A Qualitative Exploration of Women's Interest in Long-Acting Injectable Antiretroviral Therapy Across Six Cities in the Women's Interagency HIV Study: Intersections with Current and Past Injectable Medication and Substance Use.

Medications for antiretroviral therapy (ART) and preexposure prophylaxis (PrEP) are currently daily pill regimens, which pose barriers to long-term adherence. Long-acting injectable (LAI) modalities have been developed for ART and PrEP, but minimal LAI-focused research has occurred among women. Thus, little is known about how women's history of injection for medical or nonmedical purposes may influence their interest in LAI. We conducted 89 in-depth interviews at 6 sites (New York, NY; Chicago, IL; San Francisco, CA; Atlanta, GA; Chapel Hill, NC; Washington, DC) of the Women's Interagency HIV study. Interviews occurred with women living with HIV (n = 59) and HIV-negative women (n = 30) from November 2017 to October 2018. Interviews were recorded, transcribed, and analyzed using thematic content analysis. Women's prior experiences with injections occurred primarily through substance use, physical comorbidities, birth control, or flu vaccines. Four primary categories of women emerged; those who (1) received episodic injections and had few LAI-related concerns; (2) required frequent injections and would refuse additional injections; (3) had a history of injection drug use, of whom some feared LAI might trigger a recurrence, while others had few LAI-related concerns; and (4) were currently injecting drugs and had few LAI-related concerns. Most women with a history of injectable medication would prefer LAI, but those with other frequent injections and history of injection drug use might not. Future research needs to address injection-related concerns, and develop patient-centered approaches to help providers best identify which women could benefit from LAI use.

Interest in Long-Acting Injectable Pre-exposure Prophylaxis (LAI PrEP) Among Women in the Women's Interagency HIV Study (WIHS): A Qualitative Study Across Six Cities in the United States.

Long-acting injectable (LAI) pre-exposure prophylaxis (PrEP) has the potential to facilitate adherence and transform HIV prevention. However, little LAI PrEP research has occurred among women, who face unique barriers. We conducted 30 in-depth interviews with HIV-negative women from 2017-2018 across six sites (New York; Chicago; San Francisco; Atlanta; Washington, DC; Chapel Hill) of the Women's Interagency HIV Study. Interviews were recorded, transcribed, and analyzed using thematic content analysis. Few women expressed interest in PrEP and when prompted to choose a regimen, 55% would prefer LAI, 10% daily pills, and 33% said they would not take PrEP regardless of formulation. Perceived barriers included: (1) the fear of new-and perceived untested-injectable products and (2) potential side effects (e.g., injection-site pain, nausea). Facilitators included: (1) believing shots were more effective than pills; (2) ease and convenience; and (3) confidentiality. Future studies should incorporate women's LAI PrEP-related experiences to facilitate uptake.

Multisite Study of Women Living With HIV's Perceived Barriers to, and Interest in, Long-Acting Injectable Antiretroviral Therapy.

BACKGROUND: Adherence to antiretroviral therapy (ART) is imperative for viral suppression and reducing HIV transmission, but many people living with HIV report difficultly sustaining long-term adherence. Long-acting injectable (LAI) ART has the potential to transform HIV treatment and prevention. However, little LAI ART-related behavioral research has occurred among women, particularly outside of clinical trials. SETTING: Six Women's Interagency HIV Study sites: New York, Chicago, Washington DC, Atlanta, Chapel Hill, and San Francisco. METHODS: We conducted 59 in-depth interviews with women living with HIV across 6 Women's Interagency HIV Study sites (10 per site; 9 at Washington DC). We interviewed women who were not included in LAI ART clinical trials but who receive care at university settings that will administer LAI ART once it is approved. Interviews were recorded, transcribed, and analyzed using thematic content analysis. RESULTS: Most women enthusiastically endorsed monthly LAI ART and would prefer it over pills. The following 3 reasons emerged for this preference: (1) convenience and confidentiality, (2) avoiding daily reminders about living with HIV, and (3) believing that shots are more effective than pills. Challenges remain, however, specifically around (1) medical mistrust, (2) concerns about safety and effectiveness, (3) pill burden for HIV and other conditions, and (4) barriers to additional medical visits. CONCLUSIONS: Most women preferred LAI ART over daily pills given its benefits, including convenience, privacy, and perceived effectiveness. Future research should incorporate more women into LAI ART trials to better understand and align development with user concerns and preferences to enhance uptake.

Social Network Analysis Identifies Key Participants in Conservation Development.

Understanding patterns of participation in private lands conservation, which is often implemented voluntarily by individual citizens and private organizations, could improve its effectiveness at combating biodiversity loss. We used social network analysis (SNA) to examine participation in conservation development (CD), a private land conservation strategy that clusters houses in a small portion of a property while preserving the remaining land as protected open space. Using data from public records for six counties in Colorado, USA, we compared CD participation patterns among counties and identified actors that most often work with others to implement CDs. We found that social network characteristics differed among counties. The network density, or proportion of connections in the network, varied from fewer than 2 to nearly 15%, and was higher in counties with smaller populations and fewer CDs. Centralization, or the degree to which connections are held disproportionately by a few key actors, was not correlated strongly with any county characteristics. Network characteristics were not correlated with the prevalence of wildlife-friendly design features in CDs. The most highly connected actors were biological and geological consultants, surveyors, and engineers. Our work demonstrates a new application of SNA to land-use planning, in which CD network patterns are examined and key actors are identified. For better conservation outcomes of CD, we recommend using network patterns to guide strategies for outreach and information dissemination, and engaging with highly connected actor types to encourage widespread adoption of best practices for CD design and stewardship.

Subdivision design and stewardship affect bird and mammal use of conservation developments.

Developing effective tools for conservation on private lands is increasingly important for global biodiversity conservation; private lands are located in more productive and biologically diverse areas, and they face accelerated rates of land conversion. One strategy is conservation development (CD) subdivisions, which cluster houses in a small portion of a property and preserve the remaining land as protected open space. Despite widespread use, the characteristics that make CD more or less effective at achieving biodiversity conservation are not well understood. We investigated CD's ability to successfully protect animal populations by examining bird and mammal occurrences in 14 CD subdivisions and four undeveloped areas (range: 14-432 ha) in northern Colorado, USA. Using point count and camera trap data in an occupancy modeling framework, we evaluated the relative importance of nine subdivision design factors (e.g., housing density, proportion of CD protected) and 14 stewardship factors (e.g., presence of livestock, percent native vegetation cover) in influencing the overall community composition and the probability of use by 16 birds and six mammals. We found that habitat use by 75% of birds and 83% of mammals was associated with design characteristics that maximized the natural or undisturbed land area both within and near the development (e.g., proportion of CD protected, total area of protected open space, proportion of natural land cover in the surrounding landscape). These factors were also associated with an increasing dominance of human-sensitive bird species, larger-bodied mammals, and mammals with larger home ranges. Habitat use by birds was also influenced by local land use composition and quality, and use by several bird and mammal species decreased with increased localized disturbances. We found few differences in habitat use between sampling sites in undeveloped areas and in CD subdivisions. These similarities indicate that, if CDs are large enough or located within a matrix of undeveloped land, they can provide habitat that supports similar use patterns as protected areas without housing development. By incorporating characteristics that promote the persistence of sensitive birds and mammals on private lands, CDs have potential to preserve native biodiversity in areas threatened by expanding residential development.

Increases in residential and energy development are associated with reductions in recruitment for a large ungulate.

Land-use change due to anthropogenic development is pervasive across the globe and commonly associated with negative consequences for biodiversity. While land-use change has been linked to shifts in the behavior and habitat-use patterns of wildlife species, little is known about its influence on animal population dynamics, despite the relevance of such information for conservation. We conducted the first broad-scale investigation correlating temporal patterns of land-use change with the demographic rates of mule deer, an iconic species in the western United States experiencing wide-scale population declines. We employed a unique combination of long-term (1980-2010) data on residential and energy development across western Colorado, in conjunction with congruent data on deer recruitment, to quantify annual changes in land-use and correlate those changes with annual indices of demographic performance. We also examined annual variation in weather conditions, which are well recognized to influence ungulate productivity, and provided a basis for comparing the relative strength of different covariates in their association with deer recruitment. Using linear mixed models, we found that increasing residential and energy development within deer habitat were correlated with declining recruitment rates, particularly within seasonal winter ranges. Residential housing had two times the magnitude of effect of any other factor we investigated, and energy development had an effect size similar to key weather variables known to be important to ungulate dynamics. This analysis is the first to correlate a demographic response in mule deer with residential and energy development at large spatial extents relevant to population performance, suggesting that further increases in these development types on deer ranges are not compatible with the goal of maintaining highly productive deer populations. Our results underscore the significance of expanding residential development on mule deer populations, a factor that has received little research attention in recent years, despite its rapidly increasing footprint across the landscape.

Effects of Recreation on Animals Revealed as Widespread through a Global Systematic Review.

Outdoor recreation is typically assumed to be compatible with biodiversity conservation and is permitted in most protected areas worldwide. However, increasing numbers of studies are discovering negative effects of recreation on animals. We conducted a systematic review of the scientific literature and analyzed 274 articles on the effects of non-consumptive recreation on animals, across all geographic areas, taxonomic groups, and recreation activities. We quantified trends in publication rates and outlets, identified knowledge gaps, and assessed evidence for effects of recreation. Although publication rates are low and knowledge gaps remain, the evidence was clear with over 93% of reviewed articles documenting at least one effect of recreation on animals, the majority of which (59%) were classified as negative effects. Most articles focused on mammals (42% of articles) or birds (37%), locations in North America (37.7%) or Europe (26.6%), and individual-level responses (49%). Meanwhile, studies of amphibians, reptiles, and fish, locations in South America, Asia, and Africa, and responses at the population and community levels are lacking. Although responses are likely to be species-specific in many cases, some taxonomic groups (e.g., raptors, shorebirds, ungulates, and corals) had greater evidence for an effect of recreation. Counter to public perception, non-motorized activities had more evidence for a negative effect of recreation than motorized activities, with effects observed 1.2 times more frequently. Snow-based activities had more evidence for an effect than other types of recreation, with effects observed 1.3 times more frequently. Protecting biodiversity from potentially harmful effects of recreation is a primary concern for conservation planners and land managers who face increases in park visitation rates; accordingly, there is demand for science-based information to help solve these dilemmas.

Guidelines and incentives for conservation development in local land-use regulations.

Effective conservation of biological diversity on private lands will require changes in land-use policy and development practice. Conservation development (CD) is an alternative form of residential development in which homes are built on smaller lots and clustered together and the remainder of the property is permanently protected for conservation purposes. We assessed the degree to which CD is permitted and encouraged by local land-use regulations in 414 counties in the western United States. Thirty-two percent of local planning jurisdictions have adopted CD ordinances, mostly within the past 10 years. CD ordinances were adopted in counties with human population densities that were 3.0 times greater and in counties with 2.5 times more land use at urban, suburban, and exurban densities than counties without CD ordinances. Despite strong economic incentives for CD (e.g., density bonuses, which allow for a mean of 66% more homes to be built per subdivision area), several issues may limit the effectiveness of CD for biological diversity conservation. Although most CD ordinances required a greater proportion of the site area be protected than in a typical residential development, just 13% (n = 17) of the ordinances required an ecological site analysis to identify and map features that should be protected. Few CD ordinances provided guidelines regarding the design and configuration of the protected lands, including specifying a minimum size for protected land parcels or encouraging contiguity with other protected lands within or near to the site. Eight percent (n =11) of CD ordinances encouraged consultation with a biological expert or compliance with a conservation plan. We recommend that conservation scientists help to improve the effectiveness of CD by educating planning staff and government officials regarding biological diversity conservation, volunteering for their local planning boards, or consulting on development reviews.

Detection and classification of motor vehicle noise in a forested landscape.

Noise emanating from human activity has become a common addition to natural soundscapes and has the potential to harm wildlife and erode human enjoyment of nature. In particular, motor vehicles traveling along roads and trails produce high levels of both chronic and intermittent noise, eliciting varied responses from a wide range of animal species. Anthropogenic noise is especially conspicuous in natural areas where ambient background sound levels are low. In this article, we present an acoustic method to detect and analyze motor vehicle noise. Our approach uses inexpensive consumer products to record sound, sound analysis software to automatically detect sound events within continuous recordings and measure their acoustic properties, and statistical classification methods to categorize sound events. We describe an application of this approach to detect motor vehicle noise on paved, gravel, and natural-surface roads, and off-road vehicle trails in 36 sites distributed throughout a national forest in the Sierra Nevada, CA, USA. These low-cost, unobtrusive methods can be used by scientists and managers to detect anthropogenic noise events for many potential applications, including ecological research, transportation and recreation planning, and natural resource management.

Effects of management of domestic dogs and recreation on carnivores in protected areas in northern California.

In developed countries dogs (Canis lupus familiaris) are permitted to accompany human visitors to many protected areas (e.g., >96% of protected lands in California, U.S.A.), and protected-area management often focuses on regulating dogs due to concerns about predation, competition, or transmission of disease and conflicts with human visitors. In 2004 and 2005, we investigated whether carnivore species richness and abundance were associated with management of domestic dogs and recreational visitation in protected areas in northern California. We surveyed for mammalian carnivores and human visitors in 21 recreation areas in which dogs were allowed offleash or onleash or were excluded, and we compared our observations in the recreation areas with observations in seven reference sites that were not open to the public. Carnivore abundance and species richness did not differ among the three types of recreation areas, but native carnivore species richness was 1.7 times greater (p < 0.01) and the relative abundances of native coyotes (Canis latrans) and bobcats (Lynx rufus) were over four times greater (p < 0.01) in the reference sites. Abundances of bobcats and all carnivores declined as the number of visitors increased. The policy on domestic dogs did not appear to affect species richness and abundance of mammalian carnivores. But the number of dogs we observed was strongly associated with human visitation (R(2) = 0.54), so the key factors associated with recreational effects on carnivores appear to be the presence and number of human visitors to protected areas.