JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"HIV Treatment Outcomes After 10 years on ART in the TREAT Asia Observational Database and Australian HIV Observational Database.","authors":"Awachana Jiamsakul, Dhanushi Rupasinghe, Ian Woolley, Jun Yong Choi, David J Templeton, Alvina Widhani, Kathy Petoumenos, Junko Tanuma","doi":"10.1097/QAI.0000000000003515","DOIUrl":"10.1097/QAI.0000000000003515","url":null,"abstract":"<p><strong>Background: </strong>Increasing numbers of people with HIV have received prolonged antiretroviral therapy (ART). We assessed long-term immunological and survival outcomes among people with HIV from Asia (TREAT Asia HIV Observational Database) and Australia (Australian HIV Observational Database).</p><p><strong>Methods: </strong>People with HIV receiving ART for ≥10 years were included. Factors associated with CD4 counts in years 11-15 of ART were analyzed using repeated measures linear regression. Survival after 10 years was analyzed using competing risk regression.</p><p><strong>Results: </strong>There were 7139 people included: 4867 (68%) from the TREAT Asia HIV Observational Database and 2272 (32%) from the Australian HIV Observational Database. Higher CD4 levels after 10 years were observed if the nadir CD4 in the first decade was higher (CD4 (cells/µL) 101-200: difference = 35, 95% CI: 18 to 51; >200: difference = 125, 95% CI: 107 to 142) compared with ≤50. The same patterns were observed in those who achieved CD4 ≥500 cells/µL, which subsequently decreased to <500 (difference = 225, 95% confidence interval [CI]: 213 to 236), or in those who achieved and maintained CD4 ≥500 cells/µL (difference = 402, 95% CI: 384 to 420), compared with always <500 in the previous decade. Previous protease inhibitor (PI)-based regimen (difference=-17, 95% CI -33 to -1) compared with no PI, and previous treatment interruptions (TI) of 14 days to 3 months and >6 months were associated with lower CD4 counts after 10 years (difference = -38, 95% CI -62 to -15 and difference=-44, 95% CI -61 to -27, respectively) compared with no TI. The mortality rate was 1.04 per 100 person-years. Virological failure was associated with subsequent mortality (subhazard ratio = 1.34, 95% CI: 1.04 to 1.71).</p><p><strong>Conclusions: </strong>Sustaining high CD4 levels and minimizing TI has far-reaching benefits well beyond the first decade of ART.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"460-470"},"PeriodicalIF":2.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017500","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":"Outcomes of Lymphoma Patients Admitted to the ICU Are Not Influenced by HIV Status: A Retrospective, Observational Cohort Study.","authors":"Fouad El-Hibri, Ahmed Al-Hindawi, Shivani Singh, Mark Bower, Suveer Singh","doi":"10.1097/QAI.0000000000003522","DOIUrl":"10.1097/QAI.0000000000003522","url":null,"abstract":"<p><strong>Background: </strong>Patients with lymphoma may require intensive care (ICU) because of disease- or treatment-related complications. The lymphoma-HIV interaction complicates management, but whether outcomes are worse in these patients, when critically ill, is unclear. A retrospective observational cohort study reviewed outcomes of patients admitted to ICU, subsequent 5-year survival, and prognostic factors.</p><p><strong>Setting: </strong>Academic ICU at the UK National Centre for HIV Malignancy.</p><p><strong>Methods: </strong>Records between 2007 and 2020 identified the following cohorts: HIV lymphoma, lymphoma alone, HIV alone, and patients without HIV/lymphoma. Patient demographics, lymphoma characteristics, ICU admission data, and survival outcomes were collected. Five-year survival outcomes were analyzed for the lymphoma cohorts. ICU outcomes were analyzed for all cohorts. Descriptive statistics summarized baseline characteristics and outcomes. Multivariate regression identified factors associated with ICU mortality.</p><p><strong>Results: </strong>Of 5929 patients admitted to the ICU, 63 had HIV lymphoma and 43 had lymphoma alone. Survival to ICU discharge was 71% and 72%, respectively. Adjusted log-odds ratio for ICU survival was significantly better in the comparator cohort. ICU survival between the HIV lymphoma and lymphoma-alone cohorts was not significantly different. Adjusted 5-year survival was not significantly different between lymphoma cohorts. Factors independently associated with a worse ICU survival prognosis were emergency admissions, Acute Physiology and Chronic Health Evaluation II score, initial lactate, and day requiring level 3 support. Mechanical ventilation and higher Acute Physiology and Chronic Health Evaluation II scores were independent risk factors for worse 5-year survival in the lymphoma cohorts.</p><p><strong>Conclusions: </strong>ICU outcomes and 5-year survival rates of patients with lymphoma were unaffected by HIV status, revealing favorable outcomes in patients with HIV-related lymphoma admitted to the ICU.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"489-496"},"PeriodicalIF":2.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154072","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: Genital Microbiome, Inflammation, and Tenofovir Levels in Transgender Men and Cisgender Women Taking Oral PrEP.","authors":"Elizabeth Hastie, Megha S Srivatsa, Sara Gianella, Mackenzie Cottrell, Kyra Forsyth, Magali Porrachia, Leah Burke, Sheldon Morris, Stephen A Rawlings, Maile Karris, Antoine Chaillon, Jill Blumenthal","doi":"10.1097/QAI.0000000000003521","DOIUrl":"10.1097/QAI.0000000000003521","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the efficacy of preexposure prophylaxis (PrEP) or what biologic factors may influence HIV transmission in transgender men (TGM). In this study, we sought to explore the effect of testosterone on the vaginal microbiome, cervicovaginal fluid (CVF) tenofovir concentrations, and levels of CVF inflammatory markers in TGM on PrEP.</p><p><strong>Methods: </strong>Cervicovaginal fluid was collected from 13 TGM (7 using testosterone) and 32 cisgender women (CGW) on PrEP. The vaginal microbiome, CVF tenofovir concentrations, and CVF inflammatory markers were determined and compared.</p><p><strong>Results: </strong>The proportion of CVF Lactobacillus was significantly higher in CGW than in TGM (78% vs 24%, P < 0.001). Among TGM, the proportion of CVF Lactobacillus was lower, though not statistically significant, in those taking testosterone than in those not taking testosterone (14% vs 35%, P-value = 0.3). Interestingly, mean CVF tenofovir concentrations were the lowest in TGM on testosterone at 884 ng/mL compared with 3150 ng/mL in TGM not on testosterone and 1932 ng/mL in CGW; however, this difference was not statistically significant. There was no statistically significant difference in any of the genital inflammatory markers between groups and no correlation between inflammation and tenofovir levels.</p><p><strong>Conclusions: </strong>Our findings suggest a potential correlation between testosterone use, Lactobacillus dominance, and lower TFV concentrations in CVF, which may have implications on HIV acquisition from vaginal sex in TGMT. Future studies with larger sample sizes are needed to further investigate these relationships.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"97 5","pages":"477-481"},"PeriodicalIF":2.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948800","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:Availability of and Interest in Gender-Affirming Care, PrEP, and HIV Prevention Services in a Global Sample of Transmasculine Persons.","authors":"Emily Allen Paine, Max Appenroth, Ayden Scheim, Madison Goldrich, Rebecca Giguere, Theodorus Sandfort","doi":"10.1097/QAI.0000000000003512","DOIUrl":"10.1097/QAI.0000000000003512","url":null,"abstract":"<p><strong>Background: </strong>We assessed access to pre-exposure prophylaxis (PrEP) and interest in integration of PrEP with gender-affirmative care in a global sample of transmasculine persons.</p><p><strong>Methods: </strong>Transmasculine persons (N = 590) aged 18 years and above from 57 countries completed a brief online survey from April to July 2022 about sexual behavior, knowledge, and interest in PrEP, current access to PrEP and gender-affirmative care, and preferred context for accessing PrEP. Descriptive analyses were stratified by country income group.</p><p><strong>Results: </strong>Most participants (54.4%) lived near a health center offering care to trans people. Overall, 1.9% of respondents reported ever receiving a positive HIV test result. Among those who had not (n = 579), more than a third reported engaging in receptive sex in the past year (35.2%) or anticipated doing so in the next year (41.5%), 86.9% had never received information about HIV prevention specific to transmasculine people, and 76.3% had heard of PrEP. Among those who had heard of PrEP (n = 440), only 18.9% had discussed or been offered it by a provider, and only 3.6% were currently taking it-yet 67.9% who had heard of it but were not using it would \"definitely\" (28.5%) or \"maybe\" (39.4%) be interested in taking it were it available for free. Out of these participants, the majority (60.5%) preferred the idea of accessing PrEP from the same clinic where they received gender-affirming care.</p><p><strong>Conclusions: </strong>Interventions are needed to improve PrEP access for transmasculine people globally. Clinics already providing gender-affirming care to trans people are acceptable clinical contexts to integrate such interventions.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"97 5","pages":"471-476"},"PeriodicalIF":2.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948805","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: Antiretroviral Treatment Use Over Time Among Adolescents and Young Adults in the Rakai Community Cohort Study, 2011-2020.","authors":"Philip Kreniske, Fred Nalugoda, Ivy Chen, Neha Parate, Ying Wei, Larry W Chang, Robert Ssekubugu, Tom Lutalo, Godfrey Kigozi, Joseph Kagaayi, Nelson Sewankambo, M Kate Grabowski, Gertrude Nakigozi, David Serwadda, Susie Hoffman, John Santelli","doi":"10.1097/QAI.0000000000003516","DOIUrl":"10.1097/QAI.0000000000003516","url":null,"abstract":"<p><strong>Background: </strong>In sub-Saharan Africa, pediatric and adult treatment programs have not met the needs of youth living with HIV (15-24 years), whose enrollment in antiretroviral treatment (ART) programs is much lower than that of adults. To inform targeted interventions, we analyzed factors associated with ART use among youth in Uganda.</p><p><strong>Methods: </strong>Data were from 42 communities between 2011 and 2020 (5 survey rounds) from the Rakai Community Cohort Study, an open, population-based cohort. Among youth, we assessed trends in ART use over time and demographic characteristics and sexual behaviors associated with ART use.</p><p><strong>Results: </strong>Youth (N = 1518) contributed 2101 person-visits. ART coverage increased over time with 8% of men and 11% of women on ART in 2011-2013 and 45% and 68%, respectively, on ART in 2018-2020 (AORwomen vs. men=2.57; 95% CI: 1.72 to 3.84). Youth with 2 or more sexual partners compared with youth with 0-1 sexual partner were less likely to be on ART (men AOR = 0.40; 0.19-0.82; women AOR = 0.54; 0.41-0.72). Youth who reported consistent condom use were more likely to be on ART (men AOR = 2.94; 95% CI: 1.14 to 7.57; women AOR = 1.70; 95% CI: 1.00 to 2.88).</p><p><strong>Conclusions: </strong>In this longitudinal study, ART use among youth increased over time, yet at 63% remained well below UNAIDS 95-95-95 goals, thus depriving many of lifesaving treatment. Those engaging in fewer protective sexual behaviors had lower ART use, thus further increasing risk of future HIV transmission. Targeted efforts are needed to ensure rapid initiation of ART and continued engagement among this vulnerable population.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"97 5","pages":"433-438"},"PeriodicalIF":2.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948859","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":"DEVELOPING A PRACTICE-DRIVEN TAXONOMY OF IMPLEMENTATION STRATEGIES FOR HIV PREVENTION.","authors":"Sarit A Golub, Carly Wolfer, Alexa Beacham, Benjamin V Lane, Cody A Chastain, Kathrine A Meyers","doi":"10.1097/QAI.0000000000003581","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003581","url":null,"abstract":"<p><strong>Background: </strong>Effective implementation of evidence-based HIV prevention interventions continues to be a challenge in the United States, and the field is increasingly turning to implementation science for solutions. As such, it is critical to expand the current implementation science vocabulary - and its taxonomy of implementation strategies - to increase its relevance and utility for front-line implementers.</p><p><strong>Setting: </strong>Community-based health centers providing HIV prevention services in the Southeastern US.</p><p><strong>Method: </strong>We conducted a collective case-study analysis, combining document review and qualitative interviews with program directors, clinicians, and other providers (N = 30) at five sites. We employed an inductive and iterative analytic approach to specify and categorize strategies, and then conducted in-depth cross-case analysis to derive a practice-driven taxonomy of HIV prevention implementation strategies.</p><p><strong>Results: </strong>From an initial matrix of 264 activities, we identified 50 strategies common across sites. In contrast to existing implementation science frameworks, the majority (68%, n = 34) of strategies were designed to impact implementation outcomes (e.g., acceptability, adoption, feasibility) for patients. We present a practice-driven taxonomy of these strategies, operationalized according to implementation science literature, but with terminology that more directly relates to implementers.</p><p><strong>Conclusions: </strong>Findings demonstrate the feasibility and utility of this method for developing a practice-driven implementation science vocabulary for HIV prevention. Our evidence-based taxonomy provides a framework for implementers seeking data about the universe of strategies they might consider for their own programs, and increases researchers' ability to measure and evaluate the effectiveness of implementation strategies being enacted in practice settings.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768918","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":"A review of network models for HIV spread.","authors":"Heather Mattie, Ravi Goyal, Victor De Gruttola, Jukka-Pekka Onnela","doi":"10.1097/QAI.0000000000003578","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003578","url":null,"abstract":"<p><strong>Background: </strong>HIV/AIDS has been a global health crisis for over four decades. Network models, which simulate human behavior and intervention impacts, have become an essential tool in guiding HIV prevention strategies and policies. However, no comprehensive survey of network models in HIV research has been conducted. This paper fills that gap, offering a summary of past work and future directions to engage more researchers and inform policy related to eliminating HIV.</p><p><strong>Setting: </strong>Network models explicitly represent interactions between individuals, making them well-suited to study HIV transmission dynamics. Two primary modeling paradigms exist: a mechanistic approach from applied mathematics and a statistical approach from the social sciences. Each has distinct strengths and weaknesses, which should be understood for effective application to HIV research.</p><p><strong>Methods: </strong>We conducted a systematic review of network models used in HIV research, detailing the model types, populations, interventions, behaviors, datasets, and software employed, while identifying potential future research directions.</p><p><strong>Results: </strong>Network models are particularly valuable for studying behaviors central to HIV transmission, such as partner selection and treatment adherence. Unlike traditional models, they focus on indi- vidual behaviors, aligning them with clinical practice. However, more accurate network data are needed for better model calibration and actionable insights.</p><p><strong>Conclusion: </strong>This paper serves as a point of reference for HIV researchers interested in applying network models and understanding their limitations. To our knowledge, this is the most comprehensive review of HIV network models to date.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768891","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":"INCREASING THE ACCESSIBILITY AND RELEVANCE OF IMPLEMENTATION SCIENCE FOR FRONT-LINE IMPLEMENTERS.","authors":"Sarit A Golub, Carly Wolfer, Cody A Chastain","doi":"10.1097/QAI.0000000000003580","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003580","url":null,"abstract":"<p><strong>Background: </strong>Implementation science has been heralded as a critical strategy for ending the HIV epidemic (EHE), and the United States (US) has made a tremendous financial investment in implementation research. However, several dynamics in its development and organization may alienate front-line implementers and recapitulate some of the same missteps that have stymied past translational work.</p><p><strong>Setting: </strong>Increasing the accessibility and relevance of HIV implementation science for front-line implementers (e.g., health department and health systems directors, clinic administrators, program managers, clinicians, and other providers) is critical.</p><p><strong>Methods: </strong>We review current challenges to the meaningful inclusion of front-line implementers in implementation science research, and consider specific changes to language, frameworks, and methods that would maximize the accessibility and relevance of the field.</p><p><strong>Results: </strong>Our analysis suggests the need for greater attention to implementation strategies most relevant to front-line implementers, i.e., those focused on intervention recipients. We propose a novel, multi-layer framework for conceptualizing the strategies necessary to achieve HIV implementation outcomes by organizations, providers, and recipients. There is a compelling rationale to adopt incentive structures that prioritize research questions most important for practice.</p><p><strong>Conclusions: </strong>Maximizing the impact of implementation science on EHE goals requires: (a) expanding the focus of implementation science to include more recipient-focused implementation strategies; (b) developing and applying frameworks that better reflect the experience and needs of front-line implementers; (c) using language most relevant and applicable to practice, and (d) prioritizing actionable research questions that directly address the needs and concerns of those doing implementation work.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785544","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":"Estimated Impact of HIV Testing on Length of Stay at Visits to United States Emergency Departments, 2018-2021.","authors":"Brian Kuglen, Carson Clay, Derek Boothroyd, Christopher L Bennett","doi":"10.1097/QAI.0000000000003575","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003575","url":null,"abstract":"","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768941","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":"ALIGNMENT OF PREP USE WITH POTENTIAL HIV EXPOSURE IN YOUNG WOMEN AND MEN IN UGANDA.","authors":"Linxuan Wu, Timothy Ssebuliba, Timothy R Muwonge, Felix Bambia, Gabrielle Stein, Olivia Nampewo, Oliver Sapiri, B Jay Goetz, Kerri J Penrose, Urvi M Parikh, Andrew Mujugira, Renee Heffron","doi":"10.1097/QAI.0000000000003573","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003573","url":null,"abstract":"<p><strong>Background: </strong>Despite high oral pre-exposure prophylaxis (PrEP) uptake among young heterosexual cisgender women, early discontinuation is frequent. It is unclear whether this aligns with potential HIV exposure.</p><p><strong>Methods: </strong>Young women 16-25 years and ≥1 of their male partners were enrolled in separate but linked longitudinal HIV PrEP studies in Kampala, Uganda from 2018-2021. Data on sexual behavior, PrEP use, STI positivity, and Y chromosome DNA (Yc DNA; a marker for condomless sex) were collected at enrollment and quarterly visits. Potential HIV exposure was defined as one of the following in the past 3 months: any STI, detection of Yc DNA, condomless vaginal sex, or multiple sex partners. Alignment between potential HIV exposure and PrEP use by participants was examined using GEE regression.</p><p><strong>Results: </strong>88 young women (median age=20.6, IQR 19.5-22.0) and 124 male partners (median age=23.5, IQR 21.0-26.0) were included. Women and men were dispensed PrEP in 66.9% and 60.5% of their first linked visits, respectively. PrEP dispensation was more common when women or men self-reported condomless vaginal sex and multiple sex partners, or when women had Yc DNA detected in vaginal swabs. Men's self-report of multiple partners (aPR=1.56, p=0.012) and the detection of Yc DNA (aPR=1.52, p=0.040) were significantly associated with women's PrEP dispensation.</p><p><strong>Conclusions: </strong>Women and their male partners may align their PrEP use with their HIV risk behaviors, providing some reassurance that PrEP discontinuation in young people often aligns with sexual behavior. Greater attention to measurement of and mismatches in PrEP discontinuation and potential HIV exposure is needed.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768892","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}