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Article History

Received: 2 April 2026

Accepted: 6 July 2026

First Online: 15 July 2026

Declarations

Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki and all relevant institutional guidelines and regulations. This study was approved by the Institutional Review Board of the University of Nebraska Medical Center’s Office of Regulatory Affairs IRB #0014-24-EP, February 1, 2024. Audio recordings and transcripts were stored on a secure, access-restricted institutional server in accordance with UNMC data security policy.

Consent for publication: All authors reviewed and approved the final version of the manuscript and consent to its publication. No identifying personal information from participants is included in this report, and thus, additional consent for publication was not applicable.

Informed consent: Informed consent was obtained from all participants prior to enrollment. Participants were informed of the study’s purpose, procedures, voluntariness of participation, and their right to withdraw at any time without penalty.”

Competing interests: NF has received investigator-initiated research grants (to the university of Nebraska Medical Center) and consultation fees from ViiV Healthcare. The other authors declare that they have no conflicts of interest directly relevant to the content of this article.