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Introduction: Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high‐impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, "grey areas," or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research. Discussion: A group of IS experts affiliated with NIMH‐funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH‐related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence‐based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas. Conclusions: HIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high‐impact HIV/MH implementation research. [ABSTRACT FROM AUTHOR]

Acquired Immunodeficiency Syndrome (AIDS) is a sexually transmitted disease that can be passed from partner to partner, mother to child, or through blood exchange using infected syringes. AIDS symptoms might vary depending on characteristics such as age, gender, and physical activity. Headaches, muscle and joint discomfort, rashes, diarrhoea, weight loss, coughing, night sweats, sore throat, stomatitis, swollen lymph nodes, malaise, oral yeast infections, shingles (herpes zoster), and lung infections are all common symptoms. The Food and medication Administration (FDA) of the United States authorised Lenacapavir, a novel AIDS therapy medication, in 2022. Lenacapavir is a capsid inhibitor available in tablet and injection form that directly targets the Human Immunodeficiency Virus Type 1 (HIV-1) Capsid Protein. Various research and papers, like the Capella study, which assessed the safety and efficacy of subcutaneous Lenacapavir, were used to assess the safety and efficacy of Lenacapavir. The Calibrate study shed light on the absence of phenotypic resistance to Lenacapavir in HIV Gag cleavage site mutants and isolates resistant to existing medication classes. These studies also included data from a proof-of-concept clinical research on HIV patients examining phenotypic resistance to Lenacapavir and its efficacy as a monotherapy. The approval of Lenacapavir represents a viable new therapy option for those living with HIV. Its method of action, as well as promising safety and efficacy results from numerous studies, offer hope for better outcomes in the treatment of this severe disease. [ABSTRACT FROM AUTHOR]

Blood recipients, particularly frequent receivers, are at high-risk of receiving human immunodeficiency virus (HIV), and no current serologic tests eliminate this transmission risk. The current paper aimed to provide an updated comprehensive report on the prevalence of HIV infection among blood donors in different parts of the world. HIV infection prevalence in blood donors was determined based on electronically published data through a systematic review of literature in international databases until February 2020. Studies published in Farsi and English reporting the prevalence of HIV were included. Meta-analysis was performed, and final results were classified according to World Health Organization (WHO) divisions of the world. Out of 1,859 articles, 241 met the inclusion criteria. The prevalence of HIV was higher in first-time donors, males, and replacement therapy receivers. The pooled prevalence was 502.74 in 100,000. AFRO with 2,384.99 and Europe with 19.04 in 100,000 had the highest and the lowest rates, respectively. Gabon represented the highest rate of 20,623, while the USA showed the lowest rate, i.e., 4.33, among the countries. Updated reports on the prevalence of HIV among blood donors help policy-makers and care providers realize the possible need for improving the screening, diagnostics, and treatment protocols. Although the prevalence has decreased in many parts of the world, improving the current protocols is still necessary to minimize the risks in transfusion systems. [ABSTRACT FROM AUTHOR]

Black women in the United States continue to be disproportionately affected by the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) epidemic. HIV/AIDS activism among Black women for Black women may be one solution to reduce the disparate rates of HIV/AIDS among Black women. However, little is known about what processes and experiences prompt Black women to participate in HIV/AIDS activism. In this paper, I aim to identify mechanisms of empowerment for Black women to engage in HIV/AIDS activism. I draw upon empowerment theory as a theoretical framework to guide analysis of the literature and to offer a strengths‐based perspective on Black women's efforts to reduce the spread of HIV/AIDS. An extensive literature search was conducted to identify studies of Black women's participation in HIV/AIDS activism. The search yielded 11 studies that were included for review. Synthesis of the literature indicated the following analytic themes as mechanisms of empowerment for Black women to participate in HIV/AIDS activism: relationships and interactions with others, critical awareness, self‐reflection, and spirituality. Article limitations, suggestions for future research, and implications for social change are also discussed. Overall, findings from this study suggest that there are unique mechanisms that facilitate psychological empowerment and prompt Black women's entry into HIV/AIDS activism. Highlights: A comprehensive review of 11 articles on Black women's participation in Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) activism. Explores how Black women become psychologically empowered to become HIV/AIDS activists. Many mechanisms of empowerment for Black women engaged in HIV/AIDS activism are communal. Emphasizes psychological empowerment as not only an intrapsychic process. [ABSTRACT FROM AUTHOR]

The papers in this Special Supplement provide insight into current research on and partnerships needed to address HIV-related stigma and better characterize the negative effects of HIV-related stigma on populations disproportionately affected by HIV in the United States. The findings may be used to inform evidence-based strategies and ideally additional interventional research with the goal of reducing stigma, new HIV infections, and improved health for persons with HIV. [ABSTRACT FROM AUTHOR]

In 2019, the National Institutes of Health combined the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV Study (WIHS) into the MACS/WIHS Combined Cohort Study (MWCCS). In this paper, participants who made a study visit during October 2018–September 2019 (targeted for MWCCS enrollment) are described by human immunodeficiency virus (HIV) serostatus and compared with people living with HIV (PLWH) in the United States. Participants include 2,115 women and 1,901 men with a median age of 56 years (interquartile range, 48–63); 62% are PLWH. Study sites encompass the South (18%), the Mid-Atlantic/Northeast (45%), the West Coast (22%), and the Midwest (15%). Participant race/ethnicity approximates that of PLWH throughout the United States. Longitudinal data and specimens collected for 35 years (men) and 25 years (women) were combined. Differences in data collection and coding were reviewed, and key risk factor and comorbidity data were harmonized. For example, recent use of alcohol (62%) and tobacco (28%) are common, as are dyslipidemia (64%), hypertension (56%), obesity (42%), mildly or severely impaired daily activities (31%), depressive symptoms (28%), and diabetes (22%). The MWCCS repository includes serum, plasma, peripheral blood mononuclear cells, cell pellets, urine, cervicovaginal lavage samples, oral samples, B-cell lines, stool, and semen specimens. Demographic differences between the MACS and WIHS can confound analyses by sex. The merged MWCCS is both an ongoing observational cohort study and a valuable resource for harmonized longitudinal data and specimens for HIV-related research. [ABSTRACT FROM AUTHOR]

Purpose: To summarize the most noteworthy infectious diseases (ID) pharmacotherapy articles published in peer-reviewed literature in 2021. Summary: Members of the Houston Infectious Diseases Network (HIDN) nominated articles that were deemed to have significant contributions to ID pharmacotherapy in 2021. These nominations included articles pertaining to both general ID, including coronavirus disease 2019 (COVID-19), and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pharmacotherapy. A total of 35 articles were nominated by HIDN: 30 articles pertaining to general ID pharmacotherapy and 5 articles with HIV/AIDS focus. To select the most influential articles of 2021, a survey was created and distributed to members of the Society of Infectious Diseases Pharmacists (SIDP). Of the 239 SIDP members who responded to the survey, there were 192 recorded votes for the top 10 general ID pharmacotherapy articles and 47 recorded votes for the top HIV/AIDS article, respectively. The top publications are summarized. Conclusion: Antimicrobial stewardship and the optimal management of infectious disease states continues to be a priority in the midst of the ongoing coronavirus disease 2019 (COVID-19) global pandemic. In light of the sheer volume of ID-related articles published in the past year, this review aims to aid clinicians in remaining up-to-date on key practice-changing ID pharmacotherapy publications from 2021. [ABSTRACT FROM AUTHOR]

This article describes the development of a video serial drama intervention that was designed to address factors that influence HIV in the United States among Black youth. These include HIV testing, sexual behaviors not protected by condoms, negative attitudes towards sexual minorities, and HIV stigma. Behavior-change principles (social learning theory and education-entertainment) and input from members of the priority audience formed the basis of this 27-episode (3 minutes each) drama for dissemination on multiple platforms, including in public spaces or privately online. The developmental process, specifically involving members of the population of interest and use of behavioral theory, enriched the narrative elements and likely ensured intervention acceptability, enhancing effectiveness. Public health practitioners and prevention programmers may want to consider using this intervention and/or the narrative communication approach when intervening to change behavior. [ABSTRACT FROM AUTHOR]

Background: People who use drugs with life-limiting illnesses experience substantial barriers to accessing palliative care. Demand for palliative care is expected to increase during communicable disease epidemics and pandemics. Understanding how epidemics and pandemics affect palliative care for people who use drugs is important from a service delivery perspective and for reducing population health inequities. Aim: To explore what is known about communicable disease epidemics and pandemics, palliative care, and people who use drugs. Design: Scoping review. Data sources: We searched six bibliographic databases from inception to April 2021 as well as the grey literature. We included English and French records about palliative care access, programs, and policies and guidelines for people ⩾18 years old who use drugs during communicable disease epidemics and pandemics. Results: Forty-four articles were included in our analysis. We identified limited knowledge about palliative care for people who use drugs during epidemics and pandemics other than HIV/AIDS. Through our thematic synthesis of the records, we generated the following themes: enablers and barriers to access, organizational barriers, structural inequity, access to opioids and other psychoactive substances, and stigma. Conclusions: Our findings underscore the need for further research about how best to provide palliative care for people who use drugs during epidemics and pandemics. We suggest four ways that health systems can be better prepared to help alleviate the structural barriers that limit access as well as support the provision of high-quality palliative care during future epidemics and pandemics. [ABSTRACT FROM AUTHOR]

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Objective: People living with HIV have high rates of obesity and obesity‐related comorbidities. Our study sought to evaluate weight trajectory in a retrospective cohort of people living with HIV and matched HIV‐negative veterans (controls) and to evaluate risk factors for weight gain. Methods: This was a retrospective database analysis of data extracted from the VA Corporate Data Warehouse that included people living with HIV (n = 22 421) and age‐matched HIV‐negative controls (n = 63 072). The main outcomes were baseline body weight and weight change from baseline at 1, 2, and 5 years after diagnosis (baseline visit for controls). Results: Body weight at baseline was lower in people living with HIV than in controls. People living with HIV on antiretroviral therapy (ART) gained more weight than did controls. In a sub‐analysis of ART‐exposed people living with HIV, age >50 years, African American race, body mass index (BMI) <25, CD4 ≤200, and HIV diagnosis year after 2000 were associated with more weight gain at year 1. Nucleoside reverse transcriptase inhibitors (NRTI) plus non‐NRTIs (NNRTIs) were associated with less weight gain than NRTIs plus protease inhibitors, NRTIs plus integrase inhibitors, or NRTIs plus other agents at year 1. Conclusions: Among US veterans, those living with HIV had lower rates of obesity than age‐matched HIV‐negative controls; however, primarily in the first 2 years after starting ART, people living with HIV gained more weight than did controls. [ABSTRACT FROM AUTHOR]

Introduction: This study examined whether smokers' harm perceptions of nicotine replacement therapy (NRT) and nicotine vaping products (NVPs) relative to cigarettes predicted their subsequent use as smoking cessation aids during their last quit attempt (LQA).Aims and Methods: We analyzed data from 1,315 current daily smokers (10+ cigarettes per day) who were recruited at Wave 1 (2016), and who reported making a quit attempt by Wave 2 (2018) of the International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England, and the United States. We used multinomial logistic regression models to examine prospective associations between harm perceptions of (a) NRT and (b) NVPs and their use at LQA, controlling for socio-demographic and other potential confounders.Results: Smokers who perceive that (a) NRT and (b) NVPs are much less harmful than cigarettes were more likely to subsequently use the respective product as an aid than using no aid or other aids during LQA (adjusted relative risk ratio [aRRR] = 3.79, 95%CI = 2.16-6.66; and aRRR = 2.11, 95%CI = 1.29-3.45, respectively) compared to smokers who perceive these products as equally or more harmful. Additionally, those who perceive NVPs as much less harmful than cigarettes were less likely to use NRT as a quit aid (aRRR = 0.34, 95%CI = 0.20-0.60). No country variations for these associations were found.Conclusions: This study found that smokers' perceptions of the harmfulness of (a) NRT and (b) NVPs relative to cigarettes predicted the respective product use when trying to quit smoking. Corrective education targeting misperceptions of nicotine products' relative harmfulness may facilitate their use for smoking cessation.Implications: Nicotine replacement therapy and nicotine vaping products are two commonly used smoking cessation aids. This study demonstrates that misperceptions of the harms of nicotine products relative to cigarettes influence their use for smoking cessation. Believing that nicotine vaping products are much less harmful than cigarette smoking may lead some smokers to prefer these products over nicotine replacement therapy to aid smoking cessation. Education targeting misperceptions of nicotine products' harmfulness relative to cigarettes may enable smokers to make informed choices about which are appropriate to aid smoking cessation. [ABSTRACT FROM AUTHOR]

Black/African American (Black) versus White persons are unequally burdened by human immunodeficiency virus (HIV) in the United States. Structural factors can influence social determinants of health, key components in reducing HIV-related health inequality by race. This analysis examined HIV care outcomes among Black and White persons with diagnosed HIV (PWDH) in relation to three structural factors: racial redlining, Medicaid expansion, and Ryan White HIV/AIDS Program (RWHAP) use. Using National HIV Surveillance System, U.S. Census, and Home Mortgage Disclosure Act data, we examined linkage to HIV care and viral suppression (i.e., viral load < 200 copies/mL) in relation to the structural factors among 12,996 Black and White PWDH with HIV diagnosed in 2017/alive at year-end 2018, aged ≥ 18 years, and residing in 38 U.S. jurisdictions with complete laboratory data, geocoding, and census tract-level redlining indexes. Compared to White PWDH, a lower proportion of Black PWDH were linked to HIV care within 1 month after diagnosis and were virally suppressed in 2018. Redlining was not associated with the HIV care outcomes. A higher prevalence of PWDH residing (v. not residing) in states with Medicaid expansion were linked to HIV care ≤ 1 month after diagnosis. A higher prevalence of those residing (v. not residing) in states with > 50% of PWDH in RWHAP had viral suppression. Direct exposure to redlining was not associated with poor HIV care outcomes. Structural factors that reduce the financial burden of HIV care and improve care access like Medicaid expansion and RWHAP might improve HIV care outcomes of PWDH. [ABSTRACT FROM AUTHOR]

Youth at-risk for HIV are also at-risk for mental health disorders and psychiatric hospitalization. Understanding the association between engagement in HIV prevention, concurrent risk behaviors, and psychiatric hospitalization may lead to improvements in integrated prevention and mental health treatment efforts. Youth at-risk for HIV, aged 14–24 years old, predominantly Black/African American and Latinx (75%) were recruited through youth-serving clinics and community sites in Los Angeles (n = 839) and New Orleans (n = 647). We compared youth with and without histories of psychiatric hospitalization on engagement in HIV prevention, concurrent risk behaviors, and demographic characteristics. We examined predictors of hospitalization using multiple imputations for missing data. Hospitalized youth (30%) were more involved in HIV programs, but were less likely to use PrEP/PEP or condoms than non-hospitalized youth. The odds of hospitalization were higher for transgender/gender nonconforming youth relative to cisgender youth; the OR was increased after adjustment for concurrent risk behaviors. Hospitalization was associated with homelessness, trauma, incarceration, substance use, and involvement in substance abuse treatment programs. There is a continuing need to integrate the diagnosis and treatment of mental health disorders into HIV prevention programs to better address multiple challenges faced by vulnerable youth. [ABSTRACT FROM AUTHOR]

HIV/AIDS has been a public health crisis since the 1980s yet people of African descent that live in the southern region of the United States are more likely to not receive treatment for this disease. This work has four goals. The first goal is to discuss the social determinants that contribute to the HIV/AIDS epidemic in the Deep South. The second goal is to discuss the Afrocentric paradigm that promotes cultural pride and Black empowerment. The third goal is to provide a paradigm that details how racial inequalities perpetuate. The final goal is to provide recommendations regarding how the Afrocentric paradigm can help eradicate health disparities for people of African ancestry that reside in the Southern region of the United States. [ABSTRACT FROM AUTHOR]

In the late twentieth century, the American prison system expanded in ways that denied women, and especially working-class and women of color, adequate medical care with regard to HIV-AIDS and their reproductive, chronic, and other illnesses. The experience of living within a racist, misogynistic, and privatized prison system shaped women's organizing on the inside, inspiring forms of mutual aid among prisoners and compelling the formation of inside–outside alliances. Activists not only addressed HIV-AIDS, but also the absence of all the healthcare that incarcerated women failed to receive. Their efforts highlight the systemic and cyclical problems diverse groups of women have faced within the HIV-AIDS epidemic in the United States, as well as women's interpersonal, organizational, and legal efforts to overcome them. [ABSTRACT FROM AUTHOR]

Although there have been many studies of gene variant association with different stages of HIV/AIDS progression in United States and European cohorts, few gene-association studies have assessed genic determinants in sub-Saharan African populations, which have the highest density of HIV infections worldwide. We carried out genome-wide association studies on 766 study participants at risk for HIV-1 subtype C (HIV-1C) infection in Botswana. Three gene associations (AP3B1, PTPRA, and NEO1) were shown to have significant association with HIV-1C acquisition. Each gene association was replicated within Botswana or in the United States-African American or United States-European American AIDS cohorts or in both. Each associated gene has a prior reported influence on HIV/AIDS pathogenesis. Thirteen previously discovered AIDS restriction genes were further replicated in the Botswana cohorts, extending our confidence in these prior AIDS restriction gene reports. This work presents an early step toward the identification of genetic variants associated with and affecting HIV acquisition or AIDS progression in the understudied HIV-1C afflicted Botswana population. [ABSTRACT FROM AUTHOR]