HIV Research & Clinical Practice最新文献

{"title":"Comorbidity and polypharmacy burden among people living with HIV in the United States stratified by age, sex, and race: updated evidence from a contemporary cohort.","authors":"Sean P Fleming, Shweta Kamat, Girish Prajapati, Kyung Min Lee, Viktor Chirikov, Traci LeMasters, Princy N Kumar","doi":"10.1080/25787489.2026.2731527","DOIUrl":"https://doi.org/10.1080/25787489.2026.2731527","url":null,"abstract":"<p><strong>Background: </strong>Advances in antiretroviral therapy (ART) have extended the life expectancy of people living with HIV, increasing the prevalence of comorbidities and polypharmacy burden.</p><p><strong>Objective: </strong>To compare comorbidity burden and polypharmacy among people living with HIV and matched people without HIV stratified by age, sex, and race/ethnicity.</p><p><strong>Methods: </strong>This retrospective study used claims data from Optum's de-identified Clinformatics® Data Mart Database (01/01/19-12/31/24). Adults (≥18 years) with ≥1 ART claim or HIV diagnosis code during the 2024 calendar year (index date: earliest ART or HIV claim) were matched 2:1 to adults without HIV by age group, sex, race, region, and insurance type. Continuous enrolment of 12 months pre-index (baseline) and ≥30 days post-index was required. Baseline comorbidities and polypharmacy were compared between the two cohorts. .</p><p><strong>Results: </strong>A total of 26,078 people living with HIV were matched to 52,156 people without HIV. Mean age was 58.9 years, 21.3% were female and 31.3% were Black. Mean comorbidity burden was higher in people living with HIV vs without HIV overall (3.70 vs 3.14) and across age groups and sex (female: 4.40 vs 3.85; male: 3.33 vs 2.78) (all <i>p</i> < 0.001). Multimorbidity (≥2 non-HIV comorbidities) and polypharmacy (≥5 non-ART drugs) prevalence were significantly higher among people living with HIV and increased with age and among females. Similar patterns were observed across racial/ethnic groups.</p><p><strong>Conclusions: </strong>People living with HIV had greater comorbidity and polypharmacy burden than matched people without HIV across demographic subgroups. These findings underscore the need for comprehensive comorbidity assessment and comedication review to minimise drug interactions and support optimal treatment decisions for people living with HIV.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2731527"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968162","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":"Faith-based organisations in providing HIV services within low- and middle-income countries (LMICs): a systematic review.","authors":"Timothy Wiggam, Gerard Leavey","doi":"10.1080/25787489.2026.2728497","DOIUrl":"10.1080/25787489.2026.2728497","url":null,"abstract":"<p><strong>Background: </strong>To end the acquired immune deficiency syndrome (AIDS) epidemic by 2030, the Joint United Nations Programme on HIV/AIDS (UNAIDS) proposes that 95% of people living with HIV should be diagnosed, 95% of those with a diagnosis should be on treatment, and 95% of those on treatment should achieve viral suppression. To attain these targets, UNAIDS estimates that community-based HIV services should increase from 5% to 30%. Within low-and-middle-income countries (LMICs), faith-based organisations (FBOs) often possess broad societal influence and extensive reach. Thus, many major AIDS organisations expect the collaboration between health and faith sectors to strengthen community-based HIV services. However, limited research has been conducted to evaluate the effectiveness of existing FBO-based interventions in delivering HIV services.</p><p><strong>Objective: </strong>To assess and evaluate the role of FBOs in the provision of HIV services within LMICs, and the associated barriers and challenges they may face.</p><p><strong>Methods: </strong>This systematic review followed PRISMA 2020 guidelines. A literature search of EMBASE, PubMed, and MEDLINE for relevant English-language studies was conducted on 23rd October 2025. Studies were limited to empirical publications providing data on outcomes of HIV interventions by FBOs within LMICs. Data were extracted and all studies were assessed for quality and risk of bias using the Cochrane Risk of Bias 2 (ROB 2) tool, Risk of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool, the appraisal tool for Cross-Sectional Studies (AXIS) tool and the CASP qualitative checklist.</p><p><strong>Results: </strong>Sixteen studies were included in this review, including seven qualitative studies, six quantitative studies, and three studies of mixed methods. All studies were conducted within sub-Saharan Africa. FBO interventions were primarily behavioural and fell into four categories: (1) congregation-based teaching, (2) education of religious leaders, (3) comprehensive home-based care (HBC), and (4) bespoke interventions using FBO structures. Key challenges facing FBOs in HIV service provision included insufficient resources, cultural issues (e.g. stigma, traditional healing) and concerns regarding barrier contraception.</p><p><strong>Conclusions: </strong>Despite cultural and resource-based challenges, FBO interventions showed significant potential for expanding community-based HIV care within LMICs in sub-Saharan Africa. This review discusses several recommendations to strengthen FBO activities, encourage effective partnerships with FBOs, and ultimately lead to better HIV outcomes within LMICs. However, given the heterogeneity and quality of studies included, recommendations should be interpreted with caution.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2728497"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147750","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":"Utility of the brief Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2 screeners for depression and generalized anxiety symptom identification in people with human immunodeficiency virus.","authors":"Grace Y Lee, Maria C Latimer, Sharon M Kelly, Tarfa Verinumbe, Tracy Agee, Heidi Hutton, Catherine Lesko, Joyce Jones, Sheree Schwartz, Jeffrey Hsu, Oluwaseun Falade-Nwulia","doi":"10.1080/25787489.2026.2616103","DOIUrl":"10.1080/25787489.2026.2616103","url":null,"abstract":"<p><strong>Background: </strong>Despite recommendations for routine mental health screening in human immunodeficiency virus (HIV) care settings, screening uptake remains low. The brief Patient Health Questionnaire (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) are validated screeners for depression and anxiety symptoms with potential for integration into HIV primary care.</p><p><strong>Objective: </strong>This study aimed to identify the optimal cut-off points for the PHQ-2 and GAD-2 among people with HIV at risk for mental health disorders (MHD) in comparison to the PHQ-8 and GAD-7.</p><p><strong>Methods: </strong>Participants (<i>N</i> = 300) enrolled in a study evaluating a collaborative care intervention for substance use disorder and MHD care completed the PHQ-8 and GAD-7 at baseline. Sensitivity, specificity, and Youden's index were obtained for the PHQ-2 and GAD-2 at different scoring cut-off points against the PHQ-8 and GAD-7, which served as reference standards using recommended cut-off points of ≥10.</p><p><strong>Results: </strong>A cut-off point of ≥3 on the PHQ-2 demonstrated a sensitivity of 0.79 and a specificity of 0.88, while a cut-off point of ≥2 had a sensitivity of 0.95 and a specificity of 0.68. A cut-off point of ≥3 on the GAD-2 had a sensitivity of 0.87 and a specificity of 0.92.</p><p><strong>Conclusions: </strong>In the context of HIV care provision in busy clinical settings, our findings indicate that implementation of the PHQ-2 (cut point ≥ 2 or ≥3) and GAD-2 (cut point ≥ 3) detect depression and anxiety symptoms. The implementation of these brief screeners in routine health care settings has the potential for simplified detection of people with HIV who would benefit most from further evaluation for MHD.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2616103"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018373","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":"Italy is ready-extended PrEP cascade, and determinants of intention to use long-acting PrEP and unmet PrEP needs among men who have sex with men, trans* individuals, heterosexual women, and men.","authors":"Haoyi Wang, Johann Kolstee, Hanne M L Zimmermann, Jonathan Tosh, Melanie Schroeder, Kai J Jonas","doi":"10.1080/25787489.2026.2679339","DOIUrl":"10.1080/25787489.2026.2679339","url":null,"abstract":"<p><strong>Background: </strong>Italy has recently expanded access to oral pre-exposure prophylaxis (PrEP) and made rapid progress in long-acting PrEP (LA-PrEP) availability. These developments create a unique opportunity to assess population-level readiness for LA-PrEP and identify gaps that may limit its public health impact.</p><p><strong>Aim: </strong>To assess an extended PrEP cascade, quantify unmet prevention needs that LA-PrEP could mitigate, and identify determinants of LA-PrEP intention across key populations (KPs) in Italy.</p><p><strong>Methods: </strong>We analysed data from the PROTECT cross-sectional survey (October 2023-April 2024), including participants without HIV in Italy (<i>n</i> = 2215): 1707 MSM, 32 trans* individuals, 267 cis-men, and 209 cis-women. We described PrEP cascades (oral PrEP awareness, uptake, adherence, discontinuation; LA-PrEP awareness, interest, intention), unmet prevention needs potentially addressable by LA-PrEP ( defined as no current oral PrEP use or suboptimal oral PrEP adherence combined with LA-PrEP intention), and regional differences. Open-ended responses on LA-PrEP perceptions were analysed. Determinants of LA-PrEP intention and unmet PrEP needs were explored using multivariable logistic regression.</p><p><strong>Results: </strong>Overall, 19.0% (95%CI = 17.3-20.6) reported current oral PrEP use, of whom 19.8% (95%CI = 15.8-24.3) reported suboptimal adherence and 10.0% (95%CI = 8.3-13.9) had discontinued. Nearly half (47.0%, 95%CI = 44.9-49.8) expressed LA-PrEP intention. Unmet prevention needs potentially addressable by LA-PrEP were identified in 34.8% (95%CI = 32.8%-36.8%). MSM showed the highest PrEP engagement, whereas cisgender men had the lowest; unmet needs were greater in less-urbanised areas. Qualitative data reflected a positive outlook, framing LA-PrEP as safe, convenient, and empowering sexual freedom. Among MSM, unmet prevention needs potentially addressable by LA-PrEP were substantial among PrEP-naïve and discontinued users, although intention to use LA-PrEP was comparatively lower in these groups, indicating a mismatch between prevention need and acceptability.</p><p><strong>Conclusions: </strong>Despite low awareness, LA-PrEP intention is high in Italy, indicating strong readiness for rollout. However, a mismatch between prevention need and intention, particularly among PrEP-naïve individuals, may limit population-level impact. Yet, these findings should be interpreted considering the potential for selection bias associated with online convenience sampling and recruitment through social media and dating applications. Targeted, equity-oriented implementation strategies are required to ensure that LA-PrEP reaches populations experiencing substantial unmet HIV prevention needs.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2679339"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015291","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":"Exploratory assessment of nutrient-related food-frequency proxy measures among people with HIV by secondary chronic condition status.","authors":"Michael Reger, Christina Molinaro, Heidi Beidinger, Leeah Hopper","doi":"10.1080/25787489.2026.2732541","DOIUrl":"https://doi.org/10.1080/25787489.2026.2732541","url":null,"abstract":"<p><strong>Background: </strong>As people living with HIV live longer, secondary chronic conditions are increasingly common. Although nutrition important in HIV care, limited data describe nutrient-related dietary patterns among people with HIV and specific chronic conditions.</p><p><strong>Objective: </strong>To conduct an exploratory assessment of researcher-developed nutrient-related food-frequency proxy measures among people with HIV by secondary chronic condition status.</p><p><strong>Methods: </strong>This cross-sectional study included 64 people with HIV receiving services from community-based organizations in St. Joseph County, Indiana (<i>n</i> = 36), and Washington, DC (<i>n</i> = 28). Dietary information was assessed using selected items from the National Institutes of Health Diet History Questionnaire. Proxy measures for selected nutrient-related dietary exposures were derived using a researcher-developed scoring approach and expressed as percent Daily Value (%DV). Non-parametric tests compared demographic characteristics and proxy measures by secondary chronic condition status and type.</p><p><strong>Results: </strong>Participants with secondary chronic conditions had higher reported healthcare access (<i>p</i> = 0.025) and perceived relevance of nutrition (<i>p</i> = 0.036). The composite %DV-based relative intake score did not differ by condition status. Participants with cancer-related conditions had lower vitamin D-related (<i>p</i> = 0.039) and calcium-related proxy scores (<i>p</i> = 0.037) than participants without secondary chronic conditions, lower calcium-related scores than those with non-cancer conditions (<i>p</i> = 0.024), and lower vitamin C-related scores than those with cardiometabolic conditions (<i>p</i> = 0.024).</p><p><strong>Conclusions: </strong>These preliminary findings suggest possible differences in selected nutrient-related food-frequency proxy measures across chronic condition subgroups. Because key clinical and socioeconomic factors were not assessed, observed differences cannot be attributed to comorbidity status. Larger studies using validated dietary assessment methods, biomarkers, and comprehensive HIV-related clinical measures are needed.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2732541"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955831","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":"Application of dissemination and implementation science theories, models, and frameworks in HIV research: a scoping review (2020-2024).","authors":"Nicole A Stadnick, Carrie Geremia, Hetsi Modi, Ding Ding, Rosemina Bazeghi, Kelli Cain, Laramie R Smith, Maile Karris, Cathleen E Willging, Lauren Brookman-Frazee, Gregory A Aarons, Jessica Montoya, Borsika A Rabin","doi":"10.1080/25787489.2026.2739699","DOIUrl":"10.1080/25787489.2026.2739699","url":null,"abstract":"<p><strong>Background: </strong>Dissemination and implementation science (D&I) theories, models, and frameworks (TMFs) provide structured approaches to studying and enhancing the adoption, implementation, and sustainment of evidence-based interventions. Despite the growing interest in using D&I science in HIV research, details applying D&I TMFs remain limited.</p><p><strong>Objective: </strong>This scoping review characterizes the use of D&I TMFs in domestic and global HIV research.</p><p><strong>Methods: </strong>We conducted a scoping review of peer-reviewed empirical studies published between January 2020 and May 2024 that applied at least one D&I TMF in HIV research. The review focused on 15 highly cited D&I TMFs using methods by Walsh-Bailey et al. (2023). Inclusion criteria were: 1) substantive use of a D&I TMF to inform design, data collection, evaluation, or analysis; 2) addressing HIV prevention, intervention, and/or implementation; and 3) original empirical studies. An abstraction template captured study characteristics, TMF application, implementation strategies, and relevance to HIV implementation efforts.</p><p><strong>Results: </strong>Of the 2,360 articles screened, 168 met eligibility criteria. The most frequently used TMFs were the Consolidated Framework for Implementation Research (<i>n</i> = 49), RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) (<i>n</i> = 33), Theoretical Domains Framework (<i>n</i> = 24), and Exploration, Preparation, Implementation, Sustainment (EPIS; <i>n</i> = 15). Applications varied from study design and planning (<i>n</i> = 72) to informing implementation strategies (<i>n</i> = 44) and evaluation and impact assessment (<i>n</i> = 128). Case exemplars are offered to showcase how TMFs have been used across contexts.</p><p><strong>Conclusions: </strong>Findings offer insight into how D&I TMFs have been integrated in HIV implementation research. Improved reporting and use of TMFs may promote implementation effectiveness across HIV implementation efforts.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2739699"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108714","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 stressors experienced by people living with HIV during the pre-disclosure phase: a phenomenological analysis.","authors":"Roberta Mensah, Aaron Asinor, Saansong Omar Ansir Ahmed, Prince Owusu Adoma","doi":"10.1080/25787489.2026.2740930","DOIUrl":"https://doi.org/10.1080/25787489.2026.2740930","url":null,"abstract":"<p><strong>Introduction: </strong>The disclosure of HIV serostatus is central to HIV care and prevention across African countries; however, the psychological experience of the period preceding disclosure has received little direct attention in the Ghanaian evidence base. The research examined the psychosocial stressors experienced by people living with HIV during the pre-disclosure phase, defined as the period between diagnosis and disclosure to a given person, in Cape Coast, Ghana.</p><p><strong>Methods: </strong>A qualitative study design with a focus on Moustakas' transcendental phenomenological approach was used. In-depth semi-structured interviews were conducted with 24 purposively sampled people living with HIV receiving antiretroviral therapy (ART) at the Cape Coast Metropolitan Hospital in Ghana. Data analysis was done with Moustakas' phenomenological analysis, aided by Quirkos 3 software.</p><p><strong>Results: </strong>Four themes and twelve subthemes were identified. Theme A, emotional stress (two subthemes), comprised anxiety, depressive experience including suicidal ideation, and the repeated rehearsal of feared outcomes. Theme B, fear (six subthemes), spanned fear of infecting a partner, discrimination, intimate partner violence, disgracing the family, losing financial support and losing employment; for one participant, fear of job loss delayed the start of ART. Theme C, blame (two subthemes), comprised anticipated blame from partners and others, and self-blame. Theme D, structural stressors (two subthemes), comprised preparing for disclosure without professional guidance, and knowledge gaps expressed as denial and supernatural attribution of HIV.</p><p><strong>Conclusion: </strong>The pre-disclosure phase is a critical though under-resourced clinical moment. Psychological counselling, peer support and gender-sensitive economic and safety protections should be integrated into HIV care pathways from diagnosis, before disclosure takes place.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2740930"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108905","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":"Electrocardiograms and screening echocardiograms in young adults who acquired HIV perinatally and non-perinatally: a pilot study.","authors":"Pakorn Jiralak, Tachapong Ngarmukos, Somruthai Wattanachai, Nopporn Apiwattanakul, Sasisopin Kiertiburanakul, Suppachok Kirdlarp, Sirawat Srichatrapimuk, Angsana Phuphuakrat","doi":"10.1080/25787489.2026.2751243","DOIUrl":"https://doi.org/10.1080/25787489.2026.2751243","url":null,"abstract":"<p><strong>Background: </strong>Lifelong exposure to HIV and antiretroviral therapy (ART) may elevate cardiovascular risk as individuals with perinatally acquired HIV transition into adulthood. We evaluated subclinical electrocardiographic (ECG) and echocardiographic abnormalities in this population.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Thailand between 2022-2023. Young adults who acquired HIV perinatally were enroled, alongside age-matched adults who acquired HIV non-perinatally. Participants underwent standard ECG and screening echocardiography.</p><p><strong>Results: </strong>A total of 62 participants (31 who acquired HIV perinatally and 31 non-perinatally) were included in the study. Of these, 31 (50.0%) were men, and the median (interquartile range; IQR) age was 25.4 (23.9-27.0) years. The median (IQR) CD4 + count was 595 (453-835) cells/mm³. Yong adults with perinatal HIV had longer HIV/ART exposure and greater historical use of zidovudine, stavudine, and protease inhibitors. Abnormal ECG findings were present in participants with perinatally acquired HIV and non-perinatally acquired HIV, including sinus bradycardia (16.1% vs. 12.9%), low-voltage QRS (12.9% vs. 3.2%), ST-T abnormalities (6.5% vs. 3.2%), and QTc prolongation (3.2% vs. 3.2%). Abnormal echocardiograms were observed, including hyperdynamic left ventricular ejection fraction (LVEF > 70%) occurring in 9.7% vs. 0.0% (<i>p</i> = 0.238). In multivariable analysis, incomplete virologic suppression (viral load ≥ 200 copies/mL) was independently associated with low-voltage ECG (odds ratio 8.57; 95% confidence interval 1.16-63.30; <i>p</i> = 0.035).</p><p><strong>Conclusions: </strong>Subclinical cardiac abnormalities were infrequent and comparable between young adults with perinatally and non-perinatally acquired HIV. Low-voltage ECG was associated with incomplete virologic suppression. Optimising antiretroviral regimens to maintain a suppressed viral load may help reduce subclinical cardiac abnormalities in young people with HIV.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2751243"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193200","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":"Markers of gut permeability, systemic inflammation and insulin resistance in people living with HIV in rural South Africa.","authors":"Constance R Sewani-Rusike, Lusikelelwe Mkumbuzi, Laston Gonah, Hannibal T Musarurwa, B N Nkeh-Chungag","doi":"10.1080/25787489.2025.2586440","DOIUrl":"10.1080/25787489.2025.2586440","url":null,"abstract":"<p><strong>Background: </strong>The relative contributions of HIV infection, antiretroviral therapy (ART), and classical metabolic risk factors to the link between gut permeability and insulin resistance (IR) remain unclear.</p><p><strong>Aim: </strong>To examine the relationship between gut permeability, systemic inflammation, and insulin resistance among people with HIV in Mthatha, South Africa.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 226 participants: 82 HIV^-, 64 HIV⁺ART^-, and 80 HIV⁺ART⁺. Anthropometry and lipid profiles were assessed to evaluate obesity and dyslipidaemia. Gut permeability (intestinal fatty acid binding protein, IFABP) and inflammation (soluble CD14, sCD14) were measured, alongside fasting insulin and glucose to calculate HOMA-IR.</p><p><strong>Results: </strong>Overweight/obesity was more prevalent among ART-treated people with HIV (HIV⁺ART⁺) than ART-naïve participants (HIV⁺ART^-). Both HIV-positive groups showed increased gut permeability and inflammation compared with controls (<i>p</i> < 0.05). In ART-naïve people with HIV, gut permeability was associated with triglycerides, while in ART-treated people with HIV it was linked to gut-associated inflammation and markers of IR (fasting glucose, TG/HDL-c ratio). HOMA-IR correlated with obesity and dyslipidaemia (total cholesterol, LDL) in ART-naïve participants but was associated only with gut-associated inflammation in ART-treated participants (<i>p</i> < 0.05, respectively).</p><p><strong>Conclusion: </strong>Gut permeability is linked to insulin resistance in ART-treated people with HIV, independent of obesity and dyslipidaemia. This highlights a novel pathway for intervention to reduce NCD burden.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2586440"},"PeriodicalIF":2.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145603864","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":"Pilot outcomes of a telehealth model for youth PrEP (TelePrEP) among youth at risk for HIV in Colorado.","authors":"Lisa Lynn Abuogi, Rabbia Imran, Alexander Limas, Jennifer Moor, Katherine Leonard, Kimberly Pierce, A J De La Garza, Samantha Gallegos, Jacob Duenas, Zachary Littrell, Priya Vyas, Molly Richards, Diane Straub, Elizabeth J McFarland","doi":"10.1080/25787489.2025.2588009","DOIUrl":"10.1080/25787489.2025.2588009","url":null,"abstract":"<p><strong>Introduction: </strong>Despite youth representing a large proportion of incident human immunodeficiency virus (HIV) infections in the United States, uptake and retention of youth on pre-exposure prophylaxis (PrEP) remain low. This study evaluated the feasibility and effectiveness of a telehealth model for youth PrEP (TelePrEP) among individuals assigned male at birth at risk for HIV in Colorado.</p><p><strong>Methods: </strong>A mixed-methods pilot feasibility trial of telehealth-delivered PrEP services was conducted between January 2023 and December 2024. Youths 14-24 years of age eligible for PrEP using oral tenofovir alafenamide and emtricitabine (F/TAF) were enrolled in a prospective type 1 hybrid effectiveness implementation study. The primary effectiveness outcome was retention, defined as having either a PrEP visit or a PrEP prescription refill 12 months after study enrollment (+/- three months). Additional youth 18-24 years and PrEP providers were recruited for interviews or focus groups to explore implementation determinants such as youth PrEP and service model preferences, facilitators, and barriers. Rapid qualitative analysis was employed to summarize qualitative findings.</p><p><strong>Results: </strong>Among 44 eligible survey respondents, 21 enrolled in the study<b>,</b> with a median age of 22 years (interquartile range (IQR) 21-24). Eleven (52.4%) of the 21 participants initiated PrEP, and five (23.8%, 95% confidence interval 19.5%-43.3%) were retained per the study definition at 12 months. PrEP persistence (time to first discontinuation) was a median of 33 weeks (IQR 21-57). TelePrEP usage, assessed by the percentage of participants having at least 2 telehealth visits, was ten (47.6%) out of 21 enrolled participants and ten (90.1%) out of 11 participants who initiated PrEP. Qualitative findings among youth were favorable to the study recruitment approaches, including social media use, primary care providers referrals and youth-serving organizations, and community events. Both youth and PrEP providers support a TelePrEP care model.</p><p><strong>Conclusions: </strong>PrEP uptake and retention remain challenging for youth at risk for HIV. Further tailoring of PrEP models of care is needed to achieve risk reduction goals for youth.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2588009"},"PeriodicalIF":2.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714158","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}