HIV Medicine最新文献

{"title":"Association of delayed ART initiation with mortality according to documented concurrent clinical conditions in adults with HIV: A multicentre cohort study.","authors":"Qianning Liu, Ying Luo, Qingsong Shan, Daqing Zhu, Shifei Wen, Lilan Tu, Chengcheng Gong, Yan Yin, Leyao Zhang, Guihua Yang, Cuihua Fu, Huanxin Xu, Jiuyun Luo, Chengyun Yang, Shuhua Zhang, Jiehui Yuan, Jingwen Xiao, Shijie Zou, Shuqiang Ou, Xueping Tao, Yong Deng, Wei Zou","doi":"10.1111/hiv.70307","DOIUrl":"https://doi.org/10.1111/hiv.70307","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether the association between delayed antiretroviral therapy (ART) initiation and all-cause mortality differs according to documented concurrent clinical conditions at presentation in adults with HIV.</p><p><strong>Methods: </strong>We conducted a multicentre retrospective cohort study of 1826 treatment-naive adults with HIV in Jiangxi Province, China (2004-2024), linking clinical and surveillance records. Time zero was defined as ART initiation. The exposure was a delay of >30 versus ≤30 days from diagnosis; the outcome was all-cause mortality. Presenting risk was defined a priori from conditions documented by ART initiation (documented condition, none documented or untested/unknown). We fitted subgroup-specific Cox models and a full-sample interaction model. Multiple imputation was a co-primary approach for missing baseline HIV-RNA.</p><p><strong>Results: </strong>Overall, 142 participants (7.8%) died. A delay of >30 days was not associated with mortality overall (adjusted hazard ratio [aHR] 1.05, 95% confidence interval [CI] 0.83-1.33; p = 0.70). Among participants with documented concurrent conditions (n = 450), a delay of >30 days was associated with approximately two-fold higher mortality under multiple imputation (aHR 2.07, 95% CI 1.06-4.02; p = 0.033; 48-week cumulative mortality 12.1% vs. 6.2%); no association was seen without documented conditions (aHR 0.87, 95% CI 0.55-1.39). The interaction was borderline under multiple imputation (p = 0.064; fraction of missing information 0.04).</p><p><strong>Conclusions: </strong>Documented clinical complexity at presentation may identify a subgroup in whom prolonged ART delay is less well tolerated. These hypothesis-generating findings warrant external validation.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963433","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":"Venezuelan migrants living with HIV in Barcelona: Migration patterns and baseline immunovirological characteristics in a retrospective cohort study.","authors":"Alexy Inciarte, Elizabeth Zamora-Clemente, Leire Berrocal, Ana González-Cordón, Lorena De La Mora, María Martínez-Rebollar, Montserrat Laguno, Juan Ambrosioni, Iván Chivite, Elisa de Lazzari, Alberto Foncillas, Júlia Calvo, Abiu Sempere, Esteban Martínez, José M Miró, José Luis Blanco, Berta Torres, Josep Mallolas","doi":"10.1111/hiv.70300","DOIUrl":"https://doi.org/10.1111/hiv.70300","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the sociodemographic characteristics, migration patterns and immunovirological outcomes of Venezuelan migrants living with HIV (PLWH) in Barcelona, Spain, and to compare them with other Latin American (LA) migrant PLWH.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study including LA migrant PLWH who attended their first consultation at the HIV Unit of Hospital Clínic de Barcelona between 2000 and 2023. Venezuelan PLWH were compared with other LA migrant PLWH regarding demographics, HIV diagnosis timing, CD4 cell count, viral load, late HIV diagnosis (LHD) and advanced HIV disease (AHD).</p><p><strong>Results: </strong>A total of 493 Venezuelan PLWH were included, representing 16% of LA migrant PLWH in the cohort. Venezuelan PLWH were predominantly men (97%; n = 478). Most first consultations occurred after 2014 (81%; n = 399), peaking in 2018. Half were diagnosed with HIV after arrival in Spain (50%; 224/451), and 73% (328/451) had lived in Spain for less than 3 years. Among ART-naïve individuals, LHD was 38% in 2000-2008 and 53% in 2015-2023, while baseline CD4 counts progressively declined. Immunological outcomes were similar between Venezuelan and other LA migrants, including LHD (50%; n = 98 vs. 51%; n = 622) and AHD (24%; n = 48 vs. 25%; n = 301). However, ART-experienced Venezuelan PLWH showed lower virological suppression rates (67%; n = 191 vs. 72%; n = 1013; p = 0.068).</p><p><strong>Conclusion: </strong>Venezuelan PLWH in this Barcelona cohort represent a rapidly growing migrant population shaped by humanitarian displacement and disruption of HIV care. The high proportion of LHD and lower virological suppression among ART-experienced individuals is compatible with continuity-of-care disruptions before migration but do not establish causality.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944786","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":"The effect of a tailored dietary intervention on serum biomarkers and faecal microbiome composition in people with HIV at risk of cardiovascular disease.","authors":"Fabio Antonino Ranzani, Chiara Montrucchio, Ilario Ferrocino, Donatella Penoncelli, Ilaria Cavecchia, Cristina Tettoni, Micol Ferrara, Andrea Pezzana, Alice Palermiti, Alessandro Lazzaro, Stefano Bonora, Giovanni DiPerri, Andrea Calcagno","doi":"10.1111/hiv.70291","DOIUrl":"10.1111/hiv.70291","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) are at higher risk of cardiovascular disease (CVD) despite spontaneous or antiretroviral therapy-induced long-lasting suppressed viremia. Traditional and HIV-specific factors have been identified, but CVD incidence and mortality remain high. A microbiome is a community of germs living close to their human host, and bacterial dysbiosis is associated with atherosclerosis and chronic non-communicable disease development.</p><p><strong>Methods: </strong>We conducted a pilot study designed to analyze the effect of tailored diet intervention on body mass index (BMI), metabolic features and microbiota composition in PWH with suppressed HIV viremia (HIV RNA <50 copies/mL) under combination antiretroviral treatment. Biomarkers and parameters were measured at baseline and 6 months (M6) after.</p><p><strong>Results: </strong>Ten male participants were enrolled. The median age was 60.5 years (54-69) and the 10-year CV risk was 11.7% (7.2-21.2). CD4+ T lymphocyte count was 568 cells/mm³ (398-625). Approximately 75% of participants declared to be adherent to the given dietary recommendations. Participants showed reduced amounts of food intake (p = 0.022) and, specifically, of saturated fat (p = 0.007) and cholesterol (p = 0.011). At M6, most metabolic and inflammatory parameters remained stable. TMAO concentrations were higher at M6 than at baseline (157 vs. 129 ng/mL, p = 0.050). Microbiota alpha and beta diversity did not change over time: yet we observed a significant reduction of Firmicutes (p = 0.047) and an increase in Proteobacteria (p = 0.028) relative abundance at M6.</p><p><strong>Conclusions: </strong>In this pilot study assessing a tailored dietary intervention in high CV-risk PWH, we observed stable metabolic and inflammatory parameters and an unexpected increase in TMAO levels at 6 months. Microbiome composition was marginally affected, and active interventions are probably needed to elicit significant changes over time.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929601","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":"Preparing for pregnancy while living with HIV: An exploratory qualitative study of Women's preconception information needs and priorities.","authors":"Catherine Stewart, A Namiba, R Mbewe, L Kwardem, E Ndungu, S Tariq","doi":"10.1111/hiv.70304","DOIUrl":"https://doi.org/10.1111/hiv.70304","url":null,"abstract":"<p><strong>Introduction: </strong>Preconception health is a key determinant of birthing people and infant outcomes. However, for people living with HIV, preconception care has predominantly focused on preventing vertical transmission, often neglecting broader needs. We conducted an exploratory qualitative descriptive study with women living with HIV to inform the development of a preconception health resource.</p><p><strong>Methods: </strong>In collaboration with HIV peer support organization 4M Network, we conducted five focus group discussions (FGDs) via Zoom in June-July 2024. Participants were eligible if they were living with HIV, aged ≥18 years, UK residents, and had either recently been pregnant (within 5 years) or were a 4M Mentor Mother or 4M Co-Director. FGDs were recorded, transcribed and analysed thematically.</p><p><strong>Results: </strong>Sixteen cisgender women participated in five FGDs; aged 26-57, all Black/Mixed ethnicity, most non-UK born, and diagnosed with HIV for 1-33 years. We identified five themes: healthy pregnancy meaning; pregnancy preparation; managing during pregnancy and postpartum; preconception discussions; and information sources. Participants across all groups (recently pregnant women, 4M Mentor Mothers and 4M Co-Directors) identified a need for information on HIV management, physical and mental health, lifestyle, the pregnancy journey, and infant feeding. Most recently pregnant women had not discussed preconception health with their HIV clinicians, despite describing them as a main source of information and support. The findings emphasize the importance of holistic and tailored resources for women living with HIV.</p><p><strong>Conclusion: </strong>This study describes the diverse needs of women living with HIV as they prepare for pregnancy, highlighting how these needs extend beyond the prevention of vertical transmission of HIV. Our findings informed the development of a freely available preconception health resource for people living with HIV.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911524","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":"HIV-related knowledge and stigma among healthcare workers in Greece: A secondary analysis of a European survey.","authors":"Charalampos D Moschopoulos, Nikos Pantazis, Konstantinos Protopapas, Dimitra Kavatha, Giota Touloumi, Charalampos Gogos, Marios Lazanas, Antonios Papadopoulos","doi":"10.1111/hiv.70306","DOIUrl":"https://doi.org/10.1111/hiv.70306","url":null,"abstract":"<p><strong>Background: </strong>HIV-related stigma in healthcare settings remains a barrier to equitable care for people living with HIV. Data on HIV-related knowledge and stigmatizing attitudes among healthcare workers (HCWs) in Greece are limited. This study aimed to describe HIV-related knowledge, stigmatizing attitudes and discriminatory practices among HCWs in Greece and to identify factors associated with higher knowledge and stigma.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the Greek subset of the 2023 ECDC/EACS survey on HIV-related knowledge and stigma among HCWs. HIV knowledge was assessed using three items on undetectable equals untransmittable ('U=U'), post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), combined into a four-level ordinal variable. Stigmatizing attitudes were assessed using an eight-item mean score. Associations with knowledge were examined using proportional-odds ordinal logistic regression, and associations with stigma were assessed using a multivariable linear model.</p><p><strong>Results: </strong>Among 826 respondents, correct knowledge was reported by 57.9% for 'U=U', 59.4% for PEP and 39.0% for PrEP. Nearly half answered no more than one item correctly. Higher knowledge was independently associated with younger age, male gender, doctor role, hospital-based practice and greater occupational contact with people living with HIV. The mean stigma score was 2.1 on a 1-5 scale. Higher stigma scores were independently associated with older age, lower HIV knowledge and absence of prior HIV stigma/discrimination training. Doctors had lower adjusted stigma scores than nurses in pairwise comparisons.</p><p><strong>Conclusions: </strong>Important gaps in HIV prevention knowledge and persistent stigmatizing attitudes were observed among HCWs in Greece. Findings support structured, decentralized educational and stigma-reduction interventions across healthcare settings.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905768","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":"Ankle brachial index not a reliable tool for risk assessment in people with HIV","authors":"Janine M. Trevillyan,&nbsp;Saliya Hewagama,&nbsp;Sue J. Lee,&nbsp;Lucy O. Attwood,&nbsp;James Shaw,&nbsp;Jennifer F. Hoy","doi":"10.1111/hiv.70273","DOIUrl":"10.1111/hiv.70273","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1552-1553"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271238","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":"Differences in HIV testing may determine the first pillar of the HIV care continuum in a cross-border setting","authors":"Hanne M. L. Zimmermann,&nbsp;Sarah E. Stutterheim,&nbsp;Dominique van Beckhoven,&nbsp;Wim vanden Berghe,&nbsp;Jessika Deblonde,&nbsp;Sandrine Detandt,&nbsp;Ulrich Marcus,&nbsp;Ben Serrien,&nbsp;Ard van Sighem,&nbsp;Kai J. Jonas","doi":"10.1111/hiv.70263","DOIUrl":"10.1111/hiv.70263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In border regions like the EuRegio Meuse-Rhine (EMR), mobility does not stop at the border. HIV risk may therefore not only be determined by within-country factors but also by between-country differences. We explored between-country differences in HIV indicators in the EMR using two complementary data-driven approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>First, we used 2019–2021 surveillance data from the German Robert Koch Institute, the Belgian Health Institute Sciensano and the Dutch HIV Monitoring Foundation to report on the EMR-specific 95-95-95 goals. Second, we used the cross-sectional EMIS-2017 survey, including (trans)men who have sex with men (MSM), to report on determinants of HIV testing in the EMR. We employed multilevel multinomial regression modelling to identify sociodemographic factors associated with recent (&lt;1 year), non-recent (≥1 year) and never testing for HIV, with a random effect for between-country effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on 2021 surveillance data, the estimated number of individuals with HIV is 24 895, with 2236 individuals undiagnosed (9%). Countries differ most on the first pillar of the 95–95-95 goals: 95–93–96 in the Dutch, 90–98-96 in the German and 96-94-97 in the Belgian EMR-region, respectively. In EMIS-2017, half of MSM (<i>n</i> = 1335/2669) tested recently, 26% tested not-recently (<i>n</i> = 693) and 24% (<i>n</i> = 641) never tested for HIV; with 8% of HIV-testing variance explained by between-country differences. Non-recent and never-testing were both associated with socio-demographic factors, suggesting that some key populations (e.g., with transgender identity) and lack of resources determined differences in HIV testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Targeted approaches to address regional and socio-demographic differences are urgently needed, especially to tackle HIV-testing barriers and reach individuals undiagnosed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1443-1459"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163139","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":"Prior PrEP use and discontinuation in individuals newly diagnosed with HIV","authors":"Rohan Saini,&nbsp;Sarah Fidler,&nbsp;Marta Boffito,&nbsp;Vicky Tittle,&nbsp;Nicolo Girometti,&nbsp;Gary Whitlock,&nbsp;the Dean Street Collaborative Group","doi":"10.1111/hiv.70262","DOIUrl":"10.1111/hiv.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In settings with high uptake of HIV pre-exposure prophylaxis (PrEP), an increasing proportion of individuals newly diagnosed with HIV report prior PrEP exposure. Understanding patterns of PrEP use, discontinuation and adherence in such settings is essential to inform future HIV prevention strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective case-note review of individuals newly diagnosed with HIV at 56 Dean Street, London, UK, between 1 January 2017 and 31 December 2024. Data collected included demographics, prior PrEP use, adherence and reasons for discontinuation and baseline blood results. Individuals with prior PrEP use were compared with those who had never used PrEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1080 individuals newly diagnosed with HIV, 210 (19.4%) reported prior PrEP use. The annual proportion with prior PrEP use increased from 4.3% in 2017 to 60.5% in 2024. Compared with never-PrEP users, those with prior PrEP use were more likely to have recently acquired HIV (85.7% vs. 58.2%, <i>p</i> &lt; 0.00001), to have previously attended the clinic (70.0% vs. 37.7%, <i>p</i> &lt; 0.00001) and to have undergone more frequent HIV testing. Among prior PrEP users, 36.2% reported PrEP discontinuation, and in those who had not discontinued PrEP at diagnosis, 73.5% reported poor adherence. The most common reasons for discontinuation were lack of PrEP supply, monogamy and gastrointestinal side effects. The only major resistance mutation that showed a significant difference between the two groups was M184I/V: 27 (19.6%) in PrEP-exposed versus 7 (0.8%) in not-PrEP-exposed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this high-PrEP-uptake setting, a growing proportion of individuals newly diagnosed with HIV report prior PrEP use, most commonly characterized by discontinuation or suboptimal adherence. These findings highlight an ongoing unmet need for interventions that support PrEP persistence and continuity, including improved access pathways and alternative PrEP formulations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1434-1442"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194541","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":"Effect of dolutegravir on ‘Life's Simple 7’ cardiovascular risk factors: A longitudinal analysis from Tanzania","authors":"Gloria J. Manyangu,&nbsp;Bahati Wajanga,&nbsp;Bernard Desderius,&nbsp;Salama Fadhili,&nbsp;Megan Willkens,&nbsp;Christina Myalla,&nbsp;Godfrey A. Kisigo,&nbsp;George Praygod,&nbsp;Myung H. Lee,&nbsp;Robert N. Peck,&nbsp;Samuel Kalluvya,&nbsp;Lily D. Yan","doi":"10.1111/hiv.70267","DOIUrl":"10.1111/hiv.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We sought to investigate the differences and changes over time in Life's Simple 7 (LS7) and Pooled Cohort Equation (PCE) scores for cardiovascular diseases (CVD) risk by HIV status in the Mwanza HIV&amp;CVD Cohort from three outpatient, facility-based HIV clinics in urban Tanzania.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Longitudinal comparative cohort study of people with HIV and people without HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>People with HIV were enrolled at HIV diagnosis before antiretroviral therapy (ART) initiation and followed after 2 years of dolutegravir (DTG) exposure. The differences LS7 metrics by HIV status were measured. Each LS7 metric was categorized as ideal (2 points), intermediate (1 point) and poor (0 point). PCE risk score was categorized as low (&lt;5%), intermediate (5% to &lt;7.5%) and high (≥7.5%). Changes over time in total LS7 score, individual LS7 metrics and PCE scores were examined in people with HIV from the pre-ART to post-DTG visits using ordinal logistic mixed-effects regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 832 (402 people with HIV/430 people without HIV) participants were included in this analysis. Mean age was 39 (SD 10) years and 70% were female. At the post-DTG visit, mean LS7 score was 10.5 (SD 1.5), 44% of participants had ideal cardiovascular health (CVH), and mean PCE score was 2.3% (SD 3.0%). People with HIV versus people without HIV had higher odds of ideal blood pressure (BP) (adjusted odds ratio [aOR] = 1.50, 95% confidence interval [CI]: 1.14, 1.97), but 40% lower odds of achieving ideal physical activity (PA) (aOR = 0.60, 95% CI: 0.46, 0.79) during the post-DTG visit. People with HIV had a smaller increase in ideal BP compared to people without HIV, despite higher overall ideal BP at both visits. Most participants had a low PCE risk, though three times higher in males compared to females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Traditional CVD risk factors like BP and PA remain similar by HIV status during the first 2 years of DTG exposure. Further work is needed to encourage PA among people with HIV and incorporate BP monitoring into routine HIV care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1468-1478"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251388","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":"Examining pathways between stigma, extreme weather exposure, resource insecurities and ART adherence among young men who have sex with men and female sex workers living with HIV in Kampala, Uganda","authors":"Carmen H. Logie,&nbsp;Ying Wang,&nbsp;Moses Okumu,&nbsp;Jingchuan Fan,&nbsp;Frannie MacKenzie,&nbsp;Gerald Pande,&nbsp;Aidah Nakitende,&nbsp;Brenda Katisi,&nbsp;Peter Kyambadde,&nbsp;Lawrence Mbuagbaw,&nbsp;Amaya Perez-Brumer,&nbsp;Caetano Dorea,&nbsp;Lesley Gittings,&nbsp;Paul Bukuluki,&nbsp;Julien Brisson","doi":"10.1111/hiv.70275","DOIUrl":"10.1111/hiv.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Stigma is multidimensional and undermines HIV care. We examined socio-environmental pathways linking HIV-related stigma, everyday discrimination and structural stigma to antiretroviral therapy (ART) adherence among men who have sex with men (MSM) and female sex workers (FSW) living with HIV in Kampala, Uganda.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional survey (06/2024–02/2025) among MSM and FSW aged 18–35 receiving HIV services from a key population clinic in Kampala. ART adherence was assessed using the Wilson 3-item adherence scale. We conducted stratified multivariable linear regression and multi-group structural equation modelling (SEM) to estimate direct and indirect associations from stigma to adherence through socio-environmental stressors (traumatic exposure severity to extreme weather [TESS], food insecurity, water insecurity), adjusted for socio-demographic variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants included MSM (<i>n</i> = 225, mean age: 27.65, standard deviation [SD] = 3.54) and FSW (<i>n</i> = 240, mean age: 25.68, SD: 2.90). SEM showed acceptable fit. In adjusted SEM analyses (a) among MSM, higher TESS, HIV-related stigma and everyday discrimination were directly associated with lower ART adherence and (b) among FSW, higher TESS, HIV-related stigma, water and food insecurity were directly associated with lower ART adherence. There were significant indirect associations between HIV-related stigma and ART adherence via TESS for FSW and MSM, and between everyday discrimination and structural stigma with ART adherence via TESS for MSM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stigma and socio-environmental stressors, including traumatic exposure to extreme weather events, were associated with reduced ART adherence among MSM and FSW participants. Population-tailored HIV care interventions may benefit from integrating intersectional stigma reduction with economic and disaster preparedness supports.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1503-1516"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382045","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}