Human Immunodeficiency Virus (HIV) has been widely associated with comorbid depression. This study examined the prevalence of depression by HIV status and its relationship to mental health service use in rural eastern Uganda using structured questionnaires. Participants with HIV (n = 150) were recruited from local HIV clinics, while participants with negative or unknown HIV status (n = 154) were randomly sampled from nearby villages. Participants were assessed for depression using the Patient Health Questionnaire-9, loneliness using the UCLA 3-item Loneliness Scale and general mental health status using a Likert-type self-report scale. Symptomatic HIV, asymptomatic HIV and HIV negative subgroups were compared on demographics, clinical characteristics and prior service use from traditional, religious and biomedical providers. The symptomatic HIV+ group reported significantly greater depressive symptoms, loneliness and poorer self-rated mental health than other groups, but no increase in mental health service use. Furthermore, among this group, more severe depressive symptoms were associated with decreased likelihood of mental health service use, possibly due to competing demands and limited mental health service availability. Religious leaders were the most common source of care with notable overlap between providers. This study highlights the importance of utilizing existing religious and biomedical pathways to increase access to mental health services.

Pre-exposure prophylaxis (PrEP) is a critical intervention that greatly reduces the risk of HIV transmission, yet limited access to prescribing providers continues to constrain uptake in the United States. This study examines how geographic access to PrEP providers changed between 2020 and 2023 and identifies areas with limited access, referred to as PrEP deserts. Using the Integrated two-step floating catchment area method, this study finds that despite widespread gains in PrEP access, five states experienced increases in the total population living in PrEP deserts. Additionally, more than 5 million residents in states designated as priority jurisdictions under the Ending the HIV epidemic initiative gained geographic access to PrEP providers between 2020 and 2023. However, improvements were uneven: in some states, communities of colour experienced declining access and remain disproportionately represented in PrEP deserts. These findings highlight persistent geographic and demographic disparities in HIV prevention infrastructure despite recent federal efforts to expand PrEP availability.

Cognitive-behavioral therapy (CBT) has shown promising results in improving mental health outcomes among people living with human immunodeficiency virus (PLHIV) in low- and middle-income countries (LMICs), although findings remain mixed. This systematic review examined the effectiveness of CBT and CBT-based interventions in reducing depression and anxiety among PLHIV in LMICs and explored the CBT techniques used across studies. Randomized and non-randomized controlled trials were included, and standardized mean differences were pooled using random-effects meta-analysis. Eight studies focusing on depression were included in the meta-analysis. Results showed that CBT-based interventions produced a large positive effect on depression scores compared to treatment as usual (g = −0.85; 95% CI: −1.25 to −0.45). Several CBT components were compared, including therapy type, therapy provider, number of sessions, and session duration. Standard CBT showed greater effectiveness than CBT-based interventions (−1.18 vs. −0.42). CBT delivered by mental health professionals also had stronger effects on depression outcomes than interventions provided by non-mental health professionals (−1.18 vs. −0.37). Meta-analysis for anxiety outcomes could not be conducted because of limited available data.

Occupational blood exposure accidents (OBEAs) pose significant risks to healthcare workers, potentially exposing them to hepatitis B (HBV), hepatitis C (HCV), and HIV. While most research focuses on hospital settings, this study assessed OBEA management in non-hospital contexts. Although our data predate the COVID pandemic, findings remain highly relevant, especially for healthcare professionals working outside hospital settings. A retrospective analysis of OBEA registry data (2006–2014) was conducted in a southern Dutch region. Data included demographics, profession, workplace, injury type, source status (HBV, HCV, HIV), risk assessment, post-exposure measures, and lab results. Chi-square and t-tests were applied. In total, 975 OBEA were reported. Among nurses, medical assistants, students, and housekeeping staff, subcutaneous needles (51–67%) and lancets (25%) were common exposure sources. Police officers mainly reported biting (26%), scratching, or spitting (70%). HBV vaccination coverage ranged from 18% (housekeeping) to over 90% (nurses, police). Post-exposure measures were taken in 52% of cases. High-risk exposures (43%) mainly affected ambulance staff, sterilization workers, police, and dentists. Sources were tested in 85% of high-risk cases: 1.4% were HBV positive, 2% HCV positive, and 1.1% HIV positive. No seroconversions occurred. Results stress the need for better HBV vaccination coverage, targeted prevention, and prompt OBEA reporting outside hospital settings.

This retrospective, cross-sectional study assessed the burden of HIV in Israel’s Maccabi Healthcare Services in 2022. Among 2.6 million individuals assessed (lookback period: > 2 decades), 1973 PWH were identified and age-sex-matched (1:5) to 9,865 randomly selected controls without HIV. We compared sociodemographic, clinical characteristics, and healthcare resource utilization (HRU; Jan–Dec 2022) between people with and without HIV and characterized antiretroviral therapy (ART) treatment patterns among PWH (Jan–Dec 2022). Compared to controls, PWH had a higher lifetime prevalence (since 1988; P < 0.001) of several comorbid conditions, including liver disease, chronic kidney disease, any cancer, and hepatitis B and C infections. Additionally, PWH had a higher rate of anxiety and depression (26.2% vs. 13.5%; P < 0.001). PWH showed higher annual HRU than controls, including ~2-fold higher hospitalizations (≥1 new admissions; P < 0.001) and frequent use of emergency, urgent, primary, specialist, and nursing care (P < 0.05). Among 1907 PWH with ≥1 ART prescription, 78.1% had ≥90% coverage in 2022, although 69.1% experienced ART interruption and 7.2% discontinuation, the latter associated with mental health issues. This study recognizes critical gaps in care that could inform strategies to improve clinical outcomes and resource allocation in health systems for PWH.

We conducted an exploratory cross-sectional analysis of ethical principles and practices in forty-one published research papers with empirical data on HIV prevalence, incidence, or risk factors in humanitarian settings. We identified ten key concepts pertinent to ethical principles and applications, and presented recommendations to inform future HIV prevention research.

Sexually transmitted infections (STIs) are common among people living with human immunodeficiency virus (HIV) (PLWH). This nationwide register study linked HIV and STI registries to examine STI trends before and after HIV diagnosis in Finland 1995–2019 among all PLWH residing in the country. Analysed STIs were chlamydia, gonorrhoea, syphilis, and hepatitis B and C. An extended Cox model assessed factors associated with STI events. Among 3,775 PLWH (mean follow-up 17.9 person-years), 71% had no STIs, 17% had one, and 12% had two or more. Overall, 10.7% had an STI before HIV diagnosis and 18.1% after. STI incidence was 32 per 1,000 person-years and increased over time, although chlamydia and gonorrhoea declined. STI risk was highest among men who have sex with men (MSM) and lowest among people who inject drugs; it remained stable or declined after HIV diagnosis. STIs before HIV diagnosis offer opportunities for HIV testing and pre-exposure prophylaxis promotion. As most had no STIs other than HIV, HIV testing should not be limited to STI screening but also performed in other indicator conditions. After HIV diagnosis, accessible low-threshold STI testing, particularly for MSM, and consideration of doxycycline prophylaxis may benefit those at highest risk.

This paper examines the potential for, and the contradictions inherent in, voluntary sector health service providers acting as consumer representatives. The paper examines a U.K. gay men’s HIV prevention organization to consider whether members are united by their experiences of using services, whether their work involves consumerist strategies, if so whether these are influential, and what tensions emerge from the dual provider/consumer role. Fieldwork was carried out in 1997-98, examining, via documents and interviews, activity between 1992 and 1997. Qualitative analysis was performed. Consumer action is shown to emerge not so much from abstract constructions of consumer interest, but more from the particularities of consumption, which become politicized more powerfully through their attachment to other interests and ideologies.

HIV civil society advocacy in Vietnam is shaped by a unique fusion of historic and contemporary influences, resulting in nuanced ways in which advocacy is practised. In this study, we interviewed representatives from civil society, the Government of Vietnam, international NGOs, multilateral and research organisations and commercial consultancies to identify the influences on advocacy practice today. Aspects of Confucianism, Buddhism, Communism and changes to international funding were all identified as shaping HIV civil society policy advocacy practice directed towards government. These influences have resulted in a strong respect for hierarchy, non-confrontational and collaborative working relationships between civil society and the government, decision-making by consensus and changes in advocacy practice corresponding to fluctuations in international funding. This study shows how, as civil society continues to develop its role in the HIV sector in Vietnam, it is critical to understand these complex influences so that program designers, funders and evaluators can appropriately support HIV civil society policy advocacy.

This commentary discusses research workforce programs designed to enhance the representation and engagement of Latinos in HIV research, highlighting key challenges and proposing actionable strategies for improvement. Mentorship education and cultural inclusivity are identified as the most salient issues because the former leads to stronger health-related outcomes and is linked to cognitive-and career-related factors while the latter offers the potential to directly dismantle structures of inequity. This commentary suggests recasting of Diversity, Equity, and Inclusion (DEI) initiatives from eligibility as Latino self-identification, to all individuals’ lived experiences and/or prior experience in service/research activities. Some issues and constructs (i.e., heterogeneity, perseverance, acculturation, cultural values), typically important for certain underrepresented minoritized groups in diversity workforce programs, are reinterpreted for their relevance to all potential participants. This commentary proposes a holistic approach to trainee eligibility, creating a more inclusive environment that respects both individuality and diversity, and, importantly, contributing to DEI does not require being a member of an underrepresented minoritized population group.