HIV Medicine最新文献

{"title":"HIV seroconversions and genotypic viral resistance profiles in the PrEP impact trial.","authors":"Andrea Cartier, Ana Milinkovic, Lisa Goodall, Borja Mora-Peris, Dana Ogaz, Adrian Palfreeman, Branca Pereira, Iain Reeves, John Saunders, Ann K Sullivan","doi":"10.1111/hiv.70045","DOIUrl":"https://doi.org/10.1111/hiv.70045","url":null,"abstract":"<p><strong>Objectives: </strong>Here we describe HIV seroconversion events in participants of the PrEP Impact trial.</p><p><strong>Methods: </strong>Of 24 268 participants, we reviewed data for the 54 who were diagnosed with HIV during the trial; 11 at baseline.</p><p><strong>Results: </strong>Incidence was low for those diagnosed pre-pandemic at 0.13 per 100 person-years, and mainly linked to low self-reported adherence. The emergence of drug resistance in participants reporting recent oral PrEP (tenofovir disoproxil maleate with emtricitabine (TDF/FTC)) exposure was low (where analysis results are available, 21% of participants who seroconverted during trial participation showed drug resistance).</p><p><strong>Conclusions: </strong>Oral PrEP TDF/FTC is an effective HIV prevention intervention. Further data are needed to assess the prevalence and impact of increasing oral PrEP TDF/FTC use on HIV resistance.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119634","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":"Trends in prevalence of anaemia among people living with HIV in the UK: 20 cross-sectional analyses using population-based electronic primary healthcare records.","authors":"George B Freer, Jennifer Cooper, Krishnarajah Nirantharakumar, G Neil Thomas, Tiffany E Gooden","doi":"10.1111/hiv.70044","DOIUrl":"https://doi.org/10.1111/hiv.70044","url":null,"abstract":"<p><strong>Background: </strong>People living with HIV have a greater prevalence of anaemia compared with people without HIV, which increases the risk of associated morbidity and premature mortality. Risk factors for anaemia among people living with HIV have changed in recent decades due to new antiretroviral therapy (ART), increased uptake of ART and increasing chronic conditions among people living with HIV; thus, anaemia prevalence may have changed over time. We aimed to identify the prevalence and trends of anaemia among people living with HIV over a 20-year period.</p><p><strong>Methods: </strong>A series of 20 annual cross-sectional analyses were performed from 2002 to 2021. Data on people living with HIV aged ≥18 years from Clinical Practice Research Datalink (CPRD) Aurum was used, a population-based UK primary healthcare database. Overall and annual prevalence of all-cause anaemia, defined as any clinical code indicative of having anaemia, was calculated using multivariable logistic regression models and adjusted for age, sex, ethnicity, smoking status and deprivation. Trends were determined by investigating the change in prevalence across the 20 annual analyses using linear regression. Prevalence and trends of anaemia were also calculated among the following sub-groups of people living with HIV: age, sex, ethnicity, body mass index, smoking and socioeconomic deprivation.</p><p><strong>Results: </strong>Data for 41 990 people living with HIV were included. Overall adjusted prevalence of anaemia was 6.89%; however, this significantly increased from 4.6% (95% CI: 4.72%, 5.06%) in 2002 to 7.42% (95% CI: 7.33%, 7.51%) in 2021. A significant positive trend for anaemia was found (adjusted coefficient + 0.123; 95% CI: 0.107, 0.139; p < 0.001) and this was consistent among all sub-groups. Females, older age (≥50 years), non-smokers, Black ethnicity, overweight/obese and higher deprivation had an increased prevalence of anaemia.</p><p><strong>Conclusion: </strong>Anaemia among people living with HIV is increasing, with certain groups of people living with HIV experiencing a greater burden. Efforts should be made to prevent and reduce anaemia among people living with HIV to mitigate further morbidity, premature mortality and additional inequalities.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110431","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":"Knowledge about biomedical HIV prevention among healthcare workers: A cross-sectional study in Europe and Central Asia.","authors":"Ana Mendez-Lopez, Fiona Burns, Ann Sullivan, Charlotte Deogan, Katharine E A Darling, Daniel Simoes, Alex Garner, Julia Del Amo, Sini Pasanen, Elena Vaughan, Joelle Verluyten, Sanjay Bhagani, Esteban Martinez, Teymur Noori","doi":"10.1111/hiv.70048","DOIUrl":"10.1111/hiv.70048","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of HIV prevention among healthcare workers, such as undetectable equals untransmittable (U=U), post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) can hold implications for patient care and the HIV epidemic. Understanding the level of knowledge about HIV prevention among healthcare workers can provide information to enhance the effectiveness and equity of HIV prevention, treatment and care.</p><p><strong>Methods: </strong>An online survey was conducted to collect data on HIV knowledge among clinical and non-clinical healthcare workers in 54 countries in Europe and Central Asia between September and December of 2023. Knowledge was measured using questions asking respondents to agree or disagree with correct statements about HIV transmission and prevention. Four main outcome variables assessed knowledge among healthcare workers about U=U, PrEP, PEP and a combined outcome measuring overall knowledge level. Fixed-effects logistic and Poisson regression models assessed whether sociodemographic factors, professional characteristics and experiences with people living with HIV were associated with knowledge about these topics. Additionally, we assessed the impact of having ever received training on infection control and training on HIV stigma and discrimination on healthcare workers' knowledge of U=U, PEP and PrEP.</p><p><strong>Results: </strong>Among 18 348 healthcare workers, correct knowledge of U=U was reported by 61.25%, PEP by 55.70% and PrEP by 40.74%. A composite of correct knowledge across all topics was achieved by 31.29% of participants. Key sociodemographic and professional determinants influencing increased knowledge included being a man, of younger age and a medical doctor. Increased knowledge was also associated with having more experience caring for people with HIV, including working in an HIV care or infectious diseases department, and having cared for a higher number of people living with HIV in the past year. Having ever received training on infection control that included PEP and training on HIV stigma and discrimination was associated with increased knowledge in all areas. Across all determinants, respondents living in Western Europe reported higher knowledge about biomedical HIV prevention.</p><p><strong>Interpretation: </strong>Substantial knowledge gaps in HIV prevention were found among healthcare workers in Europe and Central Asia. Suboptimal knowledge and sociodemographic and professional differences warrant targeted training initiatives and interventions for improving healthcare workers' knowledge of HIV. The non-representative nature of the sample limits the generalizability of the findings.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101676","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":"Dual cross-sectional and longitudinal perspective on the continuum of HIV care to disentangle natural epidemic evolution from real progress, Belgium 2014–2022","authors":"D. Van Beckhoven,&nbsp;B. Serrien,&nbsp;R. Demeester,&nbsp;J. Van Praet,&nbsp;P. Messiaen,&nbsp;G. Darcis,&nbsp;S. Henrard,&nbsp;P. De Munter,&nbsp;A. Libois,&nbsp;J. Deblonde","doi":"10.1111/hiv.70027","DOIUrl":"10.1111/hiv.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study provides a comprehensive overview of HIV care by combining cross-sectional and longitudinal continuum of care (CoC) analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using national surveillance data 2014–2022, a five-stage cross-sectional CoC was calculated among people living with HIV (incl. undiagnosed): diagnosed, linked to care, retained in care, on antiretroviral therapy (ART) and virally suppressed. For the longitudinal CoC, cumulative incidences (CI) were calculated for each transition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 26 191 people living with HIV. By the end of 2022, an estimated 18 302 persons were living with HIV in Belgium. Of these, 92.1% were diagnosed, 90.9% linked to care, 89.2% retained in care, 87.9% on ART and 85.6% virally suppressed. One-year post-infection diagnosis rates were 38% (2014–2016), 33% (2017–2019) and 31% (2020–2022), with differences disappearing after correction for immigration timing. Time from diagnosis to care entry remained stable at 82% within 3 months. Time to ART initiation and to viral load suppression reduced substantially, with 3-month CIs rising from 69% and 71%, respectively (2014–2016), to 91% and 77% (2020–2022). Transitions between all stages of care were the fastest among Belgian men who have sex with men. People who inject drugs had the lowest CI for care entry and viral suppression. Cumulative incidences of ART initiation increased substantially for all key populations, exceeding 90% within 3 months in 2020–2022, except for non-Belgian heterosexuals (87%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A steady improvement in the CoC places Belgium close to the joint united nations programme on HIV/AIDS 95-95-95 targets, although populations like people who inject drugs and migrants still face significant barriers to care. Timely diagnosis by supporting existing and innovative testing strategies should be prioritized.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"1034-1045"},"PeriodicalIF":2.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and HIV-related stigma among Portuguese healthcare professionals: A cross-sectional analysis","authors":"F. Cota Medeiros,&nbsp;A. Méndez-López,&nbsp;R. Correia de Abreu,&nbsp;R. Sarmento e Castro,&nbsp;F. Maltez,&nbsp;F. Antunes","doi":"10.1111/hiv.70039","DOIUrl":"10.1111/hiv.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Stigma and discrimination against people living with human immunodeficiency virus (PLHIV) within healthcare settings remain significant barriers to effective care. Stigmatizing attitudes persist among healthcare professionals, potentially undermining care quality. This study aimed to assess HIV-related knowledge and attitudes among healthcare professionals in Portugal, focusing on identifying factors associated with stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was part of a European survey by the European Centre for Disease Prevention and Control (ECDC) and the European AIDS Clinical Society (EACS). Data were collected via an online self-administered questionnaire between September and December 2023, targeting healthcare professionals in Portugal. Descriptive statistics, chi-square tests and multivariate logistic regression were used to assess associations between sociodemographic characteristics, HIV knowledge and stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 807 healthcare professionals participated in the study, with a majority being women (78%), and a mean age of 43.5 years. Most respondents were nurses (38%) and doctors (28%), worked in hospitals (54%) or primary healthcare centres (31%). The analysis showed that healthcare professionals working in HIV-dedicated departments, hospitals or community centres exhibited significantly higher levels of HIV-related knowledge. In contrast, female professionals, those over 40 years old and non-doctor professionals were less likely to demonstrate high HIV-related knowledge. Regarding stigma, professionals with limited HIV training and lower HIV knowledge were more likely to display higher levels of stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings highlight the need for targeted educational interventions to reduce stigma. Strengthening HIV-specific training, especially in stigma reduction, is crucial for improving care for PLHIV and fostering an inclusive healthcare environment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"1096-1107"},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003186","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":"What services, interventions and support are available for People with HIV in England to manage their overall health and wellbeing? A scoping review","authors":"Howell T. Jones,&nbsp;Lucy Lynch,&nbsp;Tristan J. Barber,&nbsp;Meriel Rattue,&nbsp;Laura J. Waters,&nbsp;David Asboe,&nbsp;Angeline Walker,&nbsp;Ian Williams","doi":"10.1111/hiv.70041","DOIUrl":"10.1111/hiv.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The average age of a person living with HIV in high-income countries is increasing, as are rates of multimorbidity and frailty. To meet these needs, existing services must adapt. This review aimed to identify the existing literature on what services are available to undertake long-term condition management (LTCM) for People with HIV in England.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review employing the Arksey &amp; O'Malley's methodological framework was performed. Seven databases were searched most recently in October 2024 for studies describing services, interventions, or support for People with HIV in England to manage their overall health and wellbeing. Study inclusion was not limited by year of publication. Narrative reviews were excluded. Two reviewers independently performed data extraction using predetermined criteria, followed by a descriptive analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty publications were identified with six key areas where LTCM was addressed: HIV services, secondary care services, primary care, palliative care, peer support, self-management, and specialist services, suggesting that currently no service can undertake LTCM alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>If LTCM for People with HIV is to expand outside of HIV services, then additional HIV training is required for healthcare professionals with a focus on reducing stigma. Peer support should be at the forefront, and People with HIV should be involved in the assessment of need, design, and evaluation of services. There is a scarcity of high-level evidence, which justifies the need for further research and ongoing service evaluation to identify the optimal model(s) to ensure effective, equitable, and cost-effective care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"1004-1033"},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV molecular network in Mexico City (2021–2022): Understanding transmission dynamics through the role of newly diagnosed cases","authors":"Samuel E. Schulz-Medina,&nbsp;Daniela Tapia-Trejo,&nbsp;Margarita Matías-Florentino,&nbsp;Dulce M. López-Sánchez,&nbsp;Claudia García-Morales,&nbsp;Jessica Monreal-Flores,&nbsp;Ángeles Beristain-Barreda,&nbsp;Miroslava Cárdenas-Sandoval,&nbsp;Manuel Becerril-Rodríguez,&nbsp;Silvia Del Arenal-Sánchez,&nbsp;Verónica Quiroz-Morales,&nbsp;Steven Weaver,&nbsp;Joel O. Wertheim,&nbsp;Raúl Adrián Cruz-Flores,&nbsp;Gustavo Reyes-Terán,&nbsp;Andrea González-Rodríguez,&nbsp;Santiago Ávila-Ríos,&nbsp;Vanessa Dávila-Conn","doi":"10.1111/hiv.70029","DOIUrl":"10.1111/hiv.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to infer and describe Mexico City's HIV genetic transmission network from 2021 through 2022 by characterizing its members based on time since HIV acquisition, as well as sociodemographic, clinical, and behavioural characteristics. Additionally, we assessed clustering potential according to time since HIV acquisition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals with a recent HIV diagnosis at the largest HIV clinic in Mexico City were invited to participate, completing self-administered questionnaires on sociodemographic, clinical, and behavioural characteristics. Blood samples were collected for analysis of the HIV <i>pol</i> gene using next-generation sequencing. The stage of infection at diagnosis was determined using an algorithm that includes antibody avidity tests. Genetic transmission network analysis used the Seguro HIV-TRACE tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 6703 participants, 561 (8.4%) were identified as people newly living with HIV (PNLH). Transmission network analysis identified 896 clusters; 30.2% had at least one PNLH. Among all individuals, 43.5% formed clusters, with 11.8% being PNLH. PNLH added to a cluster showed higher odds for higher education, engaging in commercial sex, use of dating apps, annual HIV screening, and engaging in high-risk sexual practices (<i>p</i> &lt; 0.05). Clusters with PNLH exhibited greater growth rates than those without PNLH (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The presence of PNLH in clusters was associated with a higher growth rate. Tailored prevention strategies are crucial, including using dating apps for risk communication, promoting PrEP use, and safe sexual practices in sex venues, and enhancing harm reduction related to drug use. PNLH could be key candidates for interventions aimed at breaking transmission chains, including contact tracing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"1046-1059"},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963412","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":"Factors affecting treatment adherence in people with HIV – A single-Centre Descriptive Study from Turkey","authors":"Sabri Atalay,&nbsp;Kamil Mert,&nbsp;Derya Caglayan,&nbsp;Ufuk Sonmez,&nbsp;Ilkay Akbulut","doi":"10.1111/hiv.70042","DOIUrl":"10.1111/hiv.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment adherence is extremely important for virological suppression and a good clinical outcome in HIV. People with good adherence to treatment are less likely to experience treatment failure and have a better clinical course of the infection. In this study, we aimed to elucidate the factors affecting treatment adherence in people with HIV in a single centre from Turkey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was conducted at Tepecik Training and Research Hospital between September 2022 and December 2022. People with HIV over the age of 18 years who had been on ART for at least 6 months were included. Researchers designed a questionnaire by reviewing the literature to include factors that may affect treatment adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 306 people participated in the study (non-response rate: 30%), of which 86% were male. Among the individual factors, feeling depressed (19.5%), treatment fatigue (18.5%), and anxiety about not being able to have a healthy child (18.2%) were prominent. Major HIV/AIDS-related factors were the presence of AIDS-related opportunistic infection/cancer/comorbidity (20.9%) and lack of cure with current treatment (20.5%). Concern about side effects (14.6%) and drug–drug interaction (13.6%) were the most frequently mentioned ART-related factors. Main healthcare facility-related barriers for adherence were insufficient counselling (15.2%) and inability to reach the HIV physician (15.1%). Only a few patients stated factors related to the health system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our study, the most significant factors affecting treatment adherence appeared to be individual and HIV/AIDS-related. It is important to be aware of these factors and to spend time on tailored counselling during initial diagnosis and follow-up visits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"1150-1156"},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997954","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":"Assessment of compliance with recommendations for HIV perinatal transmission prevention, timely diagnosis and early treatment of children living with HIV in Brazil","authors":"Alexandre Alberto Cunha Mendes-Ferreira,&nbsp;Andrea Mônica Brandão Beber,&nbsp;Lino Neves da Silveira,&nbsp;Aranaí S. D. Guarabyra,&nbsp;Isabela Ornelas Pereira,&nbsp;Nazle Mendonça Collaço Véras,&nbsp;Rosana Elisa Gonçalves Gonçalves Pinho,&nbsp;Ana Roberta Pascom,&nbsp;Angelica Espinosa Miranda,&nbsp;Vivian I. Avelino-Silva","doi":"10.1111/hiv.70038","DOIUrl":"10.1111/hiv.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Strategies for perinatally transmitted HIV (PTHIV) prevention are inconsistently adopted. Moreover, delays in diagnosis and treatment initiation for children living with HIV may aggravate outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used a survey study administered to Brazilian maternities to evaluate compliance with individual PTHIV prevention interventions as well as the overall compliance using a combined endpoint. We also investigated associations with the average number of births per month and municipal social vulnerability index (SVI) using regression models. Next, using data from Brazilian HIV monitoring systems, we obtained information on age at first HIV viral load (VL) testing and age at first antiretroviral dispensation to evaluate delayed diagnosis (first VL testing ≥6 months) and delayed antiretroviral initiation (first dispensation ≥12 months) among children living with HIV, investigating associations with race/ethnicity, sex and SVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 801 maternities, only 21% were compliant with the combined endpoint. Facilities located in cities with higher SVI and those with a lower number of births per month had lower odds of being compliant. Among 1152 children living with HIV, the median age at first HIV VL testing was 3 months (range 0–18) and 24% had a delayed diagnosis. Children living with HIV in cities with higher SVI had higher odds of delayed diagnosis. The median age at antiretroviral initiation was 6 months (range 1–120), and those with a delayed diagnosis had higher odds of delayed treatment initiation (aOR 4.9, 95% CI 3.5–9.9).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study reveals significant challenges in access to PTHIV prevention, timely diagnosis and timely treatment initiation for children living with HIV, potentially related to social determinants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"1086-1095"},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984219","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":"Self-reported HIV viral load is reliable and not affected by adverse lived experiences of women living with HIV in British Columbia","authors":"Tetiana Povshedna,&nbsp;Shayda A. Swann,&nbsp;Marcela A. P. Silva,&nbsp;Shelly Tognazzini,&nbsp;Melanie Lee,&nbsp;Elizabeth M. King,&nbsp;Zoë Osborne,&nbsp;Angela Kaida,&nbsp;Melanie C. M. Murray,&nbsp;Hélène C. F. Côté,&nbsp;the British Columbia CARMA-CHIWOS Collaboration (BCC3; CIHR CTN 335)","doi":"10.1111/hiv.70035","DOIUrl":"10.1111/hiv.70035","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;HIV viral load (VL) is a key predictor of long-term health for women living with HIV. Here, we investigate how HIV VL self-reported by women living with HIV enrolled in the British Columbia CARMA-CHIWOS Collaboration Study relates to clinically measured HIV VL. Three HIV-related stigma scales and associations with selected socio-demographic characteristics, such as lifetime history of homelessness, history of substance use, ethnicity, and knowledge about ‘Undetectable = Untransmittable’, were also examined.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;For 219 women enrolled between December 2020 and August 2023, self-reported HIV VL status (classified as undetectable ≤40 copies/mL or detectable &gt;40 copies/mL) was compared with HIV VL obtained from chart review closest to, but before the date of self-report (SR). Sensitivity, specificity, predictive values, and likelihood ratios were calculated for the study sample overall and for socio-demographically defined subgroups. Concordance between self-reported HIV VL and (CC) clinical chart-derived values was examined by Cohen's kappa. Three HIV-related stigma scores were compared between women stratified by the concordance of their self-reported and chart review-based HIV VL.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ninety-five percent (208/219) of women were able to estimate their most recent HIV VL via self-report, and among them, 96% (200/208) were on antiretroviral therapy, 50% reported a history of homelessness, and 30% reported current substance use. Overall, the self-reported HIV VL was correctly estimated by 189 out of 219, and showed high overall concordance (86%) and moderate agreement (Cohen's kappa = 0.55) with HIV VL values derived from CCs. Correctly self-reported undetectable HIV VL showed high sensitivity (97.2%) and positive likelihood ratio (1.92), low negative likelihood ratio (0.06), moderate specificity (50%), and performed similarly across socio-demographic subgroups. HIV stigma scores did not differ between women who estimated their HIV VL correctly versus incorrectly. Of note, knowledge about ‘Undetectable = Untransmittable’ was lower (40%) among women who were not able to estimate their most recent VL than among those who did (74%).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our findings confirm previous reports of high awareness of HIV VL by women in British Columbia, Canada, despite a high prevalence of adverse socio-demographic experiences in this cohort. Our data further suggest that despite highly stigmatized life exp","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"1142-1149"},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}