Pet Ownership is Associated with Durable Viral Suppression but Presents Healthcare Access Challenges for People with HIV

AIDS and Behavior · 2026-01-12

Human-animal interaction (HAI; e.g., pet ownership) may contribute to enhanced health and well-being among individuals managing chronic conditions like HIV; however, responsibilities associated with pet ownership may also prevent owners from accessing timely healthcare. This study investigates the relationship between pet ownership, pet-related barriers to healthcare (PRBH), and comfort derived from pets with durable HIV viral suppression among people with HIV (PWH) in Florida. We tested three hypotheses using survey data from the Florida Cohort Study linked with Florida Department of Health HIV surveillance data, which included 623 participants recruited through HIV care providers and community health clinics. First, we hypothesized that pet owners would exhibit a higher likelihood of durable viral suppression compared to non-owners. While initial findings suggested that pet owners were more likely to be durably virally suppressed (OR = 1.82, p < 0.01), this association weakened, though remained marginally significant, after adjusting for covariates (OR = 1.55, p = 0.06). Second, we hypothesized that, among the pet-owning subset (n = 221), both experienced and anticipated PRBH would be negatively associated with viral suppression among pet owners. Our results confirmed that previously experienced PRBH were significantly associated with lower rates of viral suppression (OR = 0.22, p = 0.02), while anticipated barriers were not (OR = 0.44, p = 0.12). Lastly, we hypothesized that comfort from pets would be associated with better viral suppression; however, this was not supported (OR = 1.00, p = 0.98). These findings suggest that integrating pet-related support into HIV management strategies (e.g., providing pet sitting for patients receiving HIV care) could be supportive of HIV patient health by enabling owners to access timely care while maintaining the human-animal bond. Future research should assess the efficacy of collaborative efforts between healthcare providers and veterinary services in addressing the PRBH faced by pet-owning PWH to promote HIV management while supporting pet ownership in this population.

Racial and Ethnic Disparities in Cancer Care among People with HIV in the USA

International Healthcare Review (online) · 2025-11-20

Background: People with HIV (PwH) are at heightened cancer risk, but racial/ethnic disparities across the cancer care are not well understood. Our systematic review examined racial/ethnic differences in cancer risk, screening, treatment, and survival/mortality among PwH. Methods: We searched PubMed, Web of Science, Cochrane Library, ProQuest, and EMBASE for studies published in English (01/01/1980-05/30/2023), using key words and MeSH terms “race/ethnicity”, “cancer”, and “HIV”. Paired reviewers screened studies and extracted data. Study quality was assessed using the National Institutes of Health Study Quality Assessment Tool. All eligible studies were included, regardless of quality, to identify research gaps. Results: Of the 26 eligible studies, 11 assessed cancer risk only, 4 screening, 5 treatment, and 3 survival/mortality only, while 3 assessed both cancer risk and mortality. Risk studies focused on human papilloma virus-related (4), Kaposi sarcoma (4), urogenital (3), and lung (1) cancers. Among men who have sex with men (MSM), Kaposi sarcoma risk appeared higher among Black men than white, but lower in HHV-8 seropositive MSM. Screening studies on cervical (3), breast (3), and colorectal (2) cancers showed no evidence of disparity. Treatment studies on lymphoma (3) and multiple cancers combined (3) found Black individuals were less likely to receive treatment than their White counterparts. Most studies were rated fair (14) or poor (12). Conclusions: Our findings suggest that there are racial/ethnic disparities of cancer risk, treatment, and mortality/survival outcomes but no observable disparities related to cancer screening among PwH. Additional research on distinct cancer types to expand the breadth of evidence will address existing gaps in knowledge on racial/ethnic disparities among individuals with PwH at risk or living with cancer. Contributions to Evidence-Based Practice: Racial/ethnic disparities of cancer risk, treatment, and mortality/survival outcomes but no observable disparities related to cancer screening among PwH. Additional research on distinct cancer types to expand the breadth of evidence will address existing gaps in knowledge to allow for the planning of tailored interventions to provide a more equitable healthcare for individuals at risk or living with cancer in PwH.

Enacted HIV-Related Stigma Is Related to Sleep Disturbance Among People Living With HIV Through the Mediating Effect of Anxiety: The Florida Cohort Study, 2014–2018

Journal of the Association of Nurses in AIDS Care · 2025-07-29

ABSTRACT: HIV-related enacted stigma refers to experiencing discrimination because of one's HIV status and may be related to sleep disturbance. Using the Florida prospective cohort study ( n = 569), this study examines the direct association between enacted stigma and sleep disturbance and the indirect association between enacted stigma and sleep disturbance via anxiety. Data on stigma and anxiety were collected using self-report surveys at baseline and sleep disturbance at 6 months. Mediation analysis was conducted using structural equation modeling. Most participants were male (58.9%) and non-Hispanic Black (57.2%). Our findings suggested that anxiety fully mediated the association between enacted stigma and sleep disturbance (indirect effect: β = 0.11, 95% confidence interval [CI]: 0.05 to 0.18, p < .001; direct effect: β = 0.06, 95% CI: -0.07 to 0.19, p = .361; total estimated effect: β = 0.18, 95% CI: 0.03 to 0.32, p < .016). Reducing HIV-enacted stigma may improve anxiety and sleep disturbance among people with HIV.

Alcohol reduction strategies among persons with HIV: past attempts, self-reported effectiveness, and future strategies of interest

Addiction Science & Clinical Practice · 2025-07-20

BACKGROUND: Alcohol consumption is associated with poor health outcomes in people with HIV (PWH). Although various alcohol reduction strategies exist, little is known about PWH's past experiences or future preferences. This study describes the previous strategies PWH had used, their perceived effectiveness, among people who ever drank, and the strategies PWH who endorsed heavy drinking would consider trying in the future. It also examines how these experiences and preferences vary by sociodemographic factors and past 12 month drug use. METHODS: A cross-sectional analysis was conducted on data from 453 PWH enrolled in the Florida Cohort Wave III study (2020-2023; mean age 50 years, 60% men). Participants who attempted to reduce or quit drinking (n = 321) were asked about their use of eight alcohol reduction strategies and rated the effectiveness of each on a 4-point Likert scale. Participants reporting heavy drinking (n = 170) were asked about their willingness to try seven strategies in the future. Chi-square and Fisher's exact tests analyzed differences by sex, age, race/ethnicity, and past 12 month drug use. RESULTS: Among the 321 who had ever tried to reduce or quit drinking, endorsed strategies including "on my own"/ complete cessation (80%), prayer (61%), Alcoholics Anonymous (AA) (38%), counseling/therapy (31%), inpatient/outpatient detox (23%), self-monitoring (11%), and medication (7%). The strategies with the highest self-reported effectiveness were for prayer (59%), "on my own"/ complete cessation (58%), and in-patient detox (50%). Prayer was significantly more common among females and non-Hispanic Black or Hispanic participants. Those with past 12 month drug use were significantly more likely to have tried most strategies, except medications or prayer. Among 170 who reported heavy drinking, "on my own"/ complete cessation (43%), AA (24%), and counseling/therapy (21%) were the most endorsed strategies they would try in the future. No significant differences in future preferences were found by demographics, but those with past 12 month drug use showed more interest in formal treatment approaches. CONCLUSION: Commonly used alcohol reduction strategies among PWH were non-medical, easily accessible, and perceived as very effective. Incorporating safe and effective patient-driven methods into treatment guidelines may improve strategy uptake.

Cannabis Use for Chronic Pain in Sickle Cell Disease: A Scoping Review

Pain Management Nursing · 2025-07-24 · 1 citations

Real-Time and Long-Term Effects of Medical Marijuana on Older Adults: Protocol for a Prospective Cohort Study

JMIR Research Protocols · 2025-11-30

BACKGROUND: Older adults represent the fastest-growing group of medical marijuana (MM) users in the United States, with chronic pain being the most common reason for use. Despite this trend, scientific evidence remains limited regarding the short- and long-term effects of MM on critical health outcomes, including cognitive function, physical and mental health, and overall quality of life in this population. To better inform clinical practice and public policy, there is a clear need for more rigorous, longitudinal studies that examine the impact of real-world MM products over time. OBJECTIVE: The Study on Medical Marijuana and Its Long-Term Effects on Older Adults (SMILE) is a prospective cohort study that aims to 1) determine MM's short- and long-term effects on pain, physical, emotional, and cognitive functioning, and quality of life in older adults; and 2) identify MM product characteristics and patient subgroups associated with improved outcomes and side effects. METHODS: This study will recruit and follow 440 older adults (50 years or older, ~50% >65, ~50% male) with chronic pain for 12 months, as some initiate MM (MM group, n=330) and others do not (comparison group, n=110). Data collection included quarterly survey questionnaires (focusing longitudinal changes in cannabis use, pain, physical and emotional functioning, side effects, and quality of life); baseline and 12-month cognitive assessments, pain sensory tests, and blood/urine samples for cannabis use; and periodic smartphone- and Fitbit sensor-based measurements to capture detailed MM use patterns, real-time pain, mental health, and objective data on physical activity and sleep. Data will be analyzed using descriptive analyses, generalized linear mixed effects models, and generalized estimating equations models to assess differences in short- and long-term effects between the MM and comparison groups, and subgroups among those initiating MM treatment. RESULTS: Recruitment for the SMILE study began in July 2022 and all data collection is expected to be completed by 2026. As of October 2025, we enrolled 399 participants, with 277 in the MM group and 122 in the comparison group. Data analysis is currently underway, and results are expected to be published starting in 2027. CONCLUSIONS: With multisource data collected in real-time and over 12 months, our study will provide much-needed scientific evidence addressing: 1) whether MM can reduce pain and improve physical and emotional functioning in the short term among older adults; 2) whether effects of MM last for 12 months and demonstrate changes in quality of life or cognition; and 3) whether health benefits and consequences differ by MM product type and whether individual differences (e.g. sex, baseline pain phenotyping) moderate the relationship. Our findings will offer valuable insights for physicians and patients when considering MM as a treatment option, and will help guide more informed, individualized care decisions.

Time since HIV diagnosis is linked to amnestic mild cognitive impairment (MCI) in older adults with HIV

Journal of NeuroVirology · 2025-07-18

The Florida Cohort Wave 3: Recruitment and Data Collection from Persons with HIV in Florida: 2019-2023 (Preprint)

2025-01-22

<sec> <title>BACKGROUND</title> Ending the HIV Epidemic remains a high public health priority, and the state of Florida continues to have high HIV prevalence and incidence. </sec> <sec> <title>OBJECTIVE</title> The Florida Cohort study seeks to identify factors associated with the HIV Care Continuum and HIV-related comorbidities, with a focus on potential impact of alcohol consumption. </sec> <sec> <title>METHODS</title> The Florida Cohort Wave 3 enrolled persons with HIV aged 18+ from nine clinical, case management, and community settings across Florida from 2020 to 2023. All participants completed a baseline questionnaire, and most completed additional questionnaires at baseline and approximately one year after baseline. Data on HIV care and treatment, mental health, substance use, stigma, and technology were collected on the baseline questionnaire. Additional questionnaires covered alcohol use, gender identity, COVID-19, pets, stigma and discrimination, and antiretroviral therapy (ART) preferences. Questionnaire data were securely linked to HIV Care Continuum variables from Florida’s state HIV monitoring system. </sec> <sec> <title>RESULTS</title> Overall, the study enrolled 836 PWH (56% non-Hispanic Black, 16% Hispanic, 57% assigned male at birth, and 58% aged 50+). Most (97%) participants were linked to the state HIV reporting system and will be followed for up to five years to monitor HIV outcomes. Thirty-one participants completed the gender identity questionnaire, 230 completed the alcohol questionnaire, 287 completed the COVID-19 questionnaire, 221 completed the pet questionnaire, 461 complete the stigma and discrimination questionnaire, and 210 completed the ART preference questionnaire. </sec> <sec> <title>CONCLUSIONS</title> The study provides opportunities to monitor changes in HIV-related outcomes as well as relevant attitudes, behaviors, and healthcare preferences, but has some limitations in terms of representativeness and tracking of longitudinal outcomes. </sec>

A Topic Modeling Analysis of Stigma Dimensions, Social, and Related Behavioral Circumstances in Clinical Notes Among Patients with HIV

ArXiv.org · 2025-06-10

Objective: To characterize stigma dimensions, social, and related behavioral circumstances in people living with HIV(PLWHs) seeking care, using NLP methods applied to a large collection of EHR clinical notes from a large integrated health system in the southeast United States. Methods: We identified a cohort of PLWHs from the UF Health IDR and performed topic modeling analysis using Latent Dirichlet Allocation to uncover stigma-related dimensions and related social and behavioral contexts. Domain experts created a seed list of HIV-related stigma keywords, then applied a snowball strategy to review notes for additional terms until saturation was reached iteratively. To identify more target topics, we tested three keyword-based filtering strategies. The detected topics were evaluated using three widely used metrics and manually reviewed by specialists. In addition, we conducted word frequency analysis and topic variation analysis among subgroups to examine differences across age and sex-specific demographics. Results: We identified 9140 PLWHs at UF Health and collected 2.9 million clinical notes. Through the iterative keyword approach, we generated a list of 91 keywords associated with HIV-related stigma. Topic modeling on sentences containing at least one keyword uncovered a wide range of topic themes, such as "Mental Health Concern, Stigma", "Treatment Refusal, Isolation", and "Substance Abuse". Topic variation analysis across age subgroups revealed substantial differences. Conclusion: Extracting and understanding the HIV-related stigma and associated social and behavioral circumstances from EHR clinical notes enables scalable, time-efficient assessment and overcoming the limitations of traditional questionnaires. Findings from this research provide actionable insights to inform patient care and interventions to improve HIV-care outcomes.

Exploring how women with HIV develop hazardous drinking patterns: a qualitative assessment of drinking histories

BMC Public Health · 2025-08-09

INTRODUCTION: Hazardous alcohol use is prevalent among people with HIV, with women disproportionately experiencing adverse alcohol-related outcomes in HIV care. This study aimed to qualitatively explore factors contributing to the onset, escalation, and continuation of hazardous drinking among women with HIV. METHODS: Women with HIV and hazardous drinking patterns were recruited from the WHAT-IF? Study, a randomized trial evaluating the efficacy of naltrexone for alcohol reduction. Participants completed 60-minute semi-structured interviews. Interview transcripts were analyzed using thematic analysis methods. RESULTS: Twenty women (mean age 49.3 years; 85% Black) participated. Common themes identified by the participants as influencing their drinking onset and escalation were early exposure and normalization, and the impact of use among family and friends. Emotion and coping were identified as essential motivators in drinking escalation, as well as drug use (using alcohol and drugs together or using alcohol instead of drugs). These factors also contributed to the persistence of hazardous drinking, alongside participants' perceived health benefits of alcohol. While not common, some participants talked about a history of trying to reduce or stop drinking; they reported that their mental health and family and friends were instrumental in encouraging sobriety or continued alcohol use. CONCLUSION: Women with HIV identified emotional and social factors as primary drivers of hazardous drinking across their lifespan. Interventions that address coping strategies and enhance social support may be beneficial in reducing alcohol use in this population.