Journal of the International Association of Providers of AIDS Care最新文献

{"title":"Tuberculosis Among Men Who Have Sex With Men Living With HIV in Israel: A Retrospective Nationwide Cohort Study, 2000-2025.","authors":"Zohar Mor, Tali Wagner, Sivan H Perl","doi":"10.1177/23259582261478436","DOIUrl":"10.1177/23259582261478436","url":null,"abstract":"<p><p>ObjectivesThis study compared men who have sex with men (MSM) who lived with HIV (LWHIV) and tuberculosis to MSM LWHIV without tuberculosis and estimated tuberculosis incidence among MSM-LWHIV over 25-years.MethodsData from the Israeli national tuberculosis and HIV registries between 2000 and 2025 were cross-matched by patients' identifiers to compare MSM LWHIV and tuberculosis to other MSM LWHIV older than 15 years. They were followed up from HIV-diagnosis until they developed TB, died, left Israel or end-2025.ResultsOf 3,018 MSM LWHIV who were followed-up for 30,617 person-years, 16 (0.5%) developed tuberculosis, compared with 244 (6.6%) non-MSM LWHIV, corresponding to 5 and 70 cases per 10,000 person-years, respectively (P<0.01). MSM LWHIV and tuberculosis were more commonly non-Israeli born, had lower CD4-counts and not been treated with antiretroviral therapy than MSM LWHIV without tuberculosis.Tuberculosis in MSM was diagnosed within a median of 2.4 years after HIV (range 0-10), and 8 (50.0%) were diagnosed concomitantly with HIV and tuberculosis. Contact tracing revealed one household exposure, while nine (52.9%) probably acquired tuberculosis while originating/visiting high-tuberculosis settings.ConclusionsTuberculosis incidence among MSM LWHIV is very low. Tuberculosis was probably acquired while originating/visiting endemic countries. Routine HIV-testing of patients with tuberculosis is recommended.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261478436"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Hypertension and Associated Factors Among People Living with HIV in Ethiopia: A Systematic Review and Meta-Analysis.","authors":"Addisu Simachew Asgai, Tsegaamlak Kumelachew Derse, Desalegn Mitiku Kidie, Yideg Abinew, Tadios Lidetu, Moges Tadesse Abebe, Jenberu Mekurianew Kelkay","doi":"10.1177/23259582261444131","DOIUrl":"10.1177/23259582261444131","url":null,"abstract":"<p><p>IntroductionHypertension has emerged as a significant comorbidity among people living with Human Immunodeficiency Virus (HIV). However, the prevalence and determinants of hypertension in Ethiopia remain inconsistent across studies.MethodsA systematic search of PubMed, Science Direct, Cochrane Library, Hinari, and Google Scholar was conducted following PRISMA 2020 guidelines. Both published and grey literature conducted in Ethiopia were included. The Newcastle Ottawa scale was used to assess the quality of included studies.ResultsPooled prevalence of hypertension among people living with HIV in Ethiopia was 22% (95% CI: 17.0-28.0). Factors significantly associated with hypertension among people living with HIV included physical inactivity (AOR=2.73; 95% CI: 2.05-3.41), excessive alcohol drinking (AOR=3.01; 95% CI: 1.41-4.61), and ART duration ≥5 years (AOR=2.50; 95% CI: 1.46-3.54).ConclusionHypertension affects approximately one in five people living with HIV in Ethiopia. Physical inactivity, alcohol use and long-term ART were significantly associated with Hypertension.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261444131"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of Hepatitis B and C Viral Infections Among Patients With Diabetes Mellitus in Africa: A Systematic Review and Meta-Analysis.","authors":"Ayanaw Dinku Abebe, Worku Chekol Tassew, Agerie Mengstie Zeleke, Yeshiwas Ayale Ferede, Jember Ayelgne Beyene","doi":"10.1177/23259582261456437","DOIUrl":"10.1177/23259582261456437","url":null,"abstract":"<p><p>BackgroundHepatitis B virus (HBV), hepatitis C virus (HCV), and diabetes mellitus are major global public health concerns associated with significant morbidity and mortality. However, there is no pooled evidence on the seroprevalence of HBV and HCV among diabetic patients in Africa. This study aimed to estimate the pooled seroprevalence and associated factors.MethodsA systematic search of PubMed, Google Scholar, the Cochrane Library, and African Journals Online was conducted to identify relevant studies published from May 2012 to July 2025. Heterogeneity and publication bias were assessed using I² and Egger's test, respectively. A DerSimonian-Laird random-effects model was used to estimate pooled prevalence, with sensitivity analysis performed.ResultsAmong African diabetic patients, pooled HBV prevalence was 5.19%, while HCV prevalence was 11.34%. Multiple sexual partners increased HBV risk, whereas blood transfusion and prior hospitalization were associated with HCV.ConclusionHBV and HCV infections remain important public health concerns among patients with diabetes mellitus in Africa. Strengthening screening, vaccination, infection control, safe transfusion practices, and risk reduction education is essential.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261456437"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Tesamorelin in People Living With HIV (PLWH) With Lipodystrophy: A Systematic Review and Meta-Analysis.","authors":"Aqsa Mohammed Ditta, Ruqaiya Muhammad Naeem, Muhammad Mohsin Sami, Muhammad Abdul Rafey, Hunain Ali, Muhammad Waqar Amjad, Fahad Jahangir, Kehan Ali Rizvi, Fatima Mohammad, Husam Abu Dawood, Muhammad Suleman, Muhammad Nabeel Saddique","doi":"10.1177/23259582261475549","DOIUrl":"10.1177/23259582261475549","url":null,"abstract":"<p><p>BackgroundHIV-associated lipodystrophy, a complication of combined antiretroviral therapy (CART), causes significant physical and psychological distress in people living with HIV (PLWH), compromising treatment adherence. Tesamorelin, a growth hormone-releasing hormone (GHRH) analogue, has emerged as a therapeutic option.ObjectiveTo systematically evaluate the efficacy and safety of tesamorelin in HIV-infected individuals with lipodystrophy receiving CART, incorporating GRADE assessment.MethodsWe searched PubMed, https://ClinicalTrials.gov, and Scopus from inception to February 9, 2026, for randomized controlled trials evaluating tesamorelin in HIV-associated lipodystrophy. Mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CI) were calculated using random-effects models with heterogeneity assessed by I².ResultsFour RCTs (909 patients) were included. Tesamorelin 2mg significantly reduced visceral adipose tissue (MD= -21.47, 95%CI[-34.73,-8.22],I²=74%,p=0.002), waist circumference (MD-1.61cm,95% CI[-2.28,-0.95],I²=0%,p<0.00001), trunk fat (MD-1.20kg, 95%CI[-1.47,-0.93],I²=0%,p<0.00001), and increased lean body mass (MD1.42kg,95% CI[1.13,1.71],I²=0%,p<0.00001). Modest lipid improvements occurred in total cholesterol (MD-0.16mmol/L,95%CI[-0.27,-0.06],I²=0%,p=0.003). Growth hormone-related adverse effects and higher discontinuation rates (RR2.25,95%CI[0.98,5.17],p=0.06) were observed.ConclusionsTesamorelin demonstrates efficacy in reducing visceral adiposity in PLWH with lipodystrophy on CART. However, limited data on long-term safety, optimal dosing strategies, and durability of treatment effects warrant caution. Future research should evaluate extended treatment duration, dose-response relationships, and patient-reported outcomes to establish comprehensive clinical utility.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261475549"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the W-PREV Model: Integrating HIV/STBBI Prevention and Women's Sexual and Reproductive Healthcare Using an Intersectional Women-Centered Approach.","authors":"Kyla Gibson, Amy Ly, V Logan Kennedy, Angela Underhill, Stephanie Smith, Emily Bear, Cara Spence, Wangari Tharao, Molly Bannerman, Asli Mahdi, Ananya Inaganti, Rsha Soud, Ashley Lacombe-Duncan, Mona Loutfy","doi":"10.1177/23259582261447168","DOIUrl":"10.1177/23259582261447168","url":null,"abstract":"<p><p>IntroductionWomen, both cisgender and transgender, experience persistent inequities in sexual and reproductive health (SRH) due to sexism, transphobia, racism, and systemic discrimination. In Canada and globally, these intersecting inequities are exacerbated by limited, biomedical, and colonial models of care that overlook women's needs, leaving them underserved in HIV and sexually transmitted and blood-borne infection (STBBI) prevention. Our study describes the development of the Women-Centred Prevention (W-PREV) Model, designed to integrate HIV/STBBI prevention and SRH through an intersectional, women-led approach.MethodsGuided by the implementation science Knowledge-to-Action Framework, we adapted the existing Women-Centred HIV Care (WCHC) Model to address HIV/STBBI prevention and SRH needs for women. The development process included a rapid scoping review, environmental scan, and stakeholder interviews with women, clinicians, and service providers in two Canadian provinces, Ontario and Saskatchewan.ResultsFindings highlighted that structural barriers such as housing insecurity, stigma, and systemic racism often overshadow women's ability to prioritize HIV/STBBI prevention and SRH. The resulting W-PREV Model addresses these realities by integrating HIV/STBBI prevention within six interrelated domains: SRH care, gender-specific care, mental health care, substance use and harm reduction, social connection and peer support, and individual capacity building. The model's trauma- and violence-aware, person-centred, and culturally responsive foundation ensures prevention is accessible, relevant, and empowering across the life course. W-PREV is distinct in its focus on HIV/STBBI prevention and early intervention, integrating SRH, peer support, and outreach within community and clinical settings.ConclusionsThe W-PREV Model provides a comprehensive, women-centred framework that bridges clinical and community settings to support personalized HIV/STBBI prevention and SRH self-care. By grounding prevention in women's lived experiences and peer support, W-PREV promotes equitable, holistic, and sustainable care for women and gender diverse people in Canada.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261447168"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Dolutegravir-Based Antiretroviral Therapy on Viral Load Suppression and Uptake of DTG-Based Regimen Among Pediatric HIV Patients in Africa: A Systematic Review and Meta-Analysis.","authors":"Desalegn Mitiku Kidie, Abraham Dessie Gessesse, Jenberu Mekurianew Kelkay, Tsegaamlak Kumelachew Derse, Addisu Simachew Asgai","doi":"10.1177/23259582261467826","DOIUrl":"10.1177/23259582261467826","url":null,"abstract":"<p><p>BackgroundDespite global advances in HIV care, pediatric populations in Africa continue to experience suboptimal treatment outcomes. Dolutegravir (DTG)-based antiretroviral therapy (ART) offers improved efficacy and tolerability, however, its real-world impact on viral load suppression (VLS) and the uptake of DTG-based regimens from older ART to newly recommended DTG-based ART among children and adolescents in Africa has not been systematically quantified.ObjectiveThis systematic review and meta-analysis aimed to estimate the pooled viral load suppression after initiation of dolutegravir-based ART and the uptake of DTG-based regimens from older regimens to dolutegravir-based ART among children and adolescents living with HIV in Africa.MethodsA systematic review and meta-analysis conducted in accordance with PRISMA 2020 guidelines. Comprehensive searches of PubMed, Google Scholar, ScienceDirect, Hinari, CORE, and DOAJ were performed from January 01-10, 2026. Studies reporting VLS after initiation of DTG-based ART and the uptake of DTG-based regimens among pediatric patients with HIV in Africa were included. Pooled estimates were computed using random-effect models. Heterogeneity was assessed using I² statistics, and subgroup, sensitivity, and publication bias analyses were performed.Resultsout of 7,789 records screened, twenty-four studies comprising 119,292 participants were included. The overall pooled viral load suppression at six months after initiation of DTG-based ART was 82% (95% CI: 79-85%) and 70 (95% CI: 62-77%) among participants who were unsuppressed at baseline. The pooled uptake of DTG-based regimens was 77% (95% CI: 68-86%) based on 23 studies. Substantial heterogeneity was observed across outcomes (I²≥98%). Subgroup analysis indicated regional and study-design variation in the uptake of DTG-based regimens but not in viral suppression. No substantial publication bias was detected among the included studies.ConclusionDTG-based ART effectively suppressed viral load among pediatric patients in Africa, though adoption remains incomplete and below UNAIDS 95-95-95 targets. Significant heterogeneity highlights the influence of contextual and health system factors. Accelerated rollout, strengthened adherence support, and harmonized monitoring are needed to optimize pediatric HIV outcomes.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261467826"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinic and Provider Innovations to Improve Tuberculosis Infection Screening and Preventive Therapy Uptake in Brazil: Qualitative Findings From the PREVINE-TB Study.","authors":"Deanna Kerrigan, Lelia H Chaisson, Paula Travassos, Betina Durovni, Valeria Saraceni, Solange Cavalcante, Marcelo Cordeiro-Santos, Renata Spener-Gomes, Alexandra Brito de Souza, Sumire Sakabe, Roberta Trefiglio, José Valdez Ramalho Madruga, Silvia Cohn, Lia S Da Silva Kerrigan, Isadora Salles, Barbara Castro, Danielle Portella Ferreira, Christopher J Hoffmann, Jonathan E Golub","doi":"10.1177/23259582261447940","DOIUrl":"10.1177/23259582261447940","url":null,"abstract":"<p><p>IntroductionDiagnosing and treating tuberculosis (TB) infection are critical to reducing TB mortality among people with HIV (PLHIV). Blood-based screening using QuantiFERON-TB Gold Plus (QFT+) and shorter-course TB preventive therapy (TPT) regimens such as 3-month weekly isoniazid and rifapentine (3HP) hold promise to improve TB outcomes.MethodsWe conducted 38 qualitative interviews to explore implementation challenges and solutions related to QFT+ use and TPT uptake among PLHIV participating in the PREVINE-TB study in Brazil and utilized thematic analysis.ResultsClinic and provider implementation innovations and examples of positive deviance helped explain quantitative differences in QFT+ use and TPT uptake between cities including predetermination of eligible patients for QFT+ screening based on nurse review of electronic medical records, specialized TB clinics, the use of TPT Champions, and digital communication.ConclusionsClinic and provider innovations can support QFT+ use and TPT uptake to improve TB outcomes, including in the context of health systems challenges.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261447940"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Violence During Armed Conflict Among Women and Girls in Ethiopia: A Systematic Review and Meta-Analysis.","authors":"Yeshiwas Ayale Ferede, Misganaw Mihret Kelkay, Getanew Kegne Nigate","doi":"10.1177/23259582261456337","DOIUrl":"10.1177/23259582261456337","url":null,"abstract":"<p><p>BackgroundSexual violence during armed conflict is a grave human rights and public health issue. This systematic review and meta-analysis estimated pooled prevalence and determinants of sexual violence among Ethiopian women and girls nationwide evidence.MethodsA random-effects model in STATA 11 was used for the meta-analysis. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated through Egger's test, funnel plots.ResultsEight studies involving 10,119 participants were included. The pooled prevalence of sexual violence during armed conflict was 22.32% (95% CI: 14.02, 30.61), with moderate heterogeneity (I² = 61.9%; <i>P</i> ≤ .010). Key determinants included poor social support (POR = 2.23), urban residence (POR = 1.65), no formal education (POR = 1.79), and age ≤ 24 years (POR = 2.43).ConclusionSexual violence during armed conflict remains a major concern in Ethiopia. Strengthened protection systems, psychosocial support, community awareness, and educational interventions are urgently required.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261456337"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are People With HIV Aware of Their Cardiometabolic Risk? A Cross-Sectional Survey Study of People Living With HIV Within a Community Organization in an Urban Setting.","authors":"Christine Ann Dimaculangan Parikh, Brijesh Rana, Navaneeth Narayanan, Humberto R Jimenez","doi":"10.1177/23259582261444789","DOIUrl":"10.1177/23259582261444789","url":null,"abstract":"<p><p>BackgroundCardiometabolic diseases have become a major cause of morbidity and mortality for people living with HIV (PLWH), and it is not clear if this population is aware of such risk.ObjectiveThe objective of this study is to assess perceived knowledge of cardiometabolic risk among PLWH in an underrepresented US community and explore associations with key demographic characteristics and social determinants of health.MethodsThis study was conducted in urban communities within New Jersey. One-hundred and sixteen participants completed the survey, who were included in the final analytic sample.Results/ConclusionApproximately half of the participants reported being knowledgeable about the long-term effects of hyperlipidemia and diabetes (51.8% and 51.9%, respectively), and 61.6% of participants reported being knowledgeable about the long-term complications of hypertension. An exploratory analysis was conducted to determine if there were any associations related to reported social determinants of health and the primary outcome.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261444789"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sexuality of Women Living With HIV: Care Demands and Implications for Practice.","authors":"Tailma Silva Lino de Souza, Ana Paula de Assis Sales, Thaís Gianini Dias, Elis Regina Souza, Luciana de Alcântara Nogueira, Maria Neto da Cruz Leitão, Gareth Wiltshire, Elen Ferraz Teston","doi":"10.1177/23259582261426238","DOIUrl":"10.1177/23259582261426238","url":null,"abstract":"<p><p>ObjectiveTo understand perceptions of sexuality and care needs from the perspective of women living with human immunodeficiency virus (HIV) and health professionals.MethodThis exploratory qualitative study was conducted in 2 specialized secondary-care services in Brazil. Participants included women living with HIV (WLHIV) aged ≥18 years receiving ongoing follow-up and healthcare professionals involved in their care for at least 6 months. Semistructured interviews were conducted between September and November 2024. Data were analyzed using inductive thematic content analysis, and interpretation was informed by Bronfenbrenner's ecological model to integrate individual, relational, and structural dimensions. The final sample comprised 13 WLHIV and 9 healthcare professionals, with recruitment completed upon theoretical saturation.Resultstwo themes were identified. The first indicated that WLHIV frequently experience sexuality as a domain marked by fear, guilt, and anticipated judgment rooted in HIV-related stigma and strained intimate relationships. Concerns related to transmission, rejection, and disclosure limited sexual activity, generated emotional distress, and hindered new partnerships. Some women, however, described processes of reframing sexuality through emotional support, strengthened self-care, and renewed trust in partners. The second theme highlighted insufficient professional preparedness, including limited training, discomfort discussing sexual health, and reliance on biomedical and preventive guidance. Conversations about sexuality were typically patient-initiated and constrained by time pressures, cultural norms, and generational differences.Final considerationsFindings underscore the need to integrate sexuality into HIV care for WLHIV, addressing the impacts of stigma and gaps in professional training. Advancing sexual health in this population requires public policies and ongoing capacity-building to support comprehensive, humanized, and nonjudgmental care.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261426238"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}