ABSTRACT Demographic, behavioral, and clinical characteristics have been found to be associated with willingness to use and preferences for different HIV pre-exposure prophylaxis (PrEP) modalities. Limited data are available, however, describing how sexual behavior characteristics affect willingness to use and preferences for PrEP. Given the different clinical characteristics of available PrEP modalities (i.e., daily oral, on-demand oral, long-acting injectable), an individual’s sexual behavior (i.e., number of partners, partner characteristics) might affect their preferences for PrEP. We conducted a cross-sectional study among men who have sex with men (MSM) who are not living with HIV to assess the association between willingness to use PrEP and preferences for three different PrEP modalities with key sexual behavior characteristics. We found that willingness to use PrEP was not strongly associated with sexual behavior; however, for each sexual behavior characteristic we examined, preferences were higher for each modality of PrEP compared to no PrEP. As the number of sexual partners in the past 12 months increased, so did preferences for each modality of PrEP compared to no PrEP. Preferences were consistently stronger for injectable compared to oral PrEP. These results indicate that PrEP preferences are responsive to sexual behavior.

ABSTRACT Individuals living with HIV/AIDS (PLWHA) face significant physical, psychological and social challenges, even with the progress made in antiretroviral therapy (ART). The integration of palliative care has been shown to enhance quality of life and reduce symptom burden; however, there is limited evidence from India on this topic. This cross-sectional study investigated the unmet palliative care needs of PLWHA attending a tertiary HIV clinic in Karnataka, India. Out of 118 eligible patients, 97 (82.2%) agreed to participate from January to June 2019. Data were gathered using the Supportive and Palliative Care Indicators Tool (SPICT-LIS), the Edmonton Symptom Assessment Scale – Revised (ESAS-R) and the Needs Assessment Tool for Progressive Disease (NAT: PD). Overall, 43.3% of participants met the SPICT-LIS criteria for palliative care needs, and 42.3% reported experiencing at least one severe symptom, with fatigue, pain and depression being the most common. Factors such as functional impairment (Karnofsky Performance Status < 80), recent hospitalization, and CD4 counts below 200 cells/μL were significant predictors of the need for palliative care. Despite these findings, 97.6% of eligible participants had never received palliative services. Barriers to care included stigma, lack of awareness and limited integration of services. These findings suggest the urgent need to incorporate palliative care into ART programs to improve the quality of life and address ongoing health disparities among PLWHA in India.

ABSTRACT HIV remains a persistent global health challenge, emphasizing the urgent need for an effective cure. Meaningful engagement of affected communities is essential for advancing HIV cure efforts. Using stage theories of behavior change, this paper investigated engagement as a dynamic process. Engagement was highlighted with five interconnected stages: awareness, perceived relevance, decision-making, participation, and sustained involvement. These stages were used to understand how individuals and communities engage with HIV cure efforts across diverse contexts. Drawing predominantly, but not exclusively, on our own work in the Netherlands, France, Australia, and plans for work in Sub-Saharan Africa, we identified common patterns and local variations in engagement. Previous research underscored the importance of tailoring engagement strategies to lived experiences and sociohistorical contexts, moving beyond one-way information sharing to foster deeper, more meaningful involvement and engagement. Applying social and behavioral stage models in further interdisciplinary research may help pinpoint key opportunities for intervention and promote sustainable engagement with affected communities. Thus, this structured lens of engagement holds potential to advance the ethical and effective development of HIV cure efforts, ensuring that diverse perspectives shape its future trajectory.

ABSTRACT Oral liquid formulations of zidovudine (ZDV) and nevirapine (NVP) are the main antiretrovirals (ARVs) for neonates born to mothers living with HIV, but they have limitations including poor palatability, short shelf-life, frequent dosing and supply challenges. Understanding caregiver and provider preferences for infant ARV formulations is essential to guide the development of acceptable alternatives. Within the PETITE-DTG trial in South Africa (NCT05590325), evaluating the pharmacokinetics, safety and acceptability of novel dolutegravir (DTG) formulations in neonates, we explored ARV preferences among mothers (n = 28) and health workers (n = 6). Participants completed interviews ranking six formulations: existing ZDV and NVP syrups, a DTG dispersible tablet (DTG-DT), a novel DTG oral dispersible film (DTG-film) and two pipeline options (long-acting injectable; transdermal patch). Both groups strongly favoured DTG-film, highlighting ease of administration, confidence in accurate dosing and discreetness. Long-acting injectables were next preferred, viewed as convenient despite concerns about discomfort. DTG-DT, ZDV and NVP ranked lower due to preparation challenges and risk of spillage. Transdermal patches were least favoured, with concerns regarding the comfort of neonates, impact of water exposure and effectiveness. These findings underscore strong support for innovative ARV options, emphasizing usability, ease of administration and reduced dosing frequency for the treatment of neonates.

ABSTRACT HIV continues to be a significant global health issue, with 39 million people living with HIV in 2022, including 1.3 million new infections. Of those, 27% were young people aged 15-24, highlighting the vulnerability of this demographic. Despite advances in HIV prevention and treatment, particularly with antiretroviral therapy (ART), low to middle-income countries (LMICs) remain disproportionately affected by the epidemic. The identification and promotion of resilience factors is critical to both decreasing infections and enhancing coping mechanisms for those young people living with HIV (YPLHIV). This review investigates resilience by examining definitions, measurement processes, and tools, and identifying factors associated with resilience in YPLHIV within LMIC settings. To ensure quality, studies published from April 2014 to March 14, 2025, were reviewed using the Mixed Methods Appraisal Tool (MMAT). Findings revealed that definitions of resilience often involved overcoming adversity, and measurement processes and tools varied widely. Social support was a key resilient factor encompassing support from family, friends, loved ones, spiritual, cultural, and institutional support. This review underscores the importance of resilience as a framework for addressing the psychosocial needs of YPLHIV and calls for the standardization of measuring resilience across studies.

ABSTRACT Anal cancer, primarily caused by persistent high-risk HPV infection, is increasing worldwide. Men who have sex with men (MSM) and men with HIV (MWH) have incidence rates over ten-fold the rate among the general population. We explored health beliefs related to anal cancer, and perceived benefits, barriers, and facilitators to screening among MWH and their HIV care providers in the U.S. South, where HIV incidence remains high. We conducted in-depth interviews and thematic analyses to identify themes related to health beliefs (i.e., perceived knowledge of HPV and cancer, benefits of screening, and self-efficacy), barriers and facilitators to screening. Among MWH (N=12), benefits of screening included early detection to prevent negative outcomes and awareness about one’s body. Among providers (N=4), suggestions for overcoming barriers to screening included access to standard screening guidelines, patient education, inclusion of screening into routine care, social work services, and self-collection. Among MWH that were aware of HPV-associated cancers, perceived risk of cancer and a desire to receive HPV vaccination were common. In conclusion, improving patient education about HPV-associated cancer, inclusion of screening as part of routine care, and access to self-collection kits could facilitate anal cancer screening uptake among MWH in the South.

ABSTRACT Self-disclosure represents a pivotal challenge for older people living with HIV (PLWH) in China, who are frequently impacted by HIV-related stigma. As such, the current study aims to explore the relationship between HIV-related stigma and self-disclosure, and specifically examine the chain-mediating roles of perceived social support and acceptance of illness. A cross-sectional study was conducted among 282 older PLWH, recruited from Wuxi, China. AMOS 24.0 was used for model drawing and mediation path testing, and SPSS 26.0 was used for data analysis. Structural equation modeling (SEM) showed a satisfactory model fit (CMIN/DF = 1.744, CFI = 0.966, GFI = 0.906, AGFI = 0.853, IFI = 0.972, RMSEA = 0.051). We found that the mediated effect values of perceived social support and acceptance of illness were – 0.128 and – 0.055, respectively, while their chain mediated effect value was – 0.015. It suggests that interventions enhancing perceived social support and acceptance of illness may mitigate the negative impact of HIV-related stigma on self-disclosure behavior.

ABSTRACT Male circumcision is often undertaken to reduce the spread of HIV/AIDS and other sexually transmitted infections. However, there has been a shift in the motivation to undergo the procedure, as many perceive it as improving their sexual performance. This study investigates factors that influence decision-making about male circumcision. This qualitative study used a combination of in-depth and focus group interviews with men and women to investigate factors that influence the decision to circumcise among Zambian men. In general, both men and women were aware of the protective benefits of male circumcision. Attitudes to medical male circumcision were favourable. However, women emphasised that circumcision should not be considered the only HIV prevention method. The interviews suggest that men perceive circumcision to improve their sexual performance. There was also a greater preference for circumcised partners among women due to the perception that intercourse with uncircumcised men is less pleasurable. These reasons may potentially overshadow the main reasons for which circumcision was initially advocated. The dangers of undergoing circumcision for sexual enhancement at the expense of reducing the risk of HIV and other STIs may have longstanding consequences and must be addressed.

ABSTRACT Women account for 59% of human immunodeficiency virus (HIV) infection cases in sub-Saharan Africa. This impacts the increase in mother-to-child HIV transmission rates and presents challenges to preventive care for mother-to-child transmission. A scoping review of the scientific evidence was then developed to identify the barriers and facilitators faced by health professionals in providing services to prevent mother-to-child transmission of this virus in sub-Saharan Africa. The PubMed and CINAHL databases were accessed, and the keywords “barriers, facilitators, HIV, prevention of mother-to-child transmission of HIV, health professionals” and their synonyms were used. A total of 22 studies were included in the review, and common points between barriers and facilitators related to women, health professionals, and health services were identified. We understand that training healthcare professionals is necessary, and creating welcoming environments for users is crucial.

ABSTRACT Human immunodeficiency virus (HIV) is a significant global public health concern. Antiretroviral therapy (ART) has transformed HIV into a chronic and manageable disease, leading to an increased lifespan for people living with HIV (PLWH). However, the growing population of older PLWH presents unique challenges owing to the complexities of managing multiple medications for HIV and age-related conditions. This study aimed to explore the lived experiences, perspectives, and challenges related to medication management among older PLWH in Malaysia. Semi-structured interviews were conducted with 18 older PLWH at a tertiary hospital. Thematic analysis revealed three main themes: the perceived importance of adherence, challenges in medication management, and coping strategies. Older PLWH face challenges in medication management that are influenced by age-related health issues, treatment complexities, emotional challenges, communication barriers, and stigma. Despite these challenges, older PLWH employ multiple coping strategies, including behavioural coping strategies, open communication with healthcare providers, and seeking social support. While older PLWH generally have a positive perspective towards their medications, emotional and social factors, particularly self-isolation, can significantly impact medication management. Addressing these challenges requires a multifaceted approach that includes tailored interventions, improved communication with healthcare providers, and fostering social support networks.