For people living with HIV (PLWH), the configuration of social support networks may shape access to support, yet the structural position of support sources remains poorly understood. We conducted a cross-sectional study among 446 PLWH receiving community follow-up in Luzhou, China, from March to May 2023. A two-mode network (participants × 10 support-source categories) was analyzed in UCINET to describe support-source degree and core-periphery structure. Community Health Service Centers, hospitals, and family members occupied core positions. Overall support scores differed by gender (female vs male: t = -2.66, p = .008), age (≥ 50 vs <50 years: t = -6.79, p < .001), and transmission route (heterosexual vs homosexual: t = 6.25, p < .001). Overall, 52.47% of participants were classified as core actors. The proportion was 46.88% in the combined homosexual-transmission and other-routes group and 44.53% among young/middle-aged men. These findings describe how support sources are positioned within the community follow-up setting and may inform efforts to connect PLWH with fewer core-source ties to available services.

Unhealthy alcohol use is prevalent among people living with HIV (PLH) and is associated with worse HIV care outcomes. Non-alcoholic beverages (NABs; beer, wine, or spirits containing 0.0% to 0.5% alcohol by volume) may represent a novel alcohol reduction strategy; however, the prevalence and correlates of NAB use among PLH remain unexamined. This study utilized baseline data from the Florida Cohort Study (N = 589; June 2024-October 2025). Self-report measures assessed past 12-month NAB consumption and likelihood of future NAB use. Multivariable logistic regression models examined sociodemographic and health-related correlates of past-year NAB consumption and future use. Overall, 26.83% of participants consumed NABs in the past 12 months; 18.34% were likely or extremely likely to use NABs in the future. In multivariable analyses, higher odds of past-year NAB consumption were associated with identifying as Non-Hispanic Black (AOR = 3.10, 95% CI: 1.77-5.42 vs. Non-Hispanic White) or Latine (AOR = 2.57, 95% CI: 1.36-4.86 vs. Non-Hispanic White), lesbian, gay, bisexual, or queer (AOR = 1.74, 95% CI: 1.14-2.64 vs. straight/heterosexual), and moderate/high risk of alcohol use disorder (AUD) (AOR = 2.43, 95% CI: 1.39-4.23 vs. no/low risk). Similar patterns were observed for future likelihood to use NABs. Approximately one-quarter of PLH reported past 12-month NAB consumption, although relatively fewer expressed interest in future use. NABs may represent a promising, yet underutilized, alcohol reduction strategy for PLH; however, additional research is needed to understand motivations, contexts of use, and impacts on alcohol-related and HIV outcomes.

Pre-exposure prophylaxis (PrEP) effectively reduces HIV incidence among South African adolescent girls and young women (AGYW), but barriers to access and sustained use remain. We evaluated the effects of a clinic-level stigma and discrimination (S&D) training and the Young Women's Health CoOp (YWHC) intervention on oral PrEP outcomes among AGYW aged 16-24 years (N = 802) in Tshwane (Pretoria), South Africa. Using a modified 2 × 2 factorial cluster-randomized trial, 12 clinics and their catchment areas were assigned to one of four study arms based on receipt of S&D training for clinic staff and delivery of the YWHC intervention to AGYW. Outcomes included PrEP readiness (self-report), uptake (medical records), adherence, and persistence (dried blood spots), measured at baseline and 3-, 6-, and 9-month follow-up. Multilevel modeling showed that PrEP readiness scores were higher at follow-up among AGYW in the control arm than among those in intervention arms (p < 0.05). Differences in PrEP uptake were not statistically significant (p = 0.11), although they were clinically meaningful. AGYW attending clinics that received S&D training were more than twice as likely to initiate oral PrEP as participants in the control arm. AGYW who received the YWHC intervention were more likely to adhere to oral PrEP than those in the control arm (p ≤ 0.05). Participants in all intervention arms were also more likely to persist with PrEP use over time than controls (p < 0.05). These findings suggest that clinic- and individual-level interventions can optimize PrEP initiation, adherence, and persistence among AGYW.

HIV treatment attitudes and HIV PrEP are associated with sexual behavior that elevates the risk for bacterial STIs (B-STIs) among gay, bisexual and other men who have sex with men (GBM). Using a longitudinal multi-site study (Engage Cohort Study, 2017-2024), we modelled direct and indirect within- and between-person effects of HIV treatment attitudes and PrEP use on condomless anal sex (CAS) and incident B-STIs among 1863 HIV-negative GBM. We modelled up to four years of follow-up visits using multi-level mediation analysis, with CAS as a mediating variable between HIV treatment attitudes and PrEP use on incident B-STIs. We found direct within-person effects of HIV treatment attitudes and PrEP use on incident B-STIs, such that participants were more likely to report incident B-STIs at time points if they reported using PrEP and being more optimistic about HIV treatments; there were no indirect within-person effects through CAS. In contrast, we found both direct and indirect between-person effects. Specifically, participants who reported more PrEP use or who were more optimistic about HIV treatments over the course of the study were more likely to report incident B-STIs. Further, these effects were partially mediated by CAS. Given that we found within-person PrEP use is associated with increased CAS and STIs, and the general increase in adoption of PrEP over time, there is a need to expand biomedical intervention programs for B-STIs prophylaxis by integrating them with social and informational interventions about B-STIs risks, especially for GBM who use HIV PrEP.

Late HIV diagnosis remains prevalent in gay, bisexual, and other men who have sex with men (GBMSM) in Amsterdam and is associated with ongoing transmission. Drawing on proven but underused intervention development approaches, we co-created an innovative communication campaign with GBMSM and HIV prevention experts to promote HIV-testing amongst never or not recently tested GBMSM. The campaign addressed behavioral determinants of HIV testing through tailored messaging for key subgroups. A post-test-only pilot evaluation (N = 86) showed significantly higher HIV testing intention among GBMSM exposed to the campaign. Findings support further evaluation of the intervention and exploration of its broader implementation.

The HIV diagnosis rate in New York State declined substantially from 2013 to 2023, but the rate of decline varied across race/ethnicity groups, exacerbating disparity. For example, in 2013, the HIV diagnosis rate was 7.1 times higher among non-Hispanic Black individuals than among non-Hispanic White individuals. In 2023, it was 7.9 times higher. Racial/ethnic disparity was even more evident among females, especially non-Hispanic Black females, whose HIV diagnosis rate was 14.6 times higher than non-Hispanic White females in 2023. We compared the racial/ethnic composition of the NYS population overall with that of persons newly diagnosed with HIV in NYS and calculated HIV diagnosis rates for all race/ethnicity groups from 2013 to 2023. We calculated the percent change over time and compared the diagnosis rate for each group with that of non-Hispanic White individuals. We further examined racial/ethnic disparity stratified by sex at birth, gender, and transmission risk group.

Hospitalization remains a significant concern among people living with HIV (PLWH), particularly when admissions are recurrent. While prior research has identified psychiatric comorbidities and HIV disease severity as predictors of initial hospitalization, less is known about the factors that drive repeated hospitalizations in the modern treatment era. This study examined psychiatric, demographic, and HIV-related predictors of first and subsequent hospitalizations using longitudinal data from 9,793 PLWH with follow-up care in the Bronx, New York, between 2016 and 2023. Two primary outcomes (i.e., time to non-psychiatric hospitalization and time to HIV-related hospitalization) were modeled independently using Prentice, Williams, and Peterson gap-time models. Recent mental health visits and diagnoses, substance use-related diagnoses, lower CD4 T-cell count, and detectable viral load were each associated with increased risk of first and subsequent hospitalization. Prior mental health care engagement was associated with reduced risk of non-psychiatric hospitalization. Demographic disparities were also observed: women, older people, and patients with Medicaid had higher risk for hospitalization, while those with commercial insurance had lower risk. These findings extend previous research on first-time hospitalization in this population by explicitly distinguishing predictors of first versus subsequent hospitalizations, and underscore the need for integrated psychiatric care, sustained viral suppression, and tailored outpatient support to reduce avoidable hospitalizations.

Crowdsourcing is a participatory problem-solving approach that engages a large and diverse group of individuals to generate ideas or solutions. In HIV prevention, it provides a structured mechanism for involving youth in shaping intervention strategies. The Innovative Tools to Expand Youth-Friendly HIV Self-Testing and Long-Acting Injectable PrEP Uptake in Ghana (Y-FIT GH) National Open Call applied this method to generate youth-driven ideas to promote HIV self-testing (HIVST) and long-acting injectable PrEP (LAI-PrEP) in Ghana. This study describes youth responses to the open call and identifies strategies they proposed to strengthen HIV prevention among their peers. Ghanaian youth aged 15-24 years were invited to submit creative entries illustrating how HIVST and PrEP could be promoted and accessed by young people. Submissions were received through online platforms and community-based channels between May and August 2025. Following independent review, 103 eligible entries from 12 regions were qualitatively analyzed using an inductive multimodal approach. Written narratives (32%), posters (19%), and audiovisual pieces (18%) were the most common. Six interconnected thematic domains were identified: (1) HIVST and PrEP as pathways to autonomy, safety, and self-respect; (2) creative, peer-led, and culturally resonant communication; (3) multilevel, hybrid delivery models prioritizing accessibility, familiarity, and privacy; (4) stigma shaping youth engagement; (5) gaps in navigation, support, and trust in existing services; and (6) AI and AI-enabled chatbots as emerging channels for confidential information and peer support. The contest effectively engaged Ghanaian youth and generated actionable, contextually grounded strategies to enhance HIVST and PrEP uptake.

South African women are disproportionately affected by HIV, with increased incidence during pregnancy and postpartum. While oral TDF/FTC pre-exposure prophylaxis (PrEP) is safe, effective, and recommended for pregnant and postpartum women, adherence to a daily pill is challenging, particularly during the postpartum period. Longer-acting injectable (LAI) PrEP products may be more desirable for postpartum women however, limited data on factors influencing uptake are available to inform roll-out of LAI products among postpartum women. Using the Consolidated Framework for Implementation Research (CFIR), we explored LAI PrEP implementation determinants among postpartum women in South Africa. From March-April 2023, 4 focus group discussions (FGDs) were conducted among postpartum women in KwaZulu-Natal. A directed content analysis method was performed. Among 23 women, median age was 27 (range 19-36) years. Two (9%) reported a pregnancy partner living with HIV, 7 (30%) had ever used PrEP, and 21 (91%) had ever breastfed. Factors that may influence LAI PrEP implementation are organized by three CFIR domains. Individuals expressed interest in and potential willingness to use LAI PrEP, but limited knowledge. At the implementation process domain, participants perceived LAI-PrEP users to have high HIV risk perception, and were themselves worried about side-effects, access, and fear of partner conflict. They also identified implementation opportunities including peer PrEP mentors, mobile clinics, and community clinic integration. At the outer setting, cultural beliefs/practices during postpartum were important determinants. Our findings indicate interest and willingness to consider LAI PrEP among postpartum women and highlight implementation opportunities to reduce HIV acquisition and perinatal transmission.

People living with HIV (PLWH) experience disproportionately high rates of depression and anxiety. Human-animal interactions (HAI), particularly through pet ownership, may provide emotional support and companionship; however, the human-animal bond can be threatened by structural and socioeconomic factors that impede one's ability to meet pets' needs. The current study examined how comfort from pets and unmet pet caregiving needs were associated with depression and anxiety symptoms among pet-owning PLWH. Data were derived from the Florida Cohort (2021-2023), a survey study of PLWH in Florida. Participants included 210 pet-owning PLWH who completed the optional pet ownership module. Depression and anxiety were measured using the PHQ-8 and GAD-7; comfort from pets was assessed using the Comfort from Companion Animals Scale; unmet caregiving needs captured difficulty affording boarding, pet food/medication/supplies, and veterinary care. Linear regression models adjusted for sociodemographic covariates and perceived social support. Participants reported high levels of comfort from pets; however, comfort was not significantly associated with depression or anxiety symptoms, even after adjustment. Unmet pet caregiving needs showed a more consistent pattern: difficulty affording veterinary care was the most robust predictor, remaining significantly associated with both depression (B = 2.04, p < 0.01) and anxiety (B = 2.49, p < 0.001) after adjusting for covariates. Difficulty affording boarding and difficulty affording pet food/medications/supplies were associated with higher depression and anxiety symptoms in unadjusted models but did not remain significant after covariate adjustment. Findings highlight the dual role of pets in the lives of PLWH; while pets may provide emotional comfort, unmet pet caregiving needs-particularly around veterinary care-are associated with poorer mental health independent of broader social support and sociodemographic factors. Addressing pet caregiving needs may represent an important opportunity to reduce psychological strain and support emotional wellness among pet-owning PLWH, with implications for HIV care, social services, and future research.

Measuring alcohol and other drug (AOD) use remains challenging in HIV care in low- and middle-income countries, where self-report and point-of-care (POC) urine biomarkers capture different time windows. Among 2,059 people with HIV aged 40 years or older across eight IeDEA clinics (2020 to 2022), we examined what self-reported AOD use (AUDIT, ASSIST) and POC urine tests (uEtG for alcohol; 5-panel drug screen) each capture. Self-report identified more use than urine testing (unhealthy alcohol 19.7% versus uEtG-positive 12.2%), consistent with its longer recall window. Higher self-reported alcohol intensity was associated with uEtG positivity in a graded pattern, more strongly among women. Urine-positive but self-report-negative results, more common among men, suggested under-reporting. Self-report and biomarkers answer different measurement questions: self-report for longer-term burden and screening, biomarkers for recent use and corroboration. Combining both, including longer-window biomarkers, can strengthen AOD measurement among older PWH in LMICs.

Intravaginal rings (IVRs) can be efficacious, user-controlled devices to prevent pregnancy and HIV. Understanding potential user preferences for device characteristics can promote device uptake and use by informing design optimization. We elicited sensory perceptions from a convenience sample of women aged 18-45 years from a large statewide health system to iteratively inform design of a novel 3D-printed multipurpose (contraception and HIV prevention) technology IVRs. We assessed reactions to varying IVR designs and colors in nine virtual focus groups. We modified designs and assessed perceptions of visual AND tactile aspects of modified IVR designs in 25 individual in-person interviews. Overall, women perceived texture, hue, size, comfort, and hygiene as important. Smoother surface topography was preferred for perceived ease of insertion and ability to "see what was on it" for cleanliness. Lighter hues were seen as "calming". IVR size and pliability related most to perceived comfort, a priority for participants.

Hazardous alcohol consumption (HAC) among people living with HIV (PLHIV) has been associated with poor antiretroviral therapy (ART) adherence and unsuppressed HIV viral load (VL). We examined potential correlates of alcohol use and HAC among PLHIV aged ≥ 18 years using nationally representative data from the Tanzania HIV Impact Survey 2022-2023, a cross-sectional population-based household survey. Consenting individuals were tested for HIV and HIV-positive specimens were tested for HIV VL. HAC was determined using the World Health Organization "Alcohol Use Disorders Identification Test-Concise." Correlates of alcohol use and HAC were determined using binary logistic regression and sampling weights. Jackknife variance estimation was used to generate 95% confidence intervals (95% CI) and p values. Of 1793 individuals with positive HIV test results, 686 (34.5%) reported any alcohol consumption in the past year, and 364 (17.8%) reported HAC. Higher odds of HAC were observed among PLHIV aged 35-44 years (aOR = 2.35; 95% CI, 1.12-4.93; p = 0.026), 45-54 years (aOR = 2.66; 95% CI, 1.23-5.74; p = 0.015), and 55-64 years (aOR = 2.92; 95% CI, 1.31-6.55; p = 0.011) compared to those aged ≤ 24 years (7.5%). Also, among PLHIV with one sexual partner (18.3%, aOR = 1.85; 95% CI, 1.29-2.65; p = 0.002) and multiple partners (27.7%, aOR = 3.27; 95% CI, 1.84-5.81; p < 0.001) compared to those with no partner in the past 12 months (11.0%). No significant associations were found between alcohol use or HAC and reported ART missed days or VL suppression. In Tanzania, although nearly one-fifth of PLHIV reported HAC, it was not associated with HIV treatment outcomes.

In the United States, Black gay, bisexual, and other men who have sex with men (BGBM) continue to face disproportionate burdens of HIV. Contributing factors include unprotected sex with multiple partners, limited awareness of HIV prevention, stigma, racism, and structural barriers to healthcare access. Biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) have demonstrated effectiveness in reducing HIV transmission. However, social perceptions, stigma, and anticipated discrimination continue to influence uptake and adherence. This scoping review examined literature published between 2017 and 2024 to identify how social networks and social media shape prevention behaviors among BGBM. Guided by Social Network Theory (SNT), the review synthesized findings from 21 studies across four contexts: House Ballroom communities, social media, faith-based settings, and dating apps. Results highlight the role of culturally tailored and community-based interventions, including those delivered in religious settings, in supporting prevention uptake, while digital platforms demonstrated strong potential for outreach, testing, and linkage to care. These findings underscore the need for interventions that integrate biomedical prevention tools with culturally responsive approaches to reduce disparities and improve HIV prevention outcomes for BGBM. Findings provide suggestions for future HIV interventions for BGBM.

Pure and total movement dispersion are measures of the spread of physical activity (PA) across the day, without (pure) and with (total) intensity. Men with HIV (MWH) tend to have lower PA, more sedentary behavior, and poorer sleep quality and quality of life than men without HIV (MWOH). This study explores the relationship of pure and total movement dispersion with sleep quality, total sleep time, and quality-of-life (QoL) among MWH and MWOH. This study was a secondary analysis from the MACS/WIHS Combined Cohort Study (MWCCS). Participants wore an ActiGraph and an Actiwatch accelerometer on their wrist for 7 days to measure PA and sleep and completed the Pittsburgh Sleep Quality Index and the Medical Outcomes Study Short Form. Spearman's Rank Correlation and multivariable linear regressions were used to analyze relationships among variables. 594 participants were included (Mage = 58.1, 55% MWH, 62% White). MWH demonstrated higher pure (Z = - 3.893, p < 0.001) and total movement dispersion (Z = - 3.826, p < 0.001) than MWOH. MWH reported worse sleep quality (t = - 3.030, p=.003) and general QoL (t = 2.942, p = 0.003), yet better health compared to last year (t = - 2.557, p = 0.011) than MWOH. Pure movement dispersion was significantly associated with less total sleep time (B = - 1.227, p < 0.001), and total movement dispersion was significantly associated with a higher global general health (B = 7.498, p = 0.044). Movement across the day, with and without regard to intensity, warrants exploration on whether the way an individual achieves PA is dispersed matters more than the accumulated minutes.