JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Leronlimab Treatment for Multidrug-Resistant HIV-1 (OPTIMIZE): a Randomized, Double-Blind, Placebo-Controlled Trial.","authors":"Joseph C Gathe, Edwin Dejesus, Moti N Ramgopal, Charlotte-Paige Rolle, Otto O Yang, William E Sanchez, Jacob P Lalezari, Alok Krishen, Jonah B Sacha, Scott G Hansen, Joseph Meidling","doi":"10.1097/QAI.0000000000003648","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003648","url":null,"abstract":"<p><strong>Background: </strong>Leronlimab is a humanized κ-IgG4 monoclonal antibody that blocks C-C chemokine receptor type 5 (CCR5). We investigated leronlimab as a treatment option for people living with multidrug-resistant HIV-1.</p><p><strong>Setting: </strong>and Methods: In a phase 2b/3, multicenter, randomized, double-blind, placebo-controlled study conducted in 21 hospital centers in the United States, treatment-experienced people living with HIV (PLWH) with documented drug resistance were randomly assigned once weekly leronlimab (350 mg subcutaneously) or matching placebo for one week overlapping existing failing antiretroviral treatment (ART), followed by a 24-week single-arm extension with weekly leronlimab combined with a new optimized background treatment (OBT). The primary endpoint was achieving ≥0.5 log10 reduction in plasma HIV-1 RNA from baseline at the end of the one-week double-blinded treatment period.</p><p><strong>Results: </strong>52 participants were enrolled (25 leronlimab and 27 placebo). After the one-week randomized phase, by the intent-to-treat analysis 64.0% (16/25) receiving leronlimab achieved ≥0.5 log10 reduction in plasma HIV-1 RNA versus 23.1% (6/26) receiving placebo (p=0.0032), while by per protocol analysis 72.7% (16/22) receiving leronlimab achieved ≥0.5 log10 reduction in plasma HIV-1 RNA versus 24.0% (6/25) receiving placebo (p=0.0008). Leronlimab was generally well tolerated with no drug-related SAEs reported. Overall, 175 adverse events were reported by 34/52 participants, with 120 (68.6%) adverse events categorized as mild.</p><p><strong>Conclusions: </strong>Leronlimab resulted in significantly reduced plasma HIV-1 within one week after addition to failing ART. After 24 weeks combined with an OBT, most participants had plasma HIV-1 RNA levels <50 copies per mL plasma, suggesting utility of leronlimab as a component of salvage therapy.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457675","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":"Improving Perinatal HIV Care during the COVID-19 Pandemic: Implementing a Mobile Integrated Health Program to Close the Gap.","authors":"Aditi Ramakrishnan, Madeleine Goldstein, Shakti Shetty, Martina Badell, Ameeta S Kalokhe, Jonathan Colasanti, Jieri Sumitani, Thomas-Seaton LaTeshia, Melissa Beaupierre, Sophia A Hussen, Anandi N Sheth","doi":"10.1097/QAI.0000000000003643","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003643","url":null,"abstract":"<p><strong>Background: </strong>Pregnant people with HIV (PWH) often experience loss to follow-up and viral non-suppression after delivery, contributing to morbidity and HIV transmission. The COVID-19 pandemic disrupted health systems and exacerbated health disparities, including for PWH and their infants. To improve perinatal HIV outcomes, we implemented a perinatal care program in September 2020 that offered multidisciplinary home visits through a Mobile Integrated Health (MIH) unit within a large, safety-net healthcare system in Atlanta, Georgia.</p><p><strong>Methods: </strong>We analyzed data collected from PWH who delivered one year before (8/31/19-8/31/20; pre-implementation) to six months after (9/1/20-2/28/21; post-implementation) MIH implementation to compare HIV clinical outcomes. We evaluated barriers, facilitators, and patient preferences through exit surveys with MIH program participants.</p><p><strong>Results: </strong>Overall, 32 (53%) delivered before and 28 (47%) PWH delivered after MIH implementation; majority were non-Hispanic Black. Three-fourths who delivered post-MIH utilized MIH, mostly (62%) for postpartum obstetric visits. HIV visit attendance within 3 months and retention in care at 6 months of delivery were significantly higher post-implementation (p = 0.04). Participants noted that the MIH program significantly improved appointment scheduling and access to healthcare services during the pandemic (p < 0.05). Participants highly rated the preferability, convenience, safety, and use of the MIH program for future pregnancies.</p><p><strong>Conclusions: </strong>Implementation of a perinatal MIH program for PWH and their infants led to significant improvement in engagement in HIV care after delivery. Our findings demonstrate that novel, interdisciplinary programming can fill critical gaps in care delivery, including during periods of healthcare disruption.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407836","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 lived experiences of Ugandan community health workers engaged in prevention of vertical transmission of HIV and a capacity-building intervention.","authors":"Victor Mocanu, Hannah M Brooks, Sophie Namasopo, Robert O Opoka, Michael T Hawkes","doi":"10.1097/QAI.0000000000003649","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003649","url":null,"abstract":"<p><strong>Objective: </strong>To explore the lived experiences of community health workers (CHW) engaged in efforts toward the elimination of vertical transmission (EVT) of HIV and to assess the impact of a capacity-building training intervention.</p><p><strong>Design: </strong>The study consisted of: (1) a qualitative assessment of lived experiences of CHWs; (2) a capacity-building training intervention responsive to identified needs; and (3) assessment of the training intervention using pre- and post-intervention questionnaires.</p><p><strong>Methods: </strong>Focus group discussions (FGD) and semi-structured key informant interviews (KII) in addition to CHW training sessions for HIV/EVT were held in one rural and one semi-urban setting in Uganda, based on training materials developed by the WHO and USAID. We used standardized pre- and post-intervention questionnaires to assess comprehensive knowledge and accepting attitudes toward HIV.</p><p><strong>Results: </strong>Qualitative exploration of the lived experience of 152 CHWs in ten FGDs and four KIIs revealed several themes: (1) CHWs as bridges between health system and community; (2) CHW assets (tacit knowledge and shared social networks); (3) CHW challenges (stigma, secrecy, and ethical quandaries); (4) favorable community reception; and (5) need for continuing education and reinforcement of skills. In response to identified needs, a capacity-building intervention was designed and implemented with 143 CHWs participating in 10 sessions. The proportion of participants with comprehensive knowledge of HIV increased from 45% to 61% (p=0.006) and the proportion endorsing accepting attitudes increased from 63% to 76% (p=0.013).</p><p><strong>Conclusion: </strong>CHWs are potentially valuable players in global EVT efforts. Ongoing training is needed to support community-level initiatives.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407857","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":"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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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. Chi-square tests and multivariable logistic regression were applied to examine factors associated with readiness to use PrEP.</p><p><strong>Results: </strong>Study sample (n=187) was 51% Black, 15% Hispanic, 30% identified as bisexual or straight or other, and 29% had no health insurance. 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 (AOR=2.78, 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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiation of Dolutegravir vs Efavirenz on Viral Suppression and Retention at 6-months: A Regression Discontinuity Design.","authors":"Amy Zheng, Matthew P Fox, Ross Greener, Emma M Kileel, Jacob Bor, Willem Df Venter, Pedro T Pisa, Alana T Brennan, Mhairi Maskew","doi":"10.1097/QAI.0000000000003642","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003642","url":null,"abstract":"<p><strong>Background: </strong>In 2019, South Africa's Antiretroviral Therapy (ART) Treatment Guidelines replaced efavirenz with dolutegravir in first-line ART.</p><p><strong>Setting: </strong>We assessed the impact of this national guideline change on retention and viral suppression in the Themba Lethu Clinical Cohort, Johannesburg, South Africa. We applied a regression discontinuity design in a prospective cohort study of 1654 adults living with HIV initiating first-line ART within 12 months (±12 months) of the guideline change.</p><p><strong>Methods: </strong>We compared outcomes in individuals presenting just before and after the guideline change and estimated intention-to-treat effects on initiating a dolutegravir- vs efavirenz-based regimen. Primary outcomes were retention and viral suppression. Participants were defined as retained in care if a visit took place within +3-months of the 6-month endpoint. Viral suppression was defined as having a viral load < 1000 copies/mL 3-months prior to and up to 6-months after the 6-month endpoint.</p><p><strong>Results: </strong>The 2019 guideline change led to an increase in uptake of dolutegravir. We noted a 26.6 percentage point increase in the proportion initiating dolutegravir (95% Confidence Interval (CI): 14.1, 38.6). We saw a small increase in viral suppression (Risk Difference (RD): 7.4 percentage points; 95% CI: -1.6, 16.5) and no change in retention (RD: -1.7 percentage points; 95% CI: -13.9, 10.5) at 6 months, though our findings were imprecise.</p><p><strong>Conclusion: </strong>Our estimates suggest early uptake of the revised treatment guidelines after implementation. Despite this, there was no meaningful change in viral suppression and retention rates at 6-months.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364753","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":"Addressing Methamphetamine Use Is Essential to Stopping HIV Transmission.","authors":"Finn Black, Vanessa McMahan, Xochitl Luna Marti, Emily Pope, John Walker, Albert Liu, Phillip Oliver Coffin","doi":"10.1097/QAI.0000000000003542","DOIUrl":"10.1097/QAI.0000000000003542","url":null,"abstract":"","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"e9-e10"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380862","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":"Racial and Ethnic Disparities in HIV Diagnosis Rates by Social Determinants of Health at the Census Tract Level Among Adults in the United States and Puerto Rico, 2021.","authors":"Krishna Kiran Kota, Samuel Eppink, Zanetta Gant Sumner, Harrell Chesson, Donna Hubbard McCree","doi":"10.1097/QAI.0000000000003541","DOIUrl":"10.1097/QAI.0000000000003541","url":null,"abstract":"<p><strong>Background: </strong>We compared racial and ethnic disparities in HIV diagnosis rates among adults in census tracts with the most disadvantaged vs. the most advantaged levels of social determinants of health.</p><p><strong>Methods: </strong>In this ecologic analysis, we used the National HIV Surveillance System data from 2021 and social determinants of health data from 2017-2021 American Community Survey. We measured racial and ethnic disparities stratified by sex in the most disadvantaged quartiles and advantaged quartiles for (1) poverty, (2) education level, (3) median household income, and (4) insurance coverage. We calculated 8 relative disparity measures [Black-to-White rate ratio, Hispanic/Latino-to-White rate ratio, index of disparity (ID), population-weighted ID, mean log deviation, Theil index, population attributable proportion, Gini coefficient] and 4 absolute disparity measures (Black-to-White rate difference, Hispanic/Latino-to-White rate difference, absolute ID, and population-weighted absolute ID).</p><p><strong>Results: </strong>Comparing the most disadvantaged quartiles with the most advantaged quartiles, all 4 absolute disparity measures decreased, but 7 of the 8 relative disparity measures increased: the median percentage decreases in the absolute measures for men and women, respectively, were 38.1% and 47.6% for poverty, 12.4% and 42.6% for education level, 43.6% and 44.0% for median household income, and 44.2% and 45.4% for insurance coverage. The median percentage increases in the relative measures for men and women, respectively, were 44.3% and 61.3% for poverty, 54.9% and 95.3% for education level, 19.6% and 90.0% for median household income, and 32.8% and 46.4% for insurance coverage.</p><p><strong>Conclusions: </strong>Racial and ethnic disparities in the most disadvantaged and the most advantaged quartiles highlight the need for strategies addressing the root causes of disparities.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"114-122"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371855","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":"Accuracy of Alternative PHQ-9 Scoring Algorithms to Screen for Depression in People Living With HIV in Sub-Saharan Africa.","authors":"Charlotte Bernard, Hélène Font, Natalia Zotova, Kara Wools-Kaloustian, Suzanne Goodrich, Edith Kamaru Kwobah, Ajeh Rogers Awoh, Guy Calvin Nko'o Mbongo'o, Dominique Mahambu Nsonde, Paul Gandou, Albert Minga, Judicaël Malick Tine, Ibrahima Ndiaye, François Dabis, Moussa Seydi, Nathalie de Rekeneire, Marcel Yotebieng, Antoine Jaquet","doi":"10.1097/QAI.0000000000003551","DOIUrl":"10.1097/QAI.0000000000003551","url":null,"abstract":"<p><strong>Background: </strong>Screening for depression remains a priority for people living with HIV (PLWH) accessing care. The 9-item Patient Health Questionnaire (PHQ-9) is a widely used depression screening tool, but has limited accuracy when applied across various cultural contexts. We aimed to evaluate the performance of alternative PHQ-9 scoring algorithms in sub-Saharan African PLWH.</p><p><strong>Setting: </strong>Five HIV programs in Cameroon, Côte d'Ivoire, Kenya, Senegal, and the Republic of Congo.</p><p><strong>Methods: </strong>Adult PLWH were screened for depression during the 2018-2022 period. Diagnosis confirmation was done by psychiatrist blinded clinical evaluation (gold standard). Diagnostic performances, including sensitivity and area under the curve (AUC) of the traditional PHQ-9 scoring (positive screening - score ≥ 10), were compared to alternative scoring algorithms including (1) the presence of ≥1 mood symptom (PHQ-9 items 1 and 2) combined with ≥2 other symptoms listed in the PHQ-9, and (2) a simplified recoding of each 4-response item into 2 categories (absence/presence).</p><p><strong>Results: </strong>A total of 735 participants were included [54% women, median age 42 years (interquartile range 34-50)]. Depression was diagnosed by a psychiatrist in 95 (13%) participants. Alternative scoring sensitivities (0.59-0.74) were higher than that of the traditional score's (0.39). Compared to traditional scoring, AUC was significantly higher for PHQ-9 alternative scoring. Across settings, alternative scoring algorithms increased sensitivity and reduced variability.</p><p><strong>Conclusions: </strong>As a primary screening test, new scoring algorithms seemed to improve the PHQ-9 sensitivity in identifying depression and reducing heterogeneity across settings. This alternative might be considered to identify PLWH in need of referral for further diagnostic evaluations.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"143-149"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500592","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, Off-Label Antipsychotics, and Dementia Risk in People With HIV.","authors":"Joseph Magagnoli, Tammy H Cummings, Michael D Wyatt, Michael Shtutman, S Scott Sutton","doi":"10.1097/QAI.0000000000003545","DOIUrl":"10.1097/QAI.0000000000003545","url":null,"abstract":"<p><strong>Background: </strong>Comorbidities such as schizophrenia and medication such as antipsychotics may influence the risk of dementia among people living with HIV (PLWH). The objective of this article is to assess the associations among HIV patients with schizophrenia, off-label antipsychotics, and dementia risk.</p><p><strong>Setting: </strong>US Department of Veterans Affairs health care facilities from 2000 to September 2023.</p><p><strong>Methods: </strong>Retrospective cohort study of PLWH treated by the US Department of Veterans Affairs with history of schizophrenia, off-label antipsychotic use, and neither schizophrenia nor antipsychotic use. Propensity score-matched non-HIV controls were included for the respective HIV groups. The hazard of dementia is estimated using Cox proportional hazards models.</p><p><strong>Results: </strong>PLWH and schizophrenia, were found to have a 2.49 higher hazard of dementia than HIV patients with no history of schizophrenia or antipsychotic medication use (hazard ratio [HR] = 2.49, 95% confidence interval [CI]: 1.85 to 3.35). PLWH and off-label antipsychotic use were found to have a 1.77-fold higher hazard of dementia than HIV patients with no history of schizophrenia or antipsychotic medication use (HR = 1.77, 95% CI: 1.37 to 2.28). Propensity score-matched analysis reveals that, among patients with schizophrenia, those with HIV had a 1.65-fold higher hazard of dementia (HR = 1.65, 95% CI: 1.12 to 2.44). Among patients with no schizophrenia or antipsychotic medication, those with HIV had a 1.47-fold higher hazard of dementia (HR = 1.47, 95% CI: 1.33 to 1.63).</p><p><strong>Conclusions: </strong>This study demonstrates that among PLWH, history of schizophrenia or off-label antipsychotic medication use are associated with substantial increases in dementia incidence. Furthermore, propensity score-matched control analysis reveals that HIV infection itself is independently and significantly associated with elevated dementia risk.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"133-142"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465626","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":"Discussion of HIV and Other Sexually Transmitted Infections With Sex Partners of Nigerian Men Who Have Sex With Men and Transgender Women: Implications for Interventions to Promote Safer Sex Practices.","authors":"Abdulwasiu B Tiamiyu, Fengming Hu, Afoke Kokogho, Manhattan E Charurat, Charles Ekeh, Sylvia Adebajo, Elizabeth Shoyemi, Michael Iroezindu, Julie A Ake, Stefan D Baral, Rebecca G Nowak, Trevor A Crowell","doi":"10.1097/QAI.0000000000003552","DOIUrl":"10.1097/QAI.0000000000003552","url":null,"abstract":"<p><strong>Background: </strong>Discussion of HIV and other sexually transmitted infections among sex partners facilitates risk reduction. We evaluated HIV/STI-related communications, including broad assessment of any self-reported discussion of the topic and specific discussion of each partner's HIV status, among a historically marginalized and presently criminalized community of sexual and gender minorities (SGM) in Nigeria.</p><p><strong>Methods: </strong>From 2013 to 2018, we enrolled SGM aged 18+ years in Lagos or 16+ years in Abuja who reported anal sex with men. At enrollment and 3-, 9-, and 15-month follow-up visits, participants were asked about their sexual behaviors and communications with main sexual partners (MSP) and casual sexual partners (CSP). Questions included \"have you talked with your [MSP/CSP] about sexually transmitted infections and HIV?\" Multivariable robust Poisson regression with generalized estimating equations was used to estimate adjusted relative risks (aRRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV/STI-related communications with some or all of each type of sexual partner.</p><p><strong>Results: </strong>Among 2795 SGM enrolled with median age 23 years (interquartile range 20-27), questions about HIV/STI-related communications with MSP were answered by 2436 (87.2%) and with CSP by 2398 (85.9%) SGM. Communication with MSP was reported by 68.1% (1659/2436), of whom 897 (54.1%) discussed their own HIV status and 925 (55.8%) discussed their partner's status. Communication with CSP was reported by 43.9% (1052/2398), of whom 389 (37.0%) discussed their own HIV status and 385 (36.6%) discussed their partner's status. Among participants with both MSP and CSP, HIV/STI-related communication with MSP was more common among participants with higher than secondary education [aRR 1.40 (95% CI: 1.24 to 1.58)], who were divorced/separated/widowed [aRR 1.19 (95% CI: 1.06 to 1.33)], who discussed their HIV status with CSP [aRR 1.18 (95% CI: 1.10 to 1.25)], discussed CSP's HIV status [aRR 1.20 (95% CI: 1.13 to 1.27)], and used a condom at last sex with CSP [aRR 1.16 (95% CI: 1.08 to 1.25)]. HIV/STI-related communication with CSP was more common among participants with higher than secondary education [aRR 1.36 (95% CI: 1.12 to 1.66)], who were divorced/separated/widowed [aRR 1.38 (95% CI: 1.13 to 1.69)], who discussed their HIV status with MSP [aRR 1.47 (95% CI: 1.27 to 1.69)], who discussed CSP's HIV status [aRR 1.22 (95% CI: 1.06 to 1.40)], and used a condom at last sex with CSP [aRR 1.22 (95% CI: 1.08 to 1.38)].</p><p><strong>Conclusions: </strong>HIV/STI-related communications with main and casual sex partners were both associated with safer sex with CSP. HIV prevention and treatment programs for SGM should promote open communications in sexual relationships and consider deployment of modern strategies to facilitate disclosure, especially in settings with criminalizing legislation.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"161-170"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500593","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}