2025
Development and evaluation of an online HIV pre-exposure prophylaxis (PrEP) training program for community pharmacists to implement pharmacy-led PrEP services in Malaysia
Gan Y, Zaki R, Hafidzar S, Koh K, Nizaruddin M, Noh R, Khalid K, Yap A, Altice F, Lim S, Azwa I. Development and evaluation of an online HIV pre-exposure prophylaxis (PrEP) training program for community pharmacists to implement pharmacy-led PrEP services in Malaysia. PLOS ONE 2025, 20: e0328713. PMID: 40824910, PMCID: PMC12360552, DOI: 10.1371/journal.pone.0328713.Peer-Reviewed Original ResearchConceptsHIV pre-exposure prophylaxisPre-exposure prophylaxisCommunity pharmacistsTraining programPrEP servicesExploration-Preparation-Implementation-SustainmentKnowledge testOnline training programSimulation-based learningPrEP knowledgeClinical decision-makingPaired t-testKnowledge scoresPatient communicationParticipant feedbackBaseline assessmentDaily PrEPPharmacistsEligibility assessmentPrEP efficacyPrEPScore differencesPercentage scorePatient counselingClinical contraindicationsPilot randomized controlled trial to reduce HIV-related stigma among clinicians in Malaysia via project ECHO®
Earnshaw V, Collier Z, Wong P, Saifi R, Chong N, Ng R, Azwa I, Basri S, Hassan A, Mousavi M, Omar S, Walters S, Haddad M, Kamarulzaman A, Altice F. Pilot randomized controlled trial to reduce HIV-related stigma among clinicians in Malaysia via project ECHO®. AIDS Care 2025, 37: 1313-1331. PMID: 40736373, DOI: 10.1080/09540121.2025.2534539.Peer-Reviewed Original ResearchConceptsHIV-related stigmaClinical-related outcomesClinical Trial Registration:Scalable interventionsPilot randomized controlled trialQualitative focus groupsFocus group resultsQuantitative survey resultsSubgroup of participantsStigma reductionProject ECHOHIV testingIndividual healthcare facilitiesHIV preventionTrial Registration:Structural stigmaFocus groupsIntervention conditionHealthcare facilitiesStigmaGlobal disparitiesPotential benefitsRegistration:InterventionCliniciansUsing nominal group technique to identify and prioritize barriers to decentralizing HIV care to primary health centers in Lima, Peru
Oliveros D, Konda K, Madden L, Montenegro-Idrogo J, Tafur Quintanilla K, Sosa Barbarán K, Nikitin B, Ponticiello M, Benites C, Sánchez J, Altice F. Using nominal group technique to identify and prioritize barriers to decentralizing HIV care to primary health centers in Lima, Peru. BMC Health Services Research 2025, 25: 466. PMID: 40156011, PMCID: PMC11954239, DOI: 10.1186/s12913-025-12618-8.Peer-Reviewed Original ResearchMeSH KeywordsAdultFemaleHealth Services AccessibilityHIV InfectionsHumansMaleMiddle AgedPeruPoliticsPrimary Health CareSocial StigmaConceptsPrimary health centersNominal group techniqueDecentralized HIV careHIV careHealth centersHIV servicesGroup of healthcare providersDecentralization of HIV careNominal group technique groupsPatient's continuity of careContinuity of carePeruvian Ministry of HealthGroup techniqueEvidence-based strategiesMinistry of HealthHIV stigmaLack of confidenceHealthcare accessPerceived BarriersProvider groupsHealth outcomesHealthcare providersPatient continuityIdentified barriersEducational meetingsImpact of multi-level factors and partner characteristics on antiretroviral therapy adherence and access to HIV care during the COVID-19 pandemic
Neuenschwander P, Pala A, Altice F, Remien R, Mergenova G, Rozental E, Gulyayev V, Davis A. Impact of multi-level factors and partner characteristics on antiretroviral therapy adherence and access to HIV care during the COVID-19 pandemic. International Journal Of STD & AIDS 2025, 36: 568-576. PMID: 40155324, DOI: 10.1177/09564624251329626.Peer-Reviewed Original ResearchConceptsAntiretroviral therapy adherenceMental healthFactors associated with ART adherenceMethodsA cross-sectional surveyMultilevel generalized linear mixed modelsPoor mental healthAssociated with lower adherenceBackgroundAdherence to antiretroviral therapyAntiretroviral therapyMedication adherence ratesCross-sectional surveyCOVID-19 pandemicHIV treatment programsMulti-level factorsNegative emotional impactHIV carePublic health crisisSocial supportART adherenceSupportive partnersLinear mixed modelsAdherence ratesAssessed associationsLow adherenceAdherence levelsExploring barriers and potential solutions before implementing a scale-up strategy to expand methadone coverage among people who inject drugs in Tajikistan
O'Hara G, Madden L, Burkhonov A, Alaei A, Mohsinzoda G, Bromberg D, Abdullozoda J, Yusufi S, Altice F. Exploring barriers and potential solutions before implementing a scale-up strategy to expand methadone coverage among people who inject drugs in Tajikistan. Journal Of Substance Use And Addiction Treatment 2025, 172: 209682. PMID: 40139416, DOI: 10.1016/j.josat.2025.209682.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyNominal group techniquePre-implementationImplementation strategiesSecondary HIV prevention strategyHIV prevention strategiesPre-implementation studyAgonist therapyOpioid agonist therapy scale-upHIV epidemicPre-implementation activitiesMethadoneFocus groupsPrevention strategiesCentral Asian regionOpioidGroup techniquePWIDOrganizational factorsNIATxSocietal factorsRecipientsScale-up strategyDrugPrescribing methadone in prison predicts linkage to HIV care after release from prison: A randomized and patient preference trial
Mobley A, Wegman M, Bazazi A, Shenoi S, Bromberg D, Ahmad A, Kamarulzaman A, Altice F. Prescribing methadone in prison predicts linkage to HIV care after release from prison: A randomized and patient preference trial. International Journal Of Drug Policy 2025, 137: 104733. PMID: 39923270, PMCID: PMC11875876, DOI: 10.1016/j.drugpo.2025.104733.Peer-Reviewed Original ResearchConceptsLinkage to HIV careHIV careIncrease linkage to HIV careTreatment-as-prevention strategiesHIV treatment cascadeHIV treatment outcomesOpen-label trialCox proportional hazards modelsPatient preference trialOpioid use disorderMalaysia’s largest prison.Impact of methadoneProportional hazards modelTreatment cascadeInverse probability weighted Cox proportional hazards modelAnalytic sampleStudy participantsCareTreatment outcomesPrescribed methadoneOpioidConfounding variablesHIVUse disorderHazards modelRationale and design of a randomized clinical trial of integrated eHealth for PrEP and medications for opioid use disorders for women in the criminal legal system. The Athena study
Meyer J, Brunson S, Price C, Mulrain M, Nguyen J, Altice F, Kyriakides T, Cropsey K, Eaton E. Rationale and design of a randomized clinical trial of integrated eHealth for PrEP and medications for opioid use disorders for women in the criminal legal system. The Athena study. Addiction Science & Clinical Practice 2025, 20: 4. PMID: 39825419, PMCID: PMC11742507, DOI: 10.1186/s13722-024-00534-x.Peer-Reviewed Original ResearchConceptsCriminal legal systemOpioid use disorderLegal systemStandard of careStructural barriersUse disorderEnhanced standard of careRates of opioid use disorderDelivery of PrEPPre-exposure prophylaxisWomen's abilityRandomized clinical trialsLife-saving interventionsRandomized Controlled TrialsHealth disparitiesImplementation outcomesPrEP initiationPreventive servicesClinical outcomesIntegrated deliveryFollow-upDelivery modelsClinical trialsDecision aidPrEP
2024
Improving implementation of needle and syringe programmes to expand, scale up, and sustain evidence-based prevention interventions for HIV and hepatitis C in prisons
Kronfli N, Bromberg D, Wolff H, Montanari L, Vasyliev S, Altice F. Improving implementation of needle and syringe programmes to expand, scale up, and sustain evidence-based prevention interventions for HIV and hepatitis C in prisons. The Lancet Public Health 2024, 10: e63-e70. PMID: 39701113, PMCID: PMC11823114, DOI: 10.1016/s2468-2667(24)00275-5.Peer-Reviewed Original ResearchMeSH KeywordsEvidence-Based PracticeHepatitis CHIV InfectionsHumansNeedle-Exchange ProgramsPrisonersPrisonsSubstance Abuse, IntravenousConceptsHealth-care equityPrison-based needleHuman rights principlesStandard of health careUN General AssemblySyringe programmesEvidence-based interventionsHCV elimination goalsCarceral settingsRights principlesLegal statusMember statesGeneral AssemblyPrisonEvidence-based preventive interventionsYears of commitmentImplementation science methodsPNSPHCV prevention strategiesImplementation of needleImprove implementationDrug useCountry-level stakeholdersPolitical commitmentMultilevel stakeholdersDisruptions to HIV Prevention During Armed Conflict in Ukraine and Other Settings
Nikitin B, Bromberg D, Ivasiy R, Madden L, Machavariani E, Dvoriak S, Poole D, Otiashvilli D, Altice F. Disruptions to HIV Prevention During Armed Conflict in Ukraine and Other Settings. Current HIV/AIDS Reports 2024, 22: 10. PMID: 39672977, PMCID: PMC11823171, DOI: 10.1007/s11904-024-00716-x.Peer-Reviewed Original ResearchComparing the brief Holistic Health for HIV (3H+) to the Holistic Health Recovery Program (HHRP+) among people with HIV and opioid use disorder: Results from a randomized, controlled non-inferiority trial
Zelenev A, Huedo-Medina T, Shrestha R, Mistler C, Altice F, Sibilio B, Copenhaver M. Comparing the brief Holistic Health for HIV (3H+) to the Holistic Health Recovery Program (HHRP+) among people with HIV and opioid use disorder: Results from a randomized, controlled non-inferiority trial. PLOS ONE 2024, 19: e0312165. PMID: 39509356, PMCID: PMC11542883, DOI: 10.1371/journal.pone.0312165.Peer-Reviewed Original ResearchMeSH KeywordsAdultFemaleHIV InfectionsHolistic HealthHumansMaleMedication AdherenceMiddle AgedOpioid-Related DisordersRisk-TakingConceptsHolistic Health Recovery ProgramEvidence-based interventionsHolistic healthHIV treatmentRisk behaviorsReduce HIV risk behaviorsDifference-in-differencesEnd-of-interventionControlled non-inferiority trialHIV Epidemic goalsDrug treatment settingsAttainment of viral suppressionNon-inferiority trialRecovery programViral suppressionHigh ART adherenceHIV risk behaviorsNon-inferiorityHHRP+ART adherenceBehavioral interventionsReal-world settingsNon-parametric bootstrappingCondom useOpioid-dependent peopleHigh rates of deferring antiretroviral treatment for patients with HIV and substance use disorders: Results from a national sample of HIV physicians in Ukraine
Ottesen T, Wickersham J, Lawrence J, Antoniak S, Zezuilin O, Polonsky M, Antonyak S, Rozanova J, Dvoriak S, Pykalo I, Filippovych M, Altice F. High rates of deferring antiretroviral treatment for patients with HIV and substance use disorders: Results from a national sample of HIV physicians in Ukraine. PLOS ONE 2024, 19: e0305086. PMID: 39028735, PMCID: PMC11259278, DOI: 10.1371/journal.pone.0305086.Peer-Reviewed Original ResearchConceptsAntiretroviral therapy prescriptionAntiretroviral therapyCD4 countSubstance use disordersIncreased levels of stigmaNational sampleLevel of stigmaIndependent of risk groupSuboptimal antiretroviral therapyInitiate antiretroviral therapyPopulation of peopleHIV expertsHIV incidenceHIV physiciansHIV treatmentKey populationsTransgender womenAntiretroviral treatmentFeeling thermometerDrinking alcoholSex workersPhysiciansSex partnersPWHRisk groupsInfluence of Stigma on Engagement in HIV Care and Adherence to Antiretroviral Therapy in Specialized HIV Clinics Targeting Men Who Have Sex with Men and Transgender Women in Lima, Peru
Oliveros Gómez D, Machavariani E, Altice F, Gálvez de León S, Earnshaw V, Montenegro-Idrogo J, Sánchez J, Seminario A. Influence of Stigma on Engagement in HIV Care and Adherence to Antiretroviral Therapy in Specialized HIV Clinics Targeting Men Who Have Sex with Men and Transgender Women in Lima, Peru. AIDS And Behavior 2024, 28: 2755-2768. PMID: 38878137, DOI: 10.1007/s10461-024-04401-3.Peer-Reviewed Original ResearchConceptsAdherence to antiretroviral therapyART adherenceTransgender womenHIV careSocial determinants of healthDeterminants of healthMultiple health outcomesInfluence of stigmaHIV-related outcomesViral suppression levelsGender minoritiesStigma subscaleAntiretroviral therapyHIV stigmaHealthcare engagementSocial determinantsHealth outcomesHIV clinicHIV epidemicStigmaVulnerable populationsCareOutcome variablesAssess factorsAdherenceHIV Activist Identity, Commitment, and Orientation Scale (HAICOS): Psychometric Evaluation to Assess Clinician’s Propensity Towards HIV Activism in Malaysia
Chong N, Azwa I, Hassan A, Mousavi M, Wong P, Ng R, Saifi R, Basri S, Omar S, Walters S, Collier Z, Haddad M, Altice F, Kamarulzaman A, Earnshaw V. HIV Activist Identity, Commitment, and Orientation Scale (HAICOS): Psychometric Evaluation to Assess Clinician’s Propensity Towards HIV Activism in Malaysia. AIDS And Behavior 2024, 28: 2780-2792. PMID: 38806844, PMCID: PMC11827331, DOI: 10.1007/s10461-024-04381-4.Peer-Reviewed Original ResearchConceptsExploratory factor analysisHIV-related stigmaIntra-class correlation coefficientPrimary care physiciansTest-retest reliabilityCronbach's alpha valuesOrientation ScaleCare physiciansStigma-relatedPsychometric evaluationHIV treatmentHIV activityAlpha valuesPsychometric qualitiesActivist identitiesHIVClinical practiceFactor analysisCliniciansCorrelation coefficientDay-to-dayStructured activitiesCronbachStigmaPhysiciansImplementation of REDCap mobile app in an oral HIV clinical study
Seminario A, Karczewski A, Stanley S, Huamani J, Montenegro J, Tafur K, Julca A, Altice F. Implementation of REDCap mobile app in an oral HIV clinical study. BMC Public Health 2024, 24: 629. PMID: 38413910, PMCID: PMC10900554, DOI: 10.1186/s12889-024-17837-y.Peer-Reviewed Original ResearchConceptsAlcohol use disorderLow-middle income countriesOral healthAssociation of alcohol use disordersPerceived oral health statusAvailability of anti-retroviral therapyLevels of oral diseaseOral health statusAnti-retroviral therapyMobile appsElectronic data collection systemResultsThe mean ageHIV clinical studiesDietary supplement useClinical research staffHIV stigmaOral diseasesHIV clinicHIV casesHealth statusHIV statusMean ageClinical studiesParticipants' experiencesMedical historyIntegrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge
Bromberg D, Machavariani E, Madden L, Dumchev K, LaMonaca K, Earnshaw V, Pykalo I, Filippovych M, Haddad M, Dvoriak S, Altice F. Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge. Journal Of The International AIDS Society 2024, 27: e26202. PMID: 38379179, PMCID: PMC10879646, DOI: 10.1002/jia2.26202.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidHIV InfectionsHumansMethadonePrimary Health CareSubstance Abuse, IntravenousUkraineConceptsPrimary care clinicsStigma reduction interventionsOpioid agonist therapyClinicians' attitudesStigma constructsHIV preventionReduction interventionsEvidence-based HIV preventionCluster Randomized Controlled TrialEvidence-based carePrimary care settingIntegrated care sitesDirect providersRandomized Controlled TrialsProvider stigmaCare clinicsCare sitesHIV careCare settingsHealth outcomesClinical staffSubstance use disordersLinear mixed-effects modelsTreatment continuumImprove attitudesTesting the Feasibility and Acceptability of Using an Artificial Intelligence Chatbot to Promote HIV Testing and Pre-Exposure Prophylaxis in Malaysia: Mixed Methods Study.
Cheah M, Gan Y, Altice F, Wickersham J, Shrestha R, Salleh N, Ng K, Azwa I, Balakrishnan V, Kamarulzaman A, Ni Z. Testing the Feasibility and Acceptability of Using an Artificial Intelligence Chatbot to Promote HIV Testing and Pre-Exposure Prophylaxis in Malaysia: Mixed Methods Study. JMIR Human Factors 2024, 11: e52055. PMID: 38277206, PMCID: PMC10858413, DOI: 10.2196/52055.Peer-Reviewed Original ResearchConceptsUptake of HIV testingHIV testingPre-exposure prophylaxisUnified Theory of AcceptanceFrequency of HIV testingTheory of AcceptanceAI chatbotsPromote HIV testingMental health supportHIV risk assessmentHIV prevention effortsHIV-related informationMixed methods studyPresence of stigmaUse of technologyConsequences of HIVEffort expectancySexually transmitted infectionsWeb-based surveyEngaging MSMArtificial intelligenceTranscribed verbatimPrEP uptakeHealth supportMental health
2023
Using the exploration, preparation, implementation, sustainment (EPIS) framework to assess the cooperative re-engagement controlled trial (CoRECT)
Elder H, Lang S, Villanueva M, John B, Roosevelt K, Altice F, Brady K, Gibson B, Buchelli M, DeMaria A, Randall L. Using the exploration, preparation, implementation, sustainment (EPIS) framework to assess the cooperative re-engagement controlled trial (CoRECT). Frontiers In Public Health 2023, 11: 1223149. PMID: 38106893, PMCID: PMC10722986, DOI: 10.3389/fpubh.2023.1223149.Peer-Reviewed Original ResearchMeSH KeywordsHIV InfectionsHumansMassachusettsPublic HealthRandomized Controlled Trials as TopicResearch DesignRetrospective StudiesConceptsPublic health surveillance dataHealth surveillance dataHIV careSurveillance dataHealth department jurisdictionsPublic health practicePublic health agenciesStudy protocolClinic dataClinic partnersCase identificationHealth practicesHealth agenciesIntervention design processTrial sitesIntervention developmentTrialsCareInterventionSustainment (EPIS) frameworkEPIS frameworkIterative discussionsStaff capacityCommunity partnersRe-EngagementEarly disruptions to syringe services programs during the Russian invasion of Ukraine
Nikitin B, Bromberg D, Pykalo I, Ivasiy R, Islam Z, Altice F. Early disruptions to syringe services programs during the Russian invasion of Ukraine. Frontiers In Public Health 2023, 11: 1229057. PMID: 38074770, PMCID: PMC10702598, DOI: 10.3389/fpubh.2023.1229057.Peer-Reviewed Original ResearchConceptsSyringe service programsHIV prevention servicesHarm reduction servicesService programsWidespread HIV epidemicsSemi-structured interviewsIllicit drug usePreventive servicesHIV/AIDS preventionOutreach workersHIV epidemicReduction servicesClients transitionClient’s opennessHIV outbreakService provisionUnique clientsDrug useInterviewsPWIDHarmServicesNGO supportClientsInjection paraphernaliaGlobal HIV control: is the glass half empty or half full?
Nachega J, Musoke P, Kilmarx P, Gandhi M, Grinsztejn B, Pozniak A, Rawat A, Wilson L, Mills E, Altice F, Mellors J, Quinn T. Global HIV control: is the glass half empty or half full? The Lancet HIV 2023, 10: e617-e622. PMID: 37506723, PMCID: PMC10733629, DOI: 10.1016/s2352-3018(23)00150-9.Peer-Reviewed Original ResearchMeSH KeywordsAcquired Immunodeficiency SyndromeAfrica, NorthernHIV InfectionsHomosexuality, MaleHumansMaleSexual and Gender MinoritiesImproving HIV and HCV Testing in Substance Use Disorder Programs (SUDs) That Provide Medications for Opiate Use Disorder (MOUD): Role of Addressing Barriers and Implementing Universal and Site-Specific Approaches
Brooks R, Wegener M, Freeman B, Fowles C, Madden L, Tetrault J, Nichols L, Altice F, Villanueva M. Improving HIV and HCV Testing in Substance Use Disorder Programs (SUDs) That Provide Medications for Opiate Use Disorder (MOUD): Role of Addressing Barriers and Implementing Universal and Site-Specific Approaches. Health Promotion Practice 2023, 24: 1018-1028. PMID: 37439759, DOI: 10.1177/15248399231169791.Peer-Reviewed Original ResearchMeSH KeywordsCoinfectionHepacivirusHepatitis CHIV InfectionsHumansOpiate AlkaloidsSubstance-Related DisordersConceptsHIV/HCV coinfectionSubstance use disorder programsHCV testingOpiate use disorderHCV coinfectionUse disordersNominal group techniqueSubstance use disorder treatment centersCascade of careRates of HIVDisorder treatment centersQuality improvement effortsRate of testingHCV acquisitionHCV cureImproving HIVSUD clinicsHepatitis CHIV testingPrior diagnosisSubsequent referralReferral ratesHIV epidemicHIVTreatment centers
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