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 ResearchConceptsPrimary 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 strategyDrugRetention and dropout from sublingual and extended-release buprenorphine treatment: A comparative analysis of data from a nationally representative sample of commercially-insured people with opiod use disorder in the United States
Ivasiy R, Madden L, Johnson K, Machavariani E, Ahmad B, Oliveros D, Tan J, Kil N, Altice F. Retention and dropout from sublingual and extended-release buprenorphine treatment: A comparative analysis of data from a nationally representative sample of commercially-insured people with opiod use disorder in the United States. International Journal Of Drug Policy 2025, 138: 104748. PMID: 40020306, PMCID: PMC12045481, DOI: 10.1016/j.drugpo.2025.104748.Peer-Reviewed Original ResearchConceptsOpioid use disorderSL-BUPXR-BUPUse disorderRetrospective cohort studyExtended-release buprenorphineReduce treatment discontinuationDays of supplyTreatment discontinuationSublingual buprenorphineReduce overdose riskBuprenorphine treatmentCohort studyHigh dosesPrimary outcomeImpact of dosagePatientsBuprenorphineMonthsMg/dayCommercially-insured individualsProportion of individualsOpioidOverdose riskImprove health outcomesPrescribing 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 modelTuberculosis and people who use drugs: why focus on this overlooked population is important and why adapted interventions are necessary
D'Ottavi M, Godfrey-Faussett P, Merle C, Sofonea M, Laureillard D, Vickerman P, Molès J, Altice F, Van de Perre P, Stone J, Nagot N. Tuberculosis and people who use drugs: why focus on this overlooked population is important and why adapted interventions are necessary. The Lancet Global Health 2025, 13: e593-e598. PMID: 39862874, DOI: 10.1016/s2214-109x(24)00481-9.Peer-Reviewed Original ResearchConceptsReduce health inequalitiesCommunity-based approachActive case findingNational Tuberculosis ProgrammeHealth inequalitiesTargeted interventionsTuberculosis interventionsCase findingTreatment adherenceGeneral populationTuberculosis ProgrammeMarginalised populationsHIV fieldInterventionPrevalence of tuberculosisTuberculosis burdenPopulation levelTuberculosis transmissionHigher incidencePeoplePopulationAdherenceHIVPrevalenceLinkageRationale 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
Decrease in provider stigma is associated with improved quality health indicators among individuals receiving methadone in primary care centers in Ukraine
Machavariani E, Bromberg D, Dumchev K, Esserman D, Earnshaw V, Pykalo I, Filippovich M, Ivasiy R, Ahmad B, Long J, Haddad M, Madden L, Oliveros D, Dvoriak S, Altice F. Decrease in provider stigma is associated with improved quality health indicators among individuals receiving methadone in primary care centers in Ukraine. International Journal Of Drug Policy 2024, 136: 104682. PMID: 39705875, PMCID: PMC11821433, DOI: 10.1016/j.drugpo.2024.104682.Peer-Reviewed Original ResearchConceptsPrimary care centersQuality health indicatorsProvider stigmaEvidence-based practiceGuideline-concordantPatient outcomesHealth indicatorsReduce provider stigmaCare centerInfluence healthcare utilizationSpecialty health servicesPatient-level outcomesTele-educationImprove patient outcomesProvider fearsImplementation trialHealthcare utilizationPreventive careHealth servicesPoor healthLinear mixed-effects modelsImprove attitudesStigmaIncrease accessMixed-effects modelsImproving 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 ResearchConceptsHealth-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 ResearchConceptsHolistic 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 peopleInterventions to reduce harms related to drug use among people who experience incarceration: systematic review and meta-analysis
Macdonald C, Macpherson G, Leppan O, Tran L, Cunningham E, Hajarizadeh B, Grebely J, Farrell M, Altice F, Degenhardt L. Interventions to reduce harms related to drug use among people who experience incarceration: systematic review and meta-analysis. The Lancet Public Health 2024, 9: e684-e699. PMID: 39214637, PMCID: PMC11996259, DOI: 10.1016/s2468-2667(24)00160-9.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentDrug useRisk behaviorsReducing re-arrestsTherapeutic community interventionsEffectiveness of interventionsRecidivism outcomesReduce injection risk behaviorExperience incarcerationRe-arrestIncarcerationService provisionRecidivismPrisonSystematic reviewCommunity interventionsSubstance useSelf-harmInjection risk behaviorsRandom-effects meta-analysesMeta-analysisAlcohol useSyringe sharingPooled odds ratioRisk of deathUsing nominal group technique with people who are incarcerated in Canadian federal prisons to identify barriers and solutions to improving Prison Needle Exchange Program uptake
Lafferty L, Altice F, Leone F, Stoové M, Lloyd A, Hajarizadeh B, Kronfli N. Using nominal group technique with people who are incarcerated in Canadian federal prisons to identify barriers and solutions to improving Prison Needle Exchange Program uptake. International Journal Of Drug Policy 2024, 131: 104549. PMID: 39141957, DOI: 10.1016/j.drugpo.2024.104549.Peer-Reviewed Original ResearchConceptsCanadian federal prisonsFederal prisonsPeer advocatesProgram participantsWrap-around servicesCorrectional authoritiesPrisonParticipant confidentialityFear of repercussionsHarm reductionLack of confidentialityPerceived repercussionsPriority barriersNeedle exchange programsParticipants' narrativesDrug useAdvocatesVotingAccess barriersIdentity processesImprove accessFocus groupsNominal group techniqueConfidentialityInterview transcriptsHigh 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 ResearchConceptsPrimary 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 attitudes
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