A qualitative dyad analysis of barriers and facilitators of antiretroviral therapy (ART) adherence among people who inject drugs (PWID) with HIV in Kazakhstan.

People with HIV (PWH) who inject drugs (PWID) face many barriers to ART adherence. Kazakhstan has one of the fastest growing HIV epidemics in the world, primarily fueled by injection drug use, yet ART adherence among PWID is low. Social support can help address these barriers, but ART adherence among PWID is rarely examined within the relationship context.

High rates of deferring antiretroviral treatment for patients with HIV and substance use disorders: Results from a national sample of HIV physicians in Ukraine.

Background: HIV incidence and mortality are increasing in Ukraine despite their reductions globally, in part due to suboptimal antiretroviral therapy (ART) coverage in key populations of people with HIV (PWH) where the epidemic is concentrated. As physicians are gatekeepers to ART prescription, stigma and discrimination barriers are understudied as a key to meeting HIV treatment targets in key populations.

Methods: A national sample (N = 204) of ART-prescribing physicians in Ukraine were surveyed between August and November 2019.

Impact of Abstinence and of Reducing Illicit Drug Use Without Abstinence on Human Immunodeficiency Virus Viral Load.

Background: Substance use is common among people living with human immunodeficiency virus (PLWH) and a barrier to achieving viral suppression. Among PLWH who report illicit drug use, we evaluated associations between HIV viral load (VL) and reduced use of illicit opioids, methamphetamine/crystal, cocaine/crack, and marijuana, regardless of whether or not abstinence was achieved.

Methods: This was a longitudinal cohort study of PLWH from 7 HIV clinics or 4 clinical studies.

A multisite, longitudinal study of risk factors for incarceration and impact on mental health and substance use among young transgender women in the USA.

Background: Transgender women are disproportionately incarcerated in the US relative to the general population. A dearth of research has explored the factors that predict incarceration among transgender women or the longitudinal impact of incarceration on the health of this population.

Methods: Between 2012 and 2015, 221 transgender women ages 16-29 from Boston, MA and Chicago, IL were prospectively assessed at baseline, 4, 8 and 12 months.

Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees.

The prison setting presents not only challenges, but also opportunities, for the prevention and treatment of HIV, viral hepatitis, and tuberculosis. We did a comprehensive literature search of data published between 2005 and 2015 to understand the global epidemiology of HIV, hepatitis C virus (HCV), hepatitis B virus (HBV), and tuberculosis in prisoners. We further modelled the contribution of imprisonment and the potential impact of prevention interventions on HIV transmission in this population.

The cost of integrated HIV care and buprenorphine/naloxone treatment: results of a cross-site evaluation.

Background: Implementing integrated HIV and buprenorphine/naloxone treatment requires cost estimates to plan and obtain funding.

Methods: We identified costs incurred at HIV clinical sites participating in a cross-site evaluation of integrated care that followed patients for 1 year. Costs include labor, overhead, and urine toxicology analyses (clinic perspective), buprenorphine/naloxone (payer perspective) and patient time and transportation (patient perspective).