Background: Women living with HIV in the Southern United States, or the South, face persistent and overlapping challenges to care engagement and antiretroviral therapy adherence, including HIV-related stigma, poverty, and inequitable access to health care. While mobile health (mHealth) interventions show promise for enhancing self-management and care engagement among people living with HIV, interventions tailored to women living with HIV remain limited, particularly those developed through participatory approaches that center their lived experiences. Objective: This study sought to evaluate the acceptability, comprehensibility, and personal relevance of targeted health messages developed for a proposed mHealth app tailored to women living with HIV in the South. In addition, it explored participants’ perceptions of the feasibility and desirability of the proposed intervention. Methods: This study represents phase 3 of a multistage, mixed methods project. Message content was informed by earlier phases, which included individual interviews, surveys, perceptual mapping with women living with HIV, and input from a community and clinician advisory board. In this phase, 3 focus groups (2 virtual and 1 in person) were conducted with 30 women living with HIV recruited from Southern HIV clinics and community organizations. Participants reviewed prototype wireframes and health messages, including SMS text message–style content, and provided feedback on all content. Data were analyzed using conventional content analysis. Results: Participants expressed strong interest in the proposed mHealth app and emphasized the importance of health messaging that is clear, supportive, and personally meaningful. Four key categories emerged: (1) acceptability of a tailored mHealth app, with participants noting the value of privacy, accessibility, and convenience; (2) acceptability of message content, including preferences for affirming, uplifting language and images; (3) personal relevance, particularly for messages addressing stigma, spirituality, family, and empowerment; and (4) comprehensibility, highlighting the need for plain language and visual clarity. Conclusions: These findings support the development of a tailored mHealth intervention for women living with HIV in the South. Co-designed messages that center affirmation, spirituality, and real-life challenges were perceived as acceptable, comprehensible, and highly relevant. Future work will focus on refining the content and prototype testing.

Background/Objectives: Medical mistrust (MM) is associated with adverse health outcomes, but few studies have assessed MM in cancer patients. MM is frequently measured using the Medical Mistrust Inventory (MMI), measuring institutional MM (e.g., government), or the Group-Based Medical Mistrust Scale (GBMMS), measuring race-based MM. We sought to assess the prevalence of MM among cancer patients diverse by age, sex, race/ethnicity, and socioeconomic status (SES), recruited from an urban safety net hospital and a suburban comprehensive cancer center. Methods: Patients completed a one-time survey. The primary outcome was MM as measured by the GBMMS and MMI tools. Covariates included demographics, treatment campus (urban vs. suburban), and psychosocial measures relevant to MM. Results: Purposeful sampling recruitment resulted in 200 participants (survey completion: 74.6%). The median age was 60 years, with 62% female, 45% African-American, 15% Hispanic, 47.5% education ≤ HS diploma, and 51.5% income ≤ USD 50,000/yr. Elevated MMI and GBMMS scores (moderate-to-high) were seen, respectively, in Hispanic (20.7% and 33.4%) and African-American (AA) patients (31.8% and 48.9%), compared with White patients (14.3% and 9.9%). The MMI and GBMMS tools captured complimentary aspects of MM in cancer patients (Spearman’s 0.531, p < 0.0001). MMI was associated with lower education (0.034) and race (p = 0.04), while GBMMS was strongly associated with race (p < 0.001), urban campus (p = 0.035), and mistrust of government/health organization information (both p < 0.05). Higher MMI/GBMMS scores were both associated with research mistrust and mistrust of information from physicians. Conclusions: Institutional and race-based MM are prevalent among cancer patients diverse by age, sex, race/ethnicity, and SES. Lower education was associated with institutional MM but not race-based MM.

COVID-19 vaccine hesitancy is well documented, but less is known about booster hesitancy among fully vaccinated adults. A qualitative approach was employed to identify factors affecting COVID-19 booster hesitancy using diffusion of innovation (DoI) theory. The study was conducted in Philadelphia, Pennsylvania. In-depth interviews (n = 30) were done with adults, including those who had (n = 9) and had not (n = 21) been boosted. Participants were categorized into DoI adopter groups or a “refuser” group for those with no intention of getting boosted. Transcripts were analyzed using an iterative coding process with consensus and triangulation to develop thematic categories. Participants had a mean age of 41 and were 63.3% Black; 20% were classified as innovators, 6.7% early adopters, 3.3% early majority, 6.7% late majority, 43.3% laggards and 20% refusers. Three themes varied across groups: level of perceived risk susceptibility of getting COVID-19 in the future, information needs and levels of vaccine literacy, and effects of ongoing institutional mistrust. Those in the laggard and refuser groups generally had lower vaccine literacy, higher levels of institutional mistrust, and were more likely to listen to friends and family for booster advice, all consistent with DoI adopter characteristics. These differences indicate important intervention targets to promote booster uptake, especially in those who have been previously vaccinated.

In 2022 there were 37,981 new HIV diagnoses in the United States, 50% of which occurred in the Southern United States (Centers for Disease Control and Prevention, 2025a). Factors such as lack of aw...

Despite clinical advances, people living with HIV (PLWH) still develop complications due to HIV or the neurotoxicity of treatment regimens, including HIV-associated neurocognitive disorders (neuroHIV). However, many PLWH do not know about neuroHIV and few researchers have an understanding of the psychosocial effects of living with HIV or interact with PLWH or advocates providing services. The primary goal of this study was to understand how to enhance community engagement in neuroHIV research translation to ultimately build bidirectional communication channels among PLWH, researchers, and community advocates. To begin to understand the important gaps in building this engagement, a formative needs assessment was conducted in Philadelphia, PA, as part of the Community Partnership Core in the Comprehensive NeuroHIV Center. In-depth interviews were conducted with HIV researchers ( N = 12), PLWH ( N = 13), and community advocates and practitioners (CAPs) ( N = 14). All groups were asked a core set of questions and then group-specific questions were also used. Thematic categories were identified and coded using an iterative process. Three themes emerged: (1) Differential neuroHIV knowledge and interpretive frameworks; (2) Relational and structural disconnects in engagement; and, (3) Stakeholder-specific pathways for dissemination and partnership. All groups highlighted the importance of addressing gaps in communication, fostering meaningful collaborations, and improving the translation of research findings into actionable insights for diverse audiences, including PLWH. However, few PLWH or CAPs were aware of neuroHIV and its potential effects and most researchers were reluctant or felt they did not have the skills to communicate research findings to groups outside of academic or professional settings. Thus, understanding how to create bidirectional communication pathways to connect researchers with PLWH, as well as advocates and service providers, is crucial to ensuring that future research adequately reflects the unique needs of PLWH.