JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Efficacy and Safety of Dolutegravir/Lamivudine in Antiretroviral Therapy-Naive People Living With HIV-1 and With High-Level Viremia.","authors":"Leonardo Calza, Vincenzo Colangeli, Maddalena Giglia, Claudio Rigamonti, Isabella Bon, Silvia Cretella, Pierluigi Viale","doi":"10.1097/QAI.0000000000003600","DOIUrl":"10.1097/QAI.0000000000003600","url":null,"abstract":"<p><strong>Background: </strong>Dual regimen dolutegravir/lamivudine (DOL/3TC) showed potent efficacy and favorable safety in both antiretroviral therapy-naive and therapy-experienced patients, but data from real life about naive people with high-level viremia are still lacking.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of people living with HIV who were naive to antiretroviral therapy, had baseline HIV-1 RNA ranging from 100,000 to 500,000 copies/mL, and initiated DOL/3TC. Virologic efficacy and changes in immunologic parameters after 12 months of treatment were evaluated and compared with highly viremic people living with HIV who started a triple antiretroviral combination.</p><p><strong>Results: </strong>Inclusion criteria were met by 58 patients with median age of 43.4 years. At baseline, mean HIV RNA was 5.4 log 10 and mean CD4 T lymphocyte count was 488 cells/mm 3 . HIV RNA <50 copies/mL was obtained in 45 patients (77.6% in the intention-to-treat analysis) after 6 months and in 53 patients (91.4%) after 12 months. Reasons for treatment failure were virologic failure in 2 cases and adverse events in 3 cases. No significant changes in median value of lipids were reported, while there was a not significant increase in body weight (+1.18 kg). Virologic and immunologic response at month 12 in patients on DOL/3TC was comparable with that observed in 50 naive patients with high-level viremia and starting a triple antiretroviral therapy.</p><p><strong>Conclusions: </strong>In this real-life cohort of naive patients with high-level viremia, DOL/3TC was associated with high virologic efficacy and good tolerability after 12 months, supporting use of this dual regimen also in persons with high initial viremia.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"93-97"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978434","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":"Schizophrenia and Retention in HIV Care Among Adults Insured Through Medicaid in the United States: A Population-Based Retrospective Cohort Study.","authors":"Alexander R Bazazi, Marilyn Thomas, Eric Vittinghoff, James Walkup, Richard Hermida, Emily A Arnold, Francine Cournos, Stephen Crystal, Lindsey Dawson, Priya Dahiya, Paola Alonso-Fraire, James Dilley, Mark Olfson, Christina Mangurian","doi":"10.1097/QAI.0000000000003606","DOIUrl":"10.1097/QAI.0000000000003606","url":null,"abstract":"<p><strong>Background: </strong>People with schizophrenia spectrum disorders are at elevated risk of HIV, and people with both HIV and schizophrenia are at elevated risk of death compared with individuals with either diagnosis alone. Limited research has assessed the HIV care cascade, and in particular retention in care, among people with HIV (PWH) and schizophrenia in the United States.</p><p><strong>Methods: </strong>This population-based retrospective cohort study used Medicaid claims data to compare retention in HIV care between PWH with schizophrenia (n = 38,217) and matched controls without schizophrenia (n = 29,455) from 2001 to 2012. The primary outcome of annual retention in HIV care was at least 2 tests for CD4 + T-cell count or HIV viral load at least 90 days apart per year. Unadjusted and covariate-adjusted differences in period prevalence of retention among cases and controls were estimated.</p><p><strong>Findings: </strong>Annual retention in HIV care was 29.9% (95% CI: 29.4 to 30.4%) among people with schizophrenia and 38.5% (95% CI: 37.9 to 39.1%) among controls, representing 8.5% (95% CI: 9.3 to 7.7) lower retention in unadjusted and 9.0% (95% CI: 9.9 to 8.2) lower retention in adjusted estimates for people with HIV and schizophrenia. This disparity varied across states. Over time, retention increased and the disparity between people with and without schizophrenia diminished.</p><p><strong>Interpretation: </strong>PWH in the United States insured through Medicaid and diagnosed with schizophrenia experience lower retention in HIV care than controls. Suboptimal retention likely drives disparities in HIV-related morbidity and mortality for PWH with schizophrenia, and targeted individual and structural interventions are merited to improve the health of this population.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"20-30"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023263","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 Disparities of PrEP Adherence Among Men Who Have Sex With Men Between the Global South and the Global North: An Updated Determinantal Global Meta-Analysis.","authors":"Haoyi Wang, Marit Delnoij, Hanne M L Zimmermann, Kai J Jonas","doi":"10.1097/QAI.0000000000003635","DOIUrl":"10.1097/QAI.0000000000003635","url":null,"abstract":"<p><strong>Background: </strong>Suboptimal adherence to pre-exposure prophylaxis (PrEP) limits its global impact, with current evidence mostly from the Global North and lacking Global South perspectives. This meta-analysis synthesizes the rates and determinants of suboptimal adherence to oral PrEP among men who have sex with men (MSM) in both regions.</p><p><strong>Methods: </strong>We searched for literature describing PrEP adherence and its determinants among MSM globally up until October 2024 to conduct a meta-analysis on the rate and determinants of suboptimal adherence in both regions. The definition of (sub-)optimal adherence was study based.</p><p><strong>Results: </strong>We included 82 studies in the meta-analysis, with 24, 53, and 5 stemmed from the Global South, North, and global multicenter studies, respectively. Oral PrEP suboptimal adherence is prevalent among MSM PrEP users globally (rate = 0.33, 95% confidence interval [CI]: 0.28 to 0.38) with a significantly higher rate ( P = 0.021) in the Global South (rate = 0.41, 95% CI: 0.33 to 0.50) than in the Global North (rate = 0.29, 95% CI: 0.23 to 0.35). In the Global South, older age (OR = 0.57, 95% CI: 0.37 to 0.87), alcohol use (OR = 1.28, 95% CI: 1.02 to 1.60), and presenting depressive symptoms (OR = 1.47, 95% CI: 1.01 to 2.16) were associated with suboptimal adherence. In the Global North, MSM self-identified as Black (OR = 2.27, 95% CI: 1.31 to 3.95) or Other (OR = 1.36, 95% CI: 1.02 to 1.81), having a university degree (OR = 0.50, 95% CI: 0.34 to 0.73), and presenting depressive symptoms (OR = 2.26, 95% CI: 1.35 to 3.78) were associated with suboptimal adherence. On-demand PrEP users globally demonstrated a higher likelihood of suboptimal adherence (OR = 1.59, 95% CI: 1.18 to 2.14).</p><p><strong>Conclusions: </strong>Suboptimal adherence to oral PrEP is prevalent among MSM globally, particularly higher in the Global South. Regional differences in determinants highlight the need for tailored interventions. Tailored interventions are required to address mental health with tailored efforts to younger MSM in the Global South, while interventions in the Global North should be tailored to specific subgroups.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058798","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":"Social Determinants of Health and Unmet Needs for Services Among Young Adults With HIV: Medical Monitoring Project, 2018-2021.","authors":"Ruthanne Marcus, Sharoda Dasgupta, Jennifer Taussig, Yunfeng Tie, Priya Nair, Joseph Prejean","doi":"10.1097/QAI.0000000000003605","DOIUrl":"10.1097/QAI.0000000000003605","url":null,"abstract":"<p><strong>Background: </strong>Persons aged 13-24 years are a priority population in the National HIV/AIDS Strategy. Young adults with HIV have poorer health outcomes-including not being retained in care, antiretroviral nonadherence, and not being virally suppressed-than other persons with HIV.</p><p><strong>Setting: </strong>Centers for Disease Control and Prevention's Medical Monitoring Project data collected June 2018 through May 2022.</p><p><strong>Methods: </strong>We compared demographic characteristics, social determinants of health, and mental health between persons aged 18-24 years with HIV versus persons aged ≥25 years with HIV. Among those aged 18-24 years, we analyzed total and unmet needs for ancillary services, defined as those that support care engagement, viral suppression, and overall health and well-being among people with HIV.</p><p><strong>Results: </strong>Persons aged 18-24 years were more likely to have a household income <100% of the federal poverty level (48% vs. 39%), and experience unstable housing or homelessness (37% vs. 18%) or hunger/food insecurity (29% vs. 18%) than those aged ≥25 years. Persons aged 18-24 years had higher median HIV stigma scores (40 vs. 29) and were more likely to experience symptoms of generalized anxiety disorder (21% vs. 15%) than those aged ≥25 years. Of persons aged 18-24 years, 96% had a need for ≥1 ancillary service, of whom 56% had ≥1 unmet need; unmet needs were highest for subsistence services (53%) and non-HIV medical services (41%).</p><p><strong>Conclusions: </strong>Addressing unmet needs for subsistence and non-HIV medical services could help reduce disparities in social determinants of health and mental health that drive inequities in health outcomes among persons with HIV aged 18-24 years.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"9-19"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948855","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":"Brief Report: HIV Pre-exposure Prophylaxis Awareness and Use Among Rakai Community Cohort Study Youth Aged 15-24.","authors":"Emily Murphy, Susie Hoffman, Victor Ssempijja, Fred Nalugoda, Larry W Chang, Robert Ssekubugu, Tom Lutalo, Godfrey Kigozi, Joseph Kagaayi, Nelson K Sewankambo, Steven J Reynolds, John Santelli, Philip Kreniske","doi":"10.1097/QAI.0000000000003640","DOIUrl":"10.1097/QAI.0000000000003640","url":null,"abstract":"<p><strong>Background: </strong>Preventing HIV infections among adolescents and young adults (AYAs) is crucial for curtailing the epidemic. Oral pre-exposure prophylaxis (PrEP) is a highly effective prevention method increasingly available to this age group in sub-Saharan Africa but population-based data on awareness and use of PrEP among AYAs remains limited.</p><p><strong>Methods: </strong>Analyzing survey data from 2 rounds of the Rakai Community Cohort Study, an open, population-based cohort, we estimated prevalence ratios associating various sociodemographic characteristics with PrEP awareness and ever-use among 15- to 24-year-olds in south-central Uganda between 2018 and 2023.</p><p><strong>Results: </strong>Most (62.4%, N = 3308/5301) participants were aware of PrEP as an HIV prevention method but only 1.7% (N = 133/7999) of AYAs had ever used it. Among the 35.5% (N = 2838/7999) of participants meeting PrEP eligibility criteria, ever-use was similarly rare (2.6%, N = 75/2838). Compared with 20 to 24-year-olds, 15 to 19-year-olds were less likely to report awareness [fullyadjPR (prevalence ratio) = 0.82, 95%CI (confidence interval): 0.78, 0.86] or ever-use (fullyadjPR = 0.35, 95%CI: 0.21, 0.58). Participants from fishing communities were more likely to be PrEP-aware (fullyadjPR = 1.22, 95%CI: 1.16, 1.29) or have ever used the prevention method (fullyadjPR = 6.07, 95%CI: 4.10, 8.98) than those from non-fishing communities.</p><p><strong>Conclusions: </strong>In this cross-sectional study of AYAs in Uganda, awareness of PrEP was common but ever-use was rare, even among the third of respondents who were likely PrEP-eligible. This suggests that prevention policies and barriers besides unawareness of the method impede PrEP initiation. Efforts that target those barriers, particularly for adolescents, are critical for reducing HIV incidence among this priority population.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"41-46"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065597","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":"Management of KSHV/HHV8-Positive Multicentric Castleman Disease Concurrent With Other KSHV/HHV8-Positive Disorders: An Emergent Challenge in PLWH.","authors":"Antonino Carbone, Emanuela Vaccher, Annunziata Gloghini, Alessia Dalla Pria, Mark Bower","doi":"10.1097/QAI.0000000000003604","DOIUrl":"10.1097/QAI.0000000000003604","url":null,"abstract":"","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"e1-e2"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947887","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":"Effect of Fertility Desire-Based Service on HIV Seroconversion Among Serodiscordant Partners: A 12-year Retrospective Cohort Study.","authors":"Bin Yu, Chunnong Jike, Xiaomei Lan, Ju Wang, Gang Yu, Shujuan Yang","doi":"10.1097/QAI.0000000000003607","DOIUrl":"10.1097/QAI.0000000000003607","url":null,"abstract":"<p><strong>Background: </strong>Fertility desire-based service guided by behavioral theory is a potential strategy to mitigate the HIV transmission risk, while related evidence remains scarce. We examined the long-term effect of theory-guided fertility desire-based services on HIV seroconversion between seropositive and seronegative partners in areas with high HIV prevalence and a cultural emphasis on fertility in China.</p><p><strong>Methods: </strong>We established a retrospective cohort by recruiting 8653 seropositive partners with seronegative partners between January 1, 2009, and December 31, 2020, in Liangshan, China. The differences in HIV seroconversion between partners who received fertility desire-based services guided by the extended Information-Motivation-Behavioral Skills model and those who did not were estimated, based on multivariable and inverse probability weighting adjusted multivariable Cox regression models. Subgroup analysis was conducted based on participants' demographic and HIV-related characteristics.</p><p><strong>Results: </strong>Among the 8653 HIV-seropositive partners, 7958 (92.0%) and their seronegative partners received fertility desire-based services. At the end of the 12-year follow-up, 18 seronegative partners who did not receive fertility desire-based services experienced HIV seroconversion (incidence density: 7.4/1000 person-years), while 98 seronegative partners receiving such services exhibited HIV seroconversion (3.4/1000 person-years). Fertility desire-based services significantly reduced the risk of HIV seroconversion according to multivariable (HR = 0.32, 95% CI: 0.19 to 0.53) and inverse probability weighting-adjusted multivariable Cox regression models (HR = 0.48, 95% CI: 0.27 to 0.84). The effect of fertility desire-based services was more pronounced in men and those older than 40 years.</p><p><strong>Conclusions: </strong>Fertility desire-based services based on the extended Information-Motivation-Behavioral Skills model may help reduce the HIV transmission risk between seropositive and seronegative partners in areas with high HIV prevalence.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"31-40"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005311","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":"Rectal Douche as HIV Pre-Exposure Prophylaxis for Receptive Anal Intercourse: An End User Tenofovir Powder Sachet Preparation Feasibility Study (DREAM-04).","authors":"Clarissa P Diniz, Sandra Abdul-Massih, Christina Bagia, Rebecca Giguere, Lisa C Rohan, Lin Wang, Curtis Dolezal, Michelle Yu, Vy Bui, Sasha Beselman, Rahul Bakshi, Santiago Alvarez-Arango, Mark Marzinke, Edward J Fuchs, Craig W Hendrix","doi":"10.1097/QAI.0000000000003608","DOIUrl":"10.1097/QAI.0000000000003608","url":null,"abstract":"<p><strong>Background: </strong>Unprotected receptive anal intercourse carries the highest sexual HIV transmission risk. The need for diverse pre-exposure prophylaxis (PrEP) options has encouraged the development of on-demand, topical PrEP products for those preferring nonsystemic or occasional PrEP. We assessed end users' proficiency in preparing tenofovir douches from sachets containing 2 different powder types, lyophilized and spray dried, and evaluated their experience.</p><p><strong>Methods: </strong>Cisgender adult men with a history of RAI-related douching were consented, screened, and randomized 1:1 to the order of the powder type prepared. All participants prepared at least 3 enema bottles of each powder type. Aliquots from each prepared douche bottle were analyzed for tenofovir (TFV) concentration, osmolality, and pH. User experience and likelihood of future product use were assessed by questionnaire.</p><p><strong>Results: </strong>Twenty-one eligible participants were enrolled. Most participants reported both products as easy or very easy to prepare and likely or very likely to be used. Participants preferred the lyophilized product. The lyophilized and spray-dried douche bottles prepared met the osmolality specifications 89% and 61% of the time and TFV content specifications 81% and 29% of the time, respectively. Questionnaires indicated the most common challenges were tearing open the sachets and transferring the spray-dried product.</p><p><strong>Conclusions: </strong>Most participants reported the douches were easy to prepare and indicated likely future use. Although the lyophilized sachets were prepared sufficiently to establish preparation feasibility, the spray-dried sachets often fell outside specifications. Failure analysis provided insights to guide product modifications to improve the proficiency of douche preparation and future product use.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"75-80"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023348","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":"Positive STEPS: Enhancing Medication Adherence and Achieving Viral Load Suppression in Youth Living With HIV in the United States-Results From an Efficacious Stepped Care, Randomized Controlled Trial.","authors":"Matthew J Mimiaga, Lisa M Kuhns, Katie B Biello, Jiahao Tian, Margie R Skeer, Christina Psaros, Ethan Moitra, Diane Chen, Elizabeth Yonko, Kenneth H Mayer, Steven A Safren, Robert Garofalo","doi":"10.1097/QAI.0000000000003639","DOIUrl":"10.1097/QAI.0000000000003639","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the United States and worldwide, there is a significant number of young people acquiring and living with HIV. Antiretroviral therapy (ART) has led to significant reductions in HIV-related illnesses and deaths, allowing young people living with HIV to manage their condition as a chronic disease. Ensuring high levels of ART adherence is vital for treatment success. Despite this, to the best of our knowledge, there are no efficacious behavioral interventions for improving ART adherence and viral suppression among youth in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a multicity, randomized, controlled trial-in Boston, MA/Providence, RI and Chicago, IL-to examine the efficacy of an stepped care, behavioral and technology-based intervention, \"Positive STrategies to Enhance Problem-Solving Skills (Positive STEPS),\" compared with a standard of care (SOC) control, for improving ART adherence and viral suppression among youth living with HIV ages 16-29 years. Positive STEPS included the following: step 1: TXTXT, an evidence-based, daily 2-way personalized text message reminder to take ART medications; step 2: only participants with &lt;90% adherence anytime between weeks 5 and 12 postrandomization to the Positive STEPS arm would then receive five 50-minute sessions of manualized individual adherence counseling. If participants' adherence remained at ≥90% , then they did not progress to step 2. ART adherence was measured via Wisepill, an electronic medication monitoring device, and self-report. Participants were followed for 12 months and completed biospecimen collection (HIV plasma RNA viral load testing) and a quantitative assessment battery at baseline and at their 4-, 8-, and 12-month follow-up visits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Between March 2018 and March 2023, 123 participants were randomized (Positive STEPS = 63; SOC control = 60). Intention-to-treat analyses showed a significant positive main effect for the Positive STEPS arm, which increased the mean log ART adherence by 18.7% relative to the SOC control at the 4-month visit (coefficient = 0.187, P = 0.021). For the time effect, a significant overall increase in ART adherence across the subsequent follow-up visits was observed, with increased mean log ART adherence by 27.8% ( P &lt; 0.01) at 8 months and 30.1% at 12 months ( P &lt; 0.01), relative to the SOC control. With respect to our viral suppression outcome, the analysis revealed a significant negative main effect for the Positive STEPS arm at 4-months (odds ratio = 0.264, P = 0.023), indicating that the odds of having an unsuppressed virus were 74% lower in the Positive STEPS arm compared with the SOC control; the interaction term revealed that this effect was maintained through the 12-month follow-up time period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These findings on the efficacy of Positive STEPS to enhance ART adherence and viral suppression among youth living with HIV represent the first b","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"64-74"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065600","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":"Men's Voices on Long-Acting Pre-Exposure Prophylaxis Delivery Modalities: Acceptability and Preferences Among Cisgender Men and Men Who Have Sex With Men in South Africa.","authors":"Millicent Atujuna, Alinda M Nyamaizi, Zoe Duby, Alexandra Minnis, Miranda Diaz, Thesla Palanee-Phillips, Siyanda Tenza, Krishnaveni Reddy, Nqaba Nkomana, Linda-Gail Bekker, Elizabeth Montgomery","doi":"10.1097/QAI.0000000000003638","DOIUrl":"10.1097/QAI.0000000000003638","url":null,"abstract":"<p><strong>Introduction: </strong>In sub-Saharan Africa, cisgender men-in particular men who have sex with women (MSW) and, to a lesser degree, men who have sex with men (MSM)-are often under-represented in HIV prevention research, despite their own HIV risk and role in transmission cycles. As HIV prevention research on long-acting pre-exposure prophylaxis (LA PrEP) options expands in sub-Saharan Africa, it is essential to engage these populations to ensure their acceptability. We investigated perceptions of implants and intramuscular injectables as LA PrEP delivery among MSW and MSM.</p><p><strong>Methods: </strong>In-depth interviews were conducted between October 2020 and March 2021 with 40 MSW (n = 20) and MSM (n = 20), aged 18-35 years, self-reported as HIV negative, sexually active, and residing in resource-restricted communities in Cape Town and Johannesburg, South Africa. We explored factors influencing LA PrEP attitudes. Data analysis followed a thematic framework approach.</p><p><strong>Results: </strong>MSW and MSM found LA PrEP administration modes more acceptable than daily oral PrEP because they offered longer lasting protection while reducing frequent clinic visits for refills. MSW voiced hesitancy around the use of \"foreign products,\" fearing infertility and congenital disabilities in their future children. Both subgroups acknowledged the convenience of implants with long-dosing duration, but injections were deemed to be more discrete and familiar. Both groups described implant use as potentially stigmatizing, with a greater chance of causing tissue scarring from insertion and removal procedures.</p><p><strong>Conclusions: </strong>Evidence relating to men's engagement in HIV prevention and acceptable modalities of HIV prevention is limited. We found that both groups were enthusiastic about LA PrEP, informing the development of our subsequent clinical study to provide further insight into using placebo versions of LA PrEP and future implementation of LA PrEP options.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"99 1","pages":"55-63"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035288","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}