HIV Research & Clinical Practice最新文献

{"title":"An evaluation of the ambulatory diagnosis and treatment of seborrheic dermatitis in PWH in a regional healthcare system.","authors":"David Perez, Seble G Kassaye, Carly Herbert, Deniz Ozisik, Aniket Kini, Adam Visconti","doi":"10.1080/25787489.2025.2491891","DOIUrl":"https://doi.org/10.1080/25787489.2025.2491891","url":null,"abstract":"<p><strong>Background: </strong>Seborrheic dermatitis is a common inflammatory skin condition which disproportionately impacts persons with HIV (PWH). Non-dermatologists, including primary care and HIV clinicians, are often the first providers to diagnose and manage inflammatory dermatoses. Data is lacking regarding the quality of management of such common dermatoses by non-dermatologist compared to dermatologic specialists.</p><p><strong>Methods: </strong>We evaluated the treatment of and referral patterns for seborrheic dermatitis relative to accepted standards of care among outpatient dermatologists and non-dermatologists in a regional healthcare system. Using a cross-sectional design, we analyzed a random sample of 100 persons 18 years or older with a diagnosis of HIV and more than one visit to a regional primary care or HIV clinician with an ICD code for treatment of seborrheic dermatitis.</p><p><strong>Results: </strong>Seborrheic dermatitis was the most common specific inflammatory dermatosis among PWH in the healthcare system. Non-dermatologists were significantly more likely to prescribe one medication compared to dermatologists (62.2% vs. 50.9%, <i>p</i> = 0.05). 28.9% of persons initially diagnosed by a non-dermatologist were referred to a dermatology specialist. When considering immediate initiation of treatment as optimal management, 33/45 (73.3%) of non-dermatologists had optimal management compared with 53/55 (96.4%) of dermatologists (<i>p</i> < 0.01). However, when considering referral as optimal management, then 86.7% of patients initially diagnosed by non-dermatologists were optimally managed.</p><p><strong>Discussion: </strong>Seborrheic dermatitis remains a common issue among PWH in a multispeciality ambulatory setting. Non-dermatologists appear significantly less likely to provide optimal initial management which may affect quality of life given potential for delayed treatment in settings with limited specialists. Additional training should be provided to non-dermatologists to facilitate appropriate treatment of common inflammatory dermatological conditions.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2491891"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of virological failure among the people living with HIV on antiretroviral treatment in East Africa: evidence from a systematic review with meta-analysis and meta-regression of published studies from 2016 to 2023.","authors":"Maria Magdalene Namaganda, Hussein Mukasa Kafeero, Joyce Nakatumba Nabende, David Patrick Kateete, Charles Batte, Misaki Wanyengera, Daudi Jjingo, Moses Joloba, Florence Kivunike, Isaac Ssewanyana, Yunus Miya, Darius Kato, Simple Ouma, Frederick Elishama Kakembo, Stephen Kanyerezi, Jupiter Marina Kabahiita, Fahad Muwanda, Gerald Mboowa","doi":"10.1080/25787489.2025.2490774","DOIUrl":"https://doi.org/10.1080/25787489.2025.2490774","url":null,"abstract":"<p><strong>Background: </strong>Virological failure (VF) significantly threatens the efficacy of antiretroviral therapy (ART) programs in East Africa. This systematic review and meta-analysis assess the prevalence and predictors of VF among individuals living with HIV.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, African Journals Online, and EMBASE for relevant studies. Heterogeneity was assessed using the <i>I</i>² statistic, and random-effects models addressed between-study variability. Publication bias was examined through funnel plots, Egger's regression, and Begg's tests. Subgroup analyses and meta-regression explored heterogeneity sources and potential VF predictors. Analyses were conducted using MedCalc version 20.010, adhering to PRISMA 2020 guidelines.</p><p><strong>Results: </strong>Twenty-five records were included, with a sample size of 29,829 people living with HIV on ART. The pooled prevalence of VF in East Africa was 19.4% (95% CI: 15.2%-24.0%), with substantial heterogeneity across studies. Sociodemographic predictors of VF included male sex (30.9%, <i>p</i> < .001), unmarried status (28.2%, <i>p</i> < .001), lower educational attainment (33.0%, <i>p</i> < .001), non-formal employment (47.2%, <i>p</i> < .001), and urban residence (51.2%, <i>p</i> < .001). Clinical factors associated with higher VF rates were ambulatory status (44.7%, <i>p</i> < .001), low CD4 count (35.1%, <i>p</i> < .001), low haemoglobin (52.2%, <i>p</i> < .001), advanced HIV stage III/IV (44.2%, <i>p</i> < .001), HIV/TB co-infection (24.3%, <i>p</i> < .001), and other opportunistic infections (20.5%, <i>p</i> = .008). Treatment-related factors associated with VF were first-line nevirapine-based regimen (27.7%, <i>p</i> = .009) and poor ART adherence (41.76%, <i>p</i> < .001).</p><p><strong>Conclusion: </strong>Sociodemographic factors, advanced HIV disease, co-morbidities, poor adherence, and specific first-line ART regimens are key predictors of virological failure. Targeted, multidisciplinary interventions focusing on routine viral load monitoring, adherence support, and addressing socioeconomic barriers are essential to improve ART outcomes in East Africa.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2490774"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A combined prospective and retrospective comparative study evaluating renal outcomes after switching from TDF + FTC + EFV to TDF/3TC/DTG (TLD) <i>vs.</i> DTG + 3TC in virologically suppressed Thai people with HIV.","authors":"Samadhi Patamatamkul, Phattarapon Burimat, Sathaporn Kanogtorn, Opass Putcharoen","doi":"10.1080/25787489.2025.2509379","DOIUrl":"https://doi.org/10.1080/25787489.2025.2509379","url":null,"abstract":"<p><strong>Background: </strong>TDF/3TC/DTG (TLD) has been adopted as the first-line therapy for all people with HIV according to the WHO 2019 and Thai HIV guidelines. As a result, people with HIV in Thailand on TDF/FTC/EFV are switched to TLD. However, increasing data demonstrate the efficacy and renal safety of the TDF-sparing dual therapy with DTG + 3TC compared with TDF-based combination ART (cART) as a switching therapy. A direct comparison of estimated glomerular filtration rates (eGFR) among people with HIV treated with TDF-based regimens who switch to TLD <i>vs.</i> DTG + 3TC is yet to be made.</p><p><strong>Methods: </strong>We enrolled virologically suppressed people with HIV aged ≥18 years currently on TDF + FTC + EFV to either switch to TLD or DTG + 3TC at two tertiary care hospitals. The switching regimen was chosen at the physicians' discretion. The primary outcome was the change in eGFR, calculated by creatinine at 24 weeks. Secondary outcomes included changes in LDL, body weight, and BMI at 24 weeks.</p><p><strong>Results: </strong>Among 53 recruited participants, 28 and 15 completed the second follow-up in the TLD and DTG + 3TC groups, respectively. The mean age was higher in the TLD group compared to the DTG + 3TC group (Table 1). The median time from HIV diagnosis to switching was 8.5 years. The eGFR reduction was significantly greater in the TLD group than in the DTG + 3TC group: -17.24 ± 9.24 <i>vs.</i> -8.4 ± 9.03 mL/min/1.73 m² (<i>p</i> = 0.004). All participants in both groups achieved virological suppression. There was no significant change in CD4 counts between the two groups. Switching to DTG + 3TC was associated with a significantly smaller decline in eGFR post-switch (mean difference: 6.216 mL/min/1.73 m²; 95% CI 0.169-12.263; <i>p</i> = 0.044) compared to those who switched to TLD.</p><p><strong>Conclusions: </strong>There was a significant reduction in eGFR among people with HIV who switched to TLD compared to those switched to DTG + 3TC. Changes in LDL and BMI were comparable between groups. Dual therapy with DTG + 3TC may be a preferred switching option over TLD for individuals with renal safety concerns. Further randomized prospective trials with longer follow-up are warranted to confirm these findings.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2509379"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of 48 weeks of BIC/F/TAF and DRV/c/F/TAF on platelet function in the context of rapid ART start.","authors":"Akif A Khawaja, Gary Whitlock, Sarah Fidler, Alfredo Soler-Carracedo, Merle Henderson, Graham P Taylor, Marta Boffito, Michael Emerson","doi":"10.1080/25787489.2024.2447015","DOIUrl":"https://doi.org/10.1080/25787489.2024.2447015","url":null,"abstract":"<p><strong>Introduction: </strong>The BIC-T&T study aimed to determine the efficacy of bictegravir<b>/</b>emtricitabine/tenofovir alafenamide (BIC/F/TAF) and darunavir/cobicistat/emtricitabine<b>/</b>tenofovir alafenamide (DRV/c/F/TAF) at suppressing viral load in a two-arm, open-label, multi-centre, randomised trial under a UK test-and-treat setting. This sub-study aimed to evaluate potential off-target cardiovascular impact by examining <i>ex vivo</i> platelet function.</p><p><strong>Methods: </strong>Platelets were isolated by centrifugation of citrated blood from participants attending Chelsea and Westminster Hospital or St Mary's Hospital at Week 48 following enrolment. Platelet activation was assessed by real-time flow cytometry to examine integrin activation and granule release and platelet aggregation was evaluated by light transmission aggregometry. Statistical significance was determined by 2-way ANOVA with a Šidák's multiple comparisons post-test.</p><p><strong>Results: </strong>An analysis of 21 participants was performed at Week 48 (96% male and 48% white; mean (range) age was 37 (23-78) years). No difference between arms was observed in ADP-, collagen- or thrombin receptor activator for peptide (TRAP)-6-evoked platelet α_IIbβ₃ integrin activation, granule release or platelet aggregation in response to any of the agonists tested. Despite differences in the demographics between treatment arms, the presence of an unboosted integrase inhibitor or boosted protease inhibitor in a test-and-treat setting did not impact platelet function.</p><p><strong>Conclusions: </strong>Our study provides no evidence of differences in downstream platelet responses between participants taking BIC/F/TAF compared to DRV/c/F/TAF following 48 wk of treatment. Further data are required to explore whether there are biologically significant off-target effects, including effects on platelets and other components of the cardiovascular system between these two test-and-treat regimens.</p><p><strong>Clinical trial number: </strong>NCT04653194.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2447015"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bictegravir/emtricitabine/tenofovir alafenamide in clinical practice for people with HIV: final 24-month effectiveness and safety outcomes in key populations in the observational BICSTaR cohort.","authors":"Benoit Trottier, Chia-Jui Yang, Dai Watanabe, Giulia Marchetti, Daniel Elbirt, Eoghan De Barra, Alper Gündüz, Sun Hee Lee, Roger Vogelmann, Olivier Robineau, Chiaw Yee Choy, Marvin Berrevoets, Alison Uriel, David Thorpe, Marion Heinzkill, Andrea Marongiu, Johanna Ramroth, Lisa D'Amato, Josep Mallolas","doi":"10.1080/25787489.2025.2456890","DOIUrl":"10.1080/25787489.2025.2456890","url":null,"abstract":"<p><strong>Background: </strong>BICtegravir Single Tablet Regimen (BICSTaR) is an observational cohort study evaluating the effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in treatment-naïve (TN) and treatment-experienced (TE) people with HIV.</p><p><strong>Objective: </strong>To present final pooled 24-month outcomes for the full cohort.</p><p><strong>Methods: </strong>Prospective data were pooled from TN and TE adults with HIV initiating B/F/TAF in routine clinical practice across 14 countries (data collection: 25/06/2018-29/12/2023). Outcomes at 24 months included virologic suppression (HIV-1 RNA <50 copies/mL), immunologic effectiveness (change in CD4 cell count and CD4/CD8 ratio), persistence, and safety. Outcomes were also analysed in key populations.</p><p><strong>Results: </strong>Of 2,074 (483 TN, 1,591 TE) participants included, most were male (85%), White (70%), and had ≥1 comorbidity (66%). Median (Q1, Q3) age was 45 (35, 54) years. At 24 months, 94% of TN and 96% of TE participants had HIV-1 RNA <50 copies/mL (missing = excluded analysis). These values were 88% and 86%, respectively, in a discontinuation = failure analysis. Effectiveness remained high across all key populations at 24 months. Median (Q1, Q3) CD4 count increased by 257 (127, 447) cells/µL in TN and 40 (-70, 153) cells/µL in TE participants (both <i>p</i> < 0.001). There was no reported treatment-emergent resistance to B/F/TAF. Persistence was high at 24 months (TN, 95%; TE, 91%). Drug-related adverse events occurred in 11% of TN and 12% of TE participants, leading to B/F/TAF discontinuation in 5%.</p><p><strong>Conclusions: </strong>B/F/TAF was generally well tolerated over 24 months, with high effectiveness and persistence observed among a broad range of people with HIV.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2456890"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of a multipronged initiative with community HIV clinics to support retention and re-engagement in HIV care.","authors":"Ellen Eaton, Claudia T Martorell, Jewel Sawyer, Tanya S Schreibman, Gregory S Felzien, Jenniffer Meza Jimenez, Chelsie Anderson Chadha, Jeffrey Carter, Chris Napolitan, Laura Simone, Leah Molloy, Bonnie Douglas","doi":"10.1080/25787489.2025.2455814","DOIUrl":"10.1080/25787489.2025.2455814","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in HIV treatment, gaps in care retention threaten the individual health of people with HIV (people) and public health efforts to end the HIV epidemic.</p><p><strong>Objective: </strong>This project aimed to identify and address gaps in retention and support re-engagement in care.</p><p><strong>Methods: </strong>A multipronged initiative at five community HIV clinics and community-based organizations (CBOs) included patient, healthcare professional (HCP), and community-focused interventions. Patient-oriented interventions included instructional videos for patients to view before appointments and conversation guides about barriers to care for patients to use with staff during appointments. HCP-oriented interventions included baseline surveys assessing clinic practices and challenges and audit-feedback sessions to review survey findings and devise plans to improve retention strategies. Community-oriented interventions included education sessions co-led by clinics and CBOs, micro-learning engagements at community events, and social media campaigns covering topics related to HIV care. Data were collected through surveys administered before and after patient- and HCP-oriented interventions and community education sessions, follow-up surveys administered after micro-learning engagements, and reach of social media campaigns.</p><p><strong>Results: </strong>Patient-oriented interventions led to improvements in patient-reported empowerment and confidence in their ability to remain in care. HCPs also reported improvements in patient intake and follow-up processes after audit-feedback sessions. Community interventions reached over 1,000 community members combined, with education sessions and micro-learning engagements uncovering key barriers to HIV care and leading to improvements in knowledge and awareness of local HIV services.</p><p><strong>Conclusion: </strong>This multipronged initiative demonstrates how patient, HCP, and community-oriented education can support retention and re-engagement in care.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2455814"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial screening of youth living with HIV in an integrated care setting before and after COVID-19.","authors":"Tiffany Chenneville, Klejdis Bilali, Elham Azamian Jazi, Alicia Marion, Carina A Rodriguez","doi":"10.1080/25787489.2025.2484823","DOIUrl":"10.1080/25787489.2025.2484823","url":null,"abstract":"<p><strong>Background: </strong>Mental health concerns among youth living with HIV are well documented. Given the interconnection between physical and mental health, behavioral health screening in medical settings is recommended to ensure patients are linked to mental health services. Unfortunately, COVID-19 disrupted medical and mental health services for people living with HIV, including youth. However, the extent of this disruption and its impact are not entirely known.</p><p><strong>Objective: </strong>We aimed to explore the impact of COVID-19 on psychosocial screening practices and outcomes among youth living with HIV aged 12-25 in an integrated care setting in the southeastern United States.</p><p><strong>Methods: </strong>Using existing program evaluation and continuous quality improvement data, we examined psychosocial screenings before and after the onset of COVID-19 (2019-2022).</p><p><strong>Results: </strong>Findings revealed decreased psychosocial screening of eligible youth living with HIV between 2019 and 2021, but an increase in 2022. The percentage of positive depression and anxiety screeners decreased between 2019 and 2020, increased in 2021, and decreased again in 2022. However, positive post-traumatic stress screeners increased between 2019 and 2020, decreased in 2021, and increased again in 2022. Substance use screening indicated a steady increase in alcohol and tobacco use between 2019 and 2021. In 2022, alcohol continued to increase, but tobacco use decreased.</p><p><strong>Conclusions: </strong>Findings underscore the critical need for robust, adaptable psychosocial screening practices in integrated care settings to address the evolving mental health and substance use needs of youth living with HIV, especially during and after major public health disruptions.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2484823"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic lockdown in women living with HIV who have a Black African and/or Black Caribbean heritage.","authors":"Sophie Strachan, Elizabeth Senkoro, Wezi Thamm, Jacqui Stevenson, Frances Lander, Nicoletta Policek, Caterina Candela, Fiona Muir, Marta Boffito","doi":"10.1080/25787489.2025.2464510","DOIUrl":"10.1080/25787489.2025.2464510","url":null,"abstract":"<p><strong>Objective: </strong>Treatment, adherence and linkage to care are lower in Black African and Black Caribbean heritage women living with HIV, affected by significant psychosocial challenges compared to other groups. The COVID-19 lockdowns further amplified these inequalities. We aimed to assess its impact on this population across Chelsea and Westminster Hospitals NHS Foundation Trust.</p><p><strong>Methods: </strong>We used an online survey and in-depth interviews to collect data between 01-10-2022 and 01-06-2023. Descriptive statistics were used to summarize the survey data and thematic analysis was adopted to analyze the qualitative data.</p><p><strong>Results: </strong>Of 393 women contacted, 36 completed the survey and 22 took part in interviews. The survey found that COVID-19 lockdown restrictions worsened anxiety (48%) and low mood (45%). 54% reported that the experience of COVID-19 triggered the trauma of their initial HIV diagnosis. Interviewed participants discussed how their psychological issues and co-morbidities were not always addressed by their care system. Stigma and being forced to share their HIV information were also prominent issues.</p><p><strong>Conclusions: </strong>There is continued institutional stigma and discrimination in health care settings for women living with HIV of African or Caribbean heritage, and there is an urgent need to address the inequity in care to improve patients' experience post-pandemic.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2464510"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'It is scary to pause treatment': perspectives on HIV cure-related research and analytical treatment interruptions from women diagnosed during acute HIV in Durban, South Africa.","authors":"Deli Mthimkhulu, Krista L Dong, Mzwakhe Wiseman Ngcobo, Deborah Mindry, Ayanda Zulu, Ntombifuthi Langa, Luyanda Maphalala, Vanessa Pillay, Maud Mthembu, Annie Miall, Whitney Tran, Ana Dillen, Fang Wan, Ali Ahmed, Jamila K Stockman, Maryam Hussain, Thumbi Ndung'u, Karine Dubé","doi":"10.1080/25787489.2025.2455917","DOIUrl":"10.1080/25787489.2025.2455917","url":null,"abstract":"<p><strong>Background: </strong>HIV remains a major challenge in KwaZulu-Natal, South Africa, particularly for young women who face disproportionate risks and barriers to prevention and treatment. Most HIV cure trials, however, occur in high-income countries.</p><p><strong>Objective: </strong>To examine the perspectives of young women diagnosed with acute HIV in a longitudinal study, focusing on their perceptions on ATI-inclusive HIV cure trials and the barriers and facilitators to participation.</p><p><strong>Materials and methods: </strong>Between October 2022 and February 2024, we conducted closed-ended surveys and in-depth interviews with 20 women aged 19-33 living with HIV, who were willing but ineligible or unable to participate in an HIV cure trial.</p><p><strong>Results: </strong>Many participants reported mental health challenges, including major depression (40%), moderate to severe anxiety (35%), and low self-esteem (35%). While women diagnosed during acute HIV supported pausing antiretroviral treatment (ART) during analytical treatment interruption (ATI) to advance HIV cure research, concerns about health risks and HIV-related stigma were significant barriers to enrollment. Trust in the research team and close monitoring were seen as positive factors, while fears around sharing of HIV/ATI status and transmission to sex partners complicated decision-making. Participants expressed a need for psychological counseling and access to community resources to manage ATI-related stressors.</p><p><strong>Conclusions: </strong>Understanding women's perspectives on HIV cure research, especially ATI trials, is vital. Building trust and addressing psychosocial challenges through a healing-centered approach can facilitate trial participation. Socio-behavioral research before and during HIV cure trials will be essential to inform participant-centered protocol design.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2455917"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A closer look: factors impacting HIV durable viral suppression among a cohort of clinic attendees in Trinidad & Tobago.","authors":"Elena Cyrus, Deidre A Okeke, Omari Lavia, Mary Jo Trepka, Allysha Maragh-Bass, Lunthita Duthely, Michael Sciauodone, Jeffrey Edwards","doi":"10.1080/25787489.2024.2443886","DOIUrl":"https://doi.org/10.1080/25787489.2024.2443886","url":null,"abstract":"<p><strong>Background: </strong>In Trinidad and Tobago, high HIV prevalence among key populations necessitates studying factors that impact durable viral suppression (DVS), crucial for effective HIV management and reducing transmission among at-risk networks. This study investigates these factors using clinical data from a major HIV care clinic in the Caribbean.</p><p><strong>Methods: </strong>A retrospective analysis of 533 adult people with HIV (people) at MRFTT from 2017 to 2021 assessed the proportion achieving DVS, defined as a sustained viral load <200 copies/ml over one year. Initial univariate analysis characterized individuals with DVS, followed by bivariate analysis to explore socio-demographic differences. Significant variables from bivariate analysis were examined in a regression model to identify DVS covariates.</p><p><strong>Results: </strong>The average age of the sample was 45 years (SD = 10.88), with 52.0% male and 72.1% of African descent. 31.5% achieved durable viral suppression (DVS). Those with DVS were predominantly women (54.1%), older (mean age 45, SD = 11.32), with more frequent clinic visits over five years (mean = 101, SD = 33.26). Regression analysis showed that women (OR = 1.43, 95% CI 0.99-2.07), individuals on long-term antiretroviral therapy (ART) (>5 years) (OR = 1.66, 95% CI 1.03-2.66), and those with extended clinic enrolment (>5 years) (OR = 1.82, 95% CI 1.08-3.06) had higher odds of achieving DVS.</p><p><strong>Conclusions: </strong>Only a third of the study sample achieved DVS, with men less likely to reach this goal. Lesser engagement in care correlated with lower DVS rates. Further research into social and structural barriers to clinic attendance, particularly among younger men, is recommended.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2443886"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}