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With growing environmental and energy concerns, Jatropha plantations are promoted in degraded/waste lands for the biodiesel production. Nutrient rich nonedible deoiled seed cake, a by-product of Jatropha left out after oil extraction was evaluated at the ICRISAT centre at Patancheru, India as an environment friendly source of nutrients for rainy season maize and soybean followed by postrainy chickpea in rainfed systems. Deoiled cake as partial (50%) or full replacement of recommended basal nitrogen (N) was found superior in terms of increased crop yield over the equivalent chemical fertilizers treatments. Highest yield and net returns under full replacement of basal N for maize, while under 50% basal N replacement in case of soybean and chickpea crops were recorded by 8 to 27% in grain yield and 10 to 28% in straw yield. Deoiled Jatropha cake as a full replacement of N dose in maize also recorded higher N uptake and use efficiency in maize than chemical N source treatment along with increased organic C and nutrient contents in post-harvest soil samples. This study revealed the benefits of Jatropha deoiled seed cake as a good source of plant nutrients and soil organic C in the semi-arid tropics in addition to enhanced C sequestration under Jatropha plantation on degraded waste lands. [ABSTRACT FROM AUTHOR]

High levels of adherence to highly active antiretroviral therapy (HAART) are essential for virologic suppression and longer survival in patients with HIV. We examined the effects of substance abuse treatment, current versus former substance use, and hazardous/binge drinking on adherence to HAART. During 2003, 659 HIV patients on HAART in primary care were interviewed. Adherence was defined as ≥95% adherence to all antiretroviral medications. Current substance users used illicit drugs and/or hazardous/binge drinking within the past six months, while former users had not used substances for at least six months. Logistic regression analyses of adherence to HAART included demographic, clinical and substance abuse variables. Sixty-seven percent of the sample reported 95% adherence or greater. However, current users (60%) were significantly less likely to be adherent than former (68%) or never users (77%). In multivariate analysis, former users in substance abuse treatment were as adherent to HAART as never users (Adjusted Odds Ratio (AOR)=0.82; p>0.5). In contrast, former users who had not received recent substance abuse treatment were significantly less adherent than never users (AOR=0.61; p=0.05). Current substance users were significantly less adherent than never users, regardless of substance abuse treatment (p<0.01). Substance abuse treatment interacts with current versus former drug use status to affect adherence to HAART. Substance abuse treatment may improve HAART adherence for former substance users. [ABSTRACT FROM AUTHOR]

Effective April 2, 2007, the radiometric calibration of Landsat-5 (L5) Thematic Mapper (TM) data that are processed and distributed by the U.S. Geological Survey (USGS) Center for Earth Resources Observation and Science (EROS) will be updated. The lifetime gain model that was implemented on May 5, 2003, for the reflective bands (1-5, 7) will be replaced by a new lifetime radiometric-calibration curve that is derived from the instrument's response to pseudoinvariant desert sites and from cross calibration with the Landsat-7 (L7) Enhanced TM Plus (ETM+). Although this calibration update applies to all archived and future L5 TM data, the principal improvements in the calibration are for the data acquired during the first eight years of the mission (1984-1991), where the changes in the instrument-gain values are as much as 15%. The radiometric scaling coefficients for bands 1 and 2 for approximately the first eight years of the mission have also been changed. Users will need to apply these new coefficients to convert the calibrated data product digital numbers to radiance. The scaling coefficients for the other bands have not changed. [ABSTRACT FROM PUBLISHER]

A 36 years old female presented with symmetrical polyarthritis diagnosed as Rheumatoid Arthritis (RA). After six months, she developed tender thyroid swelling diagnosed as autoimmune thyroiditis with hypothyroidism. Another six months later, she developed butterfly rash over the face with exacerbation of polyarthritis and a diagnosis of Systemic Lupus Erythematosus (SLE) with anti- ds- DNA positive was made. She was diagnosed with rheumatoid arthritis overlapping with systemic lupus erythematosus (Rhupus syndrome) with hypothyroidism. [ABSTRACT FROM AUTHOR]

Substance abuse treatment is associated with decreases in human immunodeficiency virus (HIV) risk behavior and can improve HIV outcomes. The purpose of this study was to examine factors associated with substance abuse treatment utilization, including patient-provider discussions of substance use issues. We surveyed 951 HIV-infected adults receiving care at 14 HIV Research Network primary care sites regarding drug and alcohol use, substance abuse treatment, and provider discussions of substance use issues. Although 71% reported substance use, only 24% reported receiving substance abuse treatment and less than half reported discussing substance use issues with their HIV providers. In adjusted logistic regression models, receipt of substance abuse treatment was associated with patient-provider discussions. Patient-provider discussions of substance use issues were associated with current drug use, hazardous or binge drinking, and Black race or ethnicity, though substance use was comparable between Blacks and Whites. These data suggest potential opportunities for improving engagement in substance abuse treatment services. [ABSTRACT FROM AUTHOR]

Importance: Despite increased initiatives and funding to improve access to evidence-based treatments for opioid use disorder (OUD), including medications for OUD (mOUD), pregnant/postpartum individuals have significant obstacles to accessing these life-saving medications. Observations: Current legislation, specifically the Comprehensive Addiction and Recovery Act (CARA) , mandates that the Governor of each state has systems in place to identify and address the needs of substance-exposed infants. However, this legislation removed the word "illegal" when defining substance use and left other important words in the law up to each individual state to define. These changes resulted in pregnant/postpartum individuals with OUD who were receiving legally prescribed mOUD, being subject to legal actions. In many states, such notifications result in investigation and punitive actions, which may include the removal of children from the care of postpartum individuals. These state policies have created additional barriers to accessing mOUD for pregnant and/or postpartum individuals. Research has demonstrated that pregnant individuals delay and/or avoid recommended prenatal care or decide to stop taking mOUD altogether, to prevent potential legal and child welfare-related consequences. This situation is problematic as it places individuals at risk of overdose and death and infants at risk of health complications. Importantly, such policies are subject to bias and disproportionately impact individuals of color and those from lower socioeconomic backgrounds. Conclusions and Relevance: The need to address and change the criminalization of pregnant/postpartum substance use laws to not penalize individuals adhering to the recommended standard of evidence-based care is urgent. Specific recommendations include: not relying on toxicology testing, reinstating "illegal/non-prescribed" language in legislation, implementing Plans of Safe Care, use of a two "track" reporting system, and federal support for states complying with Child Abuse Prevention and Treatment Act Reauthorization of 2010 (CAPTA) laws, increasing resources to improve outcomes for infants/postpartum individuals with OUD, and additional mandated training to educate key individuals, such as hospital/outpatient clinic providers and child-welfare workers.

Substance use is associated with decreased antiretroviral therapy (ART) adherence among people with HIV (PWH). Adherence plays a significant role in mediating the negative effects of substance use on HIV suppression and is a principal modifiable patient-level factor in improving HIV suppression and reducing ART drug resistance. Understanding substance use and ART adherence, particularly with rapidly changing substance use epidemiology and ART regimens, is vital to improving HIV care. Among 10,557 PWH (2010-2021) from 8 academic clinical sites nationally we examined longitudinal associations of substance use severity and number of substances used (measured using AUDIT-C and modified ASSIST) with patient-reported ART adherence (visual analog scale). Alcohol (68% any use, 18% unhealthy use [AUDIT-C > 4 men, > 3 women]), marijuana (33%), and methamphetamine (9%) use were most reported. Polysubstance use was common (32%). Both higher severity substance use and higher number of substances used were associated with lower ART adherence. Severity of methamphetamine use had the strongest dose-response association with ART adherence (low severity [ASSIST 1-3]: -3.05%, 95% CI: -4.23%, -1.87%; moderate [ASSIST 4-26]: -6.20%, 95% CI: -7.08%, -5.33%; high [ASSIST > 26]: -10.77%, 95% CI: -12.76%, -8.78%). Severe substance use, especially methamphetamine, and higher number of illicit drugs used were associated with declines in adherence at levels that were likely clinically meaningful in the modern era of ART. Findings support integrating substance use care with HIV care and potential benefits of harm reduction strategies for improving adherence such as encouraging lower levels of substance use and fewer number of substances used., Competing Interests: Declarations. Conflict of Interest: The authors have no relevant conflicts of interests to declare. Ethical Approval and informed consent: All sites have approval from Human Subjects committees at their local institution for the CNICS protocol. Informed consent was obtained from all individuals to participate in CNICS. All data submitted to the CNICS Data Repository are deidentified. No additional formal consent was required for this secondary data analysis of existing data in the CNICS Data Repository. This article does not contain any studies with animals., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: National US data on the burden and risks for hepatitis C virus (HCV) infection in people with human immunodeficiency virus (HIV) during the direct-acting antiviral (DAA) era are limited. These data are important to understand current progress and guide future efforts toward HCV microelimination., Methods: We evaluated (1) HCV prevalence (2011-2013, 2014-2017, 2018-2022) using a serial cross-sectional design and (2) correlates for HCV viremia (2018-2022) in adult people with HIV (PWH) within the Centers for AIDS Research Network of Integrated Clinic Systems (CNICS) cohort using multivariable adjusted relative risk regression. The most recent data from each time period were used for calculations and models., Results: In the CNICS cohort, HCV viremia prevalence was 8.7% in 2011-2013, 10.5% in 2014-2017, and 4.8% in 2018-2022. Disparities in prevalence across demographic groups defined by age, gender, and race/ethnicity were smaller in 2018-2022 than earlier time periods. In relative risk regression, female gender, detectable HIV RNA, higher proportion of missed visits (last 18 months), higher FIB-4 score, higher depressive symptom severity, and current use of methamphetamine and illicit opioids were associated with HCV viremia in 2018-2022., Conclusions: The prevalence of HCV viremia during the DAA era in this US-based national cohort of PWH improved over time and across demographic subgroups but remains higher than those without HIV. Our findings highlight the continued importance of prioritizing HCV care in all PWH, especially in certain key, less-reached groups. Proactive, comprehensive efforts to care engagement, substance use, mental health, and other social determinants will be crucial to improve reach, prevention, and treatment to achieve HCV elimination goals., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts of interest., (© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Aim: Unhealthy alcohol use is often correlated with experiences of intimate partner violence (IPV). We investigated how different types of IPV (sexual, physical, emotional, and financial) were associated with unhealthy alcohol use among women engaged in sex work in Mombasa, Kenya., Methods: This cross-sectional study included 283 HIV-negative women who engaged in sex work recruited from an ongoing cohort study. Modified Poisson analysis was used to assess associations between recent (≤ 12 months) or past (> 12 months) experiences of sexual, physical, emotional, or financial IPV and unhealthy alcohol use defined as an Alcohol Use Disorders Identification Test score ≥ 8., Results: Among 283 participants, 34.6 % had unhealthy alcohol use. Physical (62.5 %), emotional (60.4 %), and financial (66.4 %) IPV occurred more frequently than sexual IPV (43.8 %). Adjusted risk ratios (ARR) for relationships between physical and financial IPV and unhealthy alcohol use were elevated but not statistically significant. Compared to participants who had not experienced sexual IPV, those who had experienced recent or past sexual IPV had an increased risk of unhealthy alcohol use (ARR 1.56, 95 % confidence interval [1.09, 2.23] and ARR 1.48, 95 % confidence interval [0.97, 2.25], respectively)., Conclusion: Sexual IPV was associated with unhealthy alcohol use among Kenyan women who engage in sex work. Physical, emotional, and financial IPV were also highly prevalent in the study population, though not associated with unhealthy alcohol use. These findings affirm the potential benefit of providing integrated IPV and alcohol treatment services focused on recovery after experiences of IPV for this vulnerable population., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier B.V.)

Background: People with HIV (PWH) have benefited greatly from antiretroviral therapy, but face additional challenges from age-related comorbid conditions, particularly cardiovascular disease including venous thromboembolism (VTE). Little is known about the effect of HIV viremia and immunodeficiency on VTE risk in this population., Methods: We assessed incident, centrally adjudicated VTE among 21,507 PWH in care between 1/2009-12/2019 within the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. We examined the association of three measures of HIV viral load (VL: baseline, current, cumulative) and current CD4 count with VTE. Cumulative VL (copy-days of viremia) was estimated with a time-weighted sum using the trapezoidal rule. We modeled the association between VL and VTE using Cox proportional hazards models (marginal structural Cox models for cumulative), adjusted for demographic and clinical characteristics. We compared the 75th percentile of the VL distribution with the 25th percentile using the hazard function from the model for all PWH with a VTE and those with a pulmonary embolism (PE)., Results: During a median of 4.8 years of follow-up, 424 PWH developed VTE. In adjusted analyses, higher cumulative VL (75th percentile vs. 25th percentile), the strongest VL predictor, was associated with a 1.45-fold higher risk of VTE (95%CI:1.22-1.72). Low CD4 cell count <100 cells/mm3 was associated with higher VTE risk (HR: 4.03, 95%CI: 2.76-5.89) as compared to ≥500 cells/mm3. Findings were similar for PWH who had a pulmonary embolism (n = 189)., Conclusions: Reducing HIV VL and maintaining CD4 cell count may help mitigate VTE risk in PWH., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Adults with type 2 diabetes (T2DM) and adverse social determinants of health experience barriers to healthful eating, and achieve poorer glycemic control and clinical outcomes., Objective: To examine the impact of medically tailored meals (MTM) with medical nutrition therapy (MNT) on clinical outcomes among adults with DM., Design: Pilot randomized controlled trial., Participants: English-speaking adults with DM and hemoglobin A1c (A1c) levels > 8% insured by Maryland Medicaid plans., Intervention: The treatment group received home delivery of 12 medically tailored, frozen meals and a fresh produce bag weekly for 3 months, and individual calls with a registered dietitian monthly for 6 months in addition to usual care. The control group received usual care. Outcomes were change from baseline to 6 months in A1c (primary), body mass index (BMI), blood pressure, food insecurity, and diabetes-related quality of life, knowledge, and self-efficacy (secondary)., Key Results: We randomized 74 adults; 77% completed data collection. The mean age was 48 years, 40% were male, 77% were Black, and the mean A1c was 10.3%. Eighty-six percent of meals were delivered, and on average 4.8 nutrition visits were completed. At 6 months, both groups had similar improvements in A1c (- 0.7 vs. - 0.6%); the control group reported more favorable changes in diabetes medications. Changes in systolic blood pressure and BMI at 6 months did not differ between groups. Diabetes-related quality of life, knowledge, and self-efficacy improved modestly, but not differently by group. Food insecurity decreased significantly from baseline to 3 months in the intervention (53 to 17%) compared to control (48 to 44%; p < 0.05), which lessened but remained significant at 6 months., Conclusions: Recruitment and retention of an at-risk group of adults with DM was feasible. Intervention uptake was good but did not improve clinical outcomes. More comprehensive and clinically integrated interventions are likely needed to achieve significant clinical benefits., Gov Registration: NCT04034511., Competing Interests: Declarations:. Conflict of Interest:: Sam Zisow-McClean and Susan Elias are employees of Moveable Feast. The authors have no other conflicts of interest to disclose., (© 2024. The Author(s).)

The confluence of injection drug use (IDU), alcohol consumption, and viral hepatitis increases morbidity among persons living with HIV (PWH). We present a secondary analysis of a randomized controlled trial of alcohol reduction interventions in Thai Nguyen, Vietnam conducted between 2016-2018. We assessed hepatitis B (HBV) and hepatitis C (HCV) coinfection among PWH reporting hazardous alcohol consumption and examined differences in IDU and alcohol use by coinfection status. Participants were ≥18 years old, living with HIV, and reported hazardous alcohol consumption per the WHO Alcohol Use Disorders Identification Test Consumption (AUDIT-C; score ≥4 for men, score ≥3 for women). At enrollment, participants were tested for hepatitis coinfection with HBV surface antigen tests and rapid serological HCV tests. Demographic information, IDU, and recent alcohol consumption were assessed via behavioral survey and 30-day timeline follow back. Fishers Exact and Kruskal-Wallis tests were used for statistical testing. Hepatitis coinfection was common among the 440 enrolled PWH: HCV: n = 355 (81%); HBV: n = 5 (1%); HBV and HCV: n = 37 (8%). Only 10% (n = 43) of participants had no hepatitis coinfection. Among those who tested positive for HBV, 36% had previously been diagnosed with HBV; among those who tested seropositive for HCV, 18% had previously received an HCV diagnosis. History of IDU was higher among those with hepatitis coinfection (HBV or HCV coinfection: 88%; HBV and HCV coinfections: 97%) than those without hepatitis coinfection (7%; p<0.01). Median days of alcohol consumption in the last 30 days was higher among those with coinfection (HBV or HCV coinfection: 20 (Interquartile Range (IQR): 10-30); HBV and HCV coinfections: 22 (IQR: 13-28) than those without hepatitis coinfection (10; IQR: 6-21; p<0.01). The syndemic conditions of HIV, hepatitis, IDU, and alcohol use are deeply entangled and challenging to parse out. Integrated health services are warranted to reduce the risk of liver-related morbidity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To estimate the effect of antidepressant initiation on viral nonsuppression among people with HIV (PWH) with clinically recognized, untreated depression., Design: Retrospective, observational cohort study., Methods: We included clinical diagnoses of depression from January 2012 to June 2022 among PWH in the Johns Hopkins HIV Clinical Cohort without another serious psychiatric illness who had initiated antiretroviral therapy. We excluded diagnoses less than 90 days from a prior diagnosis, antidepressant prescription, or greater than one mental health visits. We estimated the association between initiating an antidepressant within 1 month of the index depression diagnosis and viral load nonsuppression (>200 copies/ml) on the first viral load 3-12 months subsequent. We adjusted for a comprehensive set of demographic and clinical confounders., Results: We included 2346 depression diagnoses among 946 patients; patients initiated an antidepressant following 16%. The risk of viral nonsuppression in the absence of antidepressant treatment was 15.6% [95% confidence interval (CI): 13.1-18.4]. Antidepressant initiation was not associated with viral nonsuppression (risk difference: 0.5%; 95% CI: -3.7 to 4.8) or secondary outcomes: improvement or resolution of depressive symptoms or adherence to scheduled clinic visits., Conclusion: In this sample of patients with as-yet-untreated depression, in a setting with co-located, low-barrier psychiatric services, antidepressant treatment was not associated with improved viral suppression. Pharmacologic management of depression has documented benefits in other studies. However, there may be a subset of PWH with depression who have been previously unsuccessfully treated with antidepressants who are less likely to respond to approved pharmacologic options and who require different interventions to improve their viral suppression., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Smoking is a myocardial infarction (MI) risk factor among people with HIV (PWH). Questions persist regarding the role of smoking behaviors and measurements (e.g., intensity, duration) on MI risk. We used Cox proportional hazards regression to compare the association of smoking parameterization with incidents of type 1 and type 2 MI and whether smoking intensity or duration improves MI risk prediction among PWH. Among 11,637 PWH, 37% reported currently smoking, and there were 346 MIs. Current smoking was associated with type 1 (84% increased risk) but not type 2 MI in adjusted analyses. The type 1 MI model with pack years had the best goodness of fit compared with other smoking parameterizations. Ever or never parameterization and smoking diagnosis data had significantly poorer model fit. These results highlight the importance of differentiating MI types and performing patient-based smoking assessments to improve HIV care and research rather than relying on smoking status from diagnoses., (Copyright © 2024 Association of Nurses in AIDS Care.)

The Johns Hopkins HIV Clinical Cohort, established in 1989, links comprehensive, longitudinal clinical data for adults with HIV receiving care in the Johns Hopkins John G. Bartlett Specialty Practice in Baltimore, Maryland, USA, to aid in understanding HIV care and treatment outcomes. Data include demographics, laboratory results, inpatient and outpatient visit information and clinical diagnoses, and prescribed and dispensed medications abstracted from medical records. A subset of patients separately consents to self-report patient-centric outcomes on standardized instruments approximately every 6 months, and another subset separately consents to contribute plasma and peripheral blood mononuclear cells to a linked specimen repository approximately annually. The cohort has cumulatively enrolled over 8000 people, with just under 2000 on average attending ≥ 1 HIV primary care visit in any given year. The cohort reflects the HIV epidemic in Baltimore: in 2021, median age was 57, 64% of participants were male, 77% were non-Hispanic Black, and 37% acquired HIV through injection drug use. This update to the cohort profile of the Johns Hopkins HIV Clinical Cohort illustrates both how the population of people with HIV in Baltimore, Maryland, USA has changed over three decades, and we have adapted data collection procedures over three decades to ensure this long-running cohort remains responsive to patient characteristics and research gaps in the provision of care to people with HIV and substance use., (© 2024. Springer Nature B.V.)

Background: In Vietnam and other global settings, men who have sex with men (MSM) have become the population at greatest risk of HIV infection. Although HIV pre-exposure prophylaxis (PrEP) has been implemented as a prevention strategy, PrEP outcomes may be affected by low persistence and adherence among MSM with unhealthy alcohol use. MSM have a high prevalence of unhealthy alcohol use in Vietnam, which may affect PrEP outcomes., Methods: Design: We will conduct a two-arm hybrid type 1 effectiveness-implementation randomized controlled trial of a brief alcohol intervention (BAI) compared to the standard of care (SOC) at the Sexual Health Promotion (SHP) clinic Hanoi, Vietnam., Participants: Sexually active MSM (n=564) who are newly initiating PrEP or re-initiating PrEP and have unhealthy alcohol use will be recruited and randomized 1:1 to the SOC or BAI arm. A subgroup of participants (n=20) in each arm will be selected for longitudinal qualitative interviews; an additional subset (n=48) in the BAI arm will complete brief quantitative and qualitative interviews after completion of the BAI to assess the acceptability of the intervention. Additional implementation outcomes will be assessed through interviews with clinic staff and stakeholders (n=35)., Intervention: Study participants in both arms will receive standard care for PrEP clients. In the BAI arm, each participant will receive two face-to-face intervention sessions and two brief booster phone sessions, based on cognitive behavioral therapy and delivered in motivational interviewing informed style, to address their unhealthy alcohol use., Outcomes: Effectiveness (PrEP and alcohol use) and cost-effectiveness outcomes will be compared between the two arms. Intervention implementation outcomes (acceptability, feasibility, adoption) will be assessed among MSM participants, clinic staff, and stakeholders., Discussion: This proposed trial will assess an alcohol intervention for MSM with unhealthy alcohol use who initiate or re-initiate PrEP, while simultaneously preparing for subsequent implementation. The study will measure the effectiveness of the BAI for increasing PrEP persistence through reducing unhealthy alcohol use in a setting where excessive alcohol consumption is a normative behavior. If effective, implementation-focused results will inform future scale-up of the BAI in similar settings., Trial Registration: NCT06094634 on clinicaltrials.gov. Registered 16 October 2023., (© 2024. The Author(s).)

Background: Few studies have examined which subgroups of people with HIV (PWH) carry the greatest burden of internalized HIV stigma (IHS), which may be important to care provision and interventions., Methods: PWH in the CFAR Network of Integrated Clinical Systems (CNICS) longitudinal, US-based, multisite, clinical care cohort completed tablet-based assessments during clinic visits including a four-item, Likert scale (low 1-5 high), IHS instrument. Associations between sociodemographic characteristics and IHS scores were assessed in adjusted linear regression models., Results: Twelve thousand six hundred and fifty-six PWH completed the IHS assessment at least once from February 2016 to November 2022, providing 28 559 IHS assessments. At baseline IHS assessment, the mean age was 49 years, 41% reported White, 38% Black/African American, and 16% Latine race/ethnicity, and 80% were cisgender men. The mean IHS score was 2.04, with all subgroups represented among those endorsing IHS. In regression analyses, younger PWH and those in care fewer years had higher IHS scores. In addition, cisgender women vs. cisgender men, PWH residing in the West vs. the Southeast, and those with sexual identities other than gay/lesbian had higher IHS scores. Compared with White-identifying PWH, those who identified with Black/African American or Latine race/ethnicity had lower IHS scores. Age stratification revealed patterns related to age category, including specific age-related differences by gender, geographic region and race/ethnicity., Discussion: IHS is prevalent among PWH, with differential burden by subgroups of PWH. These findings highlight the benefits of routine screening for IHS and suggest the need for targeting/tailoring interventions to reduce IHS among PWH., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)