International Journal of STD & AIDS最新文献

{"title":"Understanding the sources of efficacy dilution in a trial of a monthly dapivirine vaginal ring for HIV-1 prevention.","authors":"Kathryn Peebles, Laura Matrajt, Jared M Baeten, Thesla Palanee-Phillips, Elizabeth R Brown","doi":"10.1177/09564624241300199","DOIUrl":"10.1177/09564624241300199","url":null,"abstract":"<p><strong>Introduction: </strong>Women-initiated HIV - 1 prevention products are key to reducing women's HIV-1 risk. Clinical trials of vaginal microbicides have shown limited to no efficacy in intention-to-treat (ITT) analyses. It is hypothesized that these negative results are partly due to efficacy dilution.</p><p><strong>Methods: </strong>We developed a microsimulation model of MTN-020/ASPIRE, a phase 3 trial that evaluated monthly use of a dapivirine vaginal ring for HIV-1 prevention. We evaluated four sources of efficacy dilution: trial-level factors: (i) an imbalance in the number of monthly sex acts between study arms and (ii) heterogeneity in risk emergent over time; and individual-level factors: (iii) product non-adherence and (iv) receptive anal intercourse.</p><p><strong>Results: </strong>Assuming 70% per-vaginal exposure efficacy (consistent with the ITT estimate of 27%), heterogeneity in risk accounted for the largest proportion of efficacy dilution, at 42% (90% CrI: 38, 45), followed by non-adherence (33%; 90% CrI: 27, 39), an imbalance in arms (18%; 90% CrI: 16, 21) and lastly, anal intercourse with less than 10% of efficacy dilution.</p><p><strong>Conclusion: </strong>Our results suggest that heterogeneity in risk was the most important source of efficacy dilution in the ASPIRE trial. Future trials of HIV-1 prevention products for women should consider alternative trial designs and analytic approaches that minimize bias introduced by heterogeneity in risk.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"195-204"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728695","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":"Angiopoietin-2 and endothelial damage associated with viral load in untreated people living with HIV.","authors":"Paulo Pacelli Bezerra Filizola Tôrres, Gdayllon Cavalcante Meneses, Lana Andrade Lucena Lima, Nicole Coelho Lopes, Leticia Machado de Araújo, Katarina Maria Dos Reis Araújo, Rayane Nascimento de Souza, Raoni de Oliveira Domingues-da-Silva, Alice Maria Costa Martins, Elizabeth De Francesco Daher, Geraldo Bezerra da Silva Junior","doi":"10.1177/09564624251323681","DOIUrl":"https://doi.org/10.1177/09564624251323681","url":null,"abstract":"<p><strong>Background: </strong>HIV infection is associated with various types of endothelial damage. Early and accurate diagnosis of endothelial dysfunction may help prevent adverse outcomes. For the first time, this cross-sectional study aims to investigate the effects of increased viral load on endothelial damage and nephrinuria in untreated people living with HIV.</p><p><strong>Methods: </strong>People living with HIV not on treatment were included. Laboratory parameters, such as viral load and CD4 count were collected. Participants were divided into three groups according to the tertiles of viral load: low, moderate and high viral load groups. Urinary nephrin, vascular cell adhesion molecule 1 (VCAM-1), angiopoietin-2 and syndecan-1 were quantified by sandwich ELISA assays kits.</p><p><strong>Results: </strong>A total of 49 patients were examined. The high viral load group (3rd tertile) exhibited a greater frequency of nephrinuria and significantly higher levels of syndecan-1 (58 [48-93] vs 43 [38-65] ng/mL, <i>p</i> = .049) and angiopoietin-2 (2.58 [1.5-3.06] vs 1.34 [0.89-1.76] ng/mL, <i>p</i> = .035). Syndecan-1 levels positively correlated with viral load (rho = 0.452, <i>p</i> = .006), while angiopoietin-2 was positively correlated with viral load (rho = 0.529, <i>p</i> = .001) and inversely correlated with CD4 count (rho = -0.493, <i>p</i> = .003). No significant associations were found for VCAM-1 levels.</p><p><strong>Conclusion: </strong>Untreated people living with HIV with elevated viral loads exhibited more pronounced endothelial damage and vascular inflammation, emphasizing the critical importance of early initiation of antiretroviral treatment to mitigate these complications. However, the study's findings should be interpreted with caution due to the small sample size, which may limit the generalizability of the results. Future studies with larger cohorts are needed to confirm these findings.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"9564624251323681"},"PeriodicalIF":1.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523307","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":"Barriers to HIV pre-exposure prophylaxis uptake for men who have sex with both men and women: A global scoping review.","authors":"Jodie Crossman, Daniel Richardson","doi":"10.1177/09564624251321564","DOIUrl":"https://doi.org/10.1177/09564624251321564","url":null,"abstract":"<p><strong>Background: </strong>Although PrEP is a highly effective HIV prevention method, some groups are underrepresented in PrEP uptake. Much HIV prevention research groups gay, bisexual and other men who have sex with men together; however, men who have sex with both men and women (MSWM) may have needs distinct from those who identify as exclusively gay. This scoping review aims to explore documented barriers to PrEP use among MSWM.</p><p><strong>Methods: </strong>Literature was searched using four databases. Studies were included if data referring to MSWM were reported as a distinct category. Data were extracted using a standardised form, and findings were stratified into relevant categories of the social ecological framework.</p><p><strong>Results: </strong>Alongside intersectional barriers, MSWM were found to have lower awareness of PrEP, and access sexual health services less than men who have sex only with men. Those who did not identify with the LGBT community often missed out on health promotion messages for this group and were less likely to be offered HIV prevention interventions. MSWM identified more stigmatisation around PrEP use than gay men. However, when aware of PrEP, MSWM were very motivated to use this intervention.</p><p><strong>Conclusions: </strong>Not all MSM will identify within the LGBTQ + community and may miss out on valuable opportunities for HIV prevention. PrEP information should be widely available in a variety of health and community settings. Health care professionals should avoid assumptions when assessing patients and provide information about HIV and STI prevention to all attending sexual health services.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"9564624251321564"},"PeriodicalIF":1.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449023","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":"Granulomatous vulvitis complicated by polymicrobial growth.","authors":"Divya Madonna Dsouza, Jacintha Martis, Rochelle Cheryl Monteiro, Jyothi Jayaraman, Prajna Shetty","doi":"10.1177/09564624251318086","DOIUrl":"https://doi.org/10.1177/09564624251318086","url":null,"abstract":"<p><p>Granulomatous vulvitis (GV) is a rare chronic inflammatory condition presenting with persistent vulvar swelling and noncaseating granulomas, often mimicking Crohn's disease and sarcoidosis. We report a 21-year-old sexually inactive woman with a five-month history of painless vulvar swelling and occasional itching, complicated by secondary polymicrobial infection. A thorough evaluation excluded other granulomatous diseases, and histopathology revealed noncaseating granulomas, supporting the diagnosis of granulomatous vulvitis. Initial antibiotic therapy was followed by hydroxychloroquine, and intralesional triamcinolone, leading to marked symptom resolution. This case highlights intralesional corticosteroids as an effective first-line treatment and underscores the need for a multidisciplinary and personalized approach in managing GV, particularly in the presence of secondary infections.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"9564624251318086"},"PeriodicalIF":1.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189183","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":"Genital-oral transmission of <i>Candida lusitaniae</i>.","authors":"Stefano Veraldi, Paolo Bortoluzzi, Francesca Germiniasi, Anna Grancini","doi":"10.1177/09564624241296582","DOIUrl":"10.1177/09564624241296582","url":null,"abstract":"<p><p><i>Candida lusitaniae</i> is a vaginal commensal. Cases of vaginitis, vulvovaginitis and recurrent vulvovaginitis caused by this yeast are very rare. In the oral cavity, <i>C. lusitaniae</i> causes stomatitis in immunocompromised patients. We describe a case of stomatitis and angular cheilitis caused by <i>C. lusitaniae</i> in a female patient with type 2 diabetes. The infection was most likely transmitted following genital-oral intercourse with the patient's girlfriend, who was affected by <i>C. lusitaniae</i> vulvovaginitis.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"158-160"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV retesting among people living with HIV in Lesotho in 2022.","authors":"Spencer D Pogue, Suzue Saito, Mphotleng Tlhomola, Christine A West, Fred Asiimwe, Puleng Ramphalla, Eugenie Poirot, Claire Steiner, Abigail R Greenleaf","doi":"10.1177/09564624241289984","DOIUrl":"10.1177/09564624241289984","url":null,"abstract":"<p><strong>Background: </strong>Despite widespread HIV testing in sub-Saharan Africa, regular testing among at-risk populations is crucial for effective prevention. However, reports increasingly indicate retesting among people living with HIV (PLHIV), a group that would not require additional testing since they would already have received a confirmed diagnosis. We describe the demographic characteristics of PLHIV retesters in Lesotho, report the average number of HIV tests post-diagnosis among PLHIV, and share motivations for retesting.</p><p><strong>Methods: </strong>In August 2022, a nationally representative cohort in Lesotho participated in a cell phone survey about their HIV status and testing history. Study participants were recruited from a face-to-face survey conducted in 2020, Lesotho Population Based HIV Impact Assessment survey.</p><p><strong>Results: </strong>Of the 1523 participants called, 1111 participants responded (72.9%) and 266 reported living with HIV. We found 18.8% of people living with HIV (PLHIV) reported retesting at least once for HIV, and 58% of PLHIV who reported retesting were likely or very likely to retest for HIV in the coming year. The main reason PLHIV reported retesting was because a health care worker offered the test (61.7%) followed by self-initiated testing to confirm their status (29.1%). Among male PLHIV who had a history of retesting, 92.0% were very likely or likely to retest, compared to only 30.6% of female PLHIV.</p><p><strong>Conclusion: </strong>We found almost a fifth of PLHIV in Lesotho reported a history of retesting for HIV, and 58% of PLHIV were likely or very likely to retest for HIV in the coming year. Educating providers and men living with HIV could reduce retesting among PLHIV.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"114-118"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Health interventions for HIV in Pakistan: Is it the only way out?","authors":"Muhammad Atique, Muhammad Abbas Abid","doi":"10.1177/09564624241299570","DOIUrl":"10.1177/09564624241299570","url":null,"abstract":"","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"170-171"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620437","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":"Effective management of multidrug-resistant HIV with lenacapavir and fostemsavir: A case study.","authors":"Francisca Bartilotti Matos, Dara Mbanze, Perpétua Gomes, Cristóvão Figueiredo, Daniel Coutinho, Sofia Nunes, Carlos Azevedo, Joana Fragoso, Tiago Teixeira, Luís Malheiro","doi":"10.1177/09564624241296583","DOIUrl":"10.1177/09564624241296583","url":null,"abstract":"<p><p>Resistance to antiretroviral therapy is an increasing challenge in the management of HIV. We present the case of a woman living with HIV, with a history of multiple treatment regimens and resistances to antiretrovirals, who has been successfully treated with a combination of lenacapavir and fostemsavir for the past year, obtaining an undetectable viral load within one month of starting therapy and reporting no serious side effects. This case is amongst the first to document the combined use of lenacapivir and fostemsavir in treating multidrug-resistant HIV. It supports the potential of these novel agents in managing complex cases of HIV resistance.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"161-163"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557836","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":"HIV risk perception and PrEP uptake among black MSM in Mississippi.","authors":"Fei Teng, Paul Burns, Michael Welsch, Weiming Tang, Benjamin Walker","doi":"10.1177/09564624241297830","DOIUrl":"10.1177/09564624241297830","url":null,"abstract":"<p><strong>Introduction: </strong>Rates for HIV are disproportionately higher for Black men who have sex with men (MSM) compared to other MSM in the U.S. While there is evidence that low perceived risk of HIV infection may increase HIV vulnerability, few studies have examined this relationship among Black MSM in the Southern U.S. where the HIV rates are the highest in the country. This study examined the association between perceived HIV risk and PrEP adoption among Black MSM in a medium-size city in Mississippi.</p><p><strong>Methods: </strong>Data were drawn from a subsample of the \"ACCELERATE!\" intervention, an innovative and sustainable community-driven project to improve health outcomes among Black MSM. The outcome of interest was PrEP uptake, a binary variable derived from responses to the question \"Have you taken PrEP in the last year?\". The perceived risk of HIV, an independent variable, is measured by self-report of an individual's assessment of their vulnerability of contracting HIV defined as low versus high risk. Covariates included age and socio-environmental factors (health insurance, incarceration and discrimination) Sample characteristics were provided using means and standard deviations for continuous variables and proportions for categorical variables. Exact logistic regression was used to assess the association between perceived HIV risk and PrEP adoption, adjusting for covariates.</p><p><strong>Results: </strong>A total of 84 HIV negative Black men with a median age of 30 (min = 18, max = 69) years were available for analyses. Approximately 16% of participants reported experiencing incarceration and 57% reported experiencing discrimination. Seven out of ten respondents reported having low perceived risk, and 28.6% (24/84) reported having high perceived risk for HIV. There were 73 participants (86.9%) who reported PrEP use in the last year. We observed a higher proportion of participants with high perceived risk that reported lower uptake of PrEP. After adjusting for age, socioeconomic variables, and risky sexual behaviors, higher levels of perceived risk of HIV were associated with decreased odds of PrEP uptake (OR = 0.20, 95% CI: 0.04-0.94, <i>p</i> = 0.040).</p><p><strong>Conclusion: </strong>The role of HIV risk perception on PrEP adoption is complex among Black MSM in Mississippi. Higher levels of perceived risk of HIV were associated with lower odds of PrEP adoption among Black MSM. This inverse relationship between HIV risk perception and PrEP adoption suggests social- and structural- factors play a critical role in decision-making on PrEP initiation among Black MSM in Jackson. In addition, further longitudinal studies are needed to understand the complex interactions between perceived risk and PrEP use.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"119-125"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583131","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":"The PrEP cascade in a sample of HIV-negative or unknown status adolescent and young adult transgender women in Peru.","authors":"Sari L Reisner, Dorothy Apedaile, Alfonso Silva-Santisteban, Leyla Huerta, Rodrigo Aguayo-Romero, Amaya Perez-Brumer","doi":"10.1177/09564624241272940","DOIUrl":"10.1177/09564624241272940","url":null,"abstract":"<p><strong>Background: </strong>Transgender women are a key population in the HIV epidemic globally, including in Peru. This cross-sectional epidemiological study characterized the pre-exposure prophylaxis (PrEP) cascade in adolescent and young adult transgender women in Peru to inform roll-out of early HIV prevention efforts.</p><p><strong>Methods: </strong>Between February-July 2022, a community-recruited sample of HIV-negative or status unknown young transgender women (<i>n</i> = 140) in Peru completed a socio-behavioral survey and biological testing for HIV and bacterial STIs. Logistic regression models estimated the association of sociodemographic, healthcare, and behavioral factors to PrEP indication and willingness.</p><p><strong>Results: </strong>Median age was 22 years (range = 16-24 years); 65.7% reported sex work and 28.6% homelessness. Overall, 45.7% had a PrEP indication based on past 6 months HIV behavioral risk profiles. In a multivariable model, sex work (aRR = 2.27; 95% CI = 1.24-4.17) and homelessness (aRR = 1.27; 95% CI = 1.00-1.60) were associated with PrEP indication. More than one-third (38.6%) had never been HIV tested; 25.3% were tested >1 year ago. Only 34.3% heard of daily oral PrEP, 8.6% reported ever PrEP use, and 5.0% current PrEP use. Nearly half (49.3%) reported willingness to take daily oral PrEP. In a multivariable model, younger age was associated with increased willingness to use PrEP (aRR = 0.92; 95% CI = 0.87-0.98). Highest ranked PrEP preferences were a daily oral pill (35.7%), implant (32.1%), and injection by a provider (10.0%).</p><p><strong>Conclusions: </strong>PrEP indication and willingness were high in this sample, but HIV testing and PrEP uptake were low. Findings highlight opportunities for age-responsive and contextually-relevant interventions to increase HIV prevention among young transgender women in Peru.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"141-150"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647706","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}