Publications by authors named "Mallory O Johnson"

Introduction: Perspectives on long-acting injectable cabotegravir/rilpivirine (CAB/RPV-LA) from HIV health disparity populations are under-represented in current literature yet crucial to optimize delivery.

Methods: Between August 2022 and May 2023, we conducted in-depth interviews with people with HIV (PWH) at four HIV clinics in Atlanta, Chicago and San Francisco. Eligibility criteria were current CAB/RPV-LA use with receipt of ≥3 injections or CAB/RPV-LA discontinuation.

View Article and Find Full Text PDF
Article Synopsis
  • The study examines the impact of the COVID-19 pandemic on substance use disorders (SUD) in people with HIV, highlighting a significant increase in SUD risk post-pandemic shelter-in-place orders.
  • Data from over 7,000 participants revealed that moderate/high SUD risk rose from 24% pre-pandemic to 43% post-pandemic, with notable increases in the use of drugs like heroin and methamphetamine.
  • The findings suggest that increased social isolation and reduced access to treatment during COVID-19 exacerbated SUD among people with HIV, emphasizing the need for better integrated treatment solutions moving forward.
View Article and Find Full Text PDF

This study investigates baseline differences in couples enrolled in the "It Takes Two" HIV prevention intervention for transgender women and their partners, comparing in-person participation pre-COVID-19 and digital participation during the pandemic. Among 52 couples (40% in-person, 60% digital), bivariate analyses revealed that in-person participants were more likely to be African American, have cisgender male partners, report higher unemployment, incarceration histories, greater relationship stigma, and lower relationship quality. The findings highlight the limitations of digital modalities in engaging transgender women of color and those with structural vulnerabilities.

View Article and Find Full Text PDF

Objective: To examine the effects of internalized HIV stigma on viral non-suppression via depressive symptoms, alcohol use, illicit drug use, and medication adherence and investigate whether social support moderates these effects.

Design: Longitudinal observational clinical cohort of patients in HIV care in the US.Methods: Data from the CFAR Network for Integrated Clinical Systems (2016-2019) were used to conduct structural equation models (SEM) to test the indirect effects of internalized HIV stigma on viral non-suppression through depressive symptoms, illicit drug use, alcohol use, and medication adherence.

View Article and Find Full Text PDF

Background: Virtual activities, hybrid work and virtual mentoring have become part of the ongoing milieu of academic medicine. As the shift to remote mentoring continues to evolve, it is now possible to adapt, refine, and improve tools to support thriving mentoring relationships that take place virtually. This study explores strategies for virtual mentoring as a cornerstone for effective training programs among senior mentors participating in an ongoing mentoring program.

View Article and Find Full Text PDF

The HIV Index is a validated self-report scale of engagement in HIV care previously correlated with future retention and virologic suppression. However, its performance in a monoethnic Latinx population has not been studied. We evaluated the HIV Index among Latinx persons living with HIV in the Centers for AIDS Research Network of Integrated Clinical Systems cohort and performed multivariable logistic regression to estimate its association with primary outcomes of suboptimal retention (not keeping 100% of HIV clinic appointments) and virologic suppression (HIV viral load <200 copies/mL).

View Article and Find Full Text PDF
Article Synopsis
  • - An exploratory study in Alabama aimed to improve HIV testing rates among Black young men who have sex with men (BYMSM) by interviewing both BYMSM and outreach workers about their experiences and recommendations for better outreach efforts.
  • - Data from 56 BYMSM (average age 24) and 12 outreach workers (average age 39, mostly male and Black) revealed five key themes: promoting testing earlier, increasing visibility and outreach efforts, creating connections through shared experiences, using nonjudgmental communication, and enhancing HIV knowledge among BYMSM.
  • - The study concluded that building trust is crucial for effective HIV testing promotion among BYMSM, with recommendations to start prevention discussions at a younger age and train outreach workers in
View Article and Find Full Text PDF
Article Synopsis
  • - A study involving 3,288 people with HIV (PWH) found that 27% were unvaccinated against COVID-19, with approximately 9% reporting vaccine hesitancy, particularly among women, younger individuals, and Black PWH.
  • - Factors influencing vaccine hesitancy included being female (2.3 times more likely), identifying as Black (1.7 times more likely), being younger (1.4 times more likely), and having an unsuppressed viral load (1.9 times more likely).
  • - The study highlights the need for targeted efforts to address vaccine concerns in the PWH community to improve vaccination rates as the pandemic evolves and prepare for future public health challenges.
View Article and Find Full Text PDF

As a proposed mediator between stigma-related stressors and negative mental health outcomes, HIV-related shame has been predictive of increased rates of substance use and difficulties adhering to antiretroviral treatment among people with HIV. These downstream manifestations have ultimately impeded progress toward national goals to End the HIV Epidemic, in part due to limited success of conventional psychotherapies in addressing HIV-related shame. In a pilot clinical trial (N = 12), receipt of psilocybin-assisted group therapy was associated with a large pre-post decrease in HIV-related shame as measured by the HIV and Abuse Related Shame Inventory, with a median (IQR) change of - 5.

View Article and Find Full Text PDF

Mothers living with HIV are faced with managing their own complex healthcare and wellness needs while caring for their children. Understanding the lived experiences of mothers living with HIV, including grandmothers and mothers with older children - who are less explicitly represented in existing literature, may guide the development of interventions that best support them and their families. This study sought to explore the role of motherhood and related social/structural factors on engagement with HIV care, treatment-seeking behaviour, and overall HIV management among mothers living with HIV in the USA to inform such efforts.

View Article and Find Full Text PDF

Background: Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) offers a novel drug delivery option for persons with human immunodeficiency virus (PWH) but requires administration every 4 or 8 weeks by a medical professional.

Methods: To facilitate LAI antiretroviral therapy (ART) scale-up, we evaluated patient interest in alternative administration approaches via a mixed-methods, serial cross-sectional study across 3 US HIV clinics. We surveyed PWH (December 2021 to May 2022) on appeal of self- or partner/friend/family-administered LAI-CAB/RPV; multivariable ordinal logistic regression explored associated characteristics.

View Article and Find Full Text PDF

Understanding the acceptability of long-acting injectable antiretroviral therapy (LAI-ART) among people with HIV (PWH), especially priority populations, is essential for effective implementation. We conducted semi-structured interviews with patients in three Ryan White-funded HIV clinics in San Francisco, Chicago, and Atlanta. We employed maximal variation sampling across age, gender, race, ethnicity, and time living with HIV and oversampled for individuals with suboptimal clinical engagement.

View Article and Find Full Text PDF

Women Living with HIV (WLHIV) who use substances face stigma related to HIV and substance use (SU). The relationship between the intersection of these stigmas and adherence to antiretroviral therapy (ART), as well as the underlying mechanisms, remains poorly understood. This study aimed to examine the association between intersectional HIV and SU stigma and ART adherence, while also exploring the potential role of depression and fear of negative evaluation (FNE) by other people in explaining this association.

View Article and Find Full Text PDF

Background: Despite improvements in antiretroviral therapy (ART) availability, suboptimal adherence is common among youth with HIV (YWH) and can increase drug resistance and poor clinical outcomes. Our study examined an innovative mobile app-based intervention that used automated directly observed therapy (aDOT) using artificial intelligence, along with conditional economic incentives (CEIs) to improve ART adherence and enhance viral suppression among YWH.

Setting: We conducted a pilot study of the aDOT-CEI intervention, informed by the operant framework of Key Principles in Contingency Management Implementation, to improve ART adherence among YWH (18-29) in California and Florida who had an unsuppressed HIV viral load.

View Article and Find Full Text PDF
Article Synopsis
  • A study on people with HIV (PWH) assessed how different subgroups experience internalized HIV stigma (IHS) using a four-item survey between February 2016 and November 2022, involving over 12,000 participants.
  • Results showed that younger individuals, cisgender women, and those living in specific regions reported higher IHS scores, while Black/African American and Latine participants had lower scores compared to their White counterparts.
  • The study emphasizes the widespread nature of IHS among PWH and the importance of tailored interventions and routine screenings to address and reduce stigma within different subgroups.
View Article and Find Full Text PDF

Background: Although cross-sectional studies have suggested that HIV-related stigma and depression symptoms may result in poor HIV treatment and health outcomes, few studies have investigated potential longitudinal mechanisms in these relationships. Furthermore, longitudinal effects of HIV-related stigma on health outcomes have not been examined in people with HIV (PWH) newly initiating HIV clinical care. We examined longitudinal associations between experienced and perceived community stigma and health outcomes (antiretroviral therapy [ART] adherence and viral load), mediated by internalized stigma and depression symptoms among new-to-care PWH in the United States.

View Article and Find Full Text PDF

Background: Young adults have a disproportionately high rate of HIV infection, high rates of attrition at all stages of the HIV care continuum, and an elevated probability of disease progression and transmission. Tracking and monitoring objective measures of antiretroviral therapy (ART) adherence in real time is critical to bolster the accuracy of research data, support adherence, and improve clinical outcomes. However, adherence monitoring often relies on self-reported and retrospective data or requires additional effort from providers to understand individual adherence patterns.

View Article and Find Full Text PDF

We examined changes in the proportion of people with human immunodeficiency virus (PWH) with virologic suppression (VS) in a multisite US cohort before and since the coronavirus disease 2019 (COVID-19) pandemic. Overall, prior gains in VS slowed during COVID-19, with disproportionate impacts on Black PWH and PWH who inject drugs.

View Article and Find Full Text PDF
Article Synopsis
  • Long-acting injectable antiretroviral therapy (LAI-ART) is the latest development in HIV treatment, requiring research to improve access for all individuals living with HIV.
  • Focus group discussions were held with healthcare providers in major US cities to identify barriers and facilitators for implementing LAI-ART, emphasizing organizational readiness and participant insights.
  • Key findings showed a strong commitment to equitable access to LAI-ART, the need for clinics to take on more responsibility for patient adherence, and highlighted the importance of strengthening existing systems and resources to facilitate broader implementation.
View Article and Find Full Text PDF

Introduction: Young adults with HIV (YWH) experience worse clinical outcomes than adults and have high rates of substance use (SU) and mental illness that impact their engagement in care and adherence to antiretroviral therapy (ART). The intervention for Virologic Suppression in Youth (iVY) aims to address treatment engagement/adherence, mental health (MH) and SU in a tailored manner using a differentiated care approach that is youth friendly. Findings will provide information about the impact of iVY on HIV virological suppression, MH and SU among YWH who are disproportionately impacted by HIV and at elevated risk for poor health outcomes.

View Article and Find Full Text PDF

This qualitative study explored the experiences of people living with HIV (PLWH) in the San Francisco Bay Area, United States, during the COVID-19 pandemic and subsequent public health restrictions at a safety net HIV clinic. Patients ( = 30) were recruited for Spanish/English language semi-structured interviews ( = 30), translated when necessary, and analyzed thematically. The recurring theme of "pandemic expertise" emerged from the data: skills and attitudes developed through living with HIV helped PLWH cope with the COVID-19 pandemic, including effective strategies for dealing with anxiety and depression; appreciation for life; and practical experience of changing behavior to protect their health.

View Article and Find Full Text PDF

Unhealthy alcohol use, which encompasses heavy episodic drinking to alcohol use disorder, has been identified as a modifiable barrier to optimal HIV care continuum outcomes. Despite the demonstrated efficacy of couples-based interventions for addressing unhealthy alcohol use, there are no existing couples-based alcohol interventions designed specifically for people living with HIV. This study presents the development and refinement of a three-session couples-based motivational intervention (ReACH2Gether) to address unhealthy alcohol use among a sample of 17 sexual minority men living with HIV and their partners living in the United States.

View Article and Find Full Text PDF

Research has documented associations between relationship stigma, relationship quality and adverse health outcomes among sexual and gender minority couples. However, this work focused primarily on one aspect of an individual's or a couple's identity rather than understanding the intersections of multiple, stigmatized social identities. As part of a larger project focused on testing the efficacy of a couples-based intervention to improve HIV medication adherence, 144 couples completed measures of relationship stigma, relationship quality, mental health, and substance use.

View Article and Find Full Text PDF

We created a brief version of The Index, a validated patient-reported measure that has potential to quickly identify patients at risk for poor retention. We analyzed Index scores from 2406 patients from 2016 to 2017 in a national cohort of patients in human immunodeficiency virus (HIV) care. Index scores predicted poor retention 12 months after administered.

View Article and Find Full Text PDF
Article Synopsis
  • People who inject drugs and are living with HIV, particularly along the US-Mexico border, experience low rates of treatment retention and viral suppression, with only 44% retained in care and just 24% achieving viral suppression.
  • This research uses a multiphase optimization strategy (MOST) to test 16 different intervention conditions that combine four main components aimed at improving health outcomes: peer support, behavioral therapy, medication adherence counseling, and patient navigation for HIV care.
  • The study aims to identify the most effective combination of these components by tracking participants’ viral load suppression over 6, 9, and 12 months while also examining factors that might influence their treatment outcomes.
View Article and Find Full Text PDF