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Audience: This is an in-person escape room and procedure simulation activity based on complications of human immunodeficiency virus (HIV) in India, which was created by using local HIV management guidelines. Emergency Medicine (EM) trainees of all post-graduate levels are the target audience. This may also be used by trainees in other specialties, such as infectious disease or internal medicine, who require an understanding of HIV and its complications. This escape room can be completed in teams of varying sizes and is designed to be adaptable to local resource availability. Background: Patients with HIV present to the Emergency Department (ED) for a variety of reasons such as initial viral syndrome, medication side effects, and opportunistic infections. While the widespread use of antiretroviral therapy (ART) has significantly increased the life expectancy of patients living with HIV and decreased the incidence of classical opportunistic infections, EM providers should still be vigilant and competent in diagnosing and managing these pathologies. This is particularly critical in India, where the prevalence of HIV was most recently estimated at 0.22% (2.2 million people older than 15 years) in 2020.1 This patient population, primarily infected through unprotected heterosexual contact, is at high risk for interruptions in ART and development of opportunistic infections for a variety of reasons including migration for work, low social status of women, and significant social stigma against HIV.2 Simulation is an educational opportunity to review these high-acuity low-occurrence presentations to prepare EM trainees for independent practice. Educational Objectives: By the end of the escape room, learners should be able to: 1) describe the mechanism of action of antiretroviral therapies available in India, 2) prescribe initial antiretroviral therapy to a patient presenting to the emergency department with a new diagnosis of HIV, 3) develop a differential diagnosis for a patient with HIV presenting to the ED with chest pain, 4) identify common dermatologic manifestations of opportunistic infections in patients with HIV, 5) identify computerized tomography scan and lumbar puncture features for central nervous system infections seen in patients with Acquired Immunodeficiency Syndrome (AIDS), 6) identify red flag features and appropriate workup for a patient with HIV presenting with a headache to the ED, 7) interpret images obtained during a Rapid Ultrasound for Shock and Hemorrhage (RUSH) exam, 8) identify cardiac tamponade and perform a pericardiocentesis, and 9) communicate and collaborate as a team to manage a complex, unstable patient with HIV in the ED. Educational Methods: We sought to create and implement an educational tool that could meet the complex education needs of EM trainees while being low cost, easily adapted to local resources, and engaging for trainees. Hospitals participating in the Masters in Emergency Medicine (MEM) program, a global partnership between the Ronald Reagan Institute for Emergency Medicine at the George Washington University and 18 hospitals in India, have resource variability for traditional simulation. The escape room created combines simulation, content review specific to the contextual practice of EM in India focused on HIV and its complications, and critical procedure teaching on pericardiocentesis. This innovation framework is based on Kolb's experiential learning cycle and incorporates the gamification principles of a sense of autonomy, perception of competitiveness, and learner-relatedness.3-4 Escape rooms have been shown to engage learners, and low-fidelity procedure models could further maximize the experience for learners in resource variable settings.5 A pericardiocentesis model was adapted from Lord et al.'s low-fidelity model, ensuring it could be assembled with materials readily available in-country.6 Research Methods: We adapted the escape room format to combine simulation, content review, and procedural training in a cost-effective, contextually relevant, and scalable way. The escape room was trialed using a case of chest pain and altered mental status caused by a pericardial effusion due to tuberculosis in a patient with HIV. Local practice patterns and guidelines were used to develop puzzles and clinical clues. A pericardiocentesis model was constructed using materials readily available in India. Pre- and post-surveys were developed to assess baseline trainee experience with escape rooms, self-reported knowledge of the differential diagnosis and management for altered mental status, and ways to incorporate escape room content into daily practice. Results: A total of 47 trainees participated; 41 of 47 participants completed both pre- and post-surveys (87% response rate). Participants represented all program trainee levels: 49% (n = 20) PGY-1, 27% (n = 11) PGY-2, and 24% (n = 10) PGY-3. Based on a score greater than seven on a 1-10 Likert scale, the escape room was rated as "highly effective" by 93.5% of respondents in reviewing medical knowledge. The trainees were allotted 60 minutes to escape the room; the median time for escape room completion was 57 minutes. The escape room and pericardiocentesis model cost under $100 USD, were repeated up to six times in one day, and could be recycled for future use. Discussion: Utilizing simulation in the escape room format that can be adaptable to variable resource settings is a valuable educational tool. The integrated escape room and procedure training proved to be an effective educational tool that was scalable and maintained efficacy across variable hospital resource levels. The next step includes adapting this format for other disease pathologies. This is a useful way to meet the education needs of MEM program trainees, regardless of hospital resource availability, that could be replicable in other EM training programs. [ABSTRACT FROM AUTHOR]

Adolescents with disabilities deserve the best health care without discrimination. They can access gender-sensitive health care and rehabilitation. Health services include promotive, preventive, curative, and rehabilitative care. HIV and AIDS prevention in disabled people must start as soon as possible. Those with speech disabilities are encouraged to reach their full independence potential in case of an incident. This study tested an HIV/AIDS education model for speech-impaired people. At Indonesia's School of Disability, a non-randomized control group pre- and post-test design was used. In the study, 60 speech-impaired students were divided into 30 intervention and 30 control groups. Analyses used T-tests. Speech-disabled people's knowledge and attitudes improved with the virtual HIV/AIDS education model (P=0.007). Therefore, the HIV/AIDS education model should be implemented using virtual platforms to improve knowledge and attitudes, especially among speech-disabled teens. Virtual reproductive health education for children with speech disabilities improves knowledge and attitudes more than traditional methods, especially among visually impaired children. [ABSTRACT FROM AUTHOR]

The 21st century presents significant global health challenges that necessitate an integrated health workforce capable of delivering person-centered and integrated healthcare services. Interprofessional collaboration (IPC) plays a vital role in achieving integration and training an IPC-capable workforce in sub-Saharan Africa (SSA) has become imperative. This study aims to assess changes in IPC confidence among learners participating in a team-based, case-based HIV training programme across diverse settings in SSA. Additionally, it sought to examine the impact of different course formats (in-person, synchronous virtual, or blended learning) on IPC confidence. Data from 20 institutions across 18 SSA countries were collected between May 1 and December 31, 2021. Logistic regression analysis was conducted to estimate associations between variables of interest and the increases in IPC confidence. The analysis included 3,842 learners; nurses comprised 37.9% (n = 1,172) and physicians 26.7% (n = 825). The majority of learners (67.2%, n = 2,072) were pre-service learners, while 13.0% (n = 401) had graduated within the past year. Factors significantly associated with increased IPC confidence included female gender, physician cadre, completion of graduate training over 12 months ago, and participation in virtual or in-person synchronous workshops (p <.05). The insights from this analysis can inform future curriculum development to strengthen interprofessional healthcare delivery across SSA. [ABSTRACT FROM AUTHOR]

People with disabilities (PWD) are thought to be low risk for HIV because of social norms regarding disability and sex. However, qualitative studies indicate they are at risk and are not being reached by HIV programs. The Demographic and Health Survey (DHS) conducted in Haiti in 2016 included HIV biomarker data and disability status. Crude and adjusted odds ratios were calculated using a disability severity indicator as the independent variable and HIV infection as the dependent variable. Covariates were selected based on theory and previous studies. Individuals reporting milder disabilities had a higher odds of HIV infection in the crude model (OR:1.65; CI: 1.16-2.34) and those adjusted for demographics (OR:1.73; CI:1.19-2.51) and sexual activity (OR:1.60; CI:1.06-2.42). Those with moderate and more severe disabilities have the same odds of HIV infection as the general population. PWD are HIV-positive and at risk of HIV infection. Based on this, it is essential that HIV education, testing, and treatment programs are inclusive of PWD. Accessible HIV education materials need to be created. HIV testing programs should involve PWD in planning and implementation. Providers of HIV care must be trained regarding the needs of PWD for reproductive healthcare. [ABSTRACT FROM AUTHOR]

Background: The provision of professional counseling services for persons living with human immunodeficiency virus (PLHIV) is crucial in the prevention and treatment continuum of the disease. However, for counselors of people infected with the human immunodeficiency virus (HIV) leading to acquired immune deficiency syndrome (AIDS) to give their best, their motivations to become counselors and the challenges they face in their line of duty need to be contextually understood and addressed. We ascertained the roles, motivations, and experiences of HIV/AIDS counselors in the Volta Region of Ghana to inform HIV/AIDS counseling decision-making in the region and the country. Methods: A phenomenological study conducted among sixteen (16) HIV/AIDS counselors from five HIV/AIDS sentinel sites in the Volta region of Ghana, recruited through a purposive sampling approach and interviewed to ascertain their HIV/AIDS counseling-related experiences. The data were thematically analyzed using the Atlas. ti software, and sub-themes supported with verbatim quotes. Results: Five motives for becoming an HIV/AIDS counselor were found. These include being randomly assigned to the unit, developing interest in the job, because of the status of a relative, witnessing bad attitudes of healthcare providers, and seeing HIV- clients lacking knowledge of the condition. The study found that these counselors performed six core roles: providing nutritional counseling, educating clients on HIV, treatment, and medication provision, conducting testing and comprehensive counseling of clients, providing social support to clients, and offering financial support to clients. The experiences these counselors had were boosting clients' health status, counseling clients back to a normal mental state, cooperation from clients, participants gaining knowledge on HIV through counseling, counseling clients to accept their status, and when a client delivered an HIV-negative baby. Their negative experiences included clients denying their HIV status, clients defaulting on their treatment, uncooperative clients, death of clients due to fear of breach of confidentiality, self-stigmatization among clients, and the myths some people hold towards HIV/AIDS. Conclusion: By organizing capacity-building training programs for HIV/AIDS counselors in the Volta region and addressing the negative experiences they encounter, they could be empowered to provide effective counseling, curative, and social services to people living with HIV in the region, leading to improved health outcomes. [ABSTRACT FROM AUTHOR]

Background: Without specific pharmaceutical knowledge in specialist areas such as Human Immunodeficiency Virus (HIV) management, pharmacists may lack the ability and confidence to provide optimal pharmaceutical care and optimization of outcomes. Objective: To develop a pharmacy-specific, foundational HIV education and assessment package, and assess impact on pharmacist knowledge and confidence. Methods: A foundational HIV education package with assessment was developed. Participants' baseline knowledge and self-reported confidence in HIV management were determined via an anonymous online questionnaire. Only participants who completed the pre-education questionnaire were then provided access to the self-paced, online education package. Participants completed a second questionnaire after completion of the package at a time of their choosing, within 2 months of the first questionnaire completion. Both questionnaires were similar in knowledge difficulty and addressed similar clinical domains. Mean differences in knowledge and confidence levels were analyzed, with further subgroup analyses of knowledge categories. Results: A total of 57 pharmacists completed both questionnaires. HIV knowledge was higher post-education compared with pre-education (mean correct score of 83.7% and 56.5% respectively, P <.001). The mean self-rated confidence of pharmacists in managing medications of people living with HIV, was higher post-education (73.3%) compared with pre-education (33.9%) (P <.001). Conclusion: The use of a pharmacy-specific, foundational HIV management education package significantly increased pharmacist knowledge in HIV management and improved self-reported confidence in the management of this specialty area. Future studies should assess the sustained impact of educational materials on pharmacist knowledge and confidence and investigate translation into improved outcomes for people living with HIV. [ABSTRACT FROM AUTHOR]

In June 2022, Alabama legalized fentanyl test strips (FTS). In response to this new opportunity to prevent overdoses, Project Linkage, Education, and Prevention (LEAP)—an academic–community partnership providing substance use prevention services—quickly purchased FTS and started distributing them in the Birmingham area. We describe how the Addiction Prevention Coalition, a substance use education and harm reduction provider, distributed 7300 FTS in the first year of legalization via Project LEAP and discuss its efforts to decrease substance use among young people. (Am J Public Health. 2024;114(8):785–788. https://doi.org/10.2105/AJPH.2024.307681) [ABSTRACT FROM AUTHOR]

This paper highlights the pressing need to address the HIV epidemic among adolescent boys and young men (ABYM) in sub-Saharan Africa. Despite progress in HIV prevention, ABYM still experience low diagnosis rates, treatment adherence, and linkage to care. The paper emphasizes ABYM's vulnerability due to societal norms, limited healthcare access, and economic pressures. It calls for gender-responsive interventions, including comprehensive sexual education, youth-friendly health services, community engagement, and targeted outreach. Comprehensive sexual education is pivotal in HIV prevention for ABYM, providing them with age-appropriate sexual health knowledge and safer sexual practices to reduce HIV incidence. Harmful masculine norms must be countered to promote respectful relationships, benefiting boys, men, and their partners. Inadequate access to youth-friendly health services hampers HIV prevention. Establishing spaces with confidential, non-judgmental care offering testing, counselling, circumcision, and provision of pre-exposure prophylaxis (PrEP) is essential, especially considering ABYM's unique clinic experiences. Engaging communities, leaders, educators, and peers combats stigma and discrimination. ABYM's input in intervention design, targeted outreach, and innovative technology enhances effectiveness of HIV prevention programmes. Economic factors should also be addressed. Comprehensive multi-sectoral interventions, including conditional cash transfers, effective for AGYW, could benefit ABYM. Addressing structural factors alongside behaviour change and social support is key. [ABSTRACT FROM AUTHOR]

Approaches to HIV/AIDS prevention and treatment have made significant advances since the beginning of the epidemic. However, HIV myths and misinformation continue to persist, stymieing efforts to end the epidemic in the United States, particularly in rural areas. The present study's purpose was to identify prevalent myths and misinformation about HIV/AIDS in the rural United States. Rural HIV/AIDS health care providers (n = 69) were asked via an audience response system (ARS) to provide responses to questions about HIV/AIDS myths and misinformation in their respective communities. Responses were analyzed qualitatively using thematic coding. Responses were grouped into four thematic categories: risk beliefs, consequences of infection, populations affected, and service delivery. Many responses were consistent with myths and misinformation from the start of the HIV epidemic. Study findings support the need for sustained fundamental HIV/AIDS education and stigma reduction efforts in rural areas. [ABSTRACT FROM AUTHOR]

This scoping review aimed to review and summarize the evidence related to the attitudes toward human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP)/postexposure prophylaxis (PEP) among people at risk of HIV, health care workers (HCWs), and the general population in India. A literature search of PubMed, Embase, Scopus, and PsycINFO was conducted from January 1, 2002, to February 1, 2024. The search field contained a combination of keywords and MeSH terms such as: HIV, PrEP, PEP knowledge, awareness, willingness, and practice. Studies published in English language, conducted in India, and having reported at least one prespecified outcome related to PrEP or PEP were included. Of 599 studies identified, 48 were included (PrEP, n = 17 studies; PEP, n = 31 studies). Among the people at risk of HIV, awareness about PrEP was very low (17% or less). However, willingness to use PrEP and interest in knowing more or obtaining PrEP were reported to be high (84–95%). Among the health care professionals, the knowledge and awareness of PEP and its dosing schedule varied from 20% to 96%. The uptake to prevent this occupational hazard was reported to be poor (12–36%). This scoping review highlighted critical research gaps related to PrEP and PEP in India, related to PrEP adherence, outcomes related to nonoccupational PEP, HCW readiness to provide PrEP, etc. Overall, this study indicated the need to design policies and implement interventions aimed toward improving the knowledge, awareness, and uptake of PrEP/PEP in India. An increased focus on improving PrEP/PEP access in India through government schemes at a lower cost is imperative. [ABSTRACT FROM AUTHOR]

The article discusses a proposed risk- and needs-based strategy to prevent human immunodeficiency virus (HIV) infection across the distinct life stages of adolescent girls and young women in the African region as of 2024. Topics covered include HIV risk even before conception, HIV education in the school-age years, the increased HIV risks in adolescence and young adulthood, and HIV transmission in pregnancy. Also noted is the strategy's integration of HIV services with sexual health services.

Understanding how HIV-related apps can positively impact, educate, and support patrons as a crucial tool in medication adherence, HIV testing and prevention, and education is something every librarian should consider undertaking. Librarians can further their usage by encouraging patrons to explore the possibility of incorporating them into their daily lives, regardless of their HIV status. [ABSTRACT FROM AUTHOR]

This analysis examined correlates of HIV testing among Asian immigrant female sex workers in massage parlors. We interviewed 69 Chinese and Korean immigrant women who provided sexual services in massage parlors in New York City or Los Angeles County (2014–2016). Multivariable logistic regression results showed that participants who were younger, have lived in the U.S. for a longer period of time, had greater English proficiency, perceived higher HIV risk, or were living with an intimate partner were more likely to have had an HIV test. Disclosing sex work to a close friend was also positively associated with HIV testing at p <.1. These correlates may reflect differential access to information, systems, and social networks that would facilitate HIV testing, highlighting the importance of reducing social isolation and increasing HIV education, especially for older women who have come to the U.S. more recently. As the literature has indicated that Asian immigrant female sex workers experience high rates of intersectional stigma, efforts to mitigate these intersecting stigmas could further these objectives. [ABSTRACT FROM AUTHOR]

Background: Psychoactive substance abuse can affect biological, psychological, social, and spiritual aspects, as well as the users' quality of life, and obliged to carry out medical and social rehabilitation. Purpose: The purpose of the study was to identify the effect of holistic rehabilitation programs on quality of life among drug abusers. Methods: Quasi-experimental with time series design. The sample of this study amounted to 54 people, taken by G-power, all participants who will take part in the rehabilitation program at the National Narcotics Board rehabilitation clinic. Rehabilitation interventions include health assessment, psychological assessments, health counseling, human immunodeficiency virus-related voluntary counseling and testing, addiction counseling, group therapy, family therapy, client and family monitoring, relapse prevention therapy, and postrehabilitation services. Interventions are provided for 10 weeks, and delivered by health professionals. Measurement of quality of life using World Health Organization Quality of Life—Brief Version (WHOQOL-BREF) MEAT 26 statements consisting of physical, psychological, environmental, and social relationship dimensions, with an alpha value of 0.8756. The data was analyzed with the Friedman test. Results: Holistic rehabilitation influences all dimensions quality of life of drug abusers with a P -value of <0.001. Conclusions: A holistic rehabilitation program improves the quality of life of drug abusers. [ABSTRACT FROM AUTHOR]

Background: HIV-related stigma is a major social challenge for people living with HIV/AIDS (PLHA). It can forsake the programmes related to HIV due to compromise in early diagnosis & treatment. It is necessary to understand the perceptions of HIV about care and treatment in PLHA in order to work towards a more patient-centred care. Aim & Objective: To explore the perception of care & treatment along with the other life experiences in PLHA. Methodology: This is Qualitative exploratory study prepared by study of semi-structured in-depth interviews of different individuals through thematic analysis, at the Antiretroviral therapy (ART) centre of Nehru Hospital, BRD Medical College Gorakhpur. Result: Themes emerged were: 1) Negative reactions to HIV positive results; 2) Social support was highly valued by PLHA in improving their quality of life; 3) PLHA experiences various stigma throughout their life; 4) Health staff behaviour was good but they felt the need of better arrangements for their treatment; 5) Refusal by Private Hospitals to treat HIV cases. Conclusion: Awareness campaigns & regular counselling of the individual shall be effective for PLHA on a routine basis. A better & hustlefree medical infrastructure shall be very beneficial & it is necessary to sensitize the private hospitals to treat the HIV patients in a positive manner. [ABSTRACT FROM AUTHOR]

Sexual orientations, such as gay, lesbian, and bisexual, are prevalent among individuals at high risk of experiencing mental health problems, including drug use, depression, emotional distress, and suicide. Therefore, this study aimed to assess the compliance of men who have sex with men with protective equipment and determine the dominant influential factors. This cross-sectional study included 187 men who had sexual intercourse with men who were recruited from two foundations based in Palembang City, Indonesia, focusing on people living with HIV/AIDS. Data were analyzed using Chi-square and binomial logistic regression. In this context, 50.8% of men who have sexual intercourse with men did not comply with the use of sexual protective equipment, exceeding those in compliance. The multivariate logistic regression showed that knowledge was the dominant factor (PR = 15.733; 95% CI = 4.063-60.920), and most lowknowledge individuals were 15.733 times more at risk of non-compliance. Intensive education is needed regarding the potential risk of transmission, considering the ease of access to condoms. [ABSTRACT FROM AUTHOR]

Introduction: Engaging in risky sexual behaviors can lead to HIV infection, sexually transmitted infections, and unintended pregnancy among youths. University students had greater sexual risks for many reasons. Therefore, this study aimed to assess the magnitude and associated factors of risky sexual behaviors among regular undergraduate students at Injibara University, Northwest Ethiopia. Methods: A cross-sectional study was conducted at Injibara University from 20 January to 30 2020. Multistage sampling was employed to select 770 students. Data were collected using a semistructured self-administered questionnaire. A binary logistic regression model was used to identify factors associated with risky sexual behavior. Adjusted odds ratios with 95% CIs were determined, and variables with P-values <0.05 were considered significant. Result: A total of 770 students participated in the study, providing a response rate of 100%. In this study, 294 (38%, 95% CI: 35%, 42%) students engaged in risky sexual behaviors. Risky sexual behavior was significantly associated with not tested for HIV (AOR = 1.62, 95% CI: 1.15--2.31), peer pressure (AOR = 1.90, CI: 1.37--2.64), basic HIV knowledge (AOR = 2.16, CI: 1.65--2.89), substance use (AOR = 3.56, CI: 2.11--6.06), watching pornography videos (AOR = 1.58, CI: 1.11--2.23), and HIV risk perception (AOR = 1.37, CI: 1.02--1.91). Conclusion and recommendation: A substantial proportion of university students in this study engaged in unsafe sexual behavior. Risky sexual behaviors are more likely to occur when students are under peer pressure, use substances, have no perceived HIV risk, watch pornography, and have inadequate basic HIV knowledge. Therefore, tailored strategic interventions such as life skill training should be designed to bring about positive behavioral changes among university students. [ABSTRACT FROM AUTHOR]

Thirty-eight years into the HIV and AIDS pandemic, the world is still striving to reduce global HIV infections towards zero new infections and AIDS-related deaths by 2030. Sub-Saharan Africa continues to carry the burden of global HIV infections as governmental and nongovernmental agencies try out different prevention strategies (UNAIDS, 2024b). Several scholars have argued that comprehensive sexuality education (CSE) is the best preventive strategy to reach youth and key populations with factual information regarding HIV and AIDS. This paper draws from the project, Mentoring as a Method to Promote Women's Health in the Context of HIV-Prevention and Unequal Gender Relations, which employed memory work, photo-voice, drama, drawings, and focus group discussions with third-year student teachers in a life orientation module. Focussing on the data generated through drama, I present an arts-based activity that was used to teach about HIV transmission to student teachers in a bid to equip them with alternative ways of teaching school-learners about HIV and AIDS. The findings highlight student teachers' lived experiences and how they have shaped their perceptions of HIV infections and living with AIDS. I argue from the findings, that arts-based pedagogies allow for enhanced understanding of complex phenomena due to their participatory and in-built intervention nature. Thus, I posit that pedagogies that employ participatory, arts-based, and visual methodologies should be extensively employed in teacher-education towards reducing new HIV infections among the youth. [ABSTRACT FROM AUTHOR]

Background: HIV is a chronic infection that can lead to acquired immunodeficiency syndrome, a life-threatening condition. The highest number of new HIV diagnoses occurs in males, particularly Black men living in the southern region of the United States. Black men tend to test less frequently than other races. Objective: This pilot project was a quality improvement (QI) initiative to increase HIV screening rates among Black men who received healthcare at a Federally Qualified Healthcare Center (FQHC). Methods: The 8-week QI initiative was implemented during clinic hours. A retrospective chart review was performed to compare baseline with post-initiative HIV screening rates for eligible patients who received care in Birmingham, Alabama, which was shown to be low. Then, a risk assessment questionnaire was administered before providing educational materials to improve screening rates among Black men at an urban multisite FQHC. Results: HIV screening rates among Black men increased after the two-part initiative (20% and 21%, respectively). Conclusions: This QI initiative demonstrated that HIV screening rates could increase with tailored provider-initiated interventions, including risk assessment and educational materials. Implications for Nursing: A DNP or other healthcare providers could use this project to inform the development of a larger-scale QI initiative at an FQHC to improve HIV screening rates for under-resourced populations. [ABSTRACT FROM AUTHOR]

Introduction: The current study provides people living with human immunodeficiency virus (PLHIV) the support to cope with this disease and to improve their quality of life, since their longevity has significantly increased. Aim: Investigating the effect of an educational intervention on PLHIV's strategies to cope with HIV. Methodology: Quasi-experimental, before-and-after study type, whose data were collected before and after educational intervention, was carried out with 75 PLHIV at a School Outpatient Clinic. The Brazilian version of the Ways of Coping Scale was herein used. It is a questionnaire comprising 4 disease-coping domains, namely: coping focused on problem, emotion and on seeking social support and religious practices. Results: There was increased use of all coping-strategy domains after the educational intervention, as well as reduced standard deviation, and it pointed out that the recorded values were grouped closer to the mean therefore showing less variability. Coping focused on social support was the strategy mostly used after the educational intervention; it was followed by strategies focused on both emotion and problem. The least used strategy was the one focused on religion/fantasy. Discussion: This study identified the need of introducing a new coping strategy focused on prejudice against patients with HIV. [ABSTRACT FROM AUTHOR]

Background: Black cis‐gender women are disparately affected by HIV and require prioritization in prevention efforts, including pre‐exposure prophylaxis (PrEP). Preparing trusted community leaders such as salon stylists as health‐based opinion leaders may be promising to increasing awareness, knowledge, and uptake of PrEP among Black women. We sought to develop training and better understand stylists who may participate in a salon‐based PrEP intervention for Black women. Methods: A community‐research partnership designed a stylist training workshop for stylists with a majority Black women clientele. A two‐session workshop focused on HIV knowledge, HIV prevention including PrEP, and the role of an opinion leader to influence community social and health norms. An exploratory research design and analysis was conducted to examine stylists and provide training feedback. Conclusions: Stylists showed a high level of knowledge and willingness to serve as an opinion leader in their salons and with their communities. Stylists also verified medical mistrust in the healthcare system that makes community‐based interventions attractive. This article discusses how the training was piloted and accepted by stylists. [ABSTRACT FROM AUTHOR]

Youth between the ages of 13 and 24 account for over 20% of new HIV diagnoses in the United States but are the least likely age group to be HIV tested in healthcare settings including the emergency department. This is in part due to the fact that almost 50% of youth decline testing when offered. We elucidated youth patients' perspectives on barriers to and facilitators of routine HIV testing of youth in an urban emergency department setting. Thirty-seven patients aged 13–24 years were recruited from the pediatric and adult emergency departments at a high-volume hospital in New York City from August 2019 to March 2020. Semi-structured in-depth interviews were conducted with all participants. Interviews were audio-recorded and transcribed verbatim, and transcripts were coded using an inductive thematic analysis approach. Youths' main reasons for declining HIV testing when offered included low risk perception, privacy concerns, HIV-related stigma, and low levels of HIV-related knowledge. Participants' responses suggested that HIV educational materials provided when testing is offered may be insufficient. Participants recommended providing additional HIV education and better incorporating HIV testing into the emergency department routine to increase testing among youth. Efforts are needed to help youth recognize their own HIV risk and increase their HIV-related knowledge. This may be accomplished by providing youth with additional educational materials on HIV, possibly via tablet-based interventions or other methods that may enhance privacy, combined with discussions with healthcare providers. Such efforts may help increase HIV testing acceptance among youth seen in the emergency department. [ABSTRACT FROM AUTHOR]

Background: Despite advances in biomedical HIV prevention modalities such as pre-exposure prophylaxis to prevent the transmission of HIV, racial/ethnic and sexual/gender minority populations are disproportionately impacted by HIV epidemic. Alarming rates of HIV have persisted among Black gay and bisexual men, particularly in Southern states. Methods: Utilizing data from the ViiV ACCELERATE! initiative, we explored the impact of As Much As I Can, an immersive theatre production, on HIV-related stigma behaviors. A self-administered post-performance survey was conducted with a cohort (n = 322) of randomly selected audience members. Results: Overall, the results showed participants had a highly favorable experience, rating the performance with a mean score of 9.77/10. Respondents indicated they intended to change behaviors to promote HIV prevention education and to reduce stigma and discrimination including: (1) Say something if I hear stigmatizing language against people living with HIV (75.4%), (2) Say something if I hear anti-gay language (69.7%) and (3) Tell others about HIV prevention options (e.g., PrEP, PEP, condoms (64.1%). The findings show there is an association between HIV-related behavior intention and linkage to HIV care. Respondents who reported they were more likely to say something about HIV stigma were almost three times (O.R. 2.77; 95% C.I. 0.98–7.8) more likely to indicate they would follow up with a healthcare professional. Conclusions: This study suggests that immersive theatre is an effective method for communicating HIV prevention education and reducing HIV-related structural stigma and discrimination that increases HIV vulnerability for Black sexual minority men. [ABSTRACT FROM AUTHOR]

Introduction: During COVID-19, healthcare providers reported decreased testing volumes, which meant fewer people knew their HIV status. To improve testing volumes, The County of Santa Clara Public Health Department offered a pilot HIV self-testing (HIVST) program for eligible populations. Material and methods: The purpose of this study was to understand overall reach of the intervention and effectiveness of strategies used to raise the program awareness from November 2021 to August 2022, using an observational study design. Participants were recruited through both in-person and digital outreach methods. Individuals completed an online survey in order to participate in the study. Research team collected and analyzed all responses using descriptive analysis. Results: A total of 458 individuals participated in the program. Of participants 232 that responded to optional questions the majority (77%) were identifying as male and 7% identifying as transgender, gender non-binary, or genderqueer. Social media advertisements on gay dating apps and outreach at community events were identified as effective methods for increasing awareness. Of the total participants, 21% had never taken an HIV test before, 58% selected this program for convenience reasons, and 41% received pre-exposure prophylaxis (PrEP) services. Conclusions: HIVST programs have the potential to address barriers in accessing testing services. Healthcare providers are encouraged to offer HIVSTs as options for patients. [ABSTRACT FROM AUTHOR]

Substance use treatment settings can play a critical role in ending the HIV epidemic. Community-based methadone clinics are potentially useful sites to offer biomedical HIV prevention, but little is known about how clinicians and other clinic staff communicate with patients about sexual behavior and HIV-related topics. Thirty semi-structured interviews were conducted at two methadone clinics in Northern New Jersey. Participants included medical providers (physicians, RNs, DNPs), methadone counselors, intake coordinators, lab technicians, and other auxiliary staff members. Results: Three major themes were identified: (1) HIV education is primarily provided by external organizations, (2) there is limited staff-patient communication around HIV and sexual behaviors, and (3) HIV stigma is prevalent among staff and patients. To implement PrEP in methadone treatment settings, clinic staff must be able to engage in non-judgmental communication about HIV and sex with patients. Additionally, federal and state funding for HIV prevention in substance use treatment settings must be prioritized to enable clinics to access the necessary training and resources. [ABSTRACT FROM AUTHOR]

Introduction: Human immunodeficiency virus (HIV) infection is a relevant public health problem is worldwide. From the change in the health care of people living with HIV (PLHIV) in Primary Health Care (PHC), nurses gained autonomy in their workflow, which requires a significant technological arsenal for the planning, organization and functioning of services. It is believed that the development of a mobile application for the care/prevention of HIV will contribute to the strengthening of care, resulting in greater autonomy and empowerment of nurses in Primary Health Care. Objective: To develop and validate a content script for a mobile application for nurses in PHC containing information about PLHIV management/care in PHC. Methods: This is a methodological study developed in three phases: exploratory study, content elaboration process and validation by the 16 judges. Results: The application was evaluated and validated satisfactorily in terms of content and appearance, with an average Content Validity Index (CVI) of 0.99 (99%), Item Content Validity Index (I-CVI) and Medium Content Validity (S-IVC/AVE) also obtained satisfactory levels. Conclusions: The construction of the prototype of an application called LearnHIV, is considered a valid instrument in terms of content and appearance, according to the judges. Trial registration: None because it is not an intervention study. [ABSTRACT FROM AUTHOR]

Ending the human immunodeficiency virus (HIV) epidemic relies on a robust clinical workforce. The Southeast AIDS Education and Training Center's interprofessional education program is a novel approach to increasing the interest and ability of early health professional learners to provide high-quality, comprehensive, person-first care for people with HIV. Key Points: Interprofessional education (IPE) focusing on multidisciplinary care for people with HIV can serve as a novel way to increase the HIV workforce. This brief report describes the IPE program of the Southeast AIDS Education and Training Center. [ABSTRACT FROM AUTHOR]

Southern community-based organizations often lack adequate resources to implement high-quality, culturally appropriate HIV programs and services. Shared learning communities (SLCs) combine in-depth training, tailored coaching, and peer-to-peer learning to strengthen HIV programs and services. This paper describes five SLCs, participant characteristics, and their capacity-building components. [ABSTRACT FROM AUTHOR]

For many partnered sexual minority men (SMM), PrEP decisions are shaped by their relationships. Recent innovations in HIV risk reduction interventions tailored for partnered SMM include the integration of video-based communication skill building. The purpose of the current study was to examine the responses of 37 SMM in relationships with cismale partners to understand how actual or anticipated conversations between partners may influence PrEP decision making. Results suggested an individual intervention has the ability to elicit detailed content about interactions between partners. When SMM anticipated being in agreement with their partner about PrEP, they described few challenges to discussing HIV prevention. In contrast, when SMM anticipated relationship-related concerns about PrEP, they also anticipated conversations with their partner would be challenging and likely to involve conflict. This often-diminished SMM's motivation to engage partners and develop shared HIV-prevention goals. These SMM may benefit from integrated communications skills building to overcome challenges and work collaboratively with partners around PrEP use. [ABSTRACT FROM AUTHOR]

Awareness of HIV status in Malawi is 88.3% and lowest among 15–24-year-olds (76.2%). There is a need to understand HIV testing history and transmission in this age group. We analyzed pooled HIV surveillance data to describe testing history and HIV recent infection among 8,389 HIV-positive 15–24-year-olds from 251 sites in Malawi between 2019 and 2022. Most HIV-positive 15–24-year-olds were female; aged 23–24 years; rural residents; and diagnosed at voluntary counseling and testing. No prior HIV testing was reported in 43.5% and 32.9% of 15–19-year-olds and males, respectively. Overall, 4.9% of HIV-positive diagnoses were classified as recent HIV infections, with the highest proportions among breastfeeding women (8.2%); persons tested at sexually transmitted infection clinics (9.0%); persons with a prior negative test within 6 months (13.0%); and 17–18-year-olds (7.3%). Tailored and innovative HIV prevention and testing strategies for young adolescents, young males, and pregnant and breastfeeding women are needed for HIV epidemic control. [ABSTRACT FROM AUTHOR]

Background: Youth with disabilities have the same right to sexual and reproductive health (SRH) as their peers without disabilities. However, their needs and rights are often ignored. Little is known about the knowledge, needs and access barriers related to SRH information among youth with different types of disabilities in China. Methods: A cross-sectional survey was carried out among 473 unmarried youth aged 15–24 with visual, hearing, physical disabilities in both urban and rural areas in China. Results: Out of a maximum possible score of 100, respondent's median score ranged from 30 to 50 for knowledge related to sexual physiology, STIs/HIV/AIDS and contraception. For these three categories of knowledge, respondents with hearing and physical disabilities or from rural areas scored lower than their counterparts with visual disabilities or from urban areas. The multivariate analyses showed that the residential area and education level were strong correlates of knowledge among respondents with visual and hearing disabilities. Other significant correlates were age for respondents with visual impairment and physical impairment, and single child status in the family and father's education level for respondents with hearing impairment. Sources of and barriers and preferences in accessing SRH information differed by type of disabilities, residential areas and gender. In general, school teachers were the primary and most preferred sources of SRH knowledge, followed by the Internet, peers/friends and parents. Unaware of where to get accurate information and feeling embarrassed to seek information were the two most frequently mentioned barriers in accessing SRH information. Conclusion: Respondents had poor knowledge of SRH and limited access to SRH information, especially those from rural areas. Efforts should be made to promote school and family-based sexuality education tailored for youth with different types of disabilities. Plain language summary: Youth with disabilities have the same sexual and reproductive health (SRH) needs as their peers without disabilities and the equal right to attain the highest standard of SRH. However, their SRH needs and rights are often overlooked or neglected. Studies on SRH among unmarried youth with disabilities are very limited in China. This study used data collected from 473 unmarried youths with different types of disabilities from both urban and rural areas in China, to understand their SRH knowledge and its associated factors, as well as barriers and preferences in accessing sexuality-related information. This study demonstrated that unmarried youth with disabilities lacked knowledge of SRH, especially those with hearing or physical disabilities and those from rural areas. In general, residential area and education level were significant correlates of knowledge among respondents. Sources of and barriers and preferences in accessing SRH information varied across types of disabilities, residential areas and gender. In general, school teachers were the primary and most preferred sources of knowledge, followed by the Internet, peers and parents. Unaware of the available sources of accurate information and feeling embarrassed to seek information were the most frequently mentioned barriers in accessing SRH information. The findings of the study highlight the need to reduce the barriers to sexuality education for unmarried youth with different types of disabilities. Efforts should be made to promote school and family-based sexuality education tailored for youth with different types of disabilities and empower them to seek information proactively. [ABSTRACT FROM AUTHOR]

HIV pre-exposure prophylaxis (PrEP) is highly effective, but PrEP use has been suboptimal. We describe a telementoring program for clinics in high-HIV burden areas, focusing on systems-level practice transformation and care for populations disproportionately affected by HIV. We developed and delivered a telementoring program for U.S. health centers. We analyzed participants' baseline and post-session surveys to ascertain experiences providing PrEP and caring for people disproportionately affected by HIV, comparing responses between medical and behavioral health clinicians. Forty-eight people from 16 health centers participated. Medical clinicians were more likely than behavioral health clinicians to care for people taking PrEP, but the groups did not differ in self-rated capacity to counsel about PrEP or care for populations disproportionately affected by HIV. Virtual training on practice transformation for PrEP, involving medical and behavioral health clinicians, is feasible and acceptable. PrEP training and delivery efforts should include behavioral health clinicians. [ABSTRACT FROM AUTHOR]

Since 2015, Mount Sinai HIV/HCV Center of Excellence has implemented two-day HIV and HCV preceptorships for New York State health care. Participants assessed their knowledge of and confidence to perform 13 HIV or 10 HCV prevention- and treatment-related skills, measured on a 4-point Likert scale from "not at all" to "very" knowledgeable/confident at baseline, exit survey, and a recent evaluation. Wilcoxon signed rank sum tests determined mean differences at all three time points. Between baseline to exit assessment and baseline to evaluation assessment, HIV and HCV preceptorship attendees reported significant increases in knowledge for five HIV and three HCV components and confidence for two HIV and three HCV tasks (p <.05), respectively. The preceptorship significantly and positively impacted short-term and long-term knowledge and confidence around HCV and HIV clinical skills. The implementation of HIV and HCV preceptorship programs may increase HIV and HCV treatment and prevention service efficacy within key population areas. [ABSTRACT FROM AUTHOR]

In the U.S., HIV transmission rates have increased among male-male sexual contacts. Sex education reduces HIV-related risks; yet impacts for adolescent sexual minority males (ASMM) are less known. Data from a sample (n = 556) of ASMM (aged 13-18) in three U.S cities were used to examined associations between HIV education in school and sexual behaviors. Outcomes of interest included: sexually transmitted infection (STI), multiple sex partners, and condomless anal intercourse (CAI) with a male (all past 12 months). Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were calculated. Of 556 ASMM, 84% reported received HIV education. Among sexually active ASMM (n = 440) who received HIV education, fewer reported an STI (10% vs. 21%, aPR: 0.45, CI [0.26, 0.76]) and CAI (48% vs. 64%, aPR: 0.71, CI [0.58, 0.87]) than ASMM who did not receive HIV education. Protective effects of school HIV education on sexual behaviors are promising and suggest prevention education is vital to reducing HIV- and STI-related risks among ASMM. [ABSTRACT FROM AUTHOR]

An introduction to articles in the issue is presented on topics including associations between structural racism and sexual risk, lessons learned from the implementation of an adapted intervention called Support to Reunite, Involve, and Value Each Other, and development and implementation of the Women-Centered Program for Women of Color.

Trends in HIV incidence and prevalence vary between younger MSM (YMSM) and older MSM (OMSM). HIV prevention was revolutionized with the advent of pre-exposure prophylaxis (PrEP), but uptake of PrEP among OMSM is relatively unknown. Community connectedness among MSM is a strong driver of prevention. This qualitative study sought to explore similarities and differences between YMSM and OMSM's knowledge, perceptions, and barriers of HIV prevention and understand how intergenerational communication may enhance engagement in prevention, especially PrEP. Twenty semi-structured, in-depth interviews (ten YMSM and ten OMSM) were conducted with HIV-negative, non-monogamous MSM aged 18–24 and 55+ years. Interviews were transcribed and coded using NVivo 12 to identify themes within each age group and compare between age groups. YMSM expressed greater knowledge and more positive perceptions of PrEP than OMSM. OMSM felt that PrEP use increased engagement in sexual risk behavior. Both groups emphasized a need for more conversations between different age groups of MSM to educate each other about forms of prevention and reduce stigma. Intergenerational communication among MSM about HIV risk and prevention strategies may be an effective way to address the generational gaps in knowledge and perceptions and enhance engagement in HIV prevention. [ABSTRACT FROM AUTHOR]

HIV linkage, and retention are key weaknesses in South Africa's national antiretroviral therapy (ART) program, with the greatest loss of patients in the HIV treatment pathway occurring before ART initiation. This study investigated linkage-to and early-retention-in-care (LTRIC) rates among adults newly diagnosed with HIV in a high-HIV prevalent rural district. We conducted an observational prospective cohort study to investigate LTRIC rates for adults with a new HIV diagnosis in South Africa. Patient-level survey and clinical data were collected using a one-stage-cluster design from 18 healthcare facilities and triangulated between HIV and laboratory databases and registered deaths from Department of Home Affairs. We used Chi-square tests to assess associations between categorical variables, and results were stratified by HIV status, sex, and age. Of the 5,637 participants recruited, 21.2% had confirmed HIV, of which 70.9% were women, and 46.5% were aged 25–34 years. Although 82.7% of participants were linked-to-care within 3 months, only 46.1% remained-in-care 12 months after initiating ART and 5.2% were deceased. While a significantly higher proportion of men were linked-to-care at 3 months compared to women, a significant proportion of women (49.5%) remained-in-care at 12 months than men (38.0%). Post-secondary education and child support grants were significantly associated with retention. We found high linkage-to-care rates, but less than 50% of participants remained-in-care at 12 months. Significant effort is required to retain people living with HIV in care, especially during the first year after ART initiation. Our findings suggest that interventions could target men to encourage HIV testing. [ABSTRACT FROM AUTHOR]

Since 2003, The Family Life and HIV Education (FLHE) curriculum (now referred to as Family Life Health Education) has represented Nigeria's attempt at a national comprehensive sexuality education (CSE) program. The 2003 FLHE curriculum has been implemented on a national scale but has never had a full review or been updated to meet recent evidence-informed global standards (i.e., UNESCO 2009, 2018). Given the limitations raised in a 2013 evaluation of the curriculum based on UNESCO's International Technical Guidance on Sexuality Education (2009), the Clinton Health Access Initiative (CHAI), in partnership with the Federal Ministry of Education (FMoE), developed an expanded version of the 2003 FLHE curriculum. This expansion aligns to the most up-to-date global best practices, while remaining contextually relevant, to better respond to the sexuality education needs of adolescent girls and boys aged 10 to 18 years of age in Nigeria. CHAI is supporting four states in Nigeria to pilot an Expanded-FLHE curriculum. This article presents key activities and lessons learned from CHAI's effort in conducting the Expanded FLHE curriculum pilot in selected schools across its Sexual and Reproductive Health (SRH) programs and areas of implementation in Kano, Katsina, Kaduna and Rivers states. [ABSTRACT FROM AUTHOR]

One of the most important steps in HIV prevention is the provision of education to raise awareness to ensure individuals have a sufficient understanding of HIV and AIDS and encourage them to apply that knowledge. The study is based on an earlier descriptive cross-sectional study that sought a link between fishers' mobility and their risk of HIV exposure in the Elmina fishing community in Ghana. The current paper focuses on initiatives taken within the study area to inform fishers about HIV and AIDS. Additionally, it analyzes the successes and challenges of these programs and offers suggestions for improvement. Public and community durbars, town hall meetings, radio and television transmission, film creation, and the distribution of IE&C materials are the main strategies utilized to carry out HIV and AIDS education. The results suggest that few fishers in the study area take part in programs, whiles projects on HIV and AIDS cannot be implemented consistently and effectively due to a lack of funding and delays in the delivery of government funds. To enable organizations whose mandates, relate to HIV and AIDS interventions to carry out the programs timely and fully, it is advised that government enhances its financing and ensures the timely and full release of program funds. [ABSTRACT FROM AUTHOR]

Nigeria carries a high burden of HIV infections, with Taraba State having a prevalence of 2.49%. This quasi-experimental study evaluated the impact of the Lafiyan Yara project, which utilised various community-based mobilisation models, on the enhancement of HTS uptake among women during pregnancy, and children. The intervention involved the implementation of mobilisation by Traditional Birth Attendants (TBA), Village Health Workers (VHW), Patent and Proprietary Medicine Vendors (PPMVs), and a combination of the three in four study local government areas (LGA) in Taraba State. Baseline and end-line surveys were conducted focused on women aged 15–49 years who delivered a child in the past 1 year, and children in their households, in the study and a control LGA. A difference-in-difference (DID) approach was applied by using a probit regression model with interaction terms for treatment status (intervention vs. control) and survey timing to compute the DID estimates of uptake of HTS. The TBA model showed the highest impact in the referral of women to HTS, while the combined model demonstrated the greatest impact in referrals for children. Scaling up and strengthening these community mobilisation efforts can improve access to HIV testing and contribute to HIV/AIDS prevention and control in the region. [ABSTRACT FROM AUTHOR]

The uptake of HIV prevention services is lower among youth than adults in sub-Saharan Africa. Existing youth livelihood trainings offer a potential entry point to HIV prevention services. We determined feasibility and preliminary effectiveness of integrating HIV prevention into youth clubs implementing an empowerment and livelihood for adolescents (ELA) intervention in rural Uganda. Staff conducted community mobilization for youth (15–24 years) over one month. Clubs met (3×/week) over six months, with local peer mentors trained to teach life-skills and sexual/reproductive health education. We integrated mentor-led education on HIV prevention, including pre- and post-exposure prophylaxis (PrEP/PEP). Clubs offered on-site HIV testing, a field trip to a local clinic and PrEP referrals after one month and six months. Surveys were conducted at baseline and six months. Forty-two participants (24 adolescent girls/young women (AGYW) and 18 adolescent boys/young men (ABYM)) joined the clubs. At baseline, no participants accepted referral for PrEP, whereas 5/18 (28%) sexually active, HIV-negative AGYW requested PrEP referral at follow-up. One ABYM requested PEP referral. Integration of HIV prevention services into an established ELA curriculum at mentor-led youth clubs in rural Uganda was feasible. PrEP uptake increased among sexually active AGYW. Evaluation of this approach for HIV prevention among youth merits further study. [ABSTRACT FROM AUTHOR]

Introduction. HIV infects more than 2.6 million people/year, reaching 38.0 million by 2019. WHO recognized the disease as a major threat to humanity. Objective. To assess the level of knowledge of HIV-AIDS and associated factors in students during popular events, Évora-Portugal. Methods. Quantitative cross-sectional study, convenience sample, 313 students who visited the institutional pavilion, South Portugal. Sociodemographic data were collected, the HIV Knowledge Questionnaire (HIV-KQ-18) was applied. The Kuder-Richardson test yielded a coefficient of 0.847. Data analysis SPSS version 24.0. Results. 56.9% were female (16 and 30 years). Except for 5 items, where the percentage of correct responses exceeded 50%, subjects answered incorrectly about HIV transmission. Mann-Whitney and Kruskall-Walis tests detected no differences in male/female knowledge, age groups and condom availability. Cluster analysis showed two profiles: 1) higher university knowledge, being female, 19-21 years old, low or very high use. 2) low/very low knowledge with associated factors moderate alcohol consumption, represented by males (22-24 years). Conclusion. Conducting this type of survey allows education programmes to address specific HIV/AIDS gaps. [ABSTRACT FROM AUTHOR]

HIV/AIDS remains one of the most significant global health challenges, affecting millions of people worldwide. Since the inception of the disease, various global response strategies have been devised and implemented, aiming to mitigate its impact and ultimately eradicate it. While these strategies have yielded remarkable progress, there are still key barriers impeding the global fight against the disease. This paper, thus, delves into the key global response strategies employed in response to the HIV/AIDS epidemic since its inception, examines the impediments to their successful implementation, and outlines the trajectory towards a world without AIDS. To continue the momentum in the fight against HIV/AIDS, it is imperative to adopt a multifaceted approach that addresses the existing barriers. One pivotal aspect of this approach involves intensifying efforts to improve the uptake of HIV testing. Encouraging individuals to get tested is a critical step, as it not only aids in identifying more cases of HIV infection but also facilitates the linkage of those affected to appropriate care and support services. [ABSTRACT FROM AUTHOR]

Introduction: Based on the latest estimates of the United Nations Program on HIV/AIDS (UNAIDS), acquired immunodeficiency syndrome (AIDS) is now a public health challenge in Iran, and in 2018, 61,000 people were living with human immunodeficiency virus (HIV), of which 45,000 (75%) were men. This study aimed to evaluate effect of educational intervention based on theory of planned behavior (TPB) on HIV/AIDS preventive behaviors among male barbers. Material and methods: The current quasi-experimental study was conducted in 2019 among 120 male barbers, who were selected using stratified sampling method. Data were collected using a valid and reliable questionnaire based on TPB at baseline and post-intervention. Intervention was designed and performed according to TPB. Data were analyzed with SPSS version 20 using descriptive and inferential methods. Results: Mean age of barbers was 30.41 ± 8.43 years. At baseline, mean scores of TPB constructs were not significantly different between intervention and control groups (p > 0.05). However, in post-intervention phase, there was a significant difference between two investigated groups in mean scores of TPB constructs (p < 0.05). Conclusions: Findings of the current study showed that educational intervention based on TPB can enhance knowledge level, perceived behavioral control, and attitude and creation of appropriate subjective norms for formation of behavioral intention and promoting AIDS preventive behavior among barbers. [ABSTRACT FROM AUTHOR]

Louisiana is suffering from an epidemic of HIV, and East Baton Rouge has been listed as one of the jumpstart locations for the CDC's priority programs to end HIV. The populations that are disproportionately impacted are gay, bisexual, and other men who have sex with men (GBM), those who identify as transgender, and minorities. This narrative review is aimed to understand why these populations experience HIV disproportionately. Condom use, pre-exposure prophylaxis (PrEP) access and use, race, ethnicity, sexual orientation, and incarceration were found to be major contributors. Primary care practitioners (PCPs) are a vital part of the next steps to address these shortcomings by providing HIV primary care. This would be embodied by providing sensitive and unbiased care, prescribing PrEP, prescribing antiretroviral medications, and incorporating more holistic care. This holistic care could involve workshops for HIV education, practice negotiating condom use, and working with a multidisciplinary team to decrease sociodemographic disparities. Furthermore, PCPs can act as the healthcare bridge between incarceration and post-release. There was no literature regarding transgender populations in Louisiana. This is an important direction for future research. [ABSTRACT FROM AUTHOR]

In 2020, the HIV prevention clinical trials, HPTN (HIV Prevention Trials Network) 083 and 084, reported that long-acting injectable cabotegravir (CAB-LA) for HIV prevention was statistically superior to daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) for pre-exposure prophylaxis (PrEP) in cisgender men and transgender women who have sex with men, and cisgender women. However, clinical efficacy does not translate to real-world effectiveness and clinical practice as evidenced by current global use of oral PrEP. There are ~626,000 users of PrEP, which is significantly below the 3 million goal set by UNAIDS for 2020. Implementation will be key to ensuring that CAB-LA reaches those who desire to use it. We describe the Layer Plus Approach for CAB-LA for PrEP dissemination and implementation. The "Layer" is focused on integrating CAB-LA into existing PrEP models of care and understanding the best delivery channels that could be established in existing programs. Important implications of layering include preparing health professionals to provide CAB-LA, improving access for potential users, and addressing existing PrEP structural and facility barriers. "Plus," which accounts for the existing disparities in PrEP access and use, means expanding CAB-LA to reach individuals for whom HIV prevention options have not been accessible or who have lapsed on oral PrEP. Implications for Plus include the development of new structures, systems, policies, and processes. A key aspect to the Approach is building collaborations to aid successful implementation. The Layer Plus Approach is a simple but strategic framework or a tailored approach to guide dissemination research and implementation. [ABSTRACT FROM AUTHOR]

Video-based pre-test information is used in high resource settings to increase HIV testing coverage but remains untested in resource-limited settings. We conducted formative and evaluative focus group discussions with healthcare workers (HCWs) and caregivers of children in Kenya to develop and refine a pediatric HIV pre-test informational video. We then assessed HIV knowledge among caregivers sequentially enrolled in one of three pre-test information groups: (1) individual HCW-led (N = 50), (2) individual video-based (N = 50), and (3) group video-based (N = 50) sessions. A brief video incorporating information on national pediatric testing, modes of HIV transmission, and dramatized testimonials of caregivers who tested children was produced in three languages. Compared to individual HCW-led sessions (mean: 7.2/9; standard deviation [SD]: 1.3), both the group video-based (mean: 7.7; SD: 0.9) and individual video-based (mean: 7.6; SD: 0.9) sessions had higher mean knowledge scores. Video-based pre-test information could enhance existing pediatric HIV testing services. [ABSTRACT FROM AUTHOR]

Stigmatization and discriminatory attitudes of nurses towards human immunodeficiency (HIV) patients have been reported in many countries. The current study was undertaken to assess the knowledge, attitudes and factors associated with stigmatizing attitudes and discrimination among psychiatric and mental health nurses and nurse interns towards patients diagnosed with the human immunodeficiency virus; utilizing a single‐centre hospital‐based survey design. Primary data were collected using a previously validated questionnaire in a large mental health care hospital in Riyadh, Saudi Arabia. Knowledge, attitudes, acts of discrimination and associated factors on the part of mental health nurses towards those diagnosed with the HIV were identified. The study described herein is in accordance with the STROBE guideline. A total of 241 psychiatric and mental health nurses completed the questionnaire, yielding a completion rate of 74.4%. Overall, more than half of the nurses demonstrated gaps in knowledge and reported higher stigmatizing attitudes and acts of discrimination. Factors associated with stigmatization and/or discrimination include higher exposure to seropositive patients, no formal HIV training, lower religiousness, lower awareness of HIV testing policy and lower level of knowledge about HIV infection. There is an urgent need to implement a training program that will help to reduce stigma among nurses caring for people diagnosed with this illness. [ABSTRACT FROM AUTHOR]

The HIV Prevention Ambassador Training Package for Adolescent Girls and Young Women was created in collaboration with adolescent girls and young women (AGYW) to improve skills, knowledge, and attitudes about oral pre-exposure prophylaxis (PrEP) among peer "ambassadors". It was field tested with 17 ambassadors in Mazowe District, Zimbabwe and changes in ambassadors' knowledge and attitudes about oral PrEP, as well as changes in oral PrEP uptake among AGYW in the district, were assessed. The training package improved oral PrEP knowledge among trained ambassadors and built AGYW's skills to advocate for oral PrEP awareness and rollout. Use of the training package correlated with a 59% increase in oral PrEP uptake among AGYW in Mazowe District in the seven months following the training. The ambassador training package could help support oral PrEP introduction and scale up in countries with high HIV incidence by engaging AGYW in oral PrEP rollout in their communities. [ABSTRACT FROM AUTHOR]