations on HIV outcomes is scarce.

The Longitudinal Impact of Psychosocial Syndemic Variables on Adherence to Antiretroviral Therapy Among People With HIV in Brazil, Thailand, and Zambia: An Analysis by HIV Transmission Groups in HPTN 063.

In the field of HIV prevention and care, most studies of HIV syndemic problems are cross-sectional, few differentiate by HIV transmission groups, and few focus on people living with HIV (PWH). We analyzed one-year longitudinal data of 692 sexually active PWH (heterosexual men [HM], heterosexual women [HW], and men who have sex with men [MSM]) in care from Brazil, Thailand, and Zambia. Syndemic scores (0-3+) included stimulant use, polydrug use, depression, alcohol use, and fear of discrimination.

Non-Pharmacological Interventions Addressing Chronic Pain in People Living with HIV.

Purpose Of Review: Chronic pain affects 25-85% of people living with HIV (PLWH), negatively impacting health behaviors and HIV health outcomes. While opioids are frequently prescribed for pain, there are concerns about side effects and addiction potential, and the current consensus guideline advises against their use as a first-line pain management for this population. Therefore, there is an increasing need for non-pharmacological alternatives and adjunctive interventions.

Positive STEPS: Enhancing Medication Adherence and Achieving Viral Load Suppression in Youth Living With HIV in the United States-Results From an Efficacious Stepped Care, Randomized Controlled Trial.

Background: In the United States and worldwide, there is a significant number of young people acquiring and living with HIV. Antiretroviral therapy (ART) has led to significant reductions in HIV-related illnesses and deaths, allowing young people living with HIV to manage their condition as a chronic disease. Ensuring high levels of ART adherence is vital for treatment success.

Assessment, Decision, Adaptation, Production, Topical Experts-Integration, Training, and Testing (ADAPT-ITT) Framework to Tailor Evidence-Based Posttraumatic Stress Disorder Treatment for People With HIV to Enhance Engagement and Adherence: Qualitative Results from a Feasibility Randomized Controlled Trial.

Background: Individuals with co-occurring posttraumatic stress disorder (PTSD) and HIV are at high-risk for negative HIV-related outcomes, including low adherence to antiretroviral therapy, faster disease progression, more hospitalizations, and almost twice the rate of death. Despite high rates of PTSD in persons with HIV (PWH) and poor HIV-related health outcomes associated with PTSD, an effective evidence-based treatment for PTSD symptoms in PWH does not exist.

Objective: This study aimed to describe the adaptation and theater testing of an evidence-based intervention designed for people with co-occurring PTSD and HIV.

A Transdiagnostic Treatment to Improve Biomedical and Syndemic Outcomes in People Living With HIV.

People living with HIV (PLWH) experience a range of co-occurring psychosocial stressors, mental health symptoms, and structural barriers (e.g., "syndemics") that can impair their ability to adhere to medical recommendations for treatment.

Increases in employment over six months following Khanya: A secondary analysis of a pilot randomized controlled trial of a peer-delivered behavioral intervention for substance use and HIV medication adherence in Cape Town, South Africa.

Introduction: Evidence suggests that brief, skills-based behavioral interventions are effective at improving clinical outcomes related to substance use and HIV, but little data exists on whether such interventions can incidentally improve employment. We examined preliminary changes in employment over six months following Khanya, a brief peer-delivered behavioral intervention to reduce substance use and improve antiretroviral therapy (ART) adherence compared to enhanced treatment as usual (ETAU).

Methods: Adults living with HIV (N = 61) with at least moderate substance use and ART non-adherence were recruited from a primary care clinic in Khayelitsha, South Africa, a community with high rates of unemployment.

Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials.

Background: LGBTQ-affirmative cognitive-behavioral therapy (CBT) is an evidence-based treatment for reducing transdiagnostic mental and behavioral health concerns among LGBTQ individuals. Preserving the effects of this intervention as it is translated into practice can maximize public health benefits. This study systematically identifies and evaluates implementation strategies for LGBTQ-affirmative CBT.

Severity and Number of Substances Used are Independently Associated with Antiretroviral Therapy Adherence Over Time among People with HIV in the Current Treatment Era.

Substance use is associated with decreased antiretroviral therapy (ART) adherence among people with HIV (PWH). Adherence plays a significant role in mediating the negative effects of substance use on HIV suppression and is a principal modifiable patient-level factor in improving HIV suppression and reducing ART drug resistance. Understanding substance use and ART adherence, particularly with rapidly changing substance use epidemiology and ART regimens, is vital to improving HIV care.

Exploring Latino cultural factors from the perspective of sexual minority men in the USA.

Existing research on Latino cultural factors mainly focuses on gender and nationality, often overlooking sexual orientation and giving limited attention to the experiences of Latino sexual minority men in the United States of America (USA). This study addressed this gap by exploring how sexual minority men identify, describe and experience Latino cultural factors. Between April and December 2019, semi-structured interviews were conducted with 28 men (ages 18-40, 43% non-US-born) in the greater Miami, Florida area to explore their engagement in HIV prevention and behavioural health services.

A systematic comparison of additive and interaction approaches to modeling the effects of syndemic problems on HIV outcomes in South Africa.

Much of the research on the effects of syndemics on HIV outcomes has utilized an additive approach. However, interaction effects may better account for syndemic synergy than an additive approach, but it remains difficult to specify interaction effects without empirical guidance. We sought to systematically compare additive and interaction effects approaches to modeling the effects of syndemic problems on antiretroviral therapy (ART) using empirically specified interaction terms.

Sleep actigraphy results and HIV health outcomes in an urban HIV clinic sample.

Sleep disorders are prevalent and interfering conditions that affect people living with HIV (PLWH) at higher rates than the general population. Lower quality sleep has been associated with poorer health-related quality of life and immune function in PWH, though sleep is typically assessed subjectively. The current study aimed to examine the association between objective sleep/wake patterns measured via actigraphy with HIV outcomes.

A Pilot Randomized Control Trial of the Striving Towards EmPowerment and Medication Adherence (STEP-AD) Intervention for Black Women Living with HIV.

Black women living with HIV (BWLWH) face adversities associated with lower HIV medication adherence, viral non-suppression, and mental health symptoms (e.g., post-traumatic stress disorder) such as trauma/violence, racism, HIV-related discrimination/stigma, and gender-related stressors.

HPTN 083-02: factors influencing adherence to injectable PrEP and retention in an injectable PrEP study.

Introduction: HPTN 083 demonstrated the superiority of long-acting cabotegravir (CAB-LA) versus daily oral emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) as pre-exposure prophylaxis (PrEP) among cisgender men and transgender women who have sex with men (MSM/TGW). HPTN 083 provided the first opportunity to understand experiences with injectable PrEP in a clinical trial.

Methods: Participants from two US sites (Chicago, IL and Atlanta, GA) and one international site (Rio de Janeiro, Brazil) were purposively sampled for individual qualitative interviews (N = 40), between November 2019 and March 2020, to explore trial experiences, barriers to adherence and other factors that may have impacted study implementation or outcomes.

The impact of syndemic burden, age, and sexual minority status on internalized HIV stigma among people living with HIV in South Florida.

Internalized HIV stigma has been associated with several poor mental and physical health outcomes among people living with HIV (PLWH); yet, little research has explored how internalized HIV stigma may be affected by syndemic burden. This study sought to examine the relationship between syndemic conditions and HIV stigma over and above the potential effects of two social determinants of health, age and sexual minority status, using a linear regression approach ( = 1343). Syndemic burden was significantly positively associated with internalized HIV stigma above and beyond the effects of age and sexual minority status ( = 0.

The salience of structural barriers and behavioral health problems to ART adherence in people receiving HIV primary care in South Africa.

Multilevel factors (individual and structural) influence adherence to antiretroviral therapy, particularly in high HIV prevalence areas such as South Africa. The present study examined the relative importance of structural barriers to HIV care and behavioral health factors, depression and alcohol use, in Khayelitsha, Cape Town, South Africa. People receiving HIV care in six primary care clinics in Khayelitsha (N = 194) completed the Center for Epidemiologic Studies Depression Scale, the Alcohol Use Disorders Identification Test, the Structural Barriers to Medication Taking questionnaire, and a qualitative rating of past-two-week adherence.

Identification of patient subgroups who benefit from a behavioral intervention to improve adjuvant endocrine therapy adherence: a randomized-controlled trial.

Purpose: Adjuvant endocrine therapy (AET) reduces breast cancer morbidity and mortality; however, adherence is suboptimal. Interventions exist, yet few have improved adherence. Patient characteristics may alter uptake of an intervention to boost adherence.

If we build it, will they come? A scoping review of objective engagement metrics in asynchronous psychosocial telehealth interventions for breast cancer survivors.

Burgeoning technologies and the COVID-19 pandemic resulted in a boom of telehealth for immunocompromised patients, such as those with cancer. Telehealth modalities overcome barriers and promote accessibility to care. Currently, efficacious psychosocial interventions exist to address negative aftereffects of a cancer diagnosis and treatment.