Prevalence of major INSTI and HIV-1 drug resistance mutations in pre- and antiretroviral-treated patients in Indonesia

Exploring the Intersection of Mental and Reproductive Health Among Women Living with HIV in Spain: A Qualitative Secondary Data Analysis

Background/Objectives: Globally, girls and women make up over half of those living with Human Immunodeficiency Virus (HIV), facing unique reproductive and mental health challenges. An HIV diagnosis impacts motherhood desires and increases trauma, stigma, and depression risks. Addressing these overlapping vulnerabilities with tailored, comprehensive healthcare is essential. This study aims to qualitatively explore the complex interplay between mental health and reproductive decision making among women living with HIV (WLWH). Methods: A secondary data analysis approach was employed, utilizing qualitative data from a wider study. Theoretical sampling was used to recruit a sample of WLWH attending the HIV clinic at a public hospital in Badalona (Barcelona, Spain). Interviews took place in a private and quiet space between May 2019 and January 2020. To perform secondary data analysis, Braun and Clarke's thematic analysis was used. Results: Twenty-six women living with HIV were interviewed, with an average age of 39.3 years. The participants had diverse nationalities and faced economic challenges. Following data analysis, four main themes were identified: Emotional Fragmentation and Reproductive Self-Perception after the HIV Diagnosis; Coping Strategies in Reproductive Decision Making; Impacting Emotional Resilience and Motherhood Decisions; and Emotions, Mental Health, and Desire for Motherhood. The themes revealed the profound emotional impact of HIV on their identity, mental health, and reproductive decision making, affecting motherhood aspirations. Conclusions: Women living with HIV face psychological challenges in reproductive decision making, including anxiety and stigma. The study highlights their resilience and emphasizes incorporating hope-based strategies into HIV care, advocating for integrated and mental health-focused approaches to improve support and outcomes.

Assessing Knowledge, Practices, and Barriers to PrEP and nPEP Prescription Among Texas Healthcare Providers

BACKGROUND

The effectiveness of pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) in preventing HIV is well-established, yet their use in clinical practice remains low. Healthcare providers, especially those in primary and emergency care settings, play a crucial role in adopting and implementing these prevention strategies. We conducted a statewide survey with 519 healthcare providers in Texas to assess their knowledge, practices, and barriers related to prescribing PrEP and nPEP.

METHODS

The survey collected data on demographics, clinical experience, practice type, awareness of recommended guidelines, knowledge of PrEP and nPEP, prescribing practices, and challenges encountered to prescribe these medications. We used multiple regression analysis to identify factors associated with PrEP and nPEP prescribing behavior.

RESULTS

While most providers were familiar with CDC and/or USPSTF-recommended PrEP guidelines, fewer had adequate knowledge of nPEP. Key challenges identified by providers included concerns about cost (48%), limited time (40% for PrEP and 51% for nPEP), and insufficient education or training (40% for PrEP and 35% for nPEP). Providers who were more familiar with the recommended guidelines and had greater experience in sexual health assessment were more likely to prescribe both PrEP and nPEP.

CONCLUSIONS

This study highlights the need for enhanced education and training to boost providers' knowledge and confidence in prescribing PrEP and nPEP. It also underscores the importance of addressing cost-related barriers and simplifying care processes to better integrate these HIV prevention strategies into primary and emergency care settings.