{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148066066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
George Bello, Alinune N Kabaghe, Sherri Pals, Newton L Kalata, Barbara Bighignoli, Joep J van Oosterhout, Jonathan Mkungudza, Elfriede Agyemang, Du-Ping Zheng, Louis Panja, Wilson Bilaal Matola, Moses Chitenje, Elizabeth Kampira, Clement Zeh, Benard Mvula, Bianca Alvarez, Matthews Kagoli, Wongani Mzumara, Katherine R Simon, Ireen Namakhoma, Gabrielle O'Malley, Sikhona Chipeta, Rose Nyirenda, Juliana da Silva, Nellie Wadonda
{"title":"Emerging Dolutegravir Resistance Among Children on Antiretroviral Therapy With Virological Failure in Malawi: Results From a 2023 National Cross-Sectional Survey.","authors":"George Bello, Alinune N Kabaghe, Sherri Pals, Newton L Kalata, Barbara Bighignoli, Joep J van Oosterhout, Jonathan Mkungudza, Elfriede Agyemang, Du-Ping Zheng, Louis Panja, Wilson Bilaal Matola, Moses Chitenje, Elizabeth Kampira, Clement Zeh, Benard Mvula, Bianca Alvarez, Matthews Kagoli, Wongani Mzumara, Katherine R Simon, Ireen Namakhoma, Gabrielle O'Malley, Sikhona Chipeta, Rose Nyirenda, Juliana da Silva, Nellie Wadonda","doi":"10.1002/jia2.70108","DOIUrl":"10.1002/jia2.70108","url":null,"abstract":"<p><strong>Introduction: </strong>Malawi began transitioning children living with HIV (CLHIV) to dolutegravir-based regimens (DBRs) in 2020, and 99.9% were on a DBR by September 2023. With nearly universal use of DBR, surveillance of HIV drug resistance (HIVDR) to dolutegravir is essential. We describe the prevalence and patterns of HIVDR among CLHIV on DBR with confirmed virological failure (viral load [VL] twice ≥1000 copies/mL).</p><p><strong>Methods: </strong>We randomly selected 19 of the 25 highest-volume ART health facilities in Malawi for participant enrolment between July 2022 and February 2023. Enrolment criteria included CLHIV aged 2-14 years, on a DBR for ≥9 months and VL ≥1000 copies/mL. Sanger HIVDR genotyping was performed if a repeat VL result post-intensive adherence counselling was ≥1000 copies/mL. The Stanford University HIVDR Database was used for drug resistance interpretation. We present weighted HIVDR prevalence estimates with 95% confidence limits accounting for correlation within clinics.</p><p><strong>Results: </strong>Of 302 CLHIV enrolled, 133 (44%) had confirmed virological failure. The weighted prevalence of dolutegravir resistance among CLHIV with confirmed virological failure was 15.6% (95% CI: 7.1-24.0%), with the presence of major dolutegravir drug resistance mutations (DRMs) in 14.2% (95% CI: 4.8-23.6). The most common dolutegravir DRMs were R263K (n = 11) and G118R (n = 4). Weighted prevalence rates of resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors were 42.2%, 65.5% and 5.0%, respectively. Three children had HIVDR to all four drug classes.</p><p><strong>Conclusions: </strong>Dolutegravir resistance was found in nearly one in six Malawian CLHIV with confirmed virological failure on DBRs. This raises concerns for treatment options in this vulnerable population, given the coexistence of high prevalence of resistance to NRTIs and NNRTIs. These results point to the need for regular HIVDR surveillance and further research to guide genotyping prioritization and next-line treatment strategies.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70108"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards More Accessible and More Inclusive PrEP to Break the Cycle of HIV in France.","authors":"Jade Ghosn, Marie-Laure Chaix","doi":"10.1002/jia2.70118","DOIUrl":"10.1002/jia2.70118","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-exposure prophylaxis (PrEP) represents a major advance in HIV prevention, but its rollout in France remains limited, particularly among women, migrants and socially vulnerable populations. Despite full reimbursement by the national health system, oral PrEP is still rarely prescribed outside hospital settings, hindered by organizational constraints, inaccurate medical perceptions and persistent access inequalities. In this paper, we discuss the current limits of PrEP implementation in France, identify structural and individual barriers to its uptake and highlight possible strategies to make HIV prevention more accessible for all vulnerable populations across the country.</p><p><strong>Discussion: </strong>The goal of eliminating HIV transmission by 2030 in France continues to be jeopardized by insufficient PrEP coverage. The current prevention model remains overly hospital-centred and primarily focused on a group of men who have sex with men (MSM), which limits its broader impact. In addition to structural barriers, the insufficient diversity of prescribers and the lack of inclusive communication continue to reinforce inequalities in access. The arrival of long-acting injectable PrEP offers an important opportunity to ensure greater discretion and better adherence. However, its success will depend on expanding the range of authorized prescribers to include gynaecologists, general practitioners and family planning clinics, supported by specific training and outreach consultations. Equally critical is strengthening public awareness campaigns and extending them beyond MSM and urban centres such as Paris, to reach diverse populations across the country. Durable improvements in PrEP uptake and retention also depend on close collaboration with community-based organizations, building trust with marginalized populations and participatory approaches that actively listen to individuals' concerns and lived experiences.</p><p><strong>Conclusions: </strong>France, which is lagging behind its objective of ending the HIV epidemic, has the opportunity to rethink its prevention strategy to address unmet needs and move beyond a hospital- and MSM-centred model. A structural, coordinated and inclusive response is essential to expand PrEP uptake and ensure equitable protection for all populations at risk.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70118"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah E Rutstein, Grace E Mulholland, Laura Limarzi-Klyn, Annabelle Gallinek, Nicole Brown, William C Miller
{"title":"Defining HIV Pre-Exposure Prophylaxis (PrEP) Persistence: A Scoping Review.","authors":"Sarah E Rutstein, Grace E Mulholland, Laura Limarzi-Klyn, Annabelle Gallinek, Nicole Brown, William C Miller","doi":"10.1002/jia2.70115","DOIUrl":"10.1002/jia2.70115","url":null,"abstract":"<p><strong>Introduction: </strong>When assessing the effectiveness of pre-exposure prophylaxis (PrEP) programmes, interventions, or modalities, it is important to understand patterns of PrEP use. Continued use of PrEP is frequently referred to as PrEP \"persistence.\" But persistence is not defined consistently, and differences impact the interpretation of study outcomes and public health policy. We conducted a scoping review to describe and compare definitions of PrEP persistence.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Scopus and Global Health records (01/01/2012-01/26/2026) for results that discussed longitudinal anti-HIV agents for HIV prevention. We included HIV, prevention and text variations of \"persist-.\" We screened abstracts for relevance, reviewed relevant full-text articles, and then extracted key outcomes. Screening and extraction were performed independently by two investigators; conflicts were reviewed and resolved by a third.</p><p><strong>Results: </strong>Our search returned 1549 de-duplicated results. We reviewed 362 full-text articles, yielding 147 studies for extraction. Approximately one-third (42/147, 29%) provided only qualitative persistence definitions. Among studies with operational definitions (105/147; 71%), three-quarters (80/105; 76%) considered a prescription refill and/or clinic visit date, and more than half (60/105; 57%) relied exclusively on these dates. Adherence (e.g. reported or measured drug taking) was commonly considered; 28% (29/105) of studies with an operational persistence definition included adherence assessment, and 11% (12/105) used only adherence to assess persistence. Thresholds used to classify persistent versus non-persistent PrEP use varied considerably.</p><p><strong>Discussion: </strong>Definitions of PrEP persistence are heterogeneous. Most considered engagement in PrEP services (e.g. a clinic visit or medication refill), but nearly one-third included or relied exclusively on adherence measures. The differences in definitions have important implications for cross-study comparisons.</p><p><strong>Conclusions: </strong>The heterogeneity observed among persistence definitions complicates comparisons of PrEP interventions and related public health decision-making. A single consensus definition of persistence is unlikely to suit all study settings, objectives, and designs; however, interpretability and comparability of results could be improved by increasing transparency and consistency in reporting. Our findings emphasize the importance of capturing clinically relevant, prevention-effective use when possible and of rigorously considering the implications of a chosen persistence definition on estimates and associated conclusions.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70115"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wanyi Chen, Paula M Luz, Anjali Srinivasan, Beatriz Grinsztejn, Justine A Scott, Anne M Neilan, Valdiléa G Veloso, Caitlin M Dugdale, Kenneth A Freedberg
{"title":"Long-Acting PrEP for People With High Vulnerability to HIV Acquisition in Brazil: A Cost-Effectiveness Analysis.","authors":"Wanyi Chen, Paula M Luz, Anjali Srinivasan, Beatriz Grinsztejn, Justine A Scott, Anne M Neilan, Valdiléa G Veloso, Caitlin M Dugdale, Kenneth A Freedberg","doi":"10.1002/jia2.70116","DOIUrl":"10.1002/jia2.70116","url":null,"abstract":"<p><strong>Introduction: </strong>In Brazil, men who have sex with men (MSM) and transgender women (TGW) remain heavily affected by HIV. Long-acting pre-exposure prophylaxis (LA PrEP) with injectable cabotegravir (CAB-LA) or lenacapavir (LEN-LA) is more effective at preventing HIV acquisition than oral PrEP. Our objective was to assess the potential clinical and economic impact of offering CAB-LA or LEN-LA to MSM and TGW with high vulnerability to HIV acquisition in Brazil and determine the maximum cost at which they would be cost-effective.</p><p><strong>Methods: </strong>We used the CEPAC microsimulation model of HIV prevention and treatment to evaluate two strategies for MSM and TGW aged 18-49: (1) SOC: standard-of-care oral PrEP at current coverage, and (2) SOC+LA: offering oral and LA PrEP (either CAB-LA or LEN-LA). Input parameters are derived from Brazil-based data from 2010 to 2024 and published studies: HIV incidence (%/year, MSM: 3.4 [age 18-29 years], 1.1 [30-49 years]; TGW: 5.0 [18-29 years], 1.7 [30-49 years]), relative risk reduction, LA versus oral PrEP (66% [CAB-LA]; 89% [LEN-LA]), PrEP coverage (20% [oral PrEP]; 20% [LA PrEP]) and oral PrEP cost (programmatic+drug = $207/year). Outcomes include lifetime HIV risk, life expectancy (LE) and incremental cost-effectiveness ratio (ICER) of SOC+LA versus SOC in 2024 USD/year of life saved (YLS). We identified the maximum LA PrEP cost with ICER below the established Brazilian willingness-to-pay threshold of $8740/YLS.</p><p><strong>Results: </strong>Compared to SOC, SOC+CAB-LA would decrease MSM lifetime HIV risk from 21.4% to 16.8%, increase undiscounted LE from 39.0 to 39.4 years. For TGW, SOC+CAB-LA would decrease lifetime HIV risk from 29.5% to 23.4%, increase LE from 36.0 to 36.9 years. Results for SOC+LEN-LA would be similar to SOC+CAB-LA. SOC+LA would remain cost-effective for MSM at cost below $710/year for CAB-LA and $740/year for LEN-LA. Findings are most sensitive to LA PrEP cost, HIV incidence, and whether and by how much LA PrEP increases coverage.</p><p><strong>Conclusions: </strong>Offering LA PrEP with cabotegravir or lenacapavir in addition to oral PrEP for MSM and TGW in Brazil could markedly improve clinical outcomes and be cost-effective at ∼$700/year. Cost agreements are critical to ensure these prevention options are accessible in high-incidence settings.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70116"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13176634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nadia Ahmed, Elbushra Ali Mohamed Herieka, William Abou Shahla, Binta Sultan
{"title":"Hidden in Plain Sight: HIV and LGBTQIA+ Realities in the Middle East and North Africa Region.","authors":"Nadia Ahmed, Elbushra Ali Mohamed Herieka, William Abou Shahla, Binta Sultan","doi":"10.1002/jia2.70122","DOIUrl":"10.1002/jia2.70122","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70122"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan Euvrard, Claire Marriott Keene, Erin von der Heyden, Meg Osler, David Pienaar, Hassan Mahomed, Graeme Meintjes, Mary-Ann Davies, Andrew Boulle
{"title":"Contemporary Disengagement From Antiretroviral Therapy in the Western Cape, South Africa: A Cross-Sectional Study.","authors":"Jonathan Euvrard, Claire Marriott Keene, Erin von der Heyden, Meg Osler, David Pienaar, Hassan Mahomed, Graeme Meintjes, Mary-Ann Davies, Andrew Boulle","doi":"10.1002/jia2.70124","DOIUrl":"10.1002/jia2.70124","url":null,"abstract":"<p><strong>Introduction: </strong>South Africa has the largest antiretroviral therapy (ART) programme in the world, with universal access available through the public health system. Yet, gaps in coverage persist. In the Western Cape (WC), an estimated 200,000 people living with HIV are not currently on ART-many of whom are known to the health services. Exploring how people who are not on ART differ from those who are on ART may help guide more effective strategies for re-engagement and retention in care.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of routine person-level data from the WC Provincial Health Data Centre, including adults (≥15 years) known to be living with HIV who accessed public services between October 2022 and September 2024. ART status was inferred from visit and dispensing records. Relative risks (RRs) of current disengagement were estimated using multivariable log-binomial regression on 25 imputed data sets, adjusting for sex, age, years since diagnosis, diagnosis setting and baseline CD4 count.</p><p><strong>Results: </strong>Of 494,071 adults included, 131,368 (27%) were currently disengaged from ART. Those at elevated risk included men (aRR 1.20, 95% CI 1.19-1.21), younger people aged 15-24 years (aRR 1.54, 95% CI 1.51-1.57), those with CD4 >500 cells/mm<sup>3</sup> at diagnosis (aRR 1.26, 95% CI 1.24-1.28) and individuals diagnosed in hospital (aRR 1.41, 95% CI 1.39-1.43) or during pregnancy (aRR 1.20, 95% CI 1.18-1.22). However, the majority of those disengaged were not from these groups, proportionally representing the underlying population living with HIV. Model discrimination was poor (AUC 0.614), indicating that these characteristics do not reliably identify those disengaged.</p><p><strong>Conclusions: </strong>Most disengaged individuals are from larger, lower-risk demographic groups and would be missed by interventions targeting higher-risk demographics. Whole-population strategies that address common barriers to retention through more inclusive, person-centred care offer the greatest potential to improve ART coverage.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70124"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147961621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allison M McFall, Talia A Loeb, Jiban J Baishya, Ashwini Kedar, Archit Sinha, A K Srikrishnan, Sunil S Solomon, Gregory M Lucas, Shruti H Mehta
{"title":"Acceptability and Preferences of Long-Acting Injectable Pre-Exposure Prophylaxis and Antiretroviral Therapy Among Men Who Have Sex With Men and People Who Inject Drugs in India: Insights for Future Implementation.","authors":"Allison M McFall, Talia A Loeb, Jiban J Baishya, Ashwini Kedar, Archit Sinha, A K Srikrishnan, Sunil S Solomon, Gregory M Lucas, Shruti H Mehta","doi":"10.1002/jia2.70114","DOIUrl":"10.1002/jia2.70114","url":null,"abstract":"<p><strong>Introduction: </strong>Long-acting injectable (LAI) antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) have significant potential to impact the HIV epidemic, but there is little data on the acceptability of these newer technologies among people who inject drugs (PWID) and men who have sex with men (MSM) in low-resource settings. We examined acceptability and preferences of LAI ART and PrEP among community-based samples of PWID and MSM in India.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of PWID and MSM in eight Indian cities (November 2022-May 2024) using respondent-driven sampling. Participants completed a survey including socio-demographics, substance use, risk behaviours, HIV testing/care history, acceptability of LAI ART and knowledge, acceptability, and preferences of different PrEP modalities (i.e. daily oral, monthly oral, LAI and implant). We assessed correlates of acceptability using Poisson regression models. To understand PrEP preferences, we used a modified Borda count method-a rank voting procedure.</p><p><strong>Results: </strong>Overall, 2249 MSM and 4499 PWID (98% male) were recruited. Among those previously diagnosed with HIV, 89% (MSM) and 75% (PWID) reported a very good chance they would use LAI ART. MSM experiencing unstable housing and PWID virally suppressed were more willing to use LAI ART. Twenty percent and five percent of MSM and PWID, respectively, had ever heard of PrEP. Among those without an HIV diagnosis, 77% (MSM) and 62% (PWID) reported a very good chance they would use LAI PrEP. MSM with more sexual partners and sexually transmitted infection symptoms and PWID who had heard of PrEP were more willing to use LAI PrEP. Among MSM interested in PrEP, monthly oral pills were most preferred, followed by LAI, daily oral pills and then implant. Among PWID, monthly oral pills were most preferred, followed by daily oral pills, LAI and then implant.</p><p><strong>Conclusions: </strong>MSM and PWID in India were open and interested in LAI ART and PrEP. Once these become available, programmes with thoughtful community outreach and education, alongside flexible delivery models, will be critical to success. For PrEP, continued investment in the development of extended-duration oral formulations is warranted and valuable in order to provide a variety of HIV prevention choices.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70114"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Family-Centred Care for Children and Adolescents Living With HIV in Sub-Saharan Africa: A Scoping Review.","authors":"Tawanda Makusha, Zinhle Ngubo, Janet Seeley, Moherndran Archary","doi":"10.1002/jia2.70098","DOIUrl":"10.1002/jia2.70098","url":null,"abstract":"<p><strong>Introduction: </strong>Children and adolescents living with HIV in sub-Saharan Africa (SSA) continue to face significant barriers to diagnosis, treatment adherence, retention in care and psychosocial support, despite progress in prevention and treatment coverage. Family-centred care (FCC) has emerged as a promising model that positions families-not just individual children-as the central unit of care, with potential to improve clinical and psychosocial outcomes while addressing persistent gaps in health system responsiveness.</p><p><strong>Methods: </strong>Our scoping review synthesized evidence on FCC implementation strategies and outcomes for children and adolescents living with HIV in SSA, to inform the development of a contextually relevant FCC intervention. We followed Arksey and O'Malley's five-stage framework and the PRISMA-ScR guidelines. A comprehensive search of peer-reviewed and grey literature published between 2000 and 2025 was conducted across multiple databases and organizational websites between May and July 2025. Fourteen studies met the inclusion criteria and were selected for analysis.</p><p><strong>Results: </strong>FCC was conceptualized as a multidimensional framework integrating clinical care, psychosocial support, caregiver engagement, treatment literacy and community-based delivery. Implementation models ranged from facility-based integrated services to community-driven and hybrid approaches. Interventions commonly included antiretroviral therapy provision, family-based testing, counselling and enhanced psychosocial wellbeing. Community-based and decentralized models showed particular promise in improving retention and reducing structural barriers. However, gaps persist, including limited longitudinal data, underrepresentation of fathers and adolescent caregivers, narrow assumptions of nuclear family structures and a lack of standardized FCC frameworks.</p><p><strong>Discussion: </strong>Most FCC interventions were small-scale and donor-funded, raising concerns regarding sustainability and health-system integration. Additionally, many studies assumed nuclear family structures, overlooking the role of extended and non-biological caregivers common in African contexts. The limited engagement of diverse caregiving networks and inconsistent conceptualization of FCC constrain its broader applicability and scalability.</p><p><strong>Conclusions: </strong>FCC offers a compelling and contextually appropriate model for strengthening HIV care for children and adolescents in SSA. Advancing the FCC requires standardized frameworks, inclusive and context-sensitive programme design, and integration into national health systems to ensure equitable and sustainable delivery of holistic HIV care.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70098"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147979686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Penny L Moore, Leonidas Stamatatos, Alexandra Trkola
{"title":"How Vaccinating People Living With HIV May Guide bNAb‑Based Vaccines.","authors":"Penny L Moore, Leonidas Stamatatos, Alexandra Trkola","doi":"10.1002/jia2.70119","DOIUrl":"10.1002/jia2.70119","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":"e70119"},"PeriodicalIF":5.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}