JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Non-liver malignancies as main cause of mortality after HCV eradication among people living with HIV.","authors":"Siribelli Alessia, Diotallevi Sara, Galli Laura, Muccini Camilla, Morsica Giulia, Lolatto Riccardo, Bertoni Costanza, Messina Emanuela, Bossolasco Simona, Trentacapilli Benedetta, Uberti-Foppa Caterina, Castagna Antonella, Hasson Hamid","doi":"10.1097/QAI.0000000000003559","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003559","url":null,"abstract":"<p><strong>Background: </strong>In people living with HIV (PLWH) with HCV infection, liver and non-liver-related mortality significantly decreased after receiving direct acting antivirals (DAAs). We aimed to assess main causes and predictors of mortality after sustained virological response (SVR) induced by DAAs.</p><p><strong>Methods: </strong>Retrospective study in antiretroviral treatment-experienced PLWH with HCV infection, followed at San Raffaele Hospital, Milan, Italy, who achieved SVR after DAAs. Kaplan-Meier analysis and log-rank test were used to estimate cumulative probability of death for any cause. Cox proportional hazards model was used to estimate adjusted hazard ratio (aHR) of death and the corresponding 95% confidence interval (95%CI); Baseline variables included in the model were: age, diabetes, hepatocellular carcinoma (HCC), α-fetoprotein (AFP), ALBI grade.</p><p><strong>Results: </strong>Among 663 people included with a median follow-up of 4.4 years (IQR=3.5-5.5), 49 died. Overall 5-year cumulative probability of death was 8.0% (95%CI=5.5%-10.4%); 63.2% (n=31/49) died from non-liver-related events [mainly non-liver malignancies (18/49) and cardiovascular events (7/49)].-. At multivariate analysis, death was more likely in older people [aHR (adjusted Hazard Ratio) (5-year older)=1.46, 95%CI=1.16-1.83, p=0.0009], and in people with diabetes [aHR=2.98, 95%CI=1.55-5.71, p=0.001], ALBI grade ≥2 [aHR=2.13, 95%CI=1.17-3.90, p=0.014] and AFP ≥3.4 ng/mL [aHR=1.96, 95%CI=1.01; 3.84, p=0.049].</p><p><strong>Conclusions: </strong>In our cohort, non-liver-related events and malignancies were the most common cause of death after HCV eradication. Diabetes, ALBI grade ≥2 and AFP≥ 3.4 ng/L were associated with higher risk of death. In PLWH after HCV eradication, regardless of liver disease stage, surveillance of non-liver events, particularly malignancies, should be recommended.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604452","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":"Predictors of Injection Visit Adherence in Those Receiving Injectable Cabotegravir/Rilpivirine.","authors":"Lucas Hill, Jeffrey Yin, Nimish Patel, Kari Abulhosn, Elvia Suarez, Afsana Karim, Laura Bamford","doi":"10.1097/QAI.0000000000003556","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003556","url":null,"abstract":"<p><strong>Background: </strong>There is limited data evaluating potential predictors of adherence to injection visits and the impact of late injections on viral suppression in those receiving long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) for the treatment of HIV.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among adult people with HIV (PWH) receiving LAI CAB/RPV for at least 6 months between May 2021 and August 2023. Data collected included demographics, office visit no-shows one year prior to switching to LAI CAB/RPV, injection visit no-shows, injections outside the dosing window, and virologic outcomes. Cox-proportional hazards regression was performed to evaluate predictors of no-show to injection visits or late injections.</p><p><strong>Results: </strong>Included were 287 PWH with a median follow up time (IQR) of 450 days (344-548 days). Younger age [HR 0.97 (95%CI 0.95-0.98)] and ≥ 1 office visit no-show in the year prior to switch to LAI CAB/RPV [HR 2.03 (1.32-3.12]) were associated with having a no-show to an injection visit (32.1%). Male sex assigned at birth [HR 9.18 (1.26-66.9)] with a trend towards younger age [HR 0.98 (0.95-1.0)] were associated with having a late injection (15.3%). There was no relationship between late injections and having a detectable viral load or virologic failure (n=3) after switch to LAI CAB/RPV.</p><p><strong>Conclusions: </strong>Having office visit no-shows prior to switching to LAI CAB/RPV was associated with missed injection visits, and younger age was associated with both missed injection visits and late injections. Resources to reduce and manage missed injection appointments need to be considered when implementing LAI CAB/RPV.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575957","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":"Real-world comparative Analysis of Liposomal Doxorubicin versus Paclitaxel as First-Line Therapy for Kaposi Sarcoma.","authors":"Mariana Carvalho Gouveia, Heloisa Guedes Andrade, Cassio Murilo Hidalgo Filho, Marina Acevedo Zarzar de Melo, Mateus Zapparoli Claro, Arthur de Ávila Machado Modesto, Lucas Tadeu Barrak Stangler, Mirella Nardo, Alice Nayane Rosa Morais, Renata Colombo Bonadio","doi":"10.1097/QAI.0000000000003557","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003557","url":null,"abstract":"","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575960","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":"Follow-Up Outcomes of Children, Adolescents, and Young People on Darunavir-Based Third-Line Antiretroviral Therapy: Observational Cohort From 9 African Countries.","authors":"Vincent J Tukei, Rhoderick Machekano, Boris K Tchounga, Philisiwe Ntombenhle Khumalo, Rachel Tumwebaze, Mildrate Murandu, Shannon Viana, Rose Otieno Masaba, Majoalane Mokone-Mwape, Lameck Chirwa, Simba Mashizwa, Natella Rakhmanina, Appolinaire Tiam","doi":"10.1097/QAI.0000000000003498","DOIUrl":"10.1097/QAI.0000000000003498","url":null,"abstract":"<p><strong>Background: </strong>We assessed clinical outcomes among children, adolescents, and people younger than 25 years on darunavir-based antiretroviral therapy (ART) in 9 sub-Saharan African countries.</p><p><strong>Setting: </strong>Third-line ART centers in Cameroon, Eswatini, Kenya, Lesotho, Nigeria, Rwanda, Uganda, Zambia, and Zimbabwe.</p><p><strong>Methods: </strong>From January 2019 to December 2022, we collected data from a cohort of children, adolescents, and young people receiving third-line ART from 9 sub-Saharan African countries. Data on treatment continuity, viral suppression, death, and clinic transfers were extracted from medical records and summarized. Cox proportional hazards models were used to identify factors independently associated with retention in care.</p><p><strong>Results: </strong>Of 871 participants enrolled, the median age was 14.8 (range: 0.2-24.7) years and 488 (56.0%) were male; 809 (92.9%) [median duration of follow-up of 28.3 months (interquartile range: 17.5-45.2)] had final outcomes after initiating third-line ART. Of these, 711 (87.9%) were alive and in care at the end of study follow-up, 29 (3.6%) died, 30 (3.7%) were transferred to other facilities, and 39 (4.8%) were lost to follow-up. Retention in care was less likely among male patients compared with female patients [aHR: 0.85, 95% confidence interval: 0.72 to 1.0] and in 10-14-year-old children compared with younger children. Adolescents (15-19 years old) had higher mortality compared with children younger than 10 years (aSHR: 4.20, 95% confidence interval: 1.37 to 12.87). Viral suppression was seen in 345/433 (79.7%), 249/320 (77.8%), and 546/674 (81.0%) patients with results at 6 months, 12 months, and study end, respectively.</p><p><strong>Conclusions: </strong>A high proportion of children and young people receiving third-line ART in sub-Saharan Africa remain in care and attain viral suppression during follow-up.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"305-312"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859788","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":"Posttrial Experiences in Sustainment of a Scaled Model of the Systems Analysis and Improvement Approach (SAIA-SCALE) in the Absence of External Funding in Manica Province, Mozambique.","authors":"Carmen E Hazim, Joana Coutinho, Jonny Crocker, Kristjana Asbjornsdottir, Maria Cruz, Mery Agostinho, Fernando Amaral, Maria de Fatima Cuembelo, Aneth Dinis, Quinhas Fernandes, Sarah Gimbel, Celso Inguane, Filipe Murgorgo, Regina Nassiaca, Isaias Ramiro, Kenneth Sherr","doi":"10.1097/QAI.0000000000003510","DOIUrl":"10.1097/QAI.0000000000003510","url":null,"abstract":"<p><strong>Background: </strong>Following the conclusion of a stepped-wedge cluster randomized trial of the Systems Analysis and Improvement Approach (SAIA) to optimize the prevention of mother-to-child HIV transmission cascade in Manica Province, Mozambique, we conducted a natural experiment to test the sustainability of the delivery model with limited financial inputs.</p><p><strong>Methods: </strong>District nurse supervisors were encouraged to continue to facilitate SAIA cycles in subordinate health facilities and provided phone credit and tablet access to upload implementation data. No additional resources (eg, funds for transport, refreshments, or supplies) were provided. Barriers to implementation were collected via conversations with district supervisors.</p><p><strong>Results: </strong>Monthly facilitation of SAIA cycles continued in 11 of 12 (92%) districts and 13 of 36 (36%) facilities through 12 months posttrial, which declined to 10 districts and 10 facilities by the end of the 15-month posttrial period. Despite interest among district supervisors to continue implementation, logistical and financial barriers prevented visits to facilities not in close proximity to district management offices. Turnover of district supervisors resulted in replacements not having knowledge and experience facilitating SAIA. The lack of refreshments for facility staff and limited supplies (pens and papers) were cited as additional barriers.</p><p><strong>Conclusion: </strong>Despite the scalability of the SAIA model, it is susceptible to implementation decay without sufficient health system resources. Additional research is needed to test sustainment strategies that address identified barriers and enable continued delivery of the implementation strategy core components at a sufficient level of fidelity to maintain desired health system improvements and patient-level outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"97 3","pages":"203-207"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465631","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":"Immune Activation Is Associated With Neurocognitive Performance in Ugandan Adolescents Living With HIV.","authors":"Sahera Dirajlal-Fargo, Abdus Sattar, Monika Strah, Christine Karungi, Joy Louise Gumikiriza-Onoria, Anthony F Santoro, Courtney Kirsch, Angel Nanteza, Christopher M Ferraris, Daphne Tsapalas, Nana Asiedu, Nicholas Funderburg, Victor Musiime, Grace A McComsey, Reuben N Robbins","doi":"10.1097/QAI.0000000000003483","DOIUrl":"10.1097/QAI.0000000000003483","url":null,"abstract":"<p><strong>Abstract: </strong>We examined relationships between neurocognition and immune activation in Ugandan adolescents with perinatally acquired HIV (PHIV). Eighty-nine adolescents in Kampala, Uganda (32 virally suppressed [<400 copies/mL] PHIV and 57 sociodemographically matched HIV-negative controls), completed a tablet-based neurocognitive test battery. Control-derived z-scores for 12 individual tests and a global/overall z-score were calculated. We measured plasma (soluble CD14 and CD163), monocyte (proportions of monocyte subsets), and T-cell (expression of CD38 and HLA-DR on CD4 + and CD8 + ) activation and gut markers. Spearman rank correlations and median regressions examined associations between test performance and immune activation. The median [IQR] age was 15 [13-16] years, and 40% were girls. The median time on antiretroviral therapy was 10 years [7-11] for PHIV; 87% had viral load <50 copies/mL. Compared with controls, global z-scores were lower among PHIV ( P = 0.05) and significantly worse on tests of executive functioning and delayed recall ( P 's ≤ 0.05). Overall, monocyte activation significantly correlated with worse test performance on global z-score (r = 0.21, P = 0.04), attention, processing speed, and motor speed (r = 0.2-0.3, P ≤ 0.01). T-cell activation was significantly correlated with worse performance on tests of learning, executive functioning, and working memory (r = 0.2-0.4, P ≤ 0.04). In PHIV, after adjusting for age, sex, and antiretroviral therapy duration, activated CD4 T cells remained associated with worse memory (β-0.3, 95% CI: -0.55 to -0.07, P = 0.01). PHIV with virologic suppression on antiretroviral therapy shows evidence of worse neurocognitive test performance compared with controls. Monocyte and T-cell activation is correlated with worse neurocognition in Ugandan youth with and without HIV, which has not been previously investigated in this setting.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"296-304"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431961","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":"Beyond Viral Suppression-The Impact of Cumulative Violence on Health-Related Quality of Life Among a Cohort of Virally Suppressed Patients: Erratum.","authors":"","doi":"10.1097/QAI.0000000000003520","DOIUrl":"10.1097/QAI.0000000000003520","url":null,"abstract":"","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"97 3","pages":"313"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465628","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":"Brief Report: Alternative Pulmonary Function Measures of Emphysema in People With HIV.","authors":"Sara C Auld, Kristin R V Harrington, Minh Ly T Nguyen, Jonathan A Colasanti, Vincent C Marconi, Bashar S Staitieh","doi":"10.1097/QAI.0000000000003490","DOIUrl":"10.1097/QAI.0000000000003490","url":null,"abstract":"<p><strong>Introduction: </strong>People with HIV (PWH) have nearly twice the risk of emphysema than people without HIV. This risk, which has been associated with HIV-mediated changes in the lung immune environment and more extensive radiographic emphysema, may result in different patterns of airflow limitation on pulmonary function testing (PFT) than those traditionally used in people without HIV.</p><p><strong>Methods: </strong>In this prospective cohort of PWH in Atlanta, Georgia, we analyzed PFT and chest computed tomography data from July 2013 through June 2018. After comparing the prevalence of PFT measures of airflow limitation for those with and without radiographic emphysema, we used binary recursive partitioning to identify PFT measures that differentiated between PWH with and without radiographic emphysema.</p><p><strong>Results: </strong>Among 167 PWH who had both PFT and computed tomography data during the study period, 89 (53%) had radiographic emphysema. Those with radiographic emphysema were more likely to have airflow limitations on PFTs. Recursive partitioning identified partitions at a forced expiratory volume in 1 second to forced vital capacity ratio (FEV1/FVC) of 0.78 and a residual volume of 116% predicted. These partitions enabled the identification of 84 (94%) PWH with radiographic emphysema, in contrast to the traditional diagnostic criteria of an FEV1/FVC ratio of 0.7, which only identified 49 (55%) of those with radiographic emphysema.</p><p><strong>Conclusions: </strong>Emphysema in PWH may have different patterns of airflow limitation on PFTs that are not adequately captured by traditional diagnostic criteria. Future studies can seek to validate these findings and determine optimal thresholds for diagnosing HIV-associated emphysema.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"97 3","pages":"282-285"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465629","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":"Three Novel Patient-Reported Outcome Measures to Assess the Patient Experience With Daily and Weekly HIV Oral Antiretroviral Therapy.","authors":"Julie R Bailey, Eileen Fonseca, Alexander Borsa, Emily Hawryluk, Steven I Gubernick, Anna de la Motte, Stella Karantzoulis, Matthew Reaney, Todd L Saretsky","doi":"10.1097/QAI.0000000000003482","DOIUrl":"10.1097/QAI.0000000000003482","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcome measures (PROMs) can provide data on the barriers and facilitators of adherence to daily oral antiretroviral therapy (OART) regimens. We aimed to develop PROMs to understand the perspectives of people with HIV (PWH) on (1) facilitators/barriers to daily OART regimen adherence and (2) a hypothetical switch to a long-acting (LA)-OART regimen.</p><p><strong>Methods: </strong>Following the US food and drug administration patient-reported outcome guidance, targeted literature reviews and concept elicitation interviews with clinicians (n = 7) and PWH (n = 28) were conducted to develop conceptual models (CMs) of facilitators/barriers to OART regimen adherence. Three de novo PROMs were developed after an item-generation meeting. Three waves of cognitive debriefing interviews were conducted among PWH (n = 30) to demonstrate content validity and refine the PROMs.</p><p><strong>Results: </strong>The targeted literature review identified 25 facilitators/barriers; an additional 16 facilitators/barriers were added by clinicians and PWH and represented in 2 CMs. During the item-generation meeting, the CMs were used to develop 3 de novo PROMs: (1) HIV Patient Perspective of Regimen, (2) HIV Patient Perspective of Regimen Change, and (3) HIV Drivers of Adherence Questionnaire. In the cognitive debriefing interviews, PWH corroborated the relevancy of items in the PROMs, and minor adjustments were made for clarity.</p><p><strong>Conclusion: </strong>Three content-valid PROMs were developed to understand the treatment experience of PWH taking daily OART and how that experience may be altered upon a switch to weekly LA-OART. Data from future LA-OART clinical trials will help define a scoring guide and evaluate the structure and measurement properties of the PROMs.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"97 3","pages":"286-295"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465632","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":"A Systematic Review and Meta-analysis of the Impact of the COVID-19 Pandemic on Access to HIV Pre-exposure Prophylaxis: Lessons for Future Public Health Crises.","authors":"Luh Putu Lila Wulandari, Srila Nirmithya Salita Negara, Yusuf Ari Mashuri, Siska Dian Wahyuningtias, I Wayan Cahyadi Surya Distira Putra, Yanri W Subronto, Riris Andono Ahmad, Hasbullah Thabrany, Rebecca Guy, Matthew Law, Mohamed Hammoud, Benjamin B Bavinton, John Kaldor, Nicholas Medland, Marco Liverani, Ari Probandari, David Boettiger, Virginia Wiseman","doi":"10.1097/QAI.0000000000003488","DOIUrl":"10.1097/QAI.0000000000003488","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization is committed to strengthening access to pre-exposure prophylaxis (PrEP) for HIV prevention and its integration into primary care services. Unfortunately, the COVID-19 pandemic has disrupted the delivery of primary care, including HIV-related services. To determine the extent of this disruption, we conducted a systematic review and meta-analysis of the changes in access to PrEP services during the pandemic and the reasons for these changes.</p><p><strong>Methods: </strong>A search was conducted using PubMed, Scopus, Embase, PsycINFO, and Cinahl for studies published between January 2020 and January 2023. Selected articles described self-reported disruptions to PrEP service access associated with the COVID-19 pandemic or its responses. Pooled effect sizes were computed using a random-effects model.</p><p><strong>Results: </strong>Thirteen studies involving 12,652 PrEP users were included in our analysis. The proportion of participants reporting a disruption in access to PrEP services during the COVID-19 pandemic ranged from 3% to 56%, with a pooled proportion of 21% (95% confidence intervals: 8% to 38%). Social restrictions, financial constraints, and limited health insurance coverage were key factors affecting access to PrEP services during the pandemic.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first meta-analysis to quantify the extent of disruptions to accessing PrEP services because of the COVID-19 pandemic. To increase the ability of primary care services to maintain PrEP services during public health crises, a mixture of strategies is worth considering. These include multi-month PrEP prescriptions, telehealth services, deployment of peer support groups to provide a community-based service or home delivery, and provision of financial support interventions.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"97 3","pages":"208-215"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465627","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}