People living with HIV, who have access to treatment, now have normal life expectancy. However, stigma and discrimination continue to affect health and well-being. We conducted focus groups with people living with HIV (n = 37), and key informant interviews (n = 20) with clinical and non-clinical workers who support people with HIV between May and November 2023. We aimed to explore the ongoing challenges and concerns faced by people living with HIV in England to inform a new model of person-centred HIV care. Participants discussed living well in relation to: 1) an unrestricted living; 2) emotional sexual health and intimacy well-being; and 3) autonomy of health and healthcare. Aspirations for an unrestricted living revolved around experiencing life in the same way as others, rather than having to compromise a sense of self or negotiate experiences differently due to their HIV status. Participants also shared a desire to live fulfilled sex lives without fear of being stigmatised due to living with HIV, and of feeling deserving of a satisfying sex life and sexual intimacy. There was also a particular anxiety about sharing an HIV status with new sexual partners. Conversations around sex and intimacy needed to be opened up to cover topics including pleasure and sexual wellness. A compromised autonomy of health referred to physical health; for example, the need for daily medication. Autonomy of healthcare referred to the challenges of negotiating an often fragmented and fractured healthcare service. Some shared experiences of discrimination by non-HIV healthcare workers and a requirement to advocate for their needs which is a specific challenge for marginalised groups. Person-centred care, which uses an intersectional approach to delivering HIV care, would respond to the needs and aspirations of people with HIV and their whole self. This offers the potential to address HIV-related stigma which continues to hinder progress.

We propose a new statistical modeling method to analyze functional relationship between predictor variables and correlated response variables, and apply it for modeling the number of HIV and AIDS cases influenced by early-age marriages and contraceptive users. The proposed method is LS-Spline BNNBR that is a Biresponse Nonparametric Negative Binomial Regression (BNNBR) based on least squares spline (LS-Spline). To validate the proposed method, we compare it with classical method, namely Ordinary Least Square Biresponse Parametric Negative Binomial Regression (OLS-BPNBR). The results show that the LS-Spline BNNBR method provided deviance value of 7.542334 which is smaller than that of OLS-BPNBR method, namely 7.993935. Thus, the proposed method has better prediction fit than the classical method.•This study discusses new statistical modeling method for the number of HIV and AIDS cases influenced by early-age marriages and contraceptive users where the response variables are correlated with each other.•The model estimation results show that the number of HIV and AIDS cases in Indonesia will decrease if the early-age marriages percentage increases and the contraceptive users percentage decreases.•The results are useful to provide a scientific basis for making policies to control the number of HIV and AIDS cases in Indonesia.

People living with HIV/AIDS often present neuropsychiatric symptoms, including cognitive and mood-related manifestations. Social support helps to cope with adverse events related to mental health. We aimed to analyze the relationship between satisfaction with social support and psychological symptoms in people living with HIV/AIDS at risk of developing HIV-associated dementia. An observational, cross-sectional, and correlational study was conducted. Assessment instruments included: sociodemographic questionnaire; Social Support Scale for People Living with HIV [Seidl & Tróccoli, 2006. Development of a scale for the social support evaluation in HIV/AIDS. Psicologia: Teoria e Pesquisa, 22(3), 317-326.], Brief Symptom Inventory (BSI) [Canavarro, 1999. Psychopathological Symptom Inventory - BSI. In M. G. M. R. Simões, & L. S. Almeida (Eds.), Psychological tests and tests in Portugal (Vol. II, pp. 87-109). SHO/APPORT.]; and International HIV Dementia Scale (IHDS). The sample consisted of 255 participants with a mean age of 48.16 years, 80.8% male, 68.6% living mostly with someone else. The strongest correlation was between the perception of availability of emotional support and availability of instrumental support, r (255) = 0.992; p < 0.001. Individuals with higher satisfaction with perceived emotional support had fewer psychological symptoms. Those with a higher Global Severity Index score on the BSI had a higher risk of dementia. An association was found between symptoms of psychological distress and a higher likelihood of developing HIV-related dementia. To reduce the risk of HIV-associated dementia, it is imperative to improve social support networks, which can serve as a vital clinical strategy.

Pre-exposure prophylaxis (PrEP) is a medicine that can reduce HIV transmission. Given the disproportionate impact of HIV on minority communities, health equity is an important consideration in PrEP research. We aimed to assess equity reporting in systematic reviews of PrEP using the PROGRESS Plus framework.

We conducted a systematic search of PubMed (MEDLINE), Embase and Cochrane databases for systematic reviews or meta analyses of PrEP usage. We then used the PROGRESS Plus framework to extract inclusion of the following domains: place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital, age and disability.

After screening search articles, our sample included 36 systematic reviews and meta-analyses (SRMAs). 24 (66.7%) were conducted within the USA. Few (2/36, 5.6%) were found to mention adherence to any equity reporting framework. Place and gender/sex were the most reported elements of the framework with inclusion in 34 of 36 studies. Age (30/36, 83.3%) and race/ethnicity (24/36, 66.7%) were also commonly reported. All other criteria were reported in less than half of included SRMAs; religion had the lowest inclusion at 0/36 (0%), followed by disability (1/36, 2.8%). Among the 36 SRMAs, 19 (52.78%) did not conduct any subgroup analyses among domains; those most commonly analysed were gender/sex and age.

Our study found nearly all SRMAs regarding HIV PrEP reported on gender/sex and age; however, other influential equity criteria were often overlooked. Further attention to the reporting of PROGRESS Plus items within these SRMAs may reduce barriers for PrEP utilisation, thus improving HIV prevention strategies.

Adolescents and young adults (AYA) with HIV are a population at high risk of experiencing mental issues and sleep disorder. We aim to summarise the global prevalence and risks of depression, anxiety, post-traumatic stress disorder (PTSD) and sleep disorder among AYA with HIV.

Systematic review and meta-analysis.

PubMed, Web of Science, Embase and PsycINFO were searched from inception to 3 August 2024.

Observational studies reporting the prevalence of depression, anxiety, PTSD or sleep disorder among AYA with HIV and published in English were included. Reviews, case reports, conference papers, notes, editorials and non-observational research were excluded.

Titles, abstracts and full texts were reviewed and screened, and data were independently extracted. A modified Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate study quality. Heterogeneity was assessed by I2 statistics, and subgroup analysis was performed to identify the source of heterogeneity. The pooled prevalence and the risks of depression, anxiety, PTSD and sleep disorder by comparison with HIV-uninfected peers were measured with random-effects and fixed-effects models. Publication bias was examined using Egger's correlation tests and funnel plot. The Grading of Recommendations Assessment, Development and Evaluation was used to assess the certainty of evidence.

56 articles were included in the final analysis. According to the modified NOS, 13 (23.2%) studies were considered good, 38 (67.9%) were satisfactory and 5 (8.9%) were unsatisfactory. 51 studies including 21 735 AYA with HIV contributed data for the pooled prevalence of depression (28%, 95% CI 24% to 32%, I2=98.68%; low certainty evidence); 21 studies including 8021 cases contributed data for the pooled prevalence of anxiety (22%, 95% CI 17% to 27%, I2=98.35%; low certainty evidence); 9 studies including 3691 cases contributed data for the pooled prevalence of PTSD (12%, 95% CI 8% to 17%, I2=95.60%; low certainty evidence); and 4 studies including 1909 cases contributed data for the pooled prevalence of sleep disorder (51%, 95% CI 31% to 70%, I2=98.37%; low certainty evidence). Compared with AYA without HIV, those with HIV had a higher risk of depression (OR=2.67, 95% CI 1.63 to 5.90, I2=84.0%), anxiety (OR=1.89, 95% CI 1.32 to 2.69, I2=50.3%), PTSD (OR=1.58, 95% CI 1.23 to 2.04, I2=40.1%) and sleep disorder (OR=2.11, 95% CI 1.51 to 2.95, I2=0.0%). A subgroup analysis found that studies conducted in Asia had a lower prevalence of depression (21.7% vs 29.6%, p<0.001) and anxiety (14.7% vs 21.9%, p<0.001) than studies conducted in Africa. Egger's test indicated that there was significant publication bias in the estimates of the prevalence of depression (p<0.001), anxiety (p<0.001) and PTSD (p=0.049), but not in the estimates of the prevalence of sleep disorder (p=0.861).

AYA with HIV are a population at high risk of experiencing depression, anxiety, PTSD and sleep disorder. More sensitive screening strategies and more comprehensive intervention methods are needed. However, in view of the high heterogeneity, the differences between studies need to be considered and the pooled estimates interpreted with caution.

Mental health disorders are common among people with HIV (PWH), and the overwhelming majority of PWH with mental health disorders do not receive evidence-based mental health care. One promising strategy to increase access to evidence-based mental health care for PWH is to integrate mental health screening and treatment for common mental disorders and unhealthy drinking into HIV care. However, little is known about how PWH view the role of HIV care providers in supporting their mental health or their experiences with mental health-related help-seeking. We conducted in-depth interviews with 30 PWH at three HIV treatment centers in Cameroon. Interviews were conducted in French or English. French transcripts were translated to English for analysis. Thematic analysis was used to identify key factors that influenced mental health-related help-seeking and respondents' preferred roles of HIV care providers. Overall, participants reported that they were less likely to seek support from medical providers for mental health compared to physical health needs. Previous positive contact with providers facilitated mental health help-seeking intentions among participants. Health facility characteristics, including limited provider availability, concerns about privacy and confidentiality, and high clinic volume were noted as barriers to mental health help-seeking at HIV facilities. Participants consistently reported that they desired positive, caring interactions with HIV care providers and clinic staff and noted that providers could play a critical role in helping PWH accept their HIV diagnosis and address HIV-related stigma and material needs. Overall, this sample of PWH in Cameroon reported that mental health-related help-seeking was limited in HIV care settings, but identified strategies that have the potential to enhance mental health related-help seeking in HIV care settings and may improve the mental health of PWH. The extent to which such strategies enhance mental health help-seeking and improve mental health should be evaluated.

Antiretroviral therapy has transformed human immunodeficiency virus (HIV) infection from a fatal illness into a manageable chronic condition. However, despite remarkable progress, the HIV epidemic remains a global health challenge, with ambitious targets such as 95-95-95 by 2030 at risk of being unmet. While antiretroviral therapy availability has expanded worldwide, gaps persist, including unawareness of HIV status, inconsistent medication uptake, and limited engagement in care across diverse settings. Advanced HIV represents a particularly challenging yet underexplored aspect of HIV care. Its definition is complex, complicating efforts to address the needs of this vulnerable population. This review characterizes advanced HIV populations, defines them by spectra of immune suppression, antiretroviral therapy exposure, and drug resistance, and explores contemporary approaches to their management, with a particular focus on drug resistance and its clinical implications in modern HIV care. It highlights the unique challenges faced by individuals presenting late to care, those with limited care engagement, and aging populations with long-term exposure to HIV and antiretroviral therapy. By defining these populations, refining our understanding of advanced HIV, and addressing the diverse needs of affected individuals, providers can enhance outcomes and develop strategies to overcome barriers to care. Bridging these critical gaps is essential to advancing global efforts to end the HIV epidemic, both in the USA and worldwide.

Depression and anxiety can greatly impact the overall health of a person living with HIV (PLHIV). Management of mental health disorder should be an integral part of HIV care. The Collaborative Care Model (CoCM) is an evidence-based model of care that integrates mental health in primary care. This study aimed to assess the acceptability and feasibility of implementing the CoCM for depression and anxiety in HIV clinics in the Philippines using HIV counsellors as care managers.

We conducted a descriptive qualitative study by facilitating focus group discussions (n = 7) and key informant interviews (n = 18) with 53 HIV and mental health stakeholders, including PLHIV (n = 20), HIV counsellors (n = 11), physicians (n = 10), clinic heads (n = 4), policy makers (n = 4), and mental health providers (n = 4) from August 2021 to March 2022. Participants were recruited from 17 HIV clinics in the Philippines. We employed a thematic analysis using the Consolidated Framework for Implementation Research (CFIR) domains as themes.

Almost all PLHIV participants were men (95%), with a mean age of 28 years. The other stakeholders had a mean age of 44 and had worked in their field for an average of 8 years. Overall, 58% were women. Factors that influenced the acceptability of the CoCM included the possibility of increased access to mental health services with a more holistic care team. Perceived barriers included inadequate numbers of psychiatrists, an overburdened and understaffed HIV workforce, low mental health knowledge among HIV providers, and implementation cost. Perceived facilitators were willingness of HIV providers to provide care and knowledge of HIV counselling.

We found the CoCM to be acceptable among study participants. Recommendations included capacity building for HIV providers, collaborations within and across clinics to facilitate access to psychiatrists, clear management protocols, and pilot testing. Mental health and HIV care coverage within national policies should be amended to allow for non-mental health specialists to provide low-intensity therapies. Closer partnerships among HIV and mental health policy makers would improve integration implementation.

This paper examines depression, post-traumatic stress disorder (PTSD), and comorbid depression/PTSD among Black and Latinx young and emerging adults (YEA) living with HIV. We incorporated a social-ecological framework to examine risk factors associated with mental health conditions, comparing foreign and US-born groups.

We used a hybrid recruitment strategy and surveyed 271 Black and Latinx YEA (ages 19-28 years) living with HIV in the Eastern USA. We used multivariable logistic regressions and hypothesized certain individual, interpersonal, community/societal risk factors would be positively associated with depression, PTSD, and comorbid depression/PTSD.

Participants experienced elevated rates of depression (33.9%), PTSD (34.0%), and comorbid depression/PTSD (19.1%). Contrary to our hypothesis, US-born participants had significantly higher rates of mental health conditions compared to foreign-born participants. At the individual-level, foreign-born was associated with lower comorbid depression/PTSD [RRR 0.38 (95% CI 0.15, 0.97)], cisgender with lower comorbid depression/PTSD [RRR 0.42 (95% CI 0.18, 0.99)], greater number of Adverse Childhood Experiences with PTSD [OR 1.18 (95% CI 1.08, 1.29)], and comorbid depression/PTSD [RRR 1.28 (95% CI 1.12, 1.47)], while moderate/high substance use with depression [OR 2.30 (95% CI 1.01, 5.25)] and comorbid depression/PTSD [RRR 3.74 (95% CI 1.07, 13.03)]. At the interpersonal-level, lower social support was associated with higher depression [OR 0.99 (95% CI 0.97, 1.00)], PTSD [OR 0.98 (95% CI 0.97, 0.99)], and comorbid depression/PTSD [RRR 0.97 (95% CI 0.96, 0.99)]. At the community/societal-level, discrimination was associated with higher depression [OR 1.05 (95% CI 1.02, 1.08)] and comorbid depression/PTSD [RRR 1.07 (95% CI 1.02, 1.11)].

Understanding social-ecological risk factors associated with mental health conditions of Black and Latinx YEA living with HIV is important in determining potential avenues for targeted prevention and intervention to improve mental health.

Introduction: Young people (aged 15-24) living with HIV/AIDS (YPLHIV) in sub-Saharan Africa (SSA) experience higher rates of mental health conditions compared to their uninfected peers. Research and practitioners have expressed interest in designing and implementing mental health interventions to improve the mental health and well-being of this vulnerable population. However, there is limited effort to systematically synthesize existing evidence on mental health interventions for YPLHIV to address salient questions relating to effectiveness, characteristics, practice issues among others to inform practice, and future research endeavors. This systematic review was conducted to take stock and synthesize existing data to address the above issues. Methods: This review was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy was implemented, utilizing five electronic databases and gray literature repositories. Studies (1) from SSA that focused on young adults with HIV/AIDS and (2) examined the effectiveness of interventions designed to enhance mental health outcomes and treatment adherence were included. Two independent reviewers were involved in the study selection, data extraction, and quality assessment, resolving discrepancies by consensus or consultation. Data were presented using narrative syntheses. Results: Eight studies met the inclusion criteria, with a total sample size of 1510 participants, reporting on interventions from six African countries. The interventions were categorized as follows: cognitive behavioral therapy-based, family-based, peer support, and community-based. The interventions showed mixed effectiveness for depression, with three studies demonstrating significant improvements while four showed no substantial change. The only study on improving anxiety reported promising results. Four interventions positively influenced ART adherence, although with varying magnitudes. Peer support, family-based approach, and digital (mobile phone) approaches were identified as effective strategies. Conclusions: The review showed promising approaches to improve mental health in YPLHIV, namely, through peer support, family-based, and digital (i.e., mobile phone) approaches. Although the results were mixed for depression and limited but positive for anxiety, several interventions improved ART adherence. However, the modest evidence base and varied measurement approaches necessitate more research across SSA.

Although anxiety, depression and insomnia in people with HIV (PWH) are prevalent and have a major impact on clinical outcomes and quality of life, physicians fail to evaluate them routinely. The CONECTAR Project [Neuropsychiatric Comorbidity (NPC): Key to Antiretroviral Treatment] aimed to improve NPC clinical care in PWH in Spain by upskilling healthcare professionals (HCPs).

A group of HCPs developed a training programme, supported by national and international guidelines, to improve expertise on detecting and managing NPCs in PWH. The programme was conducted through workshops for physicians and nurses in various Spanish regions from April to November 2023; survey questionnaires were administered to physicians before the commencement of training and 15 days after. Later, a workshop was held for nurses who manage NPCs in PWH.

The programme was completed by 64 physicians (22 had completed both questionnaires) and 11 nurses (no feedback obtained). Feedback from physicians reflected that the programme boosted awareness and self-perception of being more qualified, knowledgeable and able to use management tools and resources. Physicians also reported improved perception of time available for visits and more frequent enquiries about patients' NPC symptoms. Despite their satisfaction with the workshops, half of the physicians recognized the need for more training.

The CONECTAR Project was a successful training programme that was well received and valued by HCPs who routinely manage NPCs in PWH. Institutions involved in HCP training to manage anxiety, depression and insomnia more effectively in PWH should consider similar proposals to reinforce clinical practices.

Leveraging patient preferences can improve patient satisfaction and engagement in intentional health services. We explored desired health services preferences of marginalized populations accessing HIV-related care engagement to inform the implementation of an HIV prevention and treatment mobile clinic model. We conducted a maximum-difference survey with 154 people at community events and homeless encampments in Oakland, CA. Participants ranked 32 items in differentials of importance on a tablet, which were analyzed with Hierarchical Bayesian modeling. Fourteen services were prioritized, including housing, mental health counseling and screening, drug overdose prevention, personal hygiene, and food assistance. Participants indicated preferences for services that address basic physiological and safety needs (i.e., housing services, food, personal hygiene supplies, drug overdose treatment, and mental health support and engagement), physical examinations, screenings, and medication refills. Incorporating community-informed preferences into the development of services may improve engagement in care alongside a syndemic approach toward ending the HIV epidemic.

Pre-exposure prophylaxis (PrEP), an effective biomedical prevention intervention, is not sufficiently reaching populations experiencing high HIV incidence. Behavioral health (BH) treatment addressing mental health and substance use similarly requires increased reach to HIV-affected populations. HIV testing is an opportunity to refer individuals to PrEP and BH treatment. This study, conducted in Miami-Dade County, FL, a domestic HIV epicenter, aimed to assess (1) self-reported rates at which HIV test counselors refer clients to PrEP and BH treatment, (2) barriers and facilitators to PrEP and BH treatment referral, and (3) the relationship between barriers and facilitators and test counselors' referral rates. Among 127 HIV test counselors, the average PrEP referral rate was 63.8% (SD = 41.5) of those potentially meeting PrEP indications. Insufficient time was associated with lower PrEP referral (OR: 0.64, 95% CI: 0.42-0.99, p = 0.023) and training in PrEP screening was associated with higher rates of PrEP referral (OR: 1.27, 95% CI: 0.98-1.64, p = 0.034). The average BH treatment referral rate was 52.7% (SD = 44.4) of clients who the counselor felt would potentially benefit from treatment. Counselors lacking knowledge of screening (OR: 0.4, 95% CI: 0.2-0.78, p = 0.004), referral procedures (OR: 0.45, 95% CI: 0.23-0.87, p = 0.008), or locations to refer clients (OR: 0.47, 95% CI: 0.25-0.86, p = 0.008), as well as those with higher caseloads (OR: 0.998, 95% CI: 0.997-0.999, p < 0.001) were less likely to refer for BH. Training in substance use screening (OR: 1.26, 95% CI: 0.96-1.64, p = 0.046) and referral (OR: 1.28, 95% CI: 0.99-1.66, p = 0.029) were associated with increased BH referral. Implementation strategies are needed to address key barriers to PrEP and BH referrals in HIV testing contexts.

Heavy alcohol use is common in Malawi among people receiving sexually transmitted infections (STI) care and is a critical barrier to the success of HIV prevention and treatment efforts.

This protocol presents a pilot hybrid type 1 effectiveness-implementation trial evaluating the short-term effectiveness and implementation of a scalable evidence-based intervention (EBI) to reduce alcohol use and provide HIV prevention and treatment counseling for people with heavy drinking receiving STI care in Malawi. We developed a 3-session intervention, Treat4All, that uses motivational interviewing, problem-solving skills, psychoeducation, alcohol refusal, HIV prevention and treatment skills building, and goal setting to reduce alcohol and facilitate engagement in HIV prevention and treatment. We have also integrated HIV prevention content to focus on persistent PrEP use and HIV treatment adherence to improve antiretroviral therapy (ART) adherence and viral suppression. We will conduct a two-arm pilot randomized controlled trial (RCT) in an STI care setting in urban Malawi to compare the preliminary effectiveness and implementation of Treat4All to usual care for decreasing the proportion of heavy drinking days, corroborated with phosphatidylethanol, an alcohol biomarker, and improving HIV outcomes (viral suppression among PWH; PrEP use among those at risk). We will randomly assign 160 people receiving STI care in Lilongwe who report heavy drinking (n = 80 people with HIV; PWH; n = 80 people at high risk of HIV acquisition) to Treat4All or usual care.

Our study will produce a systematically braided, scalable HIV status-neutral EBI for alcohol reduction and optimization of HIV prevention and treatment behaviors to evaluate in a larger effectiveness-implementation trial. Our study will directly expand alcohol reduction and HIV status-neutral programs for alcohol-impacted populations throughout sub-Saharan Africa and other regions where alcohol contributes to the ongoing HIV epidemic.

ClinicalTrials.gov, NCT06668363.

Unhealthy substance use and physical inactivity are prevalent co-occurring risk factors for morbidity and mortality among people with HIV (PWH). Evidence-based exercise interventions targeting both risk factors are limited. We conducted a literature search across seven databases for relevant articles published through 05/07/24. Studies qualified if they involved: (a) PWH ≥ 18 years old who engage in unhealthy substance use; (b) randomized controlled trials (RCTs) or quasi-experimental designs; and (c) an exercise intervention. Two researchers independently completed the Cochrane Data Collection Form and Joanna Briggs Institute Critical Appraisal Tool. PROSPERO registry: CRD42023473582. Out of 6916 potentially qualifying studies, 46 underwent full-text review, and 7 studies qualified (6 pilot RCTs & 1 quasi-experimental). Most (k = 6) were conducted in the US. Sample sizes ranged from 16 to 73 participants and retention rates ranged from 42 to 100%. Interventions met at least 1x/week for 6-24 weeks and consisted of supervised progressive overload aerobic/resistance training (k = 3), home-based training with virtual behavioral counseling (k = 1), yoga (k = 2), and tai-chi with cognitive behavioral therapy (k = 1). Despite inconsistent assessment tools and outcomes measured, exercise interventions were significantly (p < 0.05) and positively associated with outcomes relating to improving HIV, substance use, physical activity, strength/fall risk, quality of life/stress, and pain relief. All studies were high quality with low risk of bias, safe, and feasible. Despite small sample sizes and heterogeneity across studies, evidence from this systematic review supports the use of exercise to improve a variety of health outcomes among PWH with unhealthy substance use.

Enhancing mental health-related quality of life (MHRQOL) is an important clinical objective for people with HIV (PWH), due to their elevated risk of psychological distress and mental health challenges. Depression, pain, stigma, and discrimination are among the main contributors to poor MHRQOL in this population and can negatively impact PWH's interaction with their healthcare providers, and vice versa. We used structural equation modeling to examine whether the quality of patient-provider engagement in HIV primary care mediated the effects of depression and prior experiences of discrimination in healthcare settings on later MHRQOL, assessed using the SF- 12 Mental Component Summary (MCS- 12), among a sample of predominately African Americans with HIV and a history of drug use. A total of 331 participants, recruited from HIV clinics and community venues in Baltimore, Maryland, USA, completed three semi-annual surveys between 2014 and 2018. At baseline, the sample showed a high percentage of probable depression (35.6%) and a low MCS- 12 mean score (38.72, SD = 6.88) compared with the US general population norm of 50 (SD = 10). There were significant indirect paths from baseline depression (β = - 0.04, 95% CI = - 0.10, - 0.01) and healthcare discrimination (β = - 0.05, 95% CI = - 0.12, - 0.01) to lower MHRQOL at 12-months, mediated through reduced patient-centered patient-provider engagement with primary care providers at 6-months, after adjusting for baseline assessment of the mediator and the outcome, demographic covariates, substance use, pain level, and time since HIV diagnosis. Findings suggest a potential for mitigating the impacts of depression and healthcare discrimination on MHRQOL through intervening on the quality of patient-provider engagement.

Cumulative evidence indicates that compared to HIV negative individuals, people living with HIV (PLWH) have a higher likelihood of developing depression, anxiety, and cognitive disorders. Depression, which is known to be a persistent and overwhelming feeling of sadness accompanied by a loss of interest in usual activities, is one of the most common mental illnesses encountered during HIV infection. Experts believe that several factors such as neuroinflammation, life stressors, lack of sleep, poor nutritional state, opportunistic infections and comorbidities, and HIV medications are contributing factors favoring the development of depression in PLWH. However, the fundamental mechanisms which underlie the involvement of these factors in the emergence of depression in the context of HIV remain poorly explored. Past researches describing the role of one or two of the preceding factors do exist; however, very few articles tackle this important topic while considering the several different putative causative factors comprehensively in the particular context of HIV infection. Herein, we elaborate on the factors currently understood to be responsible for the development of depression, and discuss the particular fundamental mechanisms whereby each factor may result in the outcome of depression. We believe that the understanding of these factors and of their underlying mechanisms is essential for the development of future therapeutic interventions to alleviate the burden of depression commonly seen in PLWH, and therefore facilitate the development of strategies to improve their overall quality of life.

People who have behavioral health disorders are disproportionately represented among people with HIV and those likely to be diagnosed with HIV. Despite repeated calls for the past decade for the integration of behavioral health into the HIV Care Continuum, findings from priority jurisdictions show these efforts lag. We present 5 examples of efforts to integrate behavioral health services into the HIV Care Continuum, across regions and populations in Ending the HIV Epidemic priority regions. Across diverse settings, care provision-screening, assessment, referrals, and treatments-remains insufficient. Consistent, ongoing actions are needed to address the compounded consequences of the HIV and behavioral health synergistic epidemics, or syndemic. The studies in this article involved local communities, provider groups, and people with lived experience of trauma, serious mental illness, neuropsychological disorder, substance use disorder, and HIV. These example studies reveal significant unmet needs for behavioral health care and/or HIV prevention and treatment in these priority communities. A common finding among these examples was that the success of interventions hinges on the extent to which interventions are tailored to local contexts and the specific needs of historically underserved populations, including Black women, the socioeconomically disadvantaged, LGBTQIA+ individuals, and people with serious mental illness and/or substance use disorders. We suggest recommendations for how Ending the HIV Epidemic efforts can be optimized to adapt and implement integrated HIV and behavioral health care to advance national goals.

Human immunodeficiency virus (HIV) remains a major public health issue in the United States (US) and Black women living with HIV (BWLWH) are disproportionately impacted among women. This study investigates the complexities in influences of family, friend, and special person support systems and their association with post-traumatic stress disorder symptoms (PTSD), depressive symptoms, gendered coping (self-silencing), and a composite HIV risk score related to risk of viral non-suppression through missed medical visits, low medication adherence, and high viral load. Cross-sectional data among BWLWH were analyzed using network analyses via RStudio. Data from 119 BWLWH was reduced to 104, because of missing data on indicators as well as pairwise deletion for the correlation function. Findings revealed variances based on the type of network. For composite risk scores, friend support source had a weak to moderate significant correlation, while symptoms of PTSD and depression only showed a weak positive correlation with the composite risk variable through self-silencing as a form of coping. The post-hoc analysis showed a strong correlation with care as self-sacrifice, based on the composite risk score. Based on the findings from this study, insight was given into symptoms for depression and PTSD, as well as self-silencing and viral non-suppression risk in relation to sources of support for BWLWH. Future interventions to improve the overall health of BWLWH may benefit from incorporating support from friends and lowering care as self-sacrifice.

BackgroundPregnant women living with HIV are known to be at higher risk of depression than pregnant women without HIV. Accompanied by a systematic literature review, the aim of this study was to determine the global prevalence of depression in pregnant women living with HIV.MethodsPubMed, Scopus, Google Scholar and Web of Science databases were searched. The references of the included publications and a similar meta-analysis study were also reviewed. The 19 included studies were assessed for quality using standard forms. Pooled prevalence was calculated using a random effects model. Heterogeneity and publication bias were assessed using various methods. Subgroup analyses and meta-regression were also performed.ResultsOf the 19 studies included in the review, six of the studies were published between 2008 and 2014, and 13 were published between 2017 and 2023. 15 studies were conducted in African countries. According to study type, eight studies were cross-sectional and seven were cohort studies. The pooled prevalence of depression was calculated to be 45%. The prevalence in African countries was 37.7%. The studies were found to be statistically significantly heterogeneous. Tests and funnel plots showed no publication bias in this meta-analysis. The variables place, study type and scale made the model significant in the meta-regression.ConclusionIn this meta-analysis, 6379 women aged 18 years and older were examined and their depression levels were found to be high. Taking steps to struggle with HIV and depression in people living with HIV seems important.

This study examines the relationships between HIV stigma dimensions, self-related mechanisms, and depressive symptoms among persons living with HIV.

HIV stigma hinders the well-being of individuals living with HIV, which is linked to depressive symptoms and increased risk of poor clinical outcomes. However, the mechanisms underlying stigma's impact on depression are poorly understood. Psychosocial theories propose that experiencing HIV stigma leads to internalized stigma, impacting self-concept and mental health.

Using Bayesian network analysis, we explored associations among HIV stigma processes (experienced, anticipated, internalized, perceived community stigma, and HIV status disclosure) and self-related mechanisms (self-esteem, fear of negative evaluation [FNE], self-blame coping, and social exclusion), and depressive symptoms.

Our diverse sample of 204 individuals, primarily men, gay/bisexual, Black, and lower-middle SES, who experienced stigma showed increased anticipated, internalized, and perceived community stigma, FNE, and depressive symptoms. Internalized stigma contributed to self-blame coping and higher depressive symptoms. Anticipated and perceived community stigma and FNE correlated with increased social exclusion.

This study investigates potential mechanisms through which HIV stigma may impact depression. Identifying these mechanisms establishes a foundation for future research to inform targeted interventions, enhancing mental health and HIV outcomes among individuals living with HIV, especially from minority backgrounds. Insights gained guide evidence-based interventions to mitigate HIV stigma's detrimental effects, ultimately improving overall well-being and health-related outcomes for people with HIV.

Childhood maltreatment and HIV are both associated with a greater risk for adverse mental health, including posttraumatic stress disorder (PTSD), depression, and increased systemic inflammation. However, it remains unknown whether childhood maltreatment and HIV interact to exacerbate PTSD, depression, and inflammation in a manner that may further increase the risk of adverse health outcomes in people living with HIV. This study investigated the interaction between childhood maltreatment and HIV status on PTSD and depression symptom severity, and on peripheral concentrations of lipopolysaccharide (LPS) and high sensitivity C-reactive protein (hsCRP) in women. We hypothesized that women living with HIV (WLWH) who report high levels of childhood maltreatment exposure would show the greatest PTSD and depressive symptoms, as well as the highest concentrations of LPS and hsCRP.

We conducted a cross-sectional study of 116 women (73 WLWH and 43 women without HIV). Participants completed interviews to measure trauma exposure, including childhood maltreatment, and PTSD and depression symptoms. They also provided blood samples that were analyzed for LPS and hsCRP concentrations.

Both women living with and without HIV reported high rates of trauma exposure and showed no statistically significant differences in overall rates of childhood maltreatment. Moderate to severe childhood maltreatment was associated with higher PTSD symptom severity (p =.005), greater depression severity (p =.005), and elevated plasma LPS concentrations (p =.045), regardless of HIV status. There were no effects of childhood maltreatment on hsCRP concentrations. There were no detectable significant effects of HIV status, or interactions between HIV status and childhood maltreatment, on PTSD and depression symptoms, or LPS and hsCRP concentrations (all p's > 0.05).

Our findings highlight the impact of childhood maltreatment on depression and PTSD symptoms and LPS concentrations in women. These results underscore the importance of trauma-informed health care in addressing childhood maltreatment to potentially improve both mental and physical health outcomes of adult women.

Although pre-exposure prophylaxis (PrEP) has been available in Singapore since 2016, its uptake among gay, bisexual and other men-who-have-sex-with-men (GBMSM) is low. The iPARTY study was established to evaluate the acceptability and feasibility of PrEP and a PrEP teleconsultation service for young GBMSM aged 18 to 29 years.

A total of 53 young GBMSM were enrolled in the iPARTY study. They had a total of 5 in-person consultations and teleconsultations, at 12-week intervals. Laboratory tests and quarterly baseline surveys were performed to assess PrEP adherence, sexual behaviour, and incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs).

Thirty-five participants completed the entire 12-month follow-up. Most participants had positive experiences with PrEP teleconsultations. There was a statistically significant fall in participants' aggregate Patient Health Questionnaire-9 scores throughout the study. Self-reported PrEP adherence decreased over the course of the study, denoting improved mental health. Although self-reported condom use for anal intercourse and participants' risk perception of HIV decreased after PrEP adoption, there was no statisti-cally significant increase in STI incidence.

This pilot project has shown that PrEP services provide an opportunity for YMSM to access sexual health testing, treatment and counselling, and may even have tangible benefits on the mental health of this population. Teleconsultation is shown to be a suitable platform for the delivery of such services. Collaborative initiatives are crucial to further enhance the affordability and accessibility of PrEP in Singapore, and to improve patient adherence.

Objectives: The aim of this study was to assess sleep quality in people living with HIV (PLWH), and to examine how the sleep sphere interacts with mental health, quality of life and internalized stigma. Methods: A total of 250 PLWH were consecutively enrolled during routine outpatient visits. Each participant completed a 67-item questionnaire. Sleep disturbances were measured using the Pittsburgh Sleep Quality Index (PSQI). The Depression, Anxiety and Stress Scale (DASS-21) was used to measure the mental health status. The Short Form 12 (SF-12) questionnaire was used to measure participants' quality of life. Internalized HIV-related stigma was evaluated using the modified six-item internalized AIDS-related stigma scale. Results: Many of the PLWH were male (69.2%) and the time between HIV diagnosis and first antiretroviral therapy (ART) was over 10 years (69.2% and 64%, respectively). The PSQI component most-cited as problematic by PLWH was habitual sleep efficiency (52.4%). In multivariate analysis models, a higher mean in the PSQI total score was significantly associated with internalized stigma (mean change 1.10), depression (mean change 6. 20), anxiety (mean change 12.15), stress (mean change 6.24), physical (mean change 7.54) and mental (mean change 3.56) quality of life, health status (mean change -6.04), ART adherence (mean change -5.08) and physical activity (mean change -6.20). Conclusions: Our results confirm the role of sleep quality in both mental and physical health and suggest that sleep disorders might also be a significant indicator of psychosocial challenges faced by PLWH.

Mental health disorders contribute to a lack of HIV care retention and adherence. Pharmacotherapy for mental health treatment may increase retention and adherence. However, there is often a lack of pharmacotherapy services for mental health treatment available in HIV care. The current study explores the extent to which people living with HIV find the integration of pharmacotherapy for mental health treatment into HIV care acceptable and appropriate. We conducted in-depth interviews with ten patients living with HIV and comorbid mental health or substance use challenges. We used rapid qualitative analysis to analyze the transcript data. Patients cited several barriers to mental health treatment, including having to coordinate and establish rapport with other providers. Participants' perspectives about whether HIV care providers should provide pharmacotherapy for mental health treatment varied. However, most respondents agreed that it would be beneficial for HIV care providers to maintain existing regimens or address lapses in mental health care. Patients also cited benefits to integration, including the ability to receive care from a trusted provider and increased access. These findings add to previous literature and demonstrate the nuanced nature of the acceptability of receiving pharmacotherapy for mental health treatment from an HIV care provider.

Youth living with HIV (YLHIV) face multidimensional challenges, including stigma, mental health struggles, and socioeconomic instability, which are further magnified among adolescents and young adults with perinatally acquired HIV (APHIV). Peer-led differentiated service delivery (DSD) models providing tailored support for this population have demonstrated improved outcomes, though their adaptation and implementation in India remain underexplored. We examined multi-stakeholder perceptions within a peer-support DSD intervention in India, the I'mPossible Fellowship, designed to address the health, educational, and livelihood needs of APHIV. Between May and December 2023, we enrolled three stakeholder groups involved in the I'mPossible fellowship intervention: (1) intervention deliverers (APHIV "fellows"), (2) facilitators ("supervisors" of APHIV), and (3) beneficiaries (APHIV "peers"). To examine fellows' roles and growth, we conducted in-depth interviews with fellows (n=8; 75% female; mean age: 22.5 years) and supervisors (n=7). Aiming to explore fellow-peer interactions and perceived program impact, we conducted three focus group discussions with purposefully sampled peers (n=18; 66.7% male; mean age: 16.7 years). Data collected were audio recorded, transcribed, and translated from Kannada to English for coding and analysis. Thematic deductive analysis was combined with data triangulation across participant groups to synthesize findings. Five key themes emerged, highlighting the layered influences of the I'mPossible Fellowship. First, mentorship was an important theme that provided informational and emotional support for peers; second, peer influence arising from peer-to-peer interactions contributed to a sense of trust and affirmation. Third, personal growth experienced by fellows stimulated their motivation to fulfil their mentorship roles effectively. Fourth, complex systemic challenges, such as stigma and discrimination, hindered educational and employment advancement of APHIV. Fifth, sustainability, through robust post-fellowship systems and continued mentoring support, was emphasized by supervisors and fellows as crucial for supporting APHIV in transitioning to independent living. This study highlights the pivotal role of fellows and the bi-directional power of peer mentorships in addressing the multilevel factors that enhance outcomes for APHIV. By providing knowledge and empathy to their peers and serving as credible role models with lived experience of HIV, fellows within the I'mPossible fellowship exemplify a successful DSD model incorporating the three essential attributes of peer support: informational, emotional, and affirmative support. While these findings underscore the importance of integrating peer-led interventions into HIV care frameworks to support youth with HIV, this also reframes youth as active agents of change, recognizing their capacity for empowerment and meaningful societal contribution rather than passive recipients of care.

Adolescents living with HIV are at an increased risk of experiencing mental health challenges, which may impact their overall well-being and adherence to treatment. Evidence-based interventions are crucial to addressing these issues; however, the effectiveness of these interventions remains unclear. This scoping review aimed to synthesize all interventions that tested either the prevention or improvement of mental health for adolescents living with HIV.

We used PubMed, PsycINFO, CINAHL, Embase, and Cochrane to identify RCTs evaluating mental health interventions for HIV-infected adolescents.

A scoping review included 13 out of 1015 studies demonstrating the global relevance of addressing mental health in this population. Interventions were diverse and showed mixed effectiveness in improving mental health outcomes such as depression, anxiety, trauma, and behavioural symptoms. Factors contributing to mixed results included variations in intervention design, study characteristics, and contextual factors. Identified gaps in the literature encompassed the limited number of studies in some regions and the lack of research on specific subpopulations and long-term intervention effectiveness.

A mixed result needs to be confirmed in future RCTs. This review provides valuable insights into improving the mental health of HIV-infected adolescents and can guide further research and practice in this area.

Perinatal women living with HIV face increased susceptibility to mental health challenges, including suicidal ideation (SI). This study aimed to determine the prevalence of SI among perinatal women with HIV and identify associated factors. A systematic search was done across PubMed, Embase, Scopus, ScienceDirect, and Google Scholar. Data analysis was executed using R software. Publication bias was assessed via funnel plot and Egger's test, while heterogeneity was investigated using the I2 statistic. A total of 11 studies involving 4329 participants were included. The pooled prevalence of SI was 23.4% (95% CI: 16.3-32.4). Subgroup analysis showed higher prevalence in postnatal women (36.4%) than antenatal women (27.8%), although this difference was not statistically significant. Studies employing the Edinburgh Postnatal Depression Scale reported a higher prevalence (38.9%). Studies published between 2013-2017 showed a higher prevalence (37.6%) compared to those published between 2018-2022 (18.2%). Factors associated with SI included depression during pregnancy or postpartum, unplanned pregnancy, intimate partner violence, undisclosed HIV status, lack of social support, and recent diagnosis of sexually transmitted infections other than HIV. The high prevalence of SI emphasizes the need for mental health screening and interventions. Mental health assessments should be integrated into routine antenatal and postnatal care.

Our objective was to explore how women living with HIV aged ≥40 years perceive their care in relation to their HIV infection, comorbidities, and menopausal health and to evaluate the extent to which the care they receive meets their expectations, comparatively across World Health Organization (WHO) European regions.

We conducted a cross-sectional survey (May-December 2023) among women living with HIV aged ≥40 years from the WHO European region. Five dimensions of care were assessed: content of care, information, relationship with caregiver, organization of care, and patients' rights and privacy, in addition to management of non-HIV comorbidities and menopause.

In total, 600 women completed the survey; they were predominantly from the Western European region (70.2%), followed by the Eastern (20.2%) and Central (9.6%) regions. The majority of women (46.5%-95.1%) described positive experiences, responding that they were 'always' or 'usually' satisfied with the five dimensions of HIV care. The concordance between perceptions and experiences of HIV care ranged from 49.4% to 96.1% and was lower in the Eastern region. Among menopausal women, 58.5% were 'very satisfied' or 'satisfied' with the care they received; satisfaction was significantly lower in Eastern European countries than in Western countries.

Our results highlighted a generally high concordance between respondents' expectations and the services provided, including both HIV and non-HIV care. Women aged ≥40 years living with HIV face several challenges that should be addressed. These findings inform stakeholders and decision-makers about the need to adopt a more inclusive and sensitive approach in healthcare systems.

HIV remains a significant public health concern, with an estimation of 39 million people infected. There is a lack of universally accepted benchmarks for prevalence of mental health problems among people living with HIV. We aimed to compute aggregate estimates of mental health problems among people living with HIV. We conducted a comprehensive literature search in PubMed, Web of Science, and Embase. Our inclusion criteria encompassed peer-reviewed cross-sectional or longitudinal studies conducted in any country that investigated people living with HIV and provided data allowing us to determine the prevalence of mental health problems. We conducted a meta-analysis to determine the combined prevalence of mental health problems among people living with HIV and consider predefined moderators by subgroup meta-analysis and meta-regression analysis. Our initial search identified 31 407 records. After removing the duplication and excluding ineligible records, 240 studies were included in our meta-analysis. Six commonly reported mental health problems were identified (depression, anxiety, suicidal ideation, post-traumatic stress disorder, stigma, and psychological distress). The pooled prevalence was 31% (95% CI 28-34) for depression, 29% (24-34) for anxiety, 20% (17-24) for suicidal ideation, 20% (13-28) for post-traumatic stress disorder, 47% (40-55) for stigma, 44% (31-56) for psychological distress. After considering predefined moderators, the heterogeneity was still observed. A high prevalence of mental health problems was observed among people living with HIV. Effective prevention and treatment programs can alleviate symptoms and promote mental health. This, in turn, can have a positive impact on all aspects of HIV management, leading to improved overall health outcomes for people living with HIV.

Mental health (MH) care for people living with HIV (PLWH) emerges as an important unmet need, yet there are no integrated HIV-MH clinics in Turkey. Our aim is to determine MH service use and its associated factors in PLWH followed up in the HIV/AIDS outpatient clinics in Istanbul/Turkey.

A cross-sectional study was conducted at the HIV/AIDS outpatient clinics of the Infectious Diseases (ID) departments in hospitals affiliated with the ACTHIV-IST Study Group. Structured interviews were performed using questionnaires that covered psychiatric state, medical history, and help-seeking behavior.

Out of 172 outpatients, 121 (70.3%) reported MH complaints after infection, and 65.6% felt a need to see MH professionals. Among those, 59% shared their MH distress with the ID team. However, only 20.7% applied to an MH service, and 16.5% received psychiatric treatment. Previous MH diagnoses (AOR = 4.11; 95%CI = 1.26-13.39), sharing the disease with the ID team (AOR = 4.18; 95%CI = 1.24-14.11), and being hospitalized due to HIV (AOR = 6.54; 95%CI = 1.21-35.39) emerged as the predictors of MH service use among those who would like to see an MH professional in logistic regression.

Closer contact with the healthcare system may increase the chances of PLWH receiving MH care. Thus, integrating MH services in HIV/AIDS care would help reach more PLWH who are distressed.

Depressive symptoms are highly prevalent among people with HIV, which can negatively impact HIV-related outcomes. We explore the cascade of mental healthcare for people with HIV experiencing depressive symptoms.

People with HIV who were part of the Pharmacokinetic and clinical Observations in PeoPle over fiftY (POPPY) study (2013-2016) were included. A Patient Health Questionnaire-9 (PHQ-9) score ≥10 or Center for Epidemiologic Studies Depression Scale (CES-D) ≥16 was defined as moderate/severe depressive symptoms. Diagnosed depression and access to mental healthcare were self-reported. A cascade of mental healthcare was explored, defining individuals experiencing depressive symptoms; those among them reporting a diagnosis of depression; and of this latter group, the proportion reporting accessing mental healthcare. Demographic, social and clinical characteristics were assessed at each step using logistic regression.

Of the 1009 participants (65.5% ≥50 years, 85.8% male, 85.1% white), 387 (38.4%) individuals were experiencing depressive symptoms, over half of whom (54.3%) reported a diagnosis of depression. Only 43.3% of individuals with diagnosed depression reported accessing mental healthcare. Men [odds ratio = 0.62, 95% confidence interval (CI): 0.42-0.92], people in a relationship (0.44, 0.33-0.59), those who were employed (0.28, 0.21-0.38) and those with university qualifications (0.54, 0.40-0.72) were less likely to experience depressive symptoms. Heterosexuals (0.30, 0.14-0.64) were less likely to report a diagnosed depression, whereas smokers were more likely to have a diagnosed depression (1.75, 1.10-2.77). Older individuals (2.36, 1.31-4.28) were less likely to have accessed mental healthcare.

Our findings suggest the presence of unmet mental healthcare needs for people with HIV. We hope these findings will inform policies to streamline mental health services for people with HIV.

Viral infections may disrupt the structural and functional integrity of the nervous system, leading to acute conditions such as encephalitis, and neuropsychiatric conditions as mood disorders, schizophrenia, and neurodegenerative diseases. Investigating viral interactions of human proteins may reveal mechanisms underlying these effects and offer insights for therapeutic interventions. This study explores molecular interactions of virus and human proteins that may be related to neuropsychiatric disorders.

Herpes Simplex Virus-1 (HSV-1), Cytomegalovirus (CMV), Epstein-Barr Virus (EBV), Influenza A virus (IAV) (H1N1, H5N1), and Human Immunodeficiency Virus (HIV1&2) were selected as key viruses. Protein structures for each virus were accessed from the Protein Data Bank and analyzed using the HMI-Pred web server to detect interface mimicry between viral and human proteins. The PANTHER classification system was used to categorize viral-human protein interactions based on function and cellular localization.

Energetically favorable viral-human protein interactions were identified for HSV-1 (467), CMV (514), EBV (495), H1N1 (3331), H5N1 (3533), and HIV 1&2 (62425). Besides immune and apoptosis-related pathways, key neurodegenerative pathways, including those associated with Parkinson's and Huntington's diseases, were frequently interacted. A total of 38 human proteins, including calmodulin 2, Ras-related botulinum toxin substrate 1 (Rac1), PDGF-β, and vimentin, were found to interact with all six viruses.

The study indicates a substantial number of energetically favorable interactions between human proteins and selected viral proteins, underscoring the complexity and breadth of viral strategies to hijack host cellular mechanisms. Further in vivo and in vitro validation is required to understand the implications of these interactions.

The effectiveness of antiretroviral therapy means that human immunodeficiency virus (HIV) can now be defined as a manageable chronic illness. It is the facilitation of psychosocial care that has increasingly become a priority, as people living with HIV (PLWH) are disproportionately impacted by psychosocial stressors compared to the general population. The aim of this study was to identify barriers and facilitators to psychosocial care for PLWH in Ireland.

A mixed methods study design was used, employing a national survey of PLWH (n = 54) via Qualtrics and semi-structured interviews with healthcare professionals that provide clinical support to PLWH across Ireland (n = 11). Content analysis was used to analyse the interviews.

More than half (59.3%) of survey respondents agreed that living with HIV currently impacts their mental health, with nearly two thirds (64.8%) agreeing that they have experienced stigma as a result of living with HIV. Less than half (40.7%) were comfortable disclosing their status to family, and less than a third (27.8%) to friends. Stigma was identified by healthcare professionals as a barrier to psychosocial care, along with a number of system-level barriers, provider-level or practical barriers, and individual barriers. The value of multidisciplinary care teams and reliance on community support was emphasised, and potential for further integration of support services was highlighted.

Community-based organisations contribute significantly to the facilitation of psychosocial support for PLWH in Ireland, and greater integration of community services could promote a more holistic, patient-centred approach to meeting the diverse needs of this growing cohort. PLWH benefit from multidisciplinary care teams, and the facilitation of safe and effective peer support should be encouraged to afford opportunities to disclose and receive social support. HIV-related stigma remains a barrier to psychosocial care, highlighting the need for stigma reduction interventions.

Mental health issues among women in Sub-Saharan Africa (SSA), especially those living with HIV, pose a major public health challenge. Despite the established connections between HIV status and mental health outcomes, there is a noticeable absence of targeted interventions for this group within the literature. Many studies tend to focus on broad mental health concerns without addressing the specific needs of women with HIV, or they neglect to incorporate mental health elements into current HIV-related programmes. This scoping review aims to gather and analyse the existing research on interventions designed to improve the mental health of women in SSA, both with and without HIV. It will identify barriers preventing this population from accessing mental healthcare, highlight important gaps in the current literature and suggest directions for future research.

To conduct this scoping review, the researcher will adhere to the methodological framework proposed by Arksey and O'Malley. The literature search will span several databases, including PubMed, MEDLINE, Web of Science and PsychInfo, to ensure a comprehensive collection of relevant studies. The selection process will involve two stages: two independent reviewers will initially screen titles for eligibility and a full-text review of the selected articles. A specially designed tool will be used for data extraction, focusing on minimising bias and accurately capturing study details. The final selection of studies will be analysed using a standardised tool to comprehensively assess all bibliographic information and study characteristics. The planned study dates for the review will be January to March 2025.

No ethical approval is required as the review will draw on publicly available publications and materials. The study's conclusions will be subject to peer review and published in a scientific journal, with the abstract shared at local and international conferences. Key findings will be disseminated to health ministries, community-based organisations focused on women's mental health and HIV, and policymakers to inform policy decisions regarding mental health interventions for women in SSA.

Depression among adolescents and young adults with HIV affects both their wellbeing and clinical care outcomes. Integrated care models are needed. We hypothesized that the SEARCH-Youth intervention, a life-stage-based care model that improved viral suppression, would reduce depressive symptoms as compared to the standard of care. We conducted a mixed-methods study of youth with HIV aged 15-24 years in SEARCH-Youth, a cluster-randomized trial in rural Uganda and Kenya (NCT03848728). Depression was assessed cross-sectionally with the PHQ-9 screening tool and compared by arm using targeted minimum loss-based estimation. In-depth semi-structured interviews with young participants, family members, and providers were analyzed using a modified framework of select codes pertaining to depression. We surveyed 1,234 participants (median age 21 years, 80% female). Having any depressive symptoms was less common in the intervention arm (53%) compared to the control (73%), representing a 28% risk reduction (risk ratio: 0.72; CI: 0.59-0.89). Predictors of at least mild depression included pressure to have sex, physical threats, and recent major life events. Longitudinal qualitative research among 113 participants found that supportive counseling from providers helped patients build confidence and coping skills. Integrated models of care that address social threats, adverse life events, and social support can be used to reduce depression among adolescents and young adults with HIV.

In the combination antiretroviral therapy era, HIV-associated neurocognitive disorder (HAND) is still widespread among HIV-infected individuals. However, there is no effective treatment for HAND, and the exact pathogenic mechanism of HAND remains unknown. This paper aims to provide a reference for further exploration in the field of HAND research.

We used CiteSpace software to collect 3057 articles related to HAND in the Web of Science Core Collection for comprehensive analysis. Betweenness centrality, count, and burst values were used as indicators in the visualization analysis, aiming to predict future new directions and cutting-edge trends.

The last decade has been the peak period of HAND research, with the most prominent contributions by authors, countries, and institutions being Grant, Igor (135), the USA (2211), and the University of California System (758), respectively. The most frequently cited article is "HIV-associated neurocognitive disorders persist in the area of potent antiretroviral therapy: CHARTER Study." The hotspots in this field are "neurocognitive impairment," "central nervous system," "cerebrospinal fluid," "HIV-1 tat," "SIV," "inflammation," "infection," and "pathogenesis." The current research direction of HAND is focused on exploring the pathogenic mechanism underlying HIV-associated neurocognitive impairment and potential therapeutic targets.

This study provides a bibliometric visualization of HAND-related literature to gain insight into the development and frontiers of this research field. The study also provides scholars with detailed references and identifies future research directions to better promote the development of this field of research.

Youth experiencing homelessness (YEH) face challenges that increase their susceptibility to HIV/STIs. Nurse case management is effective in managing the complex needs of populations experiencing homelessness and reducing HIV risk. A randomized wait-list control study conducted between September 2019 to May 2023 evaluated the CAYA "Come As You Are" intervention. This nurse-led HIV prevention for YEH aged 16-25 years focused on the uptake of HIV prevention methods: pre- and post-HIV exposure prophylaxis (PrEP, nPEP), HIV/STI testing and treatment, sober sex, and condom use. Secondarily, we examined intervention impact on housing stability. Descriptive statistics were calculated by study arm. Multiple imputation (m = 10) was used for missing values and intervention effects were estimated from Bayesian multilevel models with noninformative priors. Participants (N = 450) were 21.1 years old on average, 62% Black, 11% Hispanic, 11% White, and 10% other race and reported being homeless for an average of 3 years. An intervention effect was found for PrEP use, which showed a larger increase from baseline to first follow-up (OR = 3.27; 95% Cr.I.: 1.13 to 10.14). No intervention impact was found for nPEP use, HIV and STI cases, sober sex, or condom use. Sheltering arrangements improved from baseline to the first follow-up in both groups with increase in shelter stability (OR = 3.85; 95% Cr.I.: 1.61 to 10.30) and decreased shelter transiency (OR = 0.29; 95% Cr.I.: 0.14 to 0.60). This study demonstrates that a personalized, nurse-led HIV prevention approach increased uptake of some but not all HIV prevention strategies among YEH. CLINICAL TRIAL REGISTRATION NUMBER: NCT03910218.

Patient-reported outcomes (PROs) have emerged as a valuable tool for aligning HIV care with patient needs and priorities. This study aimed to explore patient and healthcare provider (HCP) experiences of integrating a PRO solution into standard clinical care for HIV in a Danish outpatient clinic.

A tailored PRO solution for people living with HIV was developed in a Danish outpatient clinic. Patients were eligible if they were aged >18 years, spoke Danish, had been on effective antiretroviral therapy for 2 years, and had no additional health issues. Patients completed an electronic questionnaire 14 days before in-clinic consultations. HCPs reviewed patients' responses before these consultations. We assessed the usability, acceptability, and relevance of the PRO solution by conducting semi-structured interviews with 24 patients (12 responders and 12 non-responders) and six HCPs. A further 95 non-responders were interviewed over the phone. Data were analysed using thematic analysis.

Respondents found that PROs improved patient-provider communication, treatment planning, and self-management. Non-respondents faced barriers such as health literacy, cultural beliefs, and access to technology, necessitating alternative delivery methods. HCPs found that PROs facilitated person-centred care and symptom management, but HCPs faced challenges such as insufficient training, resources, and organizational support.

Implementing PROs in HIV care is challenging because of the patient diversity, clinician training needs, and organizational adaptations. Nevertheless, the use of PROs is associated with enhanced person-centred care. Future recommendations include tailored use of PROs, better understanding of the impact on patient groups, on-site questionnaire completion, and emphasis on shared decision-making between patients and HCPs.