Dawn K. Smith's research while affiliated with Centers for Disease Control and Prevention and other places

... Racial/ethnic minority GBMSM and those with lower educational attainment were less likely to be side effectsconscious. Minoritized populations, particularly African American and Hispanic, have low rates of PrEP initiation [27]. Various factors contribute to low rates of PrEP use including stigma, lack of trust in the medical care system, lack of knowledge and awareness of PrEP and financial concern related to PrEP [26,28,29]. ...

... This means that AGYW take at least >4 daily oral PrEP tablets a week to have protection during periods of risk [10]. Unfortunately, numerous clinical studies have reported inconsistent or discontinuation of PrEP use, with only 25%-50% of AGYW showing high drug levels (tenofovir diphosphate [TFV-DP] ≥700 fmol/dried blood spot punch [DBS]) after the first 3 months [11][12][13][14][15][16][17][18][19][20]. This dramatically minimizes its prevention-effective benefits (i.e. ...

... However, lowest prevalence of PrEP uptake was observed primarily in states in the South: Georgia, Kentucky, North Carolina, South Carolina, Virginia, and West Virginia [7]. Noticeable gaps exist between the willingness to use PrEP and its uptake across the U.S. [3,5,7,8]. Between 2014 and 2015, 68.8% of 333 BMSM surveyed in the American Men's Internet Survey were willing to use PrEP, but only 7.5% used PrEP in the previous year [20]. Similarly in 2017, a national behavioral survey conducted in 23 U.S. cities revealed that 78.3% of BMSM were aware of PrEP, but only 18.8% had used it [21]. ...

... The DOT Diary app showed a high level of concordance with FTC-TP and TFV-DP levels (91.0% and 85.3%, respectively), suggesting that this method of measuring adherence is substantially better than self-reported measures [17,[36][37][38], which often over-report adherence levels because of social desirability [39][40][41][42]. Segmental hair levels provide a benefit over DBS levels because they can be used to measure PrEP use over a longer period of time, with drug levels from each centimeter of hair reflecting adherence over previous 4-week periods [43]. However, DOT Diary offers advantages over both measures, because it allows both for longitudinal measurement of adherence over extended periods of time, as well as providing greater granularity on patterns of adherence; measuring hair levels also requires trained personnel and a clinic visit. ...

... Uptake and retention in PrEP care among MSM have been suboptimal in real-world clinical settings [3][4][5]. PrEP efficacy is closely tied to adherence [6,7] as there needs to be enough medication circulating in the body in order to provide adequate protection against HIV. In a study among MSM at three clinics in Providence, Rhode Island (RI), St. Louis, Missouri (MO), and Jackson, Mississippi (MS), 72% were retained in care at three months and 57% were retained in PrEP care at six months [8]. ...

... A false negative HIV antigen-antibody test result can be seen in [34][35][36][37][38][39][40][41][42][43][44][45][46]: ...

... Obstetrics and Gynecology (OBGYN) and emergency department (ED) settings may be of particular importance in identifying women at high risk for HIV. A recent study found that 82% of women newly diagnosed with HIV had prior healthcare encounters that represented missed opportunities for PrEP initiation, 84% of which occurred in the ED [19]. Most women utilize family or internal medicine doctors for primary care, but OBG-YNs are more often used as a type of primary provider among people who are uninsured versus people with insurance (12% vs. 7%) and Black women versus white women (12% vs. 6%) [20]. ...

... If taken as prescribed, oral pill or long-acting injectable PrEP reduces the risk for sexual acquisition of HIV infection by approximately 99% [12]. Among the estimated number of heterosexually active adults indicated for PrEP use in 2015, approximately 70% were females [13]. Overall, despite the potential effectiveness of PrEP for decreasing HIV acquisition risk, uptake of PrEP among women most at risk for acquiring HIV is low. ...

... Open access (AA) women accounted for 55% of new HIV diagnoses among all women in the USA in 2019. 2 In 2016, the rate of new HIV diagnoses among AA women was 15 times higher than that of white women, 3 and in 2018, HIV infection ranked in the top eight leading causes of death among AA women aged 20-44 in the USA. 4 The elevated HIV risk profile among AA women in the south may reflect factors unique to rural areas, such as the prevalence of small sexual networks resulting in cyclical HIV transmission patterns 5 and barriers to HIV prevention rooted in structural racism such as high incarceration rates among male AA populations, limited awareness of and access to effective contraception and sexual health interventions, higher rates of concurrent partnerships among AA men in AA women's sexual networks, and financial and transportation-related barriers to accessing HIV/sexually transmitted infection (STI) screening, prevention and treatment. [6][7][8][9][10][11] Traditional HIV prevention efforts, like abstinenceonly education approaches that are prevalent in the rural south, have been insufficient to control high rates of STIs and HIV infections. Abstinence-only education does not provide women with comprehensive information critical for maintaining sexual health. ...

... A few months ago, however, an MMWR was circulated by the CDC that suggested condomless sex might be safe if the HIV-infected partner's HAART achieved an undetectable viral load in his blood [16]. This new opinion was based on reports by three teams of investigators cited in the MMWR: BAll three studies observed no HIV transmission to the uninfected partner while the partner with HIV was virologically suppressed with ART [16].^Unfortunately, ...