HIV Medicine最新文献

{"title":"Wellbeing of trans and gender-diverse people with HIV in the United Kingdom: Results from Positive Voices 2022.","authors":"H Kitt, C Kelly, A Aghaizu, M Ross, F C Lampe, C J Smith, V Martin, C Humphreys, A Brown, A Sparrowhawk, M Kall, J Sewell, E Wainwright, V Delpech, G Davis, A Farah, A Fasanya, A J Rodger, T Đuretić","doi":"10.1111/hiv.70286","DOIUrl":"https://doi.org/10.1111/hiv.70286","url":null,"abstract":"<p><strong>Objectives: </strong>This national cross-sectional observational study aimed to assess mental health, quality of life, supportive network, experiences of HIV-related stigma in healthcare and unmet service need among trans and gender-diverse people with HIV, compared to cisgender people with HIV.</p><p><strong>Methods: </strong>Positive Voices 2022 is a questionnaire survey of people accessing HIV care in England, Scotland and Wales carried out in 2022 and 2023 that included measures of depression and anxiety symptoms and suicidal ideation (PHQ-9 and GAD-7), health-related quality of life (EQ-5D-5L), supportive network (modified Duke FSSQ), experiences of HIV-related stigma in healthcare and service needs. Logistic and ordinal logistic regression assessed the association of gender identity with these measures unadjusted and adjusted for age group and ethnicity.</p><p><strong>Results: </strong>Overall, 67 trans or gender-diverse and 4551 cisgender people with HIV participated. Compared to cisgender participants, trans and gender-diverse participants were younger, more likely to be Asian and less likely to be black. They were less likely to be in employment, homeowners and financially secure. Trans and gender-diverse participants had a higher prevalence of depression symptoms (35.5% [22/62] vs. 20.5% [865/4219], adjusted odds ratio [aOR] [95% confidence interval, CI] = 1.96 [1.15, 3.34]; p = 0.014) and suicidal ideation (37.1% [23/62] vs. 14.6% [616/4219]; aOR = 3.09 [1.85, 5.17]; p < 0.001) compared to cisgender participants. They also had poorer health-related quality of life for three domains (anxiety and depression, usual activities and self-care) and lower levels of supportive network in unadjusted and adjusted analyses. A higher proportion of trans and gender-diverse participants than cisgender participants had unmet needs for health services, including mental health services (49.2% [31/63] vs. 30.2% [1310/4343]; aOR = 2.02 [1.22-3.35]; p = 0.007), lifestyle services, and welfare and social services.</p><p><strong>Conclusions: </strong>Trans and gender-diverse people with HIV have poorer mental health and wellbeing than cisgender people with HIV, and a higher prevalence of unmet service needs, highlighting the need for access to culturally competent mental health and other health and welfare services.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication burden and prescribing quality in older people living with HIV: Associations with quality of life.","authors":"Abdulkadir Sonkaya, Nurgül Ceran, Seniha Şenbayrak, Asuman Inan, Serpil Erol, Recep Balik, Vahibe Aydin Sarikaya","doi":"10.1111/hiv.70301","DOIUrl":"https://doi.org/10.1111/hiv.70301","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of polypharmacy, drug-drug interactions (DDIs), potential prescribing omissions (PPOs) and potentially inappropriate medications (PIMs) among people living with Human Immunodeficiency Virus (HIV) aged ≥50 years and to evaluate their association with quality of life.</p><p><strong>Methods: </strong>This cross-sectional analytical study was conducted between March and May 2025 at a tertiary infectious disease clinic. A total of 141 people living with HIV aged ≥50 years who were receiving antiretroviral therapy (ART) and under active follow-up were included. DDIs were assessed using the Liverpool HIV Drug Interactions database, while PPOs and PIMs were evaluated using the TIME-to-START and TIME-to-STOP criteria. Quality of life was assessed using the PozQoL scale.</p><p><strong>Results: </strong>Polypharmacy was identified in 42 participants (29.8%) and DDIs in 22 (15.6%). Although PPOs were initially identified in all participants according to TIME-to-START criteria, this was largely driven by vaccination-related items. Vaccination-related items were excluded when evaluating the association between PPOs and quality of life, and the prevalence of PPOs decreased to 32.6%. PIMs were detected in 16.3%. Polypharmacy was associated with low quality of life in the health concern domain (OR 3.52, 95% CI 1.34-9.27). DDIs were associated with low overall (OR 7.65, 95% CI 2.01-29.07) and psychological quality of life (OR 14.55, 95% CI 3.45-61.37). PPOs were associated with low psychological (OR 10.67, 95% CI 2.80-40.68) and health concern domains (OR 3.19, 95% CI 1.27-8.05).</p><p><strong>Conclusions: </strong>Medication-related problems were common among older people living with HIV. Polypharmacy, DDIs and PPOs were associated with impaired quality of life, highlighting the need for structured medication review and multidisciplinary care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CROI 2026-A summary from the BHIVA CROI Working Group.","authors":"Tristan J Barber, Marta Boffito, Yvonne Gilleece, Portia Jackson, Nadia Naous, Michael Rayment, Iain Reeves, Amanda Samarawickrama, Caroline Sabin","doi":"10.1111/hiv.70302","DOIUrl":"https://doi.org/10.1111/hiv.70302","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary counselling and exercise training for lipid management in people living with HIV: A systematic review and meta-analysis.","authors":"Maki Aomori, Hitomi Maeda","doi":"10.1111/hiv.70298","DOIUrl":"https://doi.org/10.1111/hiv.70298","url":null,"abstract":"<p><strong>Objectives: </strong>Dyslipidaemia is highly prevalent among people living with human immunodeficiency virus (HIV) and contributes to increased cardiovascular risk. Although lifestyle interventions are recommended, evidence specific to people living with HIV remains limited. Previous reviews have primarily focused on dietary interventions or low-density lipoprotein cholesterol (LDL-C). Here, we assessed the effects of dietary counselling and exercise training on serum lipid levels in people living with HIV.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials evaluating dietary and exercise interventions in people living with HIV, predominantly with dyslipidaemia. PubMed, CENTRAL, Cumulative Index to Nursing and Allied Health Literature and Web of Science were searched up to February 28, 2026. The primary outcome was the change in LDL-C level from baseline. Secondary outcomes included changes in total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels. Mean differences with 95% confidence intervals were pooled.</p><p><strong>Results: </strong>Seven RCTs involving 474 participants were included. Dietary counselling significantly reduced LDL-C, TC and TG levels compared with usual care, with LDL-C reductions ranging from approximately 6 to 13 mg/dL. Evidence from two trials suggested that exercise training may increase HDL-C levels, with no consistent effects on LDL-C, TC or TG levels. Differences in exercise protocols may have contributed to these findings.</p><p><strong>Conclusion: </strong>Dietary counselling may improve LDL-C, TC and TG levels, whereas limited evidence suggests that exercise training may increase HDL-C levels in people living with HIV. Lifestyle interventions may serve as adjunctive strategies for lipid management, although further large-scale studies are needed, particularly to evaluate the effects of exercise.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Material deprivation and its correlates in treatment-naïve migrants with HIV with rapid access to B/F/TAF at no cost: A sub-study of the ASAP cohort.","authors":"Moustafa Laymouna, Kim Engler, David Lessard, Melchior Belin, Serge Vicente, Dominic Chu, Sean Yaphe, Joseph Cox, Nadine Kronfli, Jean-Pierre Routy, Joel Ishak, Alexandra Hamel, Marina Klein, Alexandra de Pokomandy, Cecilia T Costiniuk, Bertrand Lebouché","doi":"10.1111/hiv.70299","DOIUrl":"10.1111/hiv.70299","url":null,"abstract":"<p><strong>Objectives: </strong>Material deprivation (MD), the inability to afford essentials, is linked with poorer HIV clinical outcomes. In Canada, migrants living with HIV are a growing group, yet little is known about their experience of MD, especially early in treatment. This study examined the prevalence, nature, sociodemographic and clinical correlates and longitudinal changes in MD among migrants living with HIV initiating antiretroviral therapy (ART).</p><p><strong>Methods: </strong>Analyses used data from 56 ART-naïve migrants enrolled in the Antiretroviral Speed Access Program (ASAP), a cohort at the McGill University Health Centre, Montreal, Canada receiving access to rapid, no-cost and onsite bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF). MD was assessed at Weeks 4 and 48 using the 17-item Canadian Material Deprivation Index (CMDI), with deprivation defined as checking ≥2 items. Statistical tests included Fisher's exact, Wilcoxon signed-rank, McNemar's exact and correlation coefficients.</p><p><strong>Results: </strong>At Week 4, 48 (85.7%) participants were materially deprived, most commonly reporting inability to cover an unexpected expense (87.5%), afford dental care (73.2%) or buy small gifts (73.2%). Week 4 MD was significantly associated with occupation (p = 0.020) and migration status (p = 0.016). No statistically significant associations were observed between MD and HIV clinical outcomes. Between Weeks 4 and 48, MD scores declined significantly (median: 7.5 to 4.0; p < 0.001), although 67.9% of participants remained deprived.</p><p><strong>Conclusions: </strong>Associated with occupation and migrant status, MD was highly prevalent and persistent among migrants living with HIV, despite partial improvement over time, underscoring the need for structural supports. Short-term HIV clinical outcomes appeared unaffected, which may reflect access to rapid, no-cost and onsite ART delivery.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial vulnerabilities and loss to follow-up in people living with HIV in France.","authors":"Charlène Mafuta, Sophie Grabar, Laurence Lievre, Cécile Goujard, Jean-Paul Viard, Olivier Bouchaud, Laurence Meyer, Rémonie Seng, Sophie Abgrall","doi":"10.1111/hiv.70293","DOIUrl":"10.1111/hiv.70293","url":null,"abstract":"<p><strong>Background: </strong>Migration status is consistently associated with a higher risk of loss to follow-up (LTFU). We investigated how sex, sexual orientation and social vulnerabilities affect the association between migration status and LTFU for hospital care in people living with HIV, using data from the ANRS CO9-COPANA cohort linked to the nationwide French hospital database on HIV (ANRS CO4-FHDH).</p><p><strong>Methods: </strong>The COPANA prospective cohort enrolled antiretroviral drug-naïve adults newly diagnosed with HIV-1 between 2004 and 2008 in France. LTFU in the hospital setting was defined as no clinical follow-up for ≥24 months before the study end. Fine and Gray models accounting for death as a competing event were used to assess factors associated with LTFU.</p><p><strong>Results: </strong>The 616 participants included 333 born in France, 209 born in sub-Saharan Africa and 74 born in other regions. There were 432 male participants, including 281 men who have sex with men (MSM). The cumulative incidence of LTFU was 17% (95% CI: 14-20) at 10 years. Migrant MSM and migrant women had a higher crude risk of LTFU than French-born MSM. After adjustment for several social factors, the risk of LTFU remained higher in migrant MSM. Lack of psychological support and non-disclosure of HIV status to friends were associated with a higher risk of LTFU and had the greatest impact on the difference between crude and adjusted sub-distribution hazard ratios for LTFU in both male and female migrants.</p><p><strong>Conclusion: </strong>The higher risk of LTFU from hospital-based care in migrant MSM and women was attenuated after adjustment for social vulnerabilities, suggesting that these factors contribute to the observed association.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and associated clinical factors among Japanese people with HIV: A multicentre cross-sectional study using the revised Japanese Cardiovascular Health Study criteria.","authors":"Hideta Nakamura, Julian Falutz, Taro Naka, Sho Miyamori, Nanae Ikemiyagi, Kazutaka Yamaniha, Shuhei Ideguchi, Rumi Minami, Masashi Narita, Michinori Shirano, Sei Samukawa, Tomoyuki Endo, Junji Imamura, Mayumi Imahashi, Shinichiro Ueda, Kazuko Yamamoto","doi":"10.1111/hiv.70297","DOIUrl":"https://doi.org/10.1111/hiv.70297","url":null,"abstract":"<p><strong>Objectives: </strong>Frailty is relevant to HIV care across middle and later life, yet Japanese data remain limited. We evaluated frailty, prefrailty and associated factors in Japanese people with HIV using the revised Japanese Cardiovascular Health Study (J-CHS) criteria.</p><p><strong>Methods: </strong>We conducted a multicentre cross-sectional study at eight HIV care centres. Eligible participants were Japanese people with HIV aged ≥40 years on antiretroviral therapy for ≥12 months. Frailty was classified as robust, prefrail or frail. Multivariable logistic regression examined factors associated with frailty-related outcomes; sensitivity analyses excluded sex from the model and restricted analyses to men.</p><p><strong>Results: </strong>Among 325 participants, median age was 55 [49-64] years and 311 (95.7%) were male; 70 (21.5%) were robust, 227 (69.8%) prefrail and 28 (8.6%) frail. Common components were low physical activity (36.6%), weight loss (33.2%) and slow gait (27.1%). In the frailty versus non-frailty model, higher PHQ-9 score (adjusted odds ratio [aOR] 1.12 per point, 95% confidence interval [CI] 1.04-1.21) and polypharmacy (aOR 3.34, 95% CI 1.23-9.10) were associated with frailty. In the prefrailty/frailty versus robust model, higher PHQ-9 score and body mass index were associated with the outcome. Sensitivity analyses yielded broadly consistent findings.</p><p><strong>Conclusions: </strong>Prefrailty was highly prevalent, and frailty was associated with depressive symptoms and polypharmacy. Frailty at a median age of 55 years suggests clinically relevant vulnerability in Japanese people with HIV, although longitudinal and comparative studies are needed. These findings support integrated HIV care combining mental-health screening, medication review and physical-function assessment.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migration pathways and HIV care Cascade among newly enrolled adult patients in a tertiary clinic in Montréal, Canada.","authors":"Kathy Nodzynski, David Lessard, Dominic Chu, Nadine Kronfli, Claire Dufrêne-Boelen, Sean Yaphe, Marina Klein, Jean-Pierre Routy, Alexandra Hamel, Cecilia Costiniuk, Alexandra de Pokomandy, Serge Vicente, Krescyn Moonsamy, Nashira Popovic, Joseph Cox, Bertrand Lebouché","doi":"10.1111/hiv.70296","DOIUrl":"10.1111/hiv.70296","url":null,"abstract":"<p><strong>Objectives: </strong>Migrants are disproportionately affected by HIV and face inequities in accessing care. This study examined the HIV care cascade among newly registered adults at the Chronic Viral Illness Service (CVIS).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults (≥18 years) living with HIV and newly registered at the CVIS, in Montréal, Canada, between January 1st, 2022, and December 31st, 2024. Sociodemographic, clinical and care cascade data were extracted from electronic records. Multivariable logistic regression models, adjusted for age, gender, region of birth and diagnosis type, examined associations between seven migration status categories and cascade outcomes.</p><p><strong>Results: </strong>Among 695 patients, 664 (95%) were born outside Canada and 528 (76%) were refugees/asylum seekers. Of these, 281/695 (40%) had a new HIV diagnosis. Among newly diagnosed refugees/asylum seekers, median time from diagnosis to linkage to care was 28 days (interquartile range [IQR]: 18-42). Median time from linkage to antiretroviral therapy (ART) prescription ranged from 0 (IQR: 0-0) to 18 (IQR: 9-27) days across groups. At 6 months, 618/695 (89%) were retained in care and 603/618 (98%) were on ART. At 12 months, 530/603 (88%) were in care and 511/530 (96%) were virally suppressed. In exploratory adjusted analyses, Canadian citizens had lower odds of retention (aOR 0.32, 95% CI 0.14-0.75) and viral suppression (aOR 0.33, 95% CI 0.15-0.75) at 12 months.</p><p><strong>Conclusions: </strong>Among newly diagnosed refugees/asylum seekers, linkage to care delays appear to have increased since pre-pandemic estimates. Meaningful heterogeneity across migration groups highlights the limitations of treating migrants as a homogeneous population in HIV care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and management of low-level viraemia in people living with HIV in a resource-limited setting: A multicentre retrospective study in Greece.","authors":"Lydia Leonidou, Giota Lourida, Konstantinos Protopapas, Charalampos D Moschopoulos, Dimitrios Zoulas, Charisis Totsikas, Dimitrios Basoulis, Elpida Mastrogianni, Apostolos Beloukas, Maria Lagadinou, Markos Marangos, Vasileios Papastamopoulos, Antonios Papadopoulos, Mina Psichogiou","doi":"10.1111/hiv.70295","DOIUrl":"https://doi.org/10.1111/hiv.70295","url":null,"abstract":"<p><strong>Objectives: </strong>Low-level viraemia (LLV) persists in some people living with HIV despite antiretroviral therapy, raising concerns about virologic failure. We assessed the characteristics, management and outcomes of LLV in Greece, where next-generation sequencing, therapeutic drug monitoring and electronic adherence monitoring are unavailable.</p><p><strong>Methods: </strong>This retrospective multicentre study included people living with HIV from four Greek clinics who had achieved virological suppression for at least 6 months. LLV was defined as two consecutive HIV-1 RNA measurements between 51 and 200 copies/mL. Patients were followed for 18 months, during which three subsequent viral load measurements were evaluated. Adherence was assessed using patient self-report and documentation in the medical record.</p><p><strong>Results: </strong>Among 3800 patients, 35 (0.9%) experienced LLV. Median age was 49 years, and 69% were male. Patients were treatment-experienced (median 3.5 ART lines; median duration of viral suppression, 7 years), with 57% receiving high genetic-barrier regimens. Baseline genotypic resistance data were available for 30 of 35 patients (85.7%), and clinically relevant resistance-associated mutations were identified in 6 (20.0%). LLV resolved in 27 of 35 patients (77.1%), persisted in 7 (20.0%) and recurred in 1 (2.9%). No patient developed virologic failure. Presumed causes of LLV were unknown in 18 (51.4%), low adherence in 14 (40.0%) and drug-drug interactions in 3 (8.6%). ART was modified in 17 patients, of whom 13 (76.5%) achieved viral resuppression, most commonly after switching from lower- to higher-genetic-barrier regimens. One patient with persistent LLV developed lymphoma during follow-up.</p><p><strong>Conclusions: </strong>LLV was uncommon but clinically relevant in this multicentre Greek cohort and frequently resolved following targeted management. Adherence optimization and ART modification, particularly to higher genetic-barrier regimens, were associated with viral resuppression in this cohort. Ongoing monitoring remains essential, especially in settings with limited access to advanced diagnostic tools.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of the acceptability, feasibility and effectiveness of opt-out blood-borne virus (BBV) testing in secondary healthcare settings, in the UK and similar settings, using APEASE criteria.","authors":"Becky Metcalfe, Karen J Maxwell, Kirsten Trayner, Max Wilkinson, Sharon Hutchinson, Claudia Estcourt, Alison J Rodger","doi":"10.1111/hiv.70284","DOIUrl":"https://doi.org/10.1111/hiv.70284","url":null,"abstract":"<p><strong>Background: </strong>Earlier diagnosis of blood-borne viruses (BBVs)-HIV, hepatitis B (HBV) and hepatitis C (HCV)-remains a significant public-health focus. Opt-out testing in secondary healthcare settings can improve early diagnosis and linkage to care as part of BBV transmission elimination targets. This scoping review used APEASE criteria (acceptability, practicability, effectiveness, affordability, side-effects and equity) to evaluate opt-out BBV testing interventions in emergency departments (EDs) and medical assessment units (MAUs).</p><p><strong>Methods: </strong>A systematic search of three databases was conducted for peer-reviewed literature up to 30th June 2025. Inclusion criteria were: (a) opt-out BBV testing intervention; (b) taking place within a secondary care setting; and (c) in the UK, Ireland, Australia and Canada. Data were extracted and analysed using APEASE criteria.</p><p><strong>Results: </strong>Twenty-eight studies met inclusion criteria. Opt-out testing was acceptable to patients and healthcare professionals, particularly when supported by clear communication, staff training and leadership engagement. Practicability varied by setting; barriers included time constraints, unclear responsibilities and logistical challenges. Automation using electronic systems facilitated implementation. Effectiveness was demonstrated through increased testing uptake and case identification, especially in EDs. Minimal evidence exists on affordability and is likely to vary by population prevalence. No significant side effects (unintended outcomes) were reported, and universal testing was associated with reduced stigma. Opt-out testing can improve access to testing for underserved populations, supporting its role in promoting health equity.</p><p><strong>Conclusion: </strong>Opt-out BBV testing in secondary care settings (EDs and MAUs) is a feasible, effective and equitable intervention when supported by appropriate infrastructure and resources. Efforts should focus on optimizing implementation strategies and extending opt-out testing, including to lower-prevalence settings.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}