2024
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
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 people
2022
Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey
Maviglia F, Wickersham J, Azwa I, Copenhaver N, Kennedy O, Kern M, Khati A, Lim S, Gautam K, Shrestha R. Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey. International Journal Of Environmental Research And Public Health 2022, 20: 294. PMID: 36612617, PMCID: PMC9819808, DOI: 10.3390/ijerph20010294.Peer-Reviewed Original ResearchConceptsInjection drug useMalaysian MSMDrug useGamma hydroxybutyrateGreater HIV risk behaviorsHIV-positive sexual partnerPre-exposure prophylaxis knowledgeRecent injection drug usePre-exposure prophylaxisHIV risk factorsHIV-positive partnerMultivariable logistic regressionSevere depressive symptomsRecent STI diagnosisHIV risk behaviorsTransactional sexCross-sectional studyMental health servicesMultiple sex partnersDrug-related behaviorsChemsex engagementRecent sexual intercourseSTI diagnosisMultivariable analysisAssociated Factors
2020
Awareness about and willingness to use long-acting injectable pre-exposure prophylaxis (LAI-PrEP) among people who use drugs
Shrestha R, DiDomizio EE, Kim RS, Altice FL, Wickersham JA, Copenhaver MM. Awareness about and willingness to use long-acting injectable pre-exposure prophylaxis (LAI-PrEP) among people who use drugs. Journal Of Substance Use And Addiction Treatment 2020, 117: 108058. PMID: 32811633, PMCID: PMC7438607, DOI: 10.1016/j.jsat.2020.108058.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisInjectable pre-exposure prophylaxisLAI-PrEPOral pre-exposure prophylaxisLong-term side effectsSelf-reported HIV risk behaviorsBangkok Tenofovir StudyEvidence-based HIVHigh-risk PWUDImportant key populationHIV-negative peopleOpioid use disorderHIV risk behaviorsHIV prevention effortsAddiction treatment programsDaily PrEPOral PrEPAdherence challengesIndependent correlatesFemale sexClinical trialsHIV preventionIndependent factorsSide effectsUse disorders
2019
Use of Smartphone to Seek Sexual Health Information Online Among Malaysian Men Who Have Sex with Men (MSM): Implications for mHealth Intervention to Increase HIV Testing and Reduce HIV Risks
Shrestha R, Lim SH, Altice FL, Copenhaver M, Wickersham JA, Saifi R, Ab Halim MA, Naning H, Kamarulzaman A. Use of Smartphone to Seek Sexual Health Information Online Among Malaysian Men Who Have Sex with Men (MSM): Implications for mHealth Intervention to Increase HIV Testing and Reduce HIV Risks. Journal Of Community Health 2019, 45: 10-19. PMID: 31375976, PMCID: PMC6957731, DOI: 10.1007/s10900-019-00713-x.Peer-Reviewed Original ResearchConceptsSexual health informationHIV testingHealth informationOnline sexual health informationSexual partnersRecent HIV testingHigh-risk MSMHIV/STIsHIV risk behaviorsHIV prevention activitiesCross-sectional online surveyHealth Information OnlineMalaysian MSMSTI preventionIndependent correlatesGeosocial networking appsHIV riskMHealth interventionsMHealth strategiesMHealth toolsRisk behaviorsOlder ageLogistic regressionMSMPrevention activitiesHIV-Related Stigma, Motivation to Adhere to Antiretroviral Therapy, and Medication Adherence Among HIV-Positive Methadone-Maintained Patients
Shrestha R, Altice FL, Copenhaver MM. HIV-Related Stigma, Motivation to Adhere to Antiretroviral Therapy, and Medication Adherence Among HIV-Positive Methadone-Maintained Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2019, 80: 166-173. PMID: 30383588, PMCID: PMC6331231, DOI: 10.1097/qai.0000000000001891.Peer-Reviewed Original ResearchConceptsOptimal ART adherenceAntiretroviral therapyMethadone-maintained patientsMethadone maintenance treatmentART adherenceMaintenance treatmentHIV treatment outcomesHIV-positive patientsOpioid agonist therapyMultivariable logistic regressionHIV risk behaviorsExplanatory pathwaysAgonist therapySuboptimal adherenceMedication adherenceHIV treatmentTreatment outcomesHIV stigmaPatientsLogistic regressionHIVPrevention initiativesTherapyAdherenceSignificant correlates
2018
HIV Sero-Status Non-disclosure Among HIV-Infected Opioid-Dependent Individuals: The Roles of HIV-Related Stigma, Risk Behavior, and Social Support
Shrestha R, Altice FL, Sibilio B, Copenhaver MM. HIV Sero-Status Non-disclosure Among HIV-Infected Opioid-Dependent Individuals: The Roles of HIV-Related Stigma, Risk Behavior, and Social Support. Journal Of Community Health 2018, 44: 112-120. PMID: 30043195, PMCID: PMC6330145, DOI: 10.1007/s10900-018-0560-7.Peer-Reviewed Original ResearchConceptsOpioid-dependent individualsOpioid-dependent patientsHIV statusFamily/friendsSexual partnersHIV disclosureHIV sero-status disclosureRisk behaviorsHIV sero statusAntiretroviral therapy adherenceHigh-risk HIVRole of HIVMultivariable logistic regressionSubstance abuse treatment settingsHIV risk behaviorsInconsistent condom useMultiple sex partnersSocial supportHigh HIVSero statusHIV transmissionTherapy adherenceIndependent correlatesHIV riskHIV stigmaExploring the Use of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among High-Risk People Who Use Drugs in Treatment
Shrestha R, Copenhaver M. Exploring the Use of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among High-Risk People Who Use Drugs in Treatment. Frontiers In Public Health 2018, 6: 195. PMID: 30062091, PMCID: PMC6054971, DOI: 10.3389/fpubh.2018.00195.Peer-Reviewed Original ResearchPre-exposure prophylaxisPrEP adherenceHIV preventionHigh-risk PWUDSubstance abuse treatment settingsUse of PrEPHigh-risk peopleHIV risk behaviorsHIV prevention approachesPrEP servicesDaily dosingPrEP useHigh adherenceDepth semi-structured qualitative interviewsSemi-structured qualitative interviewsTreatment settingsPocket costsRisk behaviorsDisclosure statusPrEPAdherencePrevention approachesProphylaxisPreliminary evidencePWUDViral suppression among HIV-infected methadone-maintained patients: The role of ongoing injection drug use and adherence to antiretroviral therapy (ART)
Shrestha R, Copenhaver MM. Viral suppression among HIV-infected methadone-maintained patients: The role of ongoing injection drug use and adherence to antiretroviral therapy (ART). Addictive Behaviors 2018, 85: 88-93. PMID: 29879611, PMCID: PMC6337064, DOI: 10.1016/j.addbeh.2018.05.031.Peer-Reviewed Original ResearchConceptsMethadone maintenance therapyMethadone-maintained patientsOngoing injection drug useViral suppressionAntiretroviral therapyInjection drug useHIV risk behaviorsDrug useSelf-reported HIV risk behaviorsImproved virologic outcomesOptimal ART adherenceHigher CD4 countsSustained viral suppressionMultivariable logistic regressionVirologic outcomesCD4 countMaintenance therapyOptimal adherenceART adherenceHIV treatmentIndependent correlatesTreatment challengesRisk populationsPatientsHIVIntegrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study
Shrestha R, Altice FL, Karki P, Copenhaver MM. Integrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study. AIDS And Behavior 2018, 22: 2640-2649. PMID: 29582199, PMCID: PMC6051885, DOI: 10.1007/s10461-018-2099-0.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidBiobehavioral SciencesCondomsFeasibility StudiesFemaleHIV InfectionsHumansMaleMedication AdherenceMethadoneMiddle AgedMotivationOpiate Substitution TreatmentOpioid-Related DisordersPatient Acceptance of Health CarePilot ProjectsPre-Exposure ProphylaxisProspective StudiesRisk Reduction BehaviorSexual BehaviorSexual PartnersSubstance Abuse, IntravenousConceptsPre-exposure prophylaxis adherenceSelf-reported PrEP adherenceSex-related risk behaviorsHIV risk reduction behaviorsBio-behavioral interventionPre-exposure prophylaxisProspective clinical trialsHigh-risk peopleHIV prevention interventionsHIV risk behaviorsPilot feasibility studyPost-intervention assessmentPrEP adherenceProphylaxis adherencePreliminary efficacyClinical trialsIntervention groupHIV riskPrevention interventionsRisk behaviorsBio-behavioral approachAdherenceInterventionHigh acceptabilityPrEP
2017
Interest in use of mHealth technology in HIV prevention and associated factors among high-risk drug users enrolled in methadone maintenance program
Shrestha R, Karki P, Copenhaver M. Interest in use of mHealth technology in HIV prevention and associated factors among high-risk drug users enrolled in methadone maintenance program. AIDS Care 2017, 29: 1144-1148. PMID: 28478706, PMCID: PMC6081193, DOI: 10.1080/09540121.2017.1325439.Peer-Reviewed Original ResearchConceptsHigh-risk PWUDMethadone maintenance programHIV preventionMedication remindersHIV risk reduction informationRisk behaviorsSex-related risk behaviorsHigh-risk drug usersMHealth technologiesHIV prevention toolHIV risk reductionHIV prevention approachesHIV risk behaviorsDrug treatment settingsRisk Behavior AssessmentHIV prevention effortsHIV-negative PWUDUse of mHealthNew intervention strategiesDepressive symptomsTreatment settingsDrug usersHealthcare providersMultivariate analysisPrevention effortsAn explanatory factor analysis of a brief self-report scale to detect neurocognitive impairment among HIV-positive men who have sex with men and transgender women in Peru
Weikum D, Shrestha R, Ferro EG, Vagenas P, Copenhaver M, Spudich S, Alpert MD, Cabello R, Lama JR, Sanchez J, Altice FL. An explanatory factor analysis of a brief self-report scale to detect neurocognitive impairment among HIV-positive men who have sex with men and transgender women in Peru. AIDS Care 2017, 29: 1297-1301. PMID: 28449599, PMCID: PMC6337065, DOI: 10.1080/09540121.2017.1322681.Peer-Reviewed Original ResearchConceptsHIV-positive menNeuropsychological Impairment ScaleNeurocognitive impairmentTransgender womenAntiretroviral therapyHIV-positive MSMPoor clinical outcomeHIV risk behaviorsClinical care settingsHealth-related outcomesExploratory factor analysisART adherenceClinical outcomesPatient populationCare settingsImpairment ScaleRisk behaviorsImpairmentMenPrincipal axis factoringSelf-report scalesOrthogonal varimax rotationWomenBrief self-report scaleOutcomesIntent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis
Shrestha R, Karki P, Huedo-Medina TB, Copenhaver M. Intent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis. Journal Of The Association Of Nurses In AIDS Care 2017, 28: 612-621. PMID: 28478870, PMCID: PMC7451137, DOI: 10.1016/j.jana.2017.04.005.Peer-Reviewed Original ResearchConceptsHIV risk behaviorsNeurocognitive impairmentRisk behaviorsPreexposure prophylaxisSelf-reported neurocognitive symptomsHigh-risk drug usersHigh-risk PWUDPrEP uptakeNeurocognitive symptomsHIV riskDrug usersSimilar outcomesUnderserved populationsSignificant correlatesProphylaxisImportant unanswered questionsPreliminary evidencePrEPDissemination effortsMediation analysisUnanswered questionsVariables of interestHIVSymptomsClinicians
2016
Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment
Shrestha R, Altice FL, Huedo-Medina TB, Karki P, Copenhaver M. Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment. AIDS And Behavior 2016, 21: 1299-1308. PMID: 27990587, PMCID: PMC5380590, DOI: 10.1007/s10461-016-1650-0.Peer-Reviewed Original ResearchConceptsHigh-risk PWUDBehavioral skills modelCommunity-based methadone maintenance treatmentPre-exposure prophylaxis trialsSex-related HIV risk behaviorsHigh-risk drug usersPre-exposure prophylaxisIMB modelMethadone maintenance treatmentEfficacy of PrEPUse of PrEPHIV risk behaviorsKey risk populationsHealth behavior changeHIV acquisitionProphylaxis trialsHIV infectionMaintenance treatmentHIV preventionRisk populationsDrug usersRisk behaviorsPrEPPWUDIntervention developmentTreatment Engagement Moderates the Effect of Neurocognitive Impairment on Antiretroviral Therapy Adherence in HIV-Infected Drug Users in Treatment
Shrestha R, Karki P, Huedo-Medina TB, Copenhaver M. Treatment Engagement Moderates the Effect of Neurocognitive Impairment on Antiretroviral Therapy Adherence in HIV-Infected Drug Users in Treatment. Journal Of The Association Of Nurses In AIDS Care 2016, 28: 85-94. PMID: 27769735, PMCID: PMC5183513, DOI: 10.1016/j.jana.2016.09.007.Peer-Reviewed Original ResearchAssociation Between Intimate Partner Violence Against Women and HIV-Risk Behaviors
Shrestha R, Copenhaver MM. Association Between Intimate Partner Violence Against Women and HIV-Risk Behaviors. Violence Against Women 2016, 22: 1621-1641. PMID: 26912296, PMCID: PMC5308057, DOI: 10.1177/1077801216628690.Peer-Reviewed Original ResearchConceptsHIV risk behaviorsIntimate partner violenceSignificant global health issueInconsistent condom useAdverse health outcomesSTIs/HIVMultiple sex partnersSafer sexual practicesGlobal health issueHIV infectionHIV riskPartner violenceHealth outcomesSex partnersCondom useDisproportionate burdenEffective interventionsHealth issuesWomenHIVSexual practicesInfectionPotential relationshipRiskModeling a Theory-Based Approach to Examine the Influence of Neurocognitive Impairment on HIV Risk Reduction Behaviors Among Drug Users in Treatment
Huedo-Medina TB, Shrestha R, Copenhaver M. Modeling a Theory-Based Approach to Examine the Influence of Neurocognitive Impairment on HIV Risk Reduction Behaviors Among Drug Users in Treatment. AIDS And Behavior 2016, 20: 1646-1657. PMID: 27052845, PMCID: PMC4945437, DOI: 10.1007/s10461-016-1394-x.Peer-Reviewed Original ResearchConceptsNeurocognitive impairmentCommunity-based methadone maintenance treatmentHIV risk reduction informationSex-related HIV risk behaviorsHIV risk reduction behaviorsHigh-risk PWUDHIV prevention benefitsMethadone maintenance treatmentHIV prevention outcomesOpioid-dependent individualsSignificant neurocognitive impairmentHIV risk behaviorsHIV prevention behaviorsRisk reduction informationHealth behavior changeBehavioral skills modelRisk reduction behaviorsRisk reduction outcomesMaintenance treatmentEfficacious interventionsDrug usersPrevention benefitsPrevention outcomesPrevention behaviorsRisk behaviorsThe Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review.
Karki P, Shrestha R, Huedo-Medina TB, Copenhaver M. The Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review. Evidence-based Medicine & Public Health 2016, 2 PMID: 27066590, PMCID: PMC4824190.Peer-Reviewed Original ResearchMethadone maintenance treatmentInjection drug usersSex-related risk behaviorsHIV risk behaviorsRisk behaviorsMaintenance treatmentDrug usersSystematic reviewHigh-risk injection drug usersFuture HIV prevention strategiesRisk Injection Drug UsersSex-related HIV risk behaviorsHigh-risk populationHIV prevention strategiesSignificant decreaseMultiple sex partnersPreventable drugHIV infectionTreatment adherenceHIV riskLower incidenceHigh riskPrevention strategiesSex partnersDrug useThe Influence of Neurocognitive Impairment on HIV Risk Behaviors and Intervention Outcomes among High-Risk Substance Users: A Systematic Review
Shrestha R, Copenhaver M. The Influence of Neurocognitive Impairment on HIV Risk Behaviors and Intervention Outcomes among High-Risk Substance Users: A Systematic Review. Frontiers In Public Health 2016, 4: 16. PMID: 26904535, PMCID: PMC4746254, DOI: 10.3389/fpubh.2016.00016.Peer-Reviewed Original ResearchHigh-risk substance usersNeurocognitive impairmentIntervention outcomesCognitive impairmentSubstance usersRisk behaviorsCognitive functioningEfficacy of interventionsHIV risk behaviorsSubstance abuseRisk reduction interventionsReciprocal relationshipSystematic reviewImpairmentMedication adherenceInterventionMemoryBehaviorFunctioningAbuseLearningOutcomesSubstantial barriersContextFindingsAn Exploratory Factor Analysis of a Brief Self-Report Scale to Detect Neurocognitive Impairment Among Participants Enrolled in Methadone Maintenance Therapy
Copenhaver M, Shrestha R, Wickersham JA, Weikum D, Altice FL. An Exploratory Factor Analysis of a Brief Self-Report Scale to Detect Neurocognitive Impairment Among Participants Enrolled in Methadone Maintenance Therapy. Journal Of Substance Use And Addiction Treatment 2016, 63: 61-65. PMID: 26879859, PMCID: PMC4775373, DOI: 10.1016/j.jsat.2016.01.002.Peer-Reviewed Original ResearchConceptsMethadone maintenance therapyNeuropsychological Impairment ScaleNeurocognitive impairmentMaintenance therapySex-related HIV risk behaviorsHIV risk behaviorsClinical care settingsNeuro-cognitive impairmentExploratory factor analysisCare settingsImpairment ScaleRisk behaviorsAddiction treatmentBrief self-report scaleImpairmentSelf-report measuresSelf-report scalesPatientsPrincipal axis factoringCognitive functioningTherapyFactor analysisOrthogonal varimax rotationPresent studyPotential utility
2015
A non-inferiority trial of an evidence-based secondary HIV prevention behavioral intervention compared to an adapted, abbreviated version: Rationale and intervention description
Shrestha R, Krishnan A, Altice FL, Copenhaver M. A non-inferiority trial of an evidence-based secondary HIV prevention behavioral intervention compared to an adapted, abbreviated version: Rationale and intervention description. Contemporary Clinical Trials 2015, 44: 95-102. PMID: 26253181, PMCID: PMC4744142, DOI: 10.1016/j.cct.2015.08.002.Peer-Reviewed Original ResearchEvidence-based interventionsHIV risk behaviorsHolistic Health Recovery ProgramSex-related HIV risk behaviorsRisk behaviorsClinical settingCurrent HIV prevention effortsReal-world clinical settingHIV prevention behavioral interventionFormal cost-effectiveness analysisAntiretroviral therapy adherenceNon-inferiority trialHIV prevention effortsAddiction treatment settingsCommon clinical settingsCost-effective relativeCost-effectiveness analysisAddiction treatment programsTherapy adherenceTarget HIVTrial designHIVIntervention DescriptionTreatment settingsUnmet need