JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

A Novel Method for Assessing Poor Quality of Life Among People With HIV. 一种评估艾滋病毒感染者生活质量低下的新方法。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-06-01 DOI: 10.1097/QAI.0000000000003644

Sharoda Dasgupta, Yunfeng Tie, Kate Buchacz, Linda J Koenig, Jen-Feng Lu, Linda Beer

{"title":"A Novel Method for Assessing Poor Quality of Life Among People With HIV.","authors":"Sharoda Dasgupta, Yunfeng Tie, Kate Buchacz, Linda J Koenig, Jen-Feng Lu, Linda Beer","doi":"10.1097/QAI.0000000000003644","DOIUrl":"10.1097/QAI.0000000000003644","url":null,"abstract":"Background: The US National HIV/AIDS Strategy prioritizes improving quality of life (QoL) among people with HIV (PWH) but co-occurrence of different aspects of QoL is not well described. We developed and applied a novel, multi-item assessment of poor QoL among PWH and examined associations with selected outcomes.Setting: 2018-2021 CDC Medical Monitoring Project data on 15,855 U.S. PWH.Methods: The poor QoL index, measured by the number of indicators of poor QoL experienced included: poor/fair self-rated health, unmet needs for mental health services, and subsistence needs (hunger/food insecurity, unstable housing/homelessness, and unemployment). Score distributions were analyzed alongside data on individual QoL indicators. Associations with selected adverse outcomes were assessed, including not being retained in care, missing ≥1 HIV medical appointments, missing ≥1 ART dose, not having sustained viral suppression, and having ≥1 emergency room visit or ≥1 hospitalization.Results: Overall, 55.1% of PWH had ≥1 indicator of poor QoL; 8.4% had ≥3 indicators. Over a quarter (26.5%) of people who inject drugs experienced ≥3 indicators of poor QoL. A large percentage of people aged 18-24 years had subsistence needs; 36.4% of Black women had poor/fair self-rated health. After adjusting for age, race/ethnicity, and sex, higher poor QoL index scores-and each indicator of poor QoL-were associated with worse outcomes.Conclusions: We demonstrated the utility in using the poor QoL index to identify those at higher risk of experiencing health challenges. Expanding national recommendations to include this QoL assessment could help in meeting National HIV/AIDS Strategy goals for improving PWH's well-being.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"99-106"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567135","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}

引用次数: 0

Brief Report: Behavioral Readiness for Daily Oral PrEP in a Diverse Sample of Gay, Bisexual, and Other Men Who Have Sex With Men Who Have Not Been Offered PrEP by a Provider. 同性恋、双性恋和其他与男性发生过性行为但未接受过PrEP的男性的日常口服PrEP行为准备情况

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-06-01 DOI: 10.1097/QAI.0000000000003650

Krishna Kiran Kota, Gordon Mansergh, Neal Carnes, Deborah Gelaude

{"title":"Brief Report: Behavioral Readiness for Daily Oral PrEP in a Diverse Sample of Gay, Bisexual, and Other Men Who Have Sex With Men Who Have Not Been Offered PrEP by a Provider.","authors":"Krishna Kiran Kota, Gordon Mansergh, Neal Carnes, Deborah Gelaude","doi":"10.1097/QAI.0000000000003650","DOIUrl":"10.1097/QAI.0000000000003650","url":null,"abstract":"Background: Daily oral pre-exposure prophylaxis (PrEP) use among gay, bisexual, and other men who have sex with men (GBMSM) remains suboptimal. Assessing behavioral readiness for PrEP use among GBMSM who can benefit and offering PrEP may increase uptake among GBMSM. We measured 4-item readiness for taking PrEP among GBMSM who have not been offered PrEP by a provider.Methods: GBMSM in Atlanta, Chicago, and Raleigh-Durham reporting recent condomless anal sex were assessed for \"readiness\" to discuss PrEP with a provider, test for HIV, take a daily pill, attend provider appointments, and a 4-component composite score for PrEP readiness. χ 2 tests and multivariable logistic regression were applied to examine factors associated with readiness to use PrEP.Results: Study sample (n = 187) was 51% Black/African American, 15% Hispanic/Latino, 30% identified as bisexual or straight or other, and 29% had no health insurance. In total, 55% said they were ready to discuss PrEP with a provider, 88% were ready to get an HIV test, 45% were ready to take a daily pill, 48% were ready to attend appointments, and 37% reported overall PrEP readiness. Having no health insurance was associated with readiness for a daily pill [adjusted odds ratio (AOR) = 2.78, confidence interval (CI) = 1.34-5.78] and 4-item PrEP readiness (AOR = 2.34, CI = 1.13-4.85). Self-identification as gay (vs bisexual/straight) was associated with readiness to discuss PrEP (AOR = 2.14, CI = 1.05-4.36).Conclusions: Only 37% of GBMSM with recent condomless anal sex were ready for PrEP based on the 4-item readiness. Readiness may differ based on sexual identity, insurance status, and other characteristics. Efforts are needed to increase readiness across behavioral components of PrEP use.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"123-127"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407833","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}

引用次数: 0

Impact of Depression at HIV PrEP Initiation on Sustained PrEP Care Engagement Among US Gay and Bisexual Men. 在美国同性恋和双性恋男性中，HIV PrEP开始时抑郁对持续PrEP护理参与的影响。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-15 DOI: 10.1097/QAI.0000000000003698

Udodirim N Onwubiko, David Benkeser, David P Holland, Stefan D Baral, Julia L Marcus, Kenneth H Mayer, Brian Herrick, Pranay Sinha, Allison T Chamberlain, Samuel M Jenness

{"title":"Impact of Depression at HIV PrEP Initiation on Sustained PrEP Care Engagement Among US Gay and Bisexual Men.","authors":"Udodirim N Onwubiko, David Benkeser, David P Holland, Stefan D Baral, Julia L Marcus, Kenneth H Mayer, Brian Herrick, Pranay Sinha, Allison T Chamberlain, Samuel M Jenness","doi":"10.1097/QAI.0000000000003698","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003698","url":null,"abstract":"Background: The effectiveness of pre-exposure prophylaxis (PrEP) in preventing HIV depends on consistent use, particularly during periods of increased risk. Depression, which disproportionately affects gay, bisexual, and other men who have sex with men (GBMSM), may hinder sustained PrEP engagement. This study examines how depression impacts consistent PrEP use among GBMSM in the first 18 months after initiating oral PrEP.Methods: We analyzed electronic health records for adult GBMSM prescribed oral PrEP between January 2015 and February 2022 at three clinics in Boston, MA. Participants were followed for 18 months after initial prescriptions, tracking three outcomes: temporary prescription gaps (interruptions in received prescriptions), dropping out of current PrEP care (cessation of prescriptions) and HIV seroconversion. Associations between baseline depression diagnosis and these outcomes were estimated using subdistribution and cause-specific Cox proportional hazards regression models.Results: Among 8,077 GBMSM prescribed oral PrEP, 19% had a baseline depression diagnosis. Of these, 41% experienced gaps, 38% dropped out, and 0.4% seroconverted without a prior gap. Depression was modestly associated with higher rates of PrEP disruptions (Prescription gaps: Adjusted hazard ratio [aHR] 1.10 [95% CI: 1.00, 1.20]; Dropping out: aHR 1.16 [95% CI: 1.05, 1.28]) after adjusting for age, race/ethnicity, urbanicity, high-risk sexual behavior, poverty, and bacterial STI diagnoses. However, it did not significantly impact the cumulative incidence of PrEP interruptions.Conclusions: Although depression's impact on PrEP use was modest, integrating mental health care into PrEP programs remains essential for improving engagement and supporting sustained use among GBMSM.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077915","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}

引用次数: 0

Out-of-pocket costs for PrEP ancillary services among U.S. commercially insured persons, 2017-2022. 2017-2022年美国商业参保人员PrEP辅助服务的自付费用。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-14 DOI: 10.1097/QAI.0000000000003695

Ya-Lin A Huang, Rupa R Patel, Laura M Mann, Weiming Zhu, Amy Killelea, Karen W Hoover

{"title":"Out-of-pocket costs for PrEP ancillary services among U.S. commercially insured persons, 2017-2022.","authors":"Ya-Lin A Huang, Rupa R Patel, Laura M Mann, Weiming Zhu, Amy Killelea, Karen W Hoover","doi":"10.1097/QAI.0000000000003695","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003695","url":null,"abstract":"Background: We assessed annual out-of-pocket (OOP) costs for HIV preexposure prophylaxis (PrEP)-related services among commercially insured individuals in the U.S. before and after the Affordable Care Act (ACA) mandated no cost-sharing in 2021.Methods: Using data from a large commercial database, we identified persons aged ≥18 years who were prescribed PrEP from 2017-2022. Medical claims for PrEP-related services submitted within one week before each PrEP prescription were extracted using CPT codes. For each service, we calculated the annual proportion of persons incurring OOP costs and associated annual amounts, adjusted to 2022 U.S. dollars. We assessed trends in the proportion of persons with OOP costs for each service from 2019-2022. We also examined the association between OOP cost occurrence and patient demographic characteristics.Results: Among 141,300 PrEP users, we observed decreasing trends in the proportion incurring OOP costs for PrEP ancillary services over the study period. In 2022, OOP costs were incurred by 65.6% for provider visits, 14.3% for HIV testing, and 32.5% for creatinine testing, with mean OOP costs of $54.18, $26.06, and $6.07, respectively. Rural users were more likely to incur costs than urban users.Conclusions: Despite ACA mandates, many persons received cost-sharing bills for PrEP services. Standardized billing and coding, along with enhanced monitoring and enforcement, could help protect access to evidence-based preventive care.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996976","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}

引用次数: 0

Association between changes in script renewal periods and HIV viral non-suppression: a cohort study of a South African private-sector HIV program. 脚本更新周期变化与HIV病毒非抑制之间的关系：南非私营部门HIV项目的队列研究。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-14 DOI: 10.1097/QAI.0000000000003697

Gabriela Patten, Andreas D Haas, Mary-Ann Davies, Gary Maartens, Chido Chinogurei, Naomi Folb, Reshma Kassanjee

{"title":"Association between changes in script renewal periods and HIV viral non-suppression: a cohort study of a South African private-sector HIV program.","authors":"Gabriela Patten, Andreas D Haas, Mary-Ann Davies, Gary Maartens, Chido Chinogurei, Naomi Folb, Reshma Kassanjee","doi":"10.1097/QAI.0000000000003697","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003697","url":null,"abstract":"Introduction: Evidence is needed to inform differentiated service delivery models for people with HIV (PWH). During the COVID-19 pandemic, South Africa temporarily changed the validity of repeat prescriptions for ART from 6 to 12 months. We evaluated the association between these changes and HIV viral non-suppression in the private health sector.Methods: We analysed routine claims data from a large private-sector HIV management programme. PWH aged >15 years from 4 months after first ART evidence were included. We conducted an interrupted time-series analysis comparing trends in the proportions of PWH with viral non-suppression (viral load ≥50 copies/mL) during three periods: January 1, 2019 to April 23, 2020 (conventional 6-monthly script renewal); April 24, 2020 to September 25, 2021 (12-monthly renewal); and September 26, 2021 to November 30, 2022 (6-monthly renewal re-instated). We used weighting to maintain the age, sex, ART regimen and medical scheme distributions of our study population over time.Results: Monthly odds of viral non-suppression initially decreased by 4% per annum (adjusted odds ratio (aOR) 0.96, 95% confidence interval (CI) 0.93-0.99). During 12-monthly renewal, there were steeper declines of 11% per annum (aOR 0.89, 95% CI 0.87-0.91). After 6-monthly renewal was re-introduced, viral non-suppression instead increased by 6% per annum (aOR 1.06 95% CI 1.03-1.09). Changes in slopes were significant (p-values <0.001).Conclusion: Measures implemented during COVID-19 to ensure continued access to chronic medication provided unique evidence for models involving less frequent clinical visits. Extending prescription renewal periods was not associated with worse virologic outcomes among privately-insured PWH.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010348","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}

引用次数: 0

Investigation of Integrase Inhibitor Resistance Mutations in gp41 in Clinical Samples. 临床样本中gp41整合酶抑制剂耐药突变的研究。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-13 DOI: 10.1097/QAI.0000000000003694

Hanwei Sudderuddin, Zhong Dang, Birgit Watson, Kieran Atkinson, Anh Le, Paul Sereda, Zabrina L Brumme, Chanson J Brumme

{"title":"Investigation of Integrase Inhibitor Resistance Mutations in gp41 in Clinical Samples.","authors":"Hanwei Sudderuddin, Zhong Dang, Birgit Watson, Kieran Atkinson, Anh Le, Paul Sereda, Zabrina L Brumme, Chanson J Brumme","doi":"10.1097/QAI.0000000000003694","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003694","url":null,"abstract":"Background: Mutations conferring resistance to HIV Integrase Strand Transfer Inhibitors (INSTI) can occur outside integrase, including in env gp41, in vitro, but it remains unclear whether these arise under INSTI selection in vivo.Methods: Using a large database of clinically-derived HIV sequences linked to antiretroviral treatment histories, we sought to identify mutations in gp41 associated with INSTI exposure by comparing integrase and gp41 amino acid frequencies in INSTI-naïve versus INSTI-treated individuals. Gp41 was investigated because this region is routinely sequenced to assess fusion inhibitor resistance.Results: We identified 72 individuals with subtype B HIV for whom a genotypic INSTI resistance test performed after ≥3 months of INSTI exposure revealed susceptibility to all INSTIs (HIVdb v8.8; score<15), and for whom plasma INSTI concentrations were detectable by mass spectrometry. Gp41 sequencing was successful for 52 (72%) of these. The median INSTI exposure duration in this group was 20 (Q1-Q3:10-39) months, with raltegravir (>54%), dolutegravir (52%) and elvitegravir (23%) being the most frequently prescribed. Comparison of gp41 amino acid frequencies between this group and a comparison group of 1221 gp41 sequences from INSTI- naïve individuals using Fisher's exact test with Benjamini-Hochberg correction for multiple comparisons identified the gp41 substitution V182I (OR=3.75, p=2.2x10-4, q=0.01) as over-represented among INSTI-treated persons. When comparing gp41 sequences pre- and post-INSTI therapy in this group however, no evidence of INSTI-driven selection was observed at this position.Conclusion: While off-target INSTI substitutions may arise in vivo, there is currently insufficient evidence to recommend expanding INSTI resistance testing to include Env.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010401","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}

引用次数: 0

Vaccine effectiveness against anal HPV infection among men with HIV who have sex with men attending sexual health clinics in three United States cities, 2018-2023. 2018-2023年，在美国三个城市的性健康诊所就诊的男男性行为者中，疫苗对肛门HPV感染的有效性。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-08 DOI: 10.1097/QAI.0000000000003691

Carla L DeSisto, Damilola Dada, Preeti Pathela, Rachel L Winer, Lenore Asbel, Troy D Querec, John Lin, Jennifer Tang, Alfred Iqbal, Elissa Meites, Elizabeth R Unger, Lauri E Markowitz

{"title":"Vaccine effectiveness against anal HPV infection among men with HIV who have sex with men attending sexual health clinics in three United States cities, 2018-2023.","authors":"Carla L DeSisto, Damilola Dada, Preeti Pathela, Rachel L Winer, Lenore Asbel, Troy D Querec, John Lin, Jennifer Tang, Alfred Iqbal, Elissa Meites, Elizabeth R Unger, Lauri E Markowitz","doi":"10.1097/QAI.0000000000003691","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003691","url":null,"abstract":"Background: Men who have sex with men (MSM) with HIV are disproportionately affected by human papillomavirus (HPV) and related diseases. We assessed HPV vaccine effectiveness (VE) against anal HPV among MSM with HIV.Methods: During 2018-2023, residual anal specimens from MSM with HIV, aged 18-45 years, attending sexual health clinics in three U.S. cities were collected and tested for HPV. Demographic and vaccination information were obtained from clinic records or immunization registries. Timing of vaccination relative to HIV acquisition was unknown. Log-binomial regression was used to calculate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for associations between vaccination (≥1 dose) and quadrivalent vaccine (4vHPV)-type infection, adjusting for city. Models were stratified by age group (18-26, 27-45 years). VE was calculated as (1-aPR) x 100.Results: Among 224 persons aged 18-26 years, 54% were vaccinated. Compared with unvaccinated persons, 4vHPV-type prevalence was lower in those vaccinated at age <18 (aPR=0.31, 95% CI:0.14-0.72, VE=69%) and ≥2 years before specimen collection (aPR=0.54, 95% CI:0.31-0.92, VE=46%). Among 700 persons aged 27-45 years, 17% were vaccinated. Compared with unvaccinated persons, 4vHPV-type prevalence was lower in those vaccinated at ages 18-26 (aPR=0.63, 95% CI:0.45-0.89, VE=37%) and ≥2 years before specimen collection (aPR=0.63, 95% CI:0.46-0.86, VE=37%).Conclusions: While timing of vaccination relative to HIV acquisition was unknown, we found significant VE against prevalent HPV infection in adult MSM with HIV. Within each age group, VE was higher with younger age at vaccination.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063818","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}

引用次数: 0

Randomized Clinical Trial of High Intensity Exercise in People with HIV: Effects on Muscle Composition and Inflammation. HIV感染者高强度运动的随机临床试验：对肌肉成分和炎症的影响。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-08 DOI: 10.1097/QAI.0000000000003692

Alice S Ryan, Brandon C Briggs, Alicia J Lozano, Ali Iranmanesh, Krisann K Oursler

{"title":"Randomized Clinical Trial of High Intensity Exercise in People with HIV: Effects on Muscle Composition and Inflammation.","authors":"Alice S Ryan, Brandon C Briggs, Alicia J Lozano, Ali Iranmanesh, Krisann K Oursler","doi":"10.1097/QAI.0000000000003692","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003692","url":null,"abstract":"Background: Myosteatosis affects muscle strength and mobility function, and further is associated with inflammation, yet there is limited work examining the effects of exercise training in people with HIV (PWH).Methods: We conducted a randomized trial of 16-weeks aerobic exercise and resistance training (AEX+RT) compared to standard of care control in PWH ≥50 years of age. Muscle area, intramuscular adipose tissue (IMAT), and muscle density (Hounsfield units) of the mid-thigh was determined by computed tomography. Inflammatory markers included IL-6, hsCRP, TNF-α, and IL-18.Results: Among participants randomized to AEX+RT (N=17) or control (N=16), the mean (SD) age was 60.1(6.7) years, and the majority identified as black (70%) and men (91%). Significant between-group differences were found for muscle area (+7.5% vs. -3.1%, p<0.01), muscle density (+5.2% vs. -0.3%, p<0.01), and leg strength (+51.8% vs. +1.3%, (p<0.001). The decrease in IMAT after AEX+RT did not reach significance (-6.7%, p=0.07). There was no change in body weight or abdominal adiposity. At baseline, muscle density significantly correlated inversely with TNF-α and IL-6. There was a significant correlation between IMAT and inflammatory markers except IL-18. There were no significant between-group differences in changes in inflammatory markers. Percent change in inflammatory measures did not correlate with change in muscle measures.Conclusion: Combined AEX+RT increased thigh muscle density, size, and strength in older PWH. Baseline association of muscle density and IMAT with inflammation underscores the need for further work in larger, more diverse populations to target underlying mechanisms for improvements in muscle quality in PWH.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981143","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}

引用次数: 0

Barriers to Rapid Enrollment and ART Initiation Among U.S. HIV Care Facilities. 在美国艾滋病毒护理机构中快速登记和开始抗逆转录病毒治疗的障碍。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-08 DOI: 10.1097/QAI.0000000000003690

Jesse O'Shea, Xin Yuan, Jen-Feng Lu, Kate Buchacz, Kashif Iqbal, Marie Johnston, Linda Beer, John Weiser

{"title":"Barriers to Rapid Enrollment and ART Initiation Among U.S. HIV Care Facilities.","authors":"Jesse O'Shea, Xin Yuan, Jen-Feng Lu, Kate Buchacz, Kashif Iqbal, Marie Johnston, Linda Beer, John Weiser","doi":"10.1097/QAI.0000000000003690","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003690","url":null,"abstract":"Background: Rapid linkage to HIV care and antiretroviral therapy (ART) initiation is now the standard of care for treating people with HIV (PWH). Understanding and intervening on barriers to rapid enrollment and ART initiation are needed to meet the goals of the Ending the HIV Epidemic in the U.S. initiative.Methods: We analyzed 2021 data from the Medical Monitoring Project on characteristics of 455 facilities providing care to a national probability sample of U.S. PWH.Results: Overall, only 19.9% (95% CI 16.0%-23.9%) of HIV facilities could routinely offer a first appointment in <1 business day (rapid enrollment). The most commonly reported barriers to rapid enrollment were insufficient provider capacity (56%), patient preference (50%), and patients lacking required documents (19%). The most commonly reported documents required for enrollment were positive HIV antibody or detectable viral load (52%), government-issued identification (36%), proof of residence (24%), and proof of income (22%). RWHAP-funded facilities more frequently required these documents than non-RWHAP-funded facilities. Most facilities (73%) were routinely able to obtain a 30-day supply of ART during the first HIV care provider visit (rapid ART initiation). The most commonly reported barriers to rapid ART included unavailable test results (56%), delays in getting medication paid for (49%), unavailable starter packs (36%), inability to afford copayment (31%), and patient preference (29%).Conclusion: Structural, provider-related, or patient-level barriers may delay rapid clinic enrollment or ART initiation. HIV care programs can benefit from removing barriers to care, easing requirements for clinical enrollment and ART prescriptions, and improving patient readiness.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006240","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}

引用次数: 0

High HIV Testing Among Black/Latino Men Who Have Sex with Men Assigned to HIV Self-Testing in a National Randomized Controlled Trial. 在一项全国随机对照试验中，黑人/拉丁裔男男性行为者中HIV检测率高。

IF 2.9 3区医学

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-08 DOI: 10.1097/QAI.0000000000003693

John Guigayoma, Katie Biello, Sara J Becker, Erik Ocean, Lori Ward, Philip A Chan, Jeffrey Klausner, Tyler Wray

{"title":"High HIV Testing Among Black/Latino Men Who Have Sex with Men Assigned to HIV Self-Testing in a National Randomized Controlled Trial.","authors":"John Guigayoma, Katie Biello, Sara J Becker, Erik Ocean, Lori Ward, Philip A Chan, Jeffrey Klausner, Tyler Wray","doi":"10.1097/QAI.0000000000003693","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003693","url":null,"abstract":"Background: Black/Latino men who have sex with men (MSM) in the United States have high rates of undiagnosed HIV infection. To assess whether HIV self-testing increases HIV screening among Black/Latino MSM and how HIV self-testing for Black/Latino MSM compares to White MSM, we analyzed data from a 12-month randomized controlled trial.Methods: Participants were randomized to quarterly allocation of: HIV testing reminders (control, no HIV self-tests), home delivery of rapid HIV self-tests (standard HIV self-test), or home delivery with counseling 24 hours after opening tests (eTest). In this secondary analysis, we used Poisson regression models to evaluate HIV testing rates for the different approaches among Black/Latino MSM compared to White MSM.Results: Of a final analytical sample of 713 participants, 353 were White MSM and 360 were Black/Latino MSM. In all approaches, we found no evidence of differences in HIV testing between White MSM and Black/Latino MSM. Predicted probabilities indicated higher testing among Black/Latino MSM assigned to the HIV self-test conditions compared to Black/Latino MSM in the control condition. The probabilities of any HIV testing among Black/Latino MSM in the standard HIV self-test, eTest, and control conditions were 92%, 90%, and 58%, respectively (all p<.05).Conclusions: Results from this randomized controlled trial suggest that Black/Latino MSM use HIV self-tests at high rates and found no evidence that HIV self-test use differs between Black/Latino MSM and White MSM. Implementation science research is needed to increase the availability of HIV self-tests for all MSM, especially underserved populations such as Black/Latino MSM.","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005661","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}

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