We suggest that people living with HIV (PLWH) may serve as pre-exposure prophylaxis (PrEP) educators for partners when informed about PrEP. Participants in this study were a convenience sample of PLWH at a public hospital in Miami. A cross-sectional survey assessed the frequency of serostatus disclosure, PrEP awareness, and willingness to recommend PrEP to intimate partners. To evaluate stigma surrounding human immunodeficiency virus (HIV), comfort discussing HIV with family, friends and intimate partners was interrogated. Surveys were completed by 137 participants; 39.5% had potentially sero-discordant sexual partners. Among respondents, 29.2% reported that they ‘occasionally’ or ‘never’ disclose HIV status to sexual partners. In all, 66.4% of patients reported that they had never heard of PrEP. After being educated about PrEP, 86.0% of respondents reported that they would encourage partners to use it. Participants were asked how often the subject of HIV comes up in conversations. Most indicated that ‘rarely’ or ‘never’ does it come up with friends and family; 46.1% indicated that ‘never’ or ‘rarely’ does it come up with partners. In bivariate analyses, participants with prior awareness of PrEP were more likely to indicate higher frequency of conversations regarding HIV with intimate partners. It is concluded that interventions which utilize partner education to increase PrEP uptake should address stigma and knowledge among other barriers.

Despite available guidelines for disclosure of HIV status to children, most children living with HIV are unaware of their diagnosis. We sought to characterize the concepts of illness and treatment among children living with HIV who do not know their status. As part of the Sankofa trial we interviewed 435 children aged 6-18 enrolled in clinical care at pediatric HIV clinics at two teaching hospitals in Ghana. Theoretic thematic analysis generated themes among responses.Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1

Background: Social determinants of health (SDOH) put some groups who access care at student-run free clinics (SRFCs) at higher risk for adverse medical outcomes. Free or low-cost community services supplement clinic-based interventions, but access is limited by knowledge, transportation, language, and/or trust. Social needs assessments may be electronically paired with resource connection tools to connect patients to local, validated resources. The objective of this pilot study was to evaluate the SDOH screen and resource connection tool developed at a SRFC. Methods: The tool was piloted with a convenience sample of 40 patients with scheduled outpatient appointments at a SRFC in Miami, Florida. Participants were given information about a variety of services and screened for high-risk situations such as human trafficking. Follow-up survey via telephone at 2-4 weeks identified survey acceptability, successful connections, and barriers to access. Results: Forty participants completed the assessment. All participants were counseled regarding exercise and nutrition and requested information about more than one resource. Sixty percent (n=24) were successfully contacted for follow-up. Of these, 29% (n=7) were able to connect with one or more recommended resources. Reasons given for failure to access resources included lack of time or transportation, health issues, and lack of response from contacted organizations. Conclusions: Social needs assessments may be implemented in SRFCs to identify high-risk needs, facilitate linkage to local organizations that meet these needs, gather data to guide future programming, and provide education and counseling. Stronger connections with local organizations and closed loop referrals may be needed to facilitate connection to community resources.

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