JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Incremental cost of pre- and post-exposure prophylaxis service provision via an online pharmacy in Kenya.","authors":"Yilin Chen, Michalina A Montaño, Paulami Naik, Nicholas Thuo, Catherine Kiptinness, Maeve Rafferty, Andy Stergachis, Melissa Latigo Mugambi, Kenneth Ngure, Katrina F Ortblad, Monisha Sharma","doi":"10.1097/QAI.0000000000003680","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003680","url":null,"abstract":"<p><strong>Background: </strong>Online pharmacy HIV pre- and post-exposure prophylaxis (PrEP/PEP) provision is a novel strategy to expand HIV prevention coverage. In the ePrEP pilot study, we found online pharmacy PrEP/PEP was feasible and reached populations at HIV risk in Kenya. However, program costs data are lacking.</p><p><strong>Methods: </strong>We conducted a costing within the ePrEP pilot study in Nairobi from 11/01/2022-12/29/2023. We obtained costs from expense reports and conducted time-and-motion observations and staff interviews. We estimated total and unit costs in the first year of implementation, cost per client and per PrEP client-month (2023 US Dollars (USD)).</p><p><strong>Results: </strong>Overall, 229 clients initiated PrEP (507 months of PrEP coverage) and 1320 initiated PEP. Based on observed program volume, annual financial cost was $109,945 USD (PrEP: $19,456; PEP: $90,489). Cost per client was higher for PrEP than PEP ($85 vs $68.6), and cost per PrEP client-month was $38 (mean duration: 2.2 months). Main drivers of financial costs were courier-delivery of HIV testing kits and drugs (PrEP: 50.6%; PEP: 40.5%), demand generation (PrEP: 25.9%; PEP: 32.1%), and equipment, system development, and utilities (PrEP: 9.3%; PEP: 9.8%). Assuming a scaled-up client volume of 2500 (PrEP: 370; PEP: 2130) reduced per-client financial costs for PrEP ($65.5) and PEP ($56) and cost per PrEP client-month ($29.6).</p><p><strong>Conclusions: </strong>Costs of online PrEP/PEP provision is likely higher than clinic-based PrEP. Implementing cost sharing models including charging clients for HIV testing and optimizing courier delivery routes can increase program efficiencies. Our cost estimates can inform economic evaluations of online PrEP/PEP delivery.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810975","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 HIV preexposure prophylaxis use before and after launch of the Ending the HIV Epidemic in the U.S. initiative, 2016-2023.","authors":"Weiming Zhu, Ya-Lin A Huang, Athena P Kourtis, Robyn Neblett-Fanfair, Jonathan Mermin, Karen W Hoover","doi":"10.1097/QAI.0000000000003674","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003674","url":null,"abstract":"<p><strong>Introduction: </strong>The Ending the HIV Epidemic in the U.S. (EHE) initiative was launched by the U.S. Department of Health and Human Services in 2019 with the goal of decreasing new HIV infections 90% by 2030. Increasing the use of HIV preexposure prophylaxis (PrEP) is one of the EHE strategies. We assessed the impact of EHE activities on PrEP use.</p><p><strong>Methods: </strong>Using IQVIA Real-world longitudinal prescription data and the National HIV Surveillance System data, we calculated jurisdiction-level PrEP to diagnosis ratios (PDRs) in the United States from 2016-2023. We assessed impact of EHE with a difference-in-difference (DID) analysis.</p><p><strong>Results: </strong>The PDR increased from 3.0 to 14.7 in EHE Jurisdictions; from 1.2 to 7.2 in EHE states; and from 2.5 to 13.4 in non-EHE jurisdictions. On average, no additional increase in the PDR was found for EHE counties compared with matched non-EHE counties, (adjusted DID: 0.2, 95% confidence interval [CI]: -1.0∼1.3), or for EHE states (adjusted DID: 0.4, 95% CI: -1.6∼2.4).</p><p><strong>Conclusions: </strong>Overall PrEP use increased markedly, with some EHE jurisdictions achieving greater increases than non-EHE jurisdictions with similar PDRs in 2019. The uneven increase in PrEP use in EHE jurisdictions underscores the need for jurisdiction-specific PrEP implementation strategies designed for the needs of each community. It also underscores the need for sufficient funding to accomplish EHE goals.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811163","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":"Retention and viral suppression with differentiated time or space for adolescent and young adult HIV care: a systematic review and meta-analysis.","authors":"Gede Benny Setia Wirawan, K Sharath Navin, Luh Putu Lila Wulandari, David Boettiger","doi":"10.1097/QAI.0000000000003681","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003681","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents and young adults living with HIV (AYAWH) encounter unique barriers affecting their adherence to treatment and overall health outcomes. Differentiated care for AYAWH has been suggested as a strategy to improve treatment outcomes for this demographic. This study evaluated the evidence on antiretroviral treatment outcomes of a differentiated care model with designated space or service time for AYAWH.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following the PRISMA guidelines. A literature search was conducted using PubMed and Embase and included peer-reviewed articles published in English. Articles comparing retention and viral suppression rates at differentiated adolescent or young adult-specific services with those at local standards of care facilities were included in the analysis. Differentiated care encompassed separate spaces (such as dedicated rooms or buildings) or operating hours designated exclusively for AYAWH. A random-effects meta-analysis was conducted to generate pooled risk ratios (RR) to evaluate the effectiveness of these tailored care models.</p><p><strong>Results: </strong>We identified 11 eligible articles, 10 of which from resource-limited settings in Africa. The meta-analysis revealed that differentiated time or space care for AYAWH significantly increases rates of retention (pooled RR 1.19, 95%CI 1.13-1.26) and viral suppression (pooled RR 1.11, 95%CI 1.05-1.17) among AYAWH, although moderate heterogeneity was observed in both outcomes (I2 of 69.5% and 57.3% for retention and viral suppression, respectively).</p><p><strong>Conclusion: </strong>Implementation of differentiated time or space for adolescent and young adult HIV care significantly improves retention and viral suppression rates among AYAWH.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810919","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":"Plasma Inflammatory Biomarkers Link to Worse Cognition Among Africans with HIV.","authors":"Andjelika Milicic, Samuel Wilson, Shireen Javandel, Isabel Elaine Allen, Elena Tsoy, Lishomwa C Ndhlovu, Hannah Kibuuka, Michael Semwogerere, Rither Langat, Ibrahim Daud, Emmanuel Bahemana, Gloria David, Winnie Rehema, Iddah Ouma, Celine Ogari, Victor Anyebe, Zahra Parker, Hendrik Streeck, Christina S Polyak, Neha Shah, Julie A Ake, Victor Valcour","doi":"10.1097/QAI.0000000000003679","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003679","url":null,"abstract":"<p><strong>Background: </strong>Despite broad access to antiretroviral therapy (ART) in sub-Saharan Africa (SSA), neurocognitive comorbidities remain common among people with HIV (PWH). Multiple lines of evidence link cognitive performance to inflammatory plasma biomarkers. This study examined this relationship within a robust sample in SSA.</p><p><strong>Methods: </strong>PWH and people without HIV (PWoH) aged 18 years or older, enrolled in the prospective African Cohort Study (AFRICOS) from 2013 to 2016 at multiple sites across Kenya, Nigeria, Tanzania, and Uganda, and underwent clinical evaluation. A neuropsychological battery assessed cognitive performance. Blood samples collected were analyzed by immunoassay. Using multivariable linear regression, we characterized associations between cognitive Z-scores and biomarker levels.</p><p><strong>Results: </strong>Participants included PWoH (17%, n=473), PWH with suppressed viremia (44%, n=1199) and PWH with unsuppressed viremia (exceeding 100 copies/mL, 39%, n=1065). Across groups, PWH with suppressed viremia were significantly older (means=37.1, 41.9 and 37.5, respectively, p<0.001). Among PWH, three biomarkers (CXCL10, CCL2, and sCD25) showed inverse relationships to cognitive performance on all measures (β=-0.163, β=-0.133, and β=-0.204, respectively, p<0.05). Inflammation did not relate to cognitive performance in PWoH. Examining individual neuropsychological test performance, the Grooved Pegboard, measuring psychomotor speed and manual dexterity, displayed the strongest associations with key biomarkers (CCL2 β=-0.252, sCD25 β=-0.293, and CXCL10 β=-0.214, p<0.01).</p><p><strong>Conclusion: </strong>In SSA, inflammatory markers associated with worse cognitive performance in both viremic and suppressed PWH.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810976","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":"Markers of inflammation and immune dysfunction and non-AIDS cancer risk in adults with HIV.","authors":"Rebeca Izquierdo, Alejandro Vallejo, Ines Suárez-García, Adrián Martín-Hondarza, Félix Gutierrez, Jose A Perez-Molina, David Vinuesa García, Juan Macías, Antonio Rivero, Julián Olalla, Marta Montero-Alonso, Víctor Asensi, Santiago Moreno, Inma Jarrín, Marta Rava","doi":"10.1097/QAI.0000000000003667","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003667","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated the association between pre-ART immune dysfunction and inflammation markers and the risk of non-AIDS cancer (NAC) in people with HIV (PWH) after starting ART.</p><p><strong>Methods: </strong>In a case-cohort study nested within CoRIS, a cohort of ART-naïve PWH, who started ART during 2004-2020, we included 113 NAC cases and a random subcohort of 512 individuals without prior cancers and with at least one pre-ART blood sample. We assessed immune dysfunction (CD4+ and CD8+ cell count, CD4/CD8 ratio) and inflammation markers (interleukin-6 [IL-6], high-sensitivity C-reactive protein, D-Dimer, and soluble CD14). We estimated hazard ratios (HRs) for the association between markers quartiles and NAC risk using Prentice-weighted Cox models separately for each marker and including all markers simultaneously.</p><p><strong>Results: </strong>Among 614 participants (87.1% men; median age 37.3 years; 23.8% with CD4+ ≥ 500 cells/µL), we observed that NAC risk was not associated with immune dysfunction markers, and it was positively associated with IL-6 and D-dimer. Adjusted HRs for IL-6 ranged from 1.77 (95%CI 0.75, 4.16) to 2.73 (1.09, 6.86), while HRs for D-dimer were 3.93 (1.75, 8.84) for the third and 2.94 (1.26, 6.86) for the fourth compared to the first quartile. When all markers were included, only D-dimer confirmed its association with NAC.</p><p><strong>Conclusions: </strong>Pre-ART inflammation and altered coagulation, but not immune dysfunction markers, were associated with risk of NAC. Limitations include the low number of cancer cases, precluding cancer-specific analyses, and lack of information on relevant confounders, like oncogenic coinfections. Further research is needed to validate these findings.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795550","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":"Preferences for PrEP Implementation and Engagement in the HIV Pre-Exposure Prophylaxis (PrEP) Care Continuum among Patients Receiving Psychiatric Care in an Ending the HIV Epidemic Priority County.","authors":"Samuel R Bunting, Brian A Feinstein, Allison Wilson, Juan Rivera, Dustin A Ehsan, Aniruddha Hazra","doi":"10.1097/QAI.0000000000003675","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003675","url":null,"abstract":"<p><strong>Introduction: </strong>People living with mental illness (PLWMI) experience disproportionate HIV incidence. Research suggests use of HIV pre-exposure prophylaxis (PrEP) is low among PLWMI. The present study was conducted to understand self-reported HIV vulnerability, previous experiences with PrEP, interest in using PrEP, and preferences for PrEP modality and prescribers among PLWMI.</p><p><strong>Methods: </strong>We conducted a survey-based study among PLWMI seeking outpatient psychiatric care in Cook County, IL. The survey was completed online following a scheduled appointment with their psychiatric provider. Data was collected between February 2023-February 2024. Only HIV-negative PLWMI who met at least one PrEP eligibility criteria were eligible for the survey (eg. condomless sex, injection drug use, STI diagnosis). Outcomes were stratified by psychiatric diagnosis.</p><p><strong>Results: </strong>A total of 417 PLWMI completed the study (response rate = 66.7%) representing a diversity of diagnoses, including depression (43.4%), bipolar disorder (24.9%), and schizophrenia/schizoaffective disorder (6.7%). Awareness of PrEP was 74.8% and among those without prior PrEP use, 70.5% were interested. We found 27.6% of PLWMI had used PrEP previously. Long-acting injectable (LAI) was equally preferable (58.2%) to daily oral PrEP (58.8%) among PLWMI. Primary care providers (94.6%) were the most acceptable PrEP prescriber and 47.6% indicated acceptability of a psychiatrist as a PrEP prescriber.</p><p><strong>Conclusions: </strong>PLWMI were interested in PrEP, including both oral and LAI formulations. Psychiatric care may serve as an efficient point of integration for PrEP prescription including LAI-PrEP. Further research is needed to understand how to best implement PrEP prescription and management for PLWMI across clinical settings.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795558","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 Viral Rebound on Dolutegravir, Lopinavir and Efavirenz: National Program Data Analysis from Ukraine.","authors":"Olga Morozova, Kyle Conroy, Serhii Riabokon, Myroslava Germanovich, Yaroslav Zelinskyi, Nancy Puttkammer, Kostyantyn Dumchev","doi":"10.1097/QAI.0000000000003676","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003676","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir (DTG), an integrase strand transfer inhibitor, is recommended as the preferred first-line HIV medication globally due to higher efficacy, better tolerability, and higher genetic barrier to resistance compared to other antiretroviral therapy (ART) drug classes. However, little is known about the comparative effectiveness of DTG in sustaining durable viral suppression (VS) in real-world settings.</p><p><strong>Methods: </strong>We analyzed data from electronic health records of a retrospective cohort of ART-naïve (N=3793) and ART-experienced (N=14367) people receiving HIV treatment in Ukraine between October 2017 - September 2018, comparing incidence of viral rebound (viral load 200 HIV RNA copies/ml) after the first documented VS among participants on DTG-, ritonavir-boosted lopinavir (LPV/r)-, and efavirenz (EFV)-based regimens. Participants were followed until June 2019. Interval censoring survival analysis with cluster-robust standard errors was used to estimate the effects of ART regimen on viral rebound adjusting for demographic and clinical characteristics.</p><p><strong>Results: </strong>N=714 (3.9%) participants experienced viral rebound during follow-up. In the ART-naïve cohort, the incidence of rebound was 6.9 events (95%CI: 5.9-8.0) per 100 person-years. LPV/r-based regimens were associated with higher hazard of rebound compared to DTG-based regimens: aHR=1.8 (95%CI: 1.3-2.4). EFV-based regimens had similar incidence of rebound compared to DTG: aHR=1.1 (95%CI: 0.9-1.3).</p><p><strong>Conclusion: </strong>Favorable performance of DTG compared to other first-line ART options in sustaining VS supports continued roll-out of DTG-based regimens. High overall incidence of viral rebound, including on DTG-based regimens, calls for targeted evidence-based adherence support interventions and improved viral load and drug resistance monitoring, especially among high-risk populations.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795545","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":"Cost and cost-effectiveness of online recruitment to increase HIV self-testing among Black and Hispanic/Latino men who have sex with men in the United States, 2020-2021.","authors":"Kristin M Wall, Patrick Sullivan, Ram K Shrestha, Ruth Dana, Marissa Hannah, Iaah L Lucas, Pollyanna R Chavez, Jerris Raiford, Joanna A Caldwell, Lisa Hightow-Weidman, Robin J MacGowan","doi":"10.1097/QAI.0000000000003666","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003666","url":null,"abstract":"<p><strong>Background: </strong>Black or African American and Hispanic/Latino gay, bisexual, and other men who have sex with men (BMSM and HLMSM) in the United States (US) are disproportionately affected by HIV. We analyze the cost and cost-effectiveness of HIV self-testing through online recruitment of BMSM and HLMSM into an HIV self-testing study.</p><p><strong>Setting: </strong>11 US states, February 2020-February 2021.</p><p><strong>Methods: </strong>BMSM and HLMSM aged ≥18 years without previous HIV diagnosis or current pre-exposure prophylaxis use were recruited through dating and general interest websites/apps (sites). Using the healthcare provider perspective and a 16-month timeframe, we assessed economic costs (2022 US Dollars) of online recruitment, HIV self-test (HIVST) distribution, and participant support. A time-motion study tracked staff time spent on study implementation activities. We reported incremental program cost, cost per HIVST used, and cost per new HIV diagnosis comparing recruitment via dating versus general interest sites.</p><p><strong>Results: </strong>The total cost was $275,776 to enroll 1,306 participants through dating sites, and support 1,005 MSM who used an HIVST (11.74% positivity). The total cost was $168,099 to enroll 600 participants through general interest sites, and support 511 MSM who used an HIVST (5.48% positivity). Recruitment via dating versus general interest sites was more costly and more effective, with incremental cost-effectiveness ratios (ICERs) of $218/HIVST used and $1,196/new diagnosis, relatively low cost per new HIV diagnosis compared with those estimated in other HIV testing interventions. ICERs were higher for HLMSM versus BMSM.</p><p><strong>Conclusions: </strong>HIV self-testing through dating and general interest site recruitment may be an effective and cost-effective approach to increase new HIV diagnoses.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795416","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":"Sexually transmitted infection testing integrated with HIV prevention and contraceptive services in hair salons in urban South Africa.","authors":"Jana Jarolimova, Joyce Yan, Sabina Govere, Sthabile Shezi, Lungile M Ngcobo, Shruti Sagar, Dani Zionts, Nduduzo Dube, Robert A Parker, Ingrid V Bassett","doi":"10.1097/QAI.0000000000003677","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003677","url":null,"abstract":"<p><strong>Introduction: </strong>Curable sexually transmitted infections (STIs) cause morbidity for women and increase HIV transmission and acquisition. To address barriers to STI care, we are implementing STI testing integrated with HIV prevention and contraceptive services in hair salons in urban South Africa.</p><p><strong>Methods: </strong>Women attending hair salons are offered oral HIV pre-exposure prophylaxis (PrEP), hormonal contraception, and testing for gonorrhea, chlamydia, trichomoniasis, and syphilis within an ongoing pilot trial. Participants with positive STI results are offered treatment at the salon or local clinic. Demographics, symptoms, and risk factors are collected using structured questionnaires.</p><p><strong>Results: </strong>Of 125 women enrolled and taking PrEP and/or contraceptives in the hair salons (median age 26y, 28.8% living with HIV), 121 (96.8%) accepted STI testing and 117 (93.6%) had complete results. Nearly half (47.8%) reported a primary sex partner ≥5 years older, 32.2% thought their partner had other partners, and 62.6% reported never using condoms. 42/117 women (35.9%) had at least one STI: 7.7% gonorrhea, 21.4% chlamydia, 4.3% trichomoniasis, and 9.4% syphilis. Only 8/42 (19.0%) women with an STI reported symptoms. In adjusted models, having an STI was associated with perceived male partner concurrency (p=0.049). Among women with any STI, 38/42 (90.5%) elected treatment at the salon.</p><p><strong>Conclusions: </strong>STI testing in hair salons in South Africa reaches women with risk factors for STIs and HIV, appears acceptable and feasible, and reveals a high STI prevalence. Hair salons may serve as novel venues to increase the reach of STI testing to women at risk for HIV and STIs.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795575","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":"Low placental growth factor levels mid-gestation predict small for gestational age in pregnant women with HIV.","authors":"Caroline E Dunk, Kathleen M Powis, Justine Legbedze, Shan Sun, Keolebogile N Mmasa, Samuel W Kgole, Gosego Masasa, Sikhulile Moyo, Terence Mohammed, Lynn M Yee, Mompati O Mmalane, Joseph M Makhema, Jennifer Jao, Lena Serghides","doi":"10.1097/QAI.0000000000003672","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003672","url":null,"abstract":"<p><strong>Background: </strong>Placental growth factor (PlGF) and soluble Fms-like tyrosine kinase 1 (sFlt-1) are angiogenic factors essential for placental and fetal growth. Associations between these factors and birth outcomes among pregnant women with HIV are limited.</p><p><strong>Methods: </strong>PlGF and sFlt-1 levels were quantified by ELISA in plasma samples collected between gestational weeks 24-29 from 114 women (46 with HIV, 68 without HIV). PlGF and sFlt-1:PlGF ratios were assessed using cut-offs used for prediction of preeclampsia (PlGF <12pg/mL, PlGF <100pg/mL, sFlt-1:PlGF >85), and compared by HIV status using χ2 testing. Logistic regression models were fit to assess associations of dichotomized PlGF and sFlt1:PlGF with preterm (<37weeks) and small for gestational age (SGA) birth (<10th percentile) in all participants and stratified by HIV status.</p><p><strong>Results: </strong>Women with HIV were older than women without HIV. More women with HIV had low or very low PlGF levels (<100pg/mL: 30.4% vs 7.4%, p=0.001; <12pg/mL: 17.4% vs 1.5%, p=0.002) and sFlt-1:PlGF >85 (19.5% vs 2.9%, p=0.0036) than women without HIV. Among all pregnancies, low PlGF and high sFlt-1:PlGF ratio were significantly associated with SGA (odds ratio [95% confidence interval] for PlGF <12pg/mL: 10.3 [2.0-53], p=0.005; PlGF <100pg/mL: 5.9 [1.7-21], p=0.006; sFlt-1:PlGF >85: 10.6 [2.5-46], p=0.002), but not preterm birth. Associations remained significant after adjusting for maternal age, BMI, and elevated blood pressure. Stratification by maternal HIV status showed this association was limited to the women with HIV.</p><p><strong>Conclusion: </strong>Low PlGF levels may be a good predictive biomarker of SGA specifically for pregnant women with HIV.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779987","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}