<scp>HIV</scp> care cascade and sustainable wellbeing of people living with <scp>HIV</scp> in context

Seckinelgin, Hakan

doi:10.1002/jia2.25259

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…18 Data also show that increased ART adherence and consistent monitoring of VL are associated with increased knowledge and trust of TasP among SMM-LHIV, in particular. 4,19 Taken together, data suggest an associationpotentially reciprocal in nature-between engagement in HIV treatment and prevention and greater acceptance and understanding of the science of VL suppression and HIV transmission.…”

Section: Introductionmentioning

confidence: 97%

“…Reaching viral suppression not only provides a benchmark for effective HIV management, 20 but U = U messaging reframes it as a positive sexual health indicator, which may offer personal and psychological benefits 19,21 and opportunities for SMM-LHIV to regain control over their physical and sexual health as well. 19,21 An undetectable VL can relieve fears of rejection or even violence when disclosing one's HIV status to a partner, and promote intimate partnerships for SMM-LHIV. 22 In addition to reducing HIV-related stigma 23 and correcting the belief that people living with HIV are ''vectors'' of transmission, 4 wide acceptance of U = U also challenges the rationale for HIV criminalization.…”

Section: Introductionmentioning

confidence: 99%

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Treatment Is More Than Prevention: Perceived Personal and Social Benefits of Undetectable = Untransmittable Messaging Among Sexual Minority Men Living with HIV

Rendina

Talan

Cienfuegos-Szalay

et al. 2020

AIDS Patient Care and STDs

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Research suggests that the science of undetectable viral load (VL) status and HIV transmission-conveyed with the slogan ''Undetectable = Untransmittable'' or ''U = U''-has gaps in acceptance despite robust scientific evidence. Nonetheless, growing acceptance of U = U creates conditions for a shift in the sociopolitical and personal implications of viral suppression. We conducted an online survey over a 23-month period in 2018 and 2019 among 30,361 adolescent and adult (aged 13-99) sexual minority men living with HIV (SMM-LHIV) across the United States. We examined the impact of U = U on self-image, potential for changing societal HIV stigma, whether SMM-LHIV had ever spoken with a provider about viral suppression and HIV transmission, and primary sources of hearing about U = U. Approximately 80% of SMM-LHIV reported that U = U was beneficial for their self-image and societal HIV stigma, 58.6% reported it made them feel ''much better'' about their own HIV status, and 40.6% reporting it had the potential to make HIV stigma ''much better.'' The most consistent factors associated with these beliefs centered around care engagement, particularly self-reported viral suppression and excellent antiretroviral therapy adherence. Two-thirds reported ever talking to a provider about VL and HIV transmission, although the primary sources for having heard about U = U were HIV and lesbian, gay, bisexual, transgender, and queer (LGBTQ) news media and personal profiles on networking apps. These findings demonstrate the significant personal and social importance of U = U for SMM-LHIV that go above-and-beyond the well-documented health benefits of viral suppression, suggesting that providers should consider routinely initiating conversations with patients around the multifaceted benefits (personal health, sexual safety and intimacy, increased self-image, and reduced social stigma) of viral suppression.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Treatment Is More Than Prevention: Perceived Personal and Social Benefits of Undetectable = Untransmittable Messaging Among Sexual Minority Men Living with HIV

Rendina

Talan

Cienfuegos-Szalay

et al. 2020

AIDS Patient Care and STDs

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“…Yet, promoting mental health and wellbeing (SDG 3.4) among young people has received very little attention. There is growing recognition for the need to include quality of life as an HIV/AIDS programme target [32,33]. Current multi-sectoral HIV programmes are focused on reducing new HIVinfections among adolescent girls and young women via improving access to health and social services, including economic opportunities [34].…”

Section: Introductionmentioning

confidence: 99%

Informing the measurement of wellbeing among young people living with HIV in sub-Saharan Africa for policy evaluations: a mixed-methods systematic review

Govindasamy

Seeley

Olaru

et al. 2020

Health Qual Life Outcomes

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Young people living with HIV (YPLHIV) in sub-Saharan Africa (SSA) are at high risk of having a poor quality of life. Addressing wellbeing explicitly within HIV/AIDS policies could assist mitigation efforts. However, guidance on wellbeing measures to evaluate policies for YPLHIV is scarce. The aims of this mixed-methods review were to identify: i) key dimensions of wellbeing and ii) wellbeing measures that align to these dimensions among YPLHIV (15-24 years) in SSA. We searched six social science and medical databases, including grey literature. We included studies that examined correlates and lived experiences of wellbeing, among YPLHIV in SSA, from January 2000 to May 2019. Two reviewers independently screened abstracts and full texts and assessed methodological quality of included articles. We analysed quantitative and qualitative data using descriptive and meta-ethnographic approaches, respectively. Thereafter, we integrated findings using a framework approach. We identified 6527 citations. Of these, 10 quantitative and 30 qualitative studies were included. Being male, higher educational status, less stigma and more social support were likely correlates of wellbeing. Themes that shaped experiences suggestive of wellbeing were: 1) acceptance and belonging-stigma, social support; 2) coping; 3) standard of living. Our final synthesis found that the following dimensions potentially characterise wellbeing: self-acceptance, belonging, autonomy; positive relations, environmental mastery, purpose in life. Wellbeing for YPLHIV is multi-dimensional and relational. Relevant measures include the Personal Wellbeing Index, Ryff's Psychological Wellbeing Scale and Mental Health Continuum Short Form. However, psychometric evaluations of these scales among YPLHIV in SSA are needed.

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Growing Acceptability of Undetectable = Untransmittable but Widespread Misunderstanding of Transmission Risk: Findings From a Very Large Sample of Sexual Minority Men in the United States

Rendina

Cienfuegos-Szalay

Talan

et al. 2020

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Several studies have demonstrated no linked HIV transmissions in serodifferent sexual encounters where the partner with HIV has an undetectable viral load. As a result, awareness and dissemination of treatment as prevention, and movements such as “Undetectable = Untransmittable” (U = U), has grown. Setting: We conducted an online cross-sectional survey from November 2017 through September 2018 to gather data from a total of 111,747 sexual minority men (SMM) in the United States. Methods: Participants provided sociodemographic data and answered questions regarding biomedical status, HIV and STI prevention behaviors, drug use, condomless anal sex, and perceived accuracy of the U = U message. We conducted analyses to understand factors associated with perceived accuracy of U = U stratified by HIV status. Results: Overall, 53.2% of the sample perceived U = U as accurate, with the highest rates among HIV-positive SMM (83.9%), followed by HIV-negative (53.8%) and status-unknown (39.0%) SMM. Multivariable models showed accuracy beliefs were, on average, 1–2% higher for each consecutive month of recruitment. Consistent with previous work, there was greater heterogeneity among HIV-negative and unknown men, with several factors differentiating perceived accuracy, compared with SMM with HIV. Perceived transmission risk levels with undetectable partners were skewed well above accurate levels, and greater perceived transmission risk was associated with lower perceived accuracy of U = U. Conclusions: Public confidence in treatment as prevention and U = U is growing, but clear, unequivocal messaging about the effectiveness of U = U is critical. Owing to misunderstandings of risk, language that focuses on protective benefits rather than transmission risks may reach more people and allow for better comparisons with PrEP and condoms.

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HIV care cascade and sustainable wellbeing of people living with HIV in context

Cited by 4 publications

References 11 publications

Treatment Is More Than Prevention: Perceived Personal and Social Benefits of Undetectable = Untransmittable Messaging Among Sexual Minority Men Living with HIV

Treatment Is More Than Prevention: Perceived Personal and Social Benefits of Undetectable = Untransmittable Messaging Among Sexual Minority Men Living with HIV

Informing the measurement of wellbeing among young people living with HIV in sub-Saharan Africa for policy evaluations: a mixed-methods systematic review

Growing Acceptability of Undetectable = Untransmittable but Widespread Misunderstanding of Transmission Risk: Findings From a Very Large Sample of Sexual Minority Men in the United States

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