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  1. Article ; Online: Early HIV viral suppression associated with subsequent 12-month treatment success among people living with HIV in South Africa.

    Violette, Lauren R / Thomas, Katherine K / Dorward, Jienchi / Quame-Amaglo, Justice / Garrett, Nigel / Drain, Paul K

    HIV medicine

    2024  

    Abstract: Background: We analyzed the STREAM (Simplifying HIV TREAtment and Monitoring) study to determine risk factors associated with HIV viraemia and poor retention 18 months after initiation of antiretroviral therapy (ART).: Methods: The STREAM study was ... ...

    Abstract Background: We analyzed the STREAM (Simplifying HIV TREAtment and Monitoring) study to determine risk factors associated with HIV viraemia and poor retention 18 months after initiation of antiretroviral therapy (ART).
    Methods: The STREAM study was an open-label randomized controlled trial in Durban, South Africa, that enrolled 390 people living with HIV presenting for their first HIV viral load measurement ~6 months after ART initiation. We used modified Poisson regression with robust standard errors to describe associations between baseline characteristics and three HIV outcomes 18 months after ART initiation: HIV viraemia (>50 copies/mL), poor retention in HIV care, and a composite outcome of poor retention in care and/or HIV viraemia.
    Results: Approximately 18 months after ART initiation, 45 (11.5%) participants were no longer retained in care and 43 (11.8%) had viraemia. People with CD4 counts <200 and those with viraemia 6 months after ART initiation were significantly more likely to have viraemia 18 months after ART initiation (adjusted relative risk [aRR] 4.0; 95% confidence interval [CI] 2.1-7.5 and aRR 5.5; 95% CI 3.3-9.0, respectively). People who did not disclose their HIV status and had viraemia after ART initiation were more likely to not be retained in care 12 months later (aRR 2.6; 95% CI 1.1-6.1 and aRR 2.2; 95% CI 1.0-4.8). People with a CD4 count <200 and those with viraemia were more likely to not achieve the composite outcome 18 months after ART initiation.
    Conclusions: Viraemia after ART initiation was the strongest predictor of subsequent viraemia and poor care retention. Understanding early indicators can help target our interventions to better engage people who may be more likely to experience persistent viraemia or disengage from HIV care.
    Language English
    Publishing date 2024-03-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2001932-4
    ISSN 1468-1293 ; 1464-2662
    ISSN (online) 1468-1293
    ISSN 1464-2662
    DOI 10.1111/hiv.13633
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  2. Article: Efficient Expansion of a Behavioral Survey to Assess Sex, Gender, and Behavioral Risk Among Transgender and Nonbinary Individuals: HMU! (

    Frank, Noah / McMahan, Vanessa M / Violette, Lauren R / Martin, Aleks / Glick, Sara N / Stekler, Joanne D

    Transgender health

    2023  Volume 8, Issue 5, Page(s) 472–476

    Abstract: Transgender and gender nonbinary (TGNB) individuals are at high risk for HIV acquisition. However, TGNB individuals are often excluded from research and public health surveillance, both as participants and as reported sexual partners. This research study ...

    Abstract Transgender and gender nonbinary (TGNB) individuals are at high risk for HIV acquisition. However, TGNB individuals are often excluded from research and public health surveillance, both as participants and as reported sexual partners. This research study aimed to be inclusive, correctly classify TGNB participants, and accurately describe sex partners and sexual activity of participants to assess HIV risk while minimizing participant burden. The adaptation of survey questions designed for cisgender men to include TGNB participants and partners was feasible and relatively straightforward. However, additional work is still needed in this area to increase inclusivity and research participation by TGNB individuals. Clinical Trial Registration Number - NCT03584282.
    Language English
    Publishing date 2023-10-04
    Publishing country United States
    Document type Journal Article
    ISSN 2688-4887
    ISSN 2688-4887
    DOI 10.1089/trgh.2021.0082
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  3. Article ; Online: Challenges recruiting and retaining people at risk for HIV who use methamphetamine in a randomized PrEP adherence trial in Seattle, WA.

    McMahan, Vanessa M / Atkins, Dana L / Buckler, Smitty / Violette, Lauren R / Niemann, Lisa / Frank, Noah / Kimiam Waters / Herrera Perales, Luis Enrique / Viquez, Luis / Tung, Elyse / Stekler, Joanne D

    International journal of STD & AIDS

    2024  , Page(s) 9564624241244835

    Abstract: Background: Methamphetamine is associated with increased HIV risk and suboptimal adherence to pre-exposure prophylaxis (PrEP). Interventions to support PrEP adherence for people who use methamphetamine are needed.: Methods: We evaluated peer ... ...

    Abstract Background: Methamphetamine is associated with increased HIV risk and suboptimal adherence to pre-exposure prophylaxis (PrEP). Interventions to support PrEP adherence for people who use methamphetamine are needed.
    Methods: We evaluated peer navigation to support adherence among people initiating PrEP who use methamphetamine. The
    Results: We enrolled 21 participants of a target sample of 40, of whom 20 were prescribed PrEP. Nine participants (43%) received peer navigation and 12 (57%) received standard of care or text messaging. At baseline, most participants reported at least weekly methamphetamine use (17, 81%) and condomless receptive anal intercourse (CRAI) (16, 76%). One-third reported CRAI with a partner with HIV. Among those who provided a DBS, 78% and 50% had results commensurate with ≥4 pills/week at the month 3 and 6 visit, respectively. More than half of those prescribed PrEP completed a month 6 visit (11, 55%). Retention was not associated with peer support compared to standard of care or text messaging (
    Conclusions: We enrolled half our target sample size despite extensive recruitment efforts. As expected, participants had challenges with PrEP adherence and persistence. While peer navigation interventions should be studied further, additional interventions are likely needed to support PrEP uptake, adherence, and persistence among people who use methamphetamine.
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 1018089-8
    ISSN 1758-1052 ; 0956-4624
    ISSN (online) 1758-1052
    ISSN 0956-4624
    DOI 10.1177/09564624241244835
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  4. Article ; Online: Heroin pipe distribution to reduce high-risk drug consumption behaviors among people who use heroin: a pilot quasi-experimental study.

    Fitzpatrick, Thomas / McMahan, Vanessa M / Frank, Noah D / Glick, Sara N / Violette, Lauren R / Davis, Shantel / Jama, Shilo

    Harm reduction journal

    2022  Volume 19, Issue 1, Page(s) 103

    Abstract: Background: Heroin pipe distribution may encourage people who use heroin (PWUH) to transition from injecting to smoking heroin, reducing harms associated with injection drug use. A syringe services program (SSP) in Seattle, Washington, led by people who ...

    Abstract Background: Heroin pipe distribution may encourage people who use heroin (PWUH) to transition from injecting to smoking heroin, reducing harms associated with injection drug use. A syringe services program (SSP) in Seattle, Washington, led by people who use drugs developed a heroin pipe distribution program.
    Methods: We conducted a pretest-posttest quasi-experimental study to evaluate the impact of heroin pipe distribution on drug consumption behaviors among PWUH between March and December 2019. SSP clients were surveyed during three weeklong timepoints before and four weeklong timepoints after heroin pipe distribution. Primary outcomes were change in proportion of SSP clients who exclusively injected heroin, exclusively smoked heroin, and both injected and smoked heroin in the past seven days comparing the pre- and post-intervention periods.
    Results: Across the seven observation timepoints, 694 unique respondents completed 957 surveys. Multiple responses from a single respondent in a given period were collapsed, resulting in 360 pre-intervention and 430 post-intervention records. Heroin use was reported in over half of pre-intervention (56%, 201/360) and post-intervention records (58%, 251/430). Compared to pre-intervention behaviors, the proportion of respondents who exclusively injected heroin was lower after the start of heroin pipe distribution (32%, 80/251 vs 43%, 86/201, p = 0.02), while the proportion of respondents who both injected and smoked heroin was higher (45%, 113/251 vs 36%, 72/201, p = 0.048). Just under half (44%, 110/251) of respondents who used heroin during the post-intervention period used a heroin pipe obtained from the SSP, of which 34% (37/110) reported heroin pipe distribution had reduced their heroin injection frequency. Self-reported hospitalization for a pulmonary cause was not associated with using a heroin pipe.
    Conclusions: The proportion of SSP clients who exclusively injected heroin was lower after implementation of heroin pipe distribution. Randomized studies with longer follow-up are needed to investigate whether heroin pipe distribution reduces heroin injection and improves health outcomes associated with drug use. Limited intervention exposure, loss to follow-up, and pipe availability from other sources pose methodological challenges to evaluations of route transition interventions in community settings. This pilot highlights the potential for organizations led by people who use drugs to develop, implement, and evaluate novel public health programming.
    MeSH term(s) Drug Users ; Heroin ; Heroin Dependence ; Humans ; Public Health ; Substance Abuse, Intravenous
    Chemical Substances Heroin (70D95007SX)
    Language English
    Publishing date 2022-09-22
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2146691-9
    ISSN 1477-7517 ; 1477-7517
    ISSN (online) 1477-7517
    ISSN 1477-7517
    DOI 10.1186/s12954-022-00685-7
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  5. Article ; Online: Characteristics of Kenyan women using HIV PrEP enrolled in a randomized trial on doxycycline postexposure prophylaxis for sexually transmitted infection prevention.

    Oware, Kevin / Adiema, Lydia / Rono, Bernard / Violette, Lauren R / McClelland, R Scott / Donnell, Deborah / Scoville, Caitlin W / Odoyo, Josephine / Baeten, Jared M / Bukusi, Elizabeth / Stewart, Jenell

    BMC women's health

    2023  Volume 23, Issue 1, Page(s) 296

    Abstract: Introduction: The global incidence of sexually transmitted infections (STIs) has been rapidly increasing over the past decade, with more than one million curable STIs being acquired daily. Young women in sub-Saharan Africa have a high prevalence and ... ...

    Abstract Introduction: The global incidence of sexually transmitted infections (STIs) has been rapidly increasing over the past decade, with more than one million curable STIs being acquired daily. Young women in sub-Saharan Africa have a high prevalence and incidence of both curable STIs and HIV. The use of doxycycline as a prophylaxis to prevent STIs is promising; however, clinical trials, to date, have only been conducted among men who have sex with men (MSM) in high-income settings. We describe the characteristics of participants enrolled in the first trial to determine the efficacy of doxycycline post-exposure prophylaxis (PEP) to reduce STI incidence among women taking daily, oral HIV pre-exposure prophylaxis (PrEP).
    Methods: This is an open-label 1:1 randomized clinical trial on the efficacy of doxycycline PEP compared with standard of care (e.g., quarterly STI screening and treatment) to reduce incident bacterial STIs - Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum - among Kenyan women aged ≥18 and ≤30 years. All were also taking HIV pre-exposure prophylaxis (PrEP). We describe the baseline characteristics, STI prevalence, and STI risk perception of participants.
    Results: Between February 2020 and November 2021, 449 women were enrolled. The median age was 24 years (IQR 21-27), the majority were never married (66.1%), 370 women (82.4%) reported having a primary sex partner, and 33% had sex with new partners in the three months prior to enrolment. Two-thirds (67.5%, 268 women) did not use condoms, 36.7% reported transactional sex, and 43.2% suspected their male partners of having sex with other women. Slightly less than half (45.9%, 206 women) were recently concerned about being exposed to an STI. The prevalence of STIs was 17.9%, with C. trachomatis accounting for the majority of infections. Perceived risk of STIs was not associated with the detection of an STI.
    Conclusion: Young cisgender women using HIV PrEP in Kenya and enrolled in a trial of doxycycline postexposure prophylaxis had a high prevalence of curable STIs and represent a target population for an STI prevention intervention.
    MeSH term(s) Male ; Female ; Humans ; Young Adult ; Adult ; Kenya/epidemiology ; Homosexuality, Male ; Doxycycline/therapeutic use ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; HIV Infections/drug therapy ; Post-Exposure Prophylaxis ; Sexual and Gender Minorities ; Sexually Transmitted Diseases/epidemiology ; Sexually Transmitted Diseases/prevention & control ; Chlamydia trachomatis
    Chemical Substances Doxycycline (N12000U13O)
    Language English
    Publishing date 2023-06-03
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2050444-5
    ISSN 1472-6874 ; 1472-6874
    ISSN (online) 1472-6874
    ISSN 1472-6874
    DOI 10.1186/s12905-023-02413-0
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  6. Article ; Online: Seroconversion, seroreversion, and serowaffling among participants initiating antiretroviral therapy in Project DETECT.

    Stekler, Joanne D / Violette, Lauren R / Niemann, Lisa A / McMahan, Vanessa M / Katz, David A / Chavez, Pollyanna R / Clark, Hollie A / Cornelius-Hudson, Andy / McDougal, Sarah J / Delaney, Kevin P

    International journal of STD & AIDS

    2023  Volume 34, Issue 6, Page(s) 385–394

    Abstract: Background: Incomplete HIV seroconversion and seroreversion are increasingly documented by testing and pre-exposure prophylaxis programs more than previously recognized. This analysis reports on incomplete seroconversion and seroreversion by specimen ... ...

    Abstract Background: Incomplete HIV seroconversion and seroreversion are increasingly documented by testing and pre-exposure prophylaxis programs more than previously recognized. This analysis reports on incomplete seroconversion and seroreversion by specimen and test type among Project DETECT participants.
    Methods: Project DETECT included a longitudinal study of point-of-care tests. Participants were categorized as having "incomplete seroconversion" if all timepoints had ≥1 nonreactive test at study censoring. Among participants with incomplete seroconversion, we defined "seroreversion" as sustained regression to nonreactive for any test following a reactive result. We define "serowaffling" as any reactive result followed by a nonreactive and then reactive result. We used Fisher's exact tests to explore relationships between Fiebig stage at ART initiation and incomplete seroconversion, seroreversion, and serowaffling.
    Results: Twenty of 1940 Project DETECT participants met criteria for this subset. Ten participants had complete seroconversion after a median of 23 (IQR 16-47) days following initial positive tests. Ten participants had incomplete seroconversion, eight of whom had seroreversion. Incomplete seroconversion with persistent nonreactive tests was seen only with oral fluid (OF). Of eight participants with seroreversion, all experienced seroreversion of OF tests if the test was ever reactive (
    Conclusions: OF tests may be particularly susceptible to providing false-negative results. Seroreversion and incomplete seroconversion among individuals on antiretroviral treatment may represent a growing problem for HIV testing and treatment programs.
    MeSH term(s) Humans ; HIV Seropositivity/drug therapy ; Longitudinal Studies ; Seroconversion ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; Anti-HIV Agents/therapeutic use
    Chemical Substances Anti-HIV Agents
    Language English
    Publishing date 2023-01-26
    Publishing country England
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
    ZDB-ID 1018089-8
    ISSN 1758-1052 ; 0956-4624
    ISSN (online) 1758-1052
    ISSN 0956-4624
    DOI 10.1177/09564624231152929
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  7. Article ; Online: Delivery of Community-based Antiretroviral Therapy to Maintain Viral Suppression and Retention in Care in South Africa.

    Wang, Melody / Violette, Lauren R / Dorward, Jienchi / Ngobese, Hope / Sookrajh, Yukteshwar / Bulo, Elliot / Quame-Amaglo, Justice / Thomas, Katherine K / Garrett, Nigel / Drain, Paul K

    Journal of acquired immune deficiency syndromes (1999)

    2023  Volume 93, Issue 2, Page(s) 126–133

    Abstract: Background: To determine whether the Centralized Chronic Medication Dispensing and Distribution (CCMDD) program in South Africa's differentiated ART delivery model affects clinical outcomes, we assessed viral load (VL) suppression and retention in care ... ...

    Abstract Background: To determine whether the Centralized Chronic Medication Dispensing and Distribution (CCMDD) program in South Africa's differentiated ART delivery model affects clinical outcomes, we assessed viral load (VL) suppression and retention in care between patients participating in the program and those receiving the clinic-based standard of care.
    Methods: Clinically stable people living with HIV (PLHIV) eligible for differentiated care were referred to the national CCMDD program and followed up for up to 6 months. In this secondary analysis of trial cohort data, we estimated the association between routine patient participation in the CCMDD program and their clinical outcomes of viral suppression (<200 copies/mL) and retention in care.
    Results: Among 390 PLHIV, 236 (61%) were assessed for CCMDD eligibility; 144 (37%) were eligible, and 116 (30%) participated in the CCMDD program. Participants obtained their ART in a timely manner at 93% (265/286) of CCMDD visits. VL suppression and retention in care was very similar among CCMDD-eligible patients who participated in the program compared with patients who did not participate in the program (aRR: 1.03; 95% CI: 0.94-1.12). VL suppression alone (aRR: 1.02; 95% CI: 0.97-1.08) and retention in care alone (aRR: 1.03; 95% CI: 0.95-1.12) were also similar between CCMDD-eligible PLHIV who participated in the program and those who did not.
    Conclusion: The CCMDD program successfully facilitated differentiated care among clinically stable participants. PLHIV participating in the CCMDD program maintained a high proportion of viral suppression and retention in care, indicating that community-based ART delivery model did not negatively affect their HIV care outcomes.
    MeSH term(s) Humans ; HIV Infections/drug therapy ; Anti-HIV Agents/therapeutic use ; South Africa ; Retention in Care ; Ambulatory Care Facilities ; Viral Load
    Chemical Substances Anti-HIV Agents
    Language English
    Publishing date 2023-03-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 645053-2
    ISSN 1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
    ISSN (online) 1944-7884 ; 1077-9450
    ISSN 0897-5965 ; 0894-9255 ; 1525-4135
    DOI 10.1097/QAI.0000000000003176
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    Zs.A 2442: Show issues Location:
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  8. Article ; Online: Doxycycline Prophylaxis to Prevent Sexually Transmitted Infections in Women.

    Stewart, Jenell / Oware, Kevin / Donnell, Deborah / Violette, Lauren R / Odoyo, Josephine / Soge, Olusegun O / Scoville, Caitlin W / Omollo, Victor / Mogaka, Felix O / Sesay, Fredericka A / McClelland, R Scott / Spinelli, Matthew / Gandhi, Monica / Bukusi, Elizabeth A / Baeten, Jared M

    The New England journal of medicine

    2023  Volume 389, Issue 25, Page(s) 2331–2340

    Abstract: Background: Doxycycline postexposure prophylaxis (PEP) has been shown to prevent sexually transmitted infections (STIs) among cisgender men and transgender women, but data from trials involving cisgender women are lacking.: Methods: We conducted a ... ...

    Abstract Background: Doxycycline postexposure prophylaxis (PEP) has been shown to prevent sexually transmitted infections (STIs) among cisgender men and transgender women, but data from trials involving cisgender women are lacking.
    Methods: We conducted a randomized, open-label trial comparing doxycycline PEP (doxycycline hyclate, 200 mg taken within 72 hours after condomless sex) with standard care among Kenyan women 18 to 30 years of age who were receiving preexposure prophylaxis against human immunodeficiency virus (HIV). The primary end point was any incident infection with
    Results: A total of 449 participants underwent randomization; 224 were assigned to the doxycycline-PEP group and 225 to the standard-care group. Participants were followed quarterly over 12 months. A total of 109 incident STIs occurred (50 in the doxycycline-PEP group [25.1 per 100 person-years] and 59 in the standard-care group [29.0 per 100 person-years]), with no significant between-group difference in incidence (relative risk, 0.88; 95% confidence interval [CI], 0.60 to 1.29; P = 0.51). Among the 109 incident STIs, chlamydia accounted for 85 (78.0%) (35 in the doxycycline-PEP group and 50 in the standard-care group; relative risk, 0.73; 95% CI, 0.47 to 1.13). No serious adverse events were considered by the trial investigators to be related to doxycycline, and there were no incident HIV infections. Among 50 randomly selected participants in the doxycycline-PEP group, doxycycline was detected in 58 of 200 hair samples (29.0%). All
    Conclusions: Among cisgender women, the incidence of STIs was not significantly lower with doxycycline PEP than with standard care. According to hair-sample analysis, the use of doxycycline PEP among those assigned to receive it was low. (Funded by the National Institutes of Health; dPEP ClinicalTrials.gov number, NCT04050540.).
    MeSH term(s) Female ; Humans ; Chlamydia Infections/microbiology ; Chlamydia Infections/prevention & control ; Chlamydia trachomatis ; Doxycycline/administration & dosage ; Doxycycline/adverse effects ; Doxycycline/analysis ; Doxycycline/therapeutic use ; HIV Infections/prevention & control ; Kenya/epidemiology ; Neisseria gonorrhoeae ; Pre-Exposure Prophylaxis/methods ; Sexually Transmitted Diseases/prevention & control ; Unsafe Sex ; Anti-Infective Agents/administration & dosage ; Anti-Infective Agents/adverse effects ; Anti-Infective Agents/analysis ; Anti-Infective Agents/therapeutic use ; Adolescent ; Young Adult ; Adult ; Gonorrhea/microbiology ; Gonorrhea/prevention & control ; Treponema pallidum ; Syphilis/microbiology ; Syphilis/prevention & control ; Drug Monitoring/methods ; Hair/chemistry
    Chemical Substances Doxycycline (N12000U13O) ; Anti-Infective Agents
    Language English
    Publishing date 2023-12-18
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMoa2304007
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  9. Article ; Online: Evaluation of SAMBA II: A Qualitative and Semiquantitative HIV Point-of-Care Nucleic Acid Test.

    Violette, Lauren R / Cornelius-Hudson, Andy / Snidarich, Madison / Niemann, Lisa A / Assennato, Sonny Michael / Ritchie, Allyson / Goel, Neha / Chavez, Pollyanna R / Ethridge, Steven F / Katz, David A / Lee, Helen / Delaney, Kevin P / Stekler, Joanne D

    Journal of acquired immune deficiency syndromes (1999)

    2022  Volume 89, Issue 5, Page(s) 537–545

    Abstract: Background: Point-of-care (POC) nucleic acid tests (NATs) have potential to diagnose acute HIV infection and monitor persons taking pre-exposure prophylaxis or antiretroviral therapy (ART). POC NATs have not yet been evaluated in the US.: Methods: ... ...

    Abstract Background: Point-of-care (POC) nucleic acid tests (NATs) have potential to diagnose acute HIV infection and monitor persons taking pre-exposure prophylaxis or antiretroviral therapy (ART). POC NATs have not yet been evaluated in the US.
    Methods: From June 2018-March 2019, we conducted a cross-sectional evaluation of the Simple Amplification-Based Assay version II (SAMBA II) POC NAT. People with HIV (PWH) and persons testing for HIV were tested with the SAMBA II qualitative (Qual) whole blood (WB) test. From April-September 2019, the Qual test was used on persons who were ART-naive, and SAMBA II Semi-quantitative (Semi-Q) WB was used with ART-experienced PWH. Both were performed on unprocessed venipuncture (VP) and, when indicated by protocol, fingerstick (FS) WB and plasma. SAMBA results were compared with Abbott RealTime HIV-1 polymerase chain reaction results on plasma. We calculated sensitivity, specificity, and concordance between tests.
    Results: SAMBA was used in 330 visits among 280 participants: 202 (61.2%) visits from PWH, and 128 (38.8%) from HIV-negative persons. Qual test sensitivity with ART-naive participants was 91.4% [32/35, 95% confidence interval (CI): 77.6% to 97.0%] using VP WB and 100% (27/27, 95% CI: 87.5% to 100%) using FS WB. Specificity was 100% using both specimen types. Concordance between the gold standard and Semi-Q at 1000 copies/mL among PWH on ART was 97.7% (86/88, 95% CI: 92.1% to 99.4%) and 100% (30/30, 95% CI: 88.7% to 100%) using VP and FS WB, respectively.
    Conclusions: The SAMBA II POC NATs showed high sensitivity, specificity, and concordance with the gold standard assay, indicating its potential use in diagnostics and monitoring. Future work will evaluate POC NAT implementation in the US.
    MeSH term(s) Cross-Sectional Studies ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; Humans ; Nucleic Acids/therapeutic use ; Point-of-Care Systems ; Point-of-Care Testing ; Sensitivity and Specificity ; Viral Load/methods
    Chemical Substances Nucleic Acids
    Language English
    Publishing date 2022-01-06
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 645053-2
    ISSN 1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
    ISSN (online) 1944-7884 ; 1077-9450
    ISSN 0897-5965 ; 0894-9255 ; 1525-4135
    DOI 10.1097/QAI.0000000000002902
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: 'I make sure my doctor doesn't know that I use meth': perceived barriers to pre-exposure prophylaxis (PrEP) uptake among community peer educators in Seattle (WA, USA).

    McMahan, Vanessa M / Violette, Lauren R / Andrasik, Michele P / Martin, Aleks / Garske, Lindsay / Stekler, Joanne D

    Sexual health

    2020  Volume 17, Issue 1, Page(s) 29–37

    Abstract: Background HIV disproportionately affects cisgender men and transgender people who have sex with men (MSM/TG) and use methamphetamine. Pre-exposure prophylaxis (PrEP) uptake has been slow in this group. It is important to understand perceptions about ... ...

    Abstract Background HIV disproportionately affects cisgender men and transgender people who have sex with men (MSM/TG) and use methamphetamine. Pre-exposure prophylaxis (PrEP) uptake has been slow in this group. It is important to understand perceptions about PrEP and barriers to its use among MSM/TG who use methamphetamine to reduce new HIV infections.
    Methods: We conducted four focus groups with peer educators of a harm reduction program. We assessed their perspectives of PrEP and barriers across the PrEP continuum among MSM/TG who use methamphetamine.
    Results: Notably, stigma related to the multiple marginalised identities of MSM/TG who use methamphetamine (e.g. MSM/TG-related stigma, methamphetamine-related stigma) was a barrier at each step. We developed a framework that combined the PrEP continuum and a stigma-based treatment cascade to explore these themes and describe the effects of stigma on PrEP engagement. Methamphetamine-related barriers were also identified.
    Conclusions: The findings of this study emphasise the importance of incorporating stigma reduction into PrEP delivery for MSM/TG who use methamphetamine.
    MeSH term(s) Adult ; Anti-HIV Agents/administration & dosage ; Communication ; Drug Users/psychology ; Drug Users/statistics & numerical data ; HIV Infections/prevention & control ; Homosexuality, Male/psychology ; Homosexuality, Male/statistics & numerical data ; Humans ; Male ; Methamphetamine ; Middle Aged ; Peer Group ; Physician-Patient Relations ; Pre-Exposure Prophylaxis ; Social Stigma
    Chemical Substances Anti-HIV Agents ; Methamphetamine (44RAL3456C)
    Language English
    Publishing date 2020-01-24
    Publishing country Australia
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2256731-8
    ISSN 1449-8987 ; 1448-5028
    ISSN (online) 1449-8987
    ISSN 1448-5028
    DOI 10.1071/SH19083
    Database MEDical Literature Analysis and Retrieval System OnLINE

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