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Using a tool integrated into the electronic health record, we determined prevalence of 10 social needs among 377 people with HIV (PWH) and 27,833 patients without HIV receiving care in the Montefiore Health System. PWH (median age 53) were 55% women, 41% Black, 44% Hispanic. 33% of PWH reported at least one social need vs. 18% among patients without HIV, with healthcare transportation and housing needs significantly higher among PWH in adjusted analyses. PWH reporting transportation needs were 27% less likely to be virologically suppressed ( 200 copies/mL, adjusted prevalence ratio 0.73, 95% CI 0.55-0.96) compared with PWH without transportation needs.Por medio del uso de encuestas integradas en el registro electrónico de salud, determinamos la prevalencia de 10 necesidades sociales entre 377 personas con VIH (PCV) y 27 833 pacientes sin VIH que reciben atención en el Montefiore Health System. PCV (edad mediana de 53 años) fueron 55% mujeres, 41% negras, 44% hispanas. 33% de PCV reportó al menos una necesidad social vs. 18% de los pacientes sin VIH, siendo las necesidades de transporte a cuidados de salud y de vivienda significativamente mayores en PCV en análisis multivariable ajustado. PCV con necesidades de transportación fueron 27% menos probables de tener supresión viral ( 200 copias/ml, razón de prevalencias ajustada 0.73, IC 95% 0.55–0.96) comparada con PCV sin necesidades de transportación.

Vaginal rings for pre-exposure prophylaxis are a female-initiated HIV prevention method that does not require daily or coitally-dependent dosing. As part of a randomized placebo-controlled trial of a tenofovir disoproxil fumarate intravaginal ring, we assessed product acceptability through in-depth interviews with 18 women during and after 14 days of continuous use. Women reported that the ring was comfortable with few side effects, regardless of experimental arm. However, interest in future use by this cohort was modest for several reasons including: low self-perceived HIV risk; concern that use implied promiscuity; potential for interference with relationship formation and trust; concern for interference with menstruation and cleanliness; and worries about partners' acceptability and sexual pleasure. Potential issues were raised with duration of use prior to ring exchange. Future studies should continue to identify and address individual and relationship factors that influence acceptability, early in the product development process.

Research indicates that people use condoms less often with a regular sexual partner than with a casual partner because they believe condoms are not needed. This article reports qualitative findings from four group meetings and 11 in-depth interviews in which sexually experienced inner-city adolescents aged 14-17 talked about their sexual relationships. Three types of relationships were described: messing, for sex only; boy-girlfriend, a more intense relationship, and "hubby-wifey," which mimics marriage. The four types of relationships differ along four analytic dimensions, which give them meaning: future commitment; public vs. secret; expectation of monogamy; and degree of affection and love. Decisions about condom use are influenced by these dimensions which may be underestimated in theoretical models that focus on individuals, not couples.

Factors associated with psychological distress were examined in 220 low-income, mostly minority mothers with late-stage HIV/AIDS. Mothers lived with at least one HIV-negative child of age 2-12 years and participated in a study of the effectiveness of a custody planning intervention provided by The Family Center. The mothers exhibited extraordinarily high levels of psychological disturbance on the Psychiatric Symptom Index (PSI). Multiple regression showed that higher PSI Total scores were significantly related to the mother's reports of having non-HIV-related medical conditions, spending time in bed in the past 2 weeks, having more activity restrictions, and having a lot of difficulty caring for her child due to ill health. Higher scores also were associated with lower education, experiencing more negative life events, and greater receipt and lower adequacy of social support. Thus, higher distress was associated with inability to perform usual activities and mobilization of support. However, other HIV-related health factors, traditional background characteristics, and psychosocial measures (e.g., HIV stigma, parenting stress, family environment) failed to indicate who was most vulnerable. Researchers need to identify the mechanisms of risk and develop appropriate mental health interventions.