Journal of the International AIDS Society最新文献

{"title":"Impact of Tenofovir Alafenamide Sub-Dermal Implant Insertion Site Scarring on Acceptability and HIV Prevention Preferences: A Prospective Cohort Study in Durban, South Africa.","authors":"Tanuja N Gengiah, Lara Lewis, Ishana Harkoo, Nqobile Myeni, Leila E Mansoor, Salim S Abdool Karim, Quarraisha Abdool Karim","doi":"10.1002/jia2.70107","DOIUrl":"10.1002/jia2.70107","url":null,"abstract":"<p><strong>Introduction: </strong>The CAPRISA 018 Phase I trial evaluated the safety, tolerability and pharmacokinetics of a 110 mg tenofovir alafenamide (TAF) implant for HIV prevention in South African women. This follow-up cohort study, CAPRISA 097, assessed the long-term resolution of implant site reactions (ISRs) after implant removal and explored user acceptability and implant attribute preferences to inform the development of next-generation pre-exposure prophylaxis (PrEP) implants.</p><p><strong>Methods: </strong>Women previously enrolled in CAPRISA 018 were recruited and followed quarterly for 12 months between 13 October 2022 and 27 October 2023. ISR prevalence, severity and resolution were evaluated at each visit. Implant acceptability, implant attribute preferences and PrEP preferences were assessed at enrolment and at month 12.</p><p><strong>Results: </strong>Of 36 eligible participants, 35 were enrolled a median of 299 days after implant removal (IQR: 243-490). At enrolment, all 35 participants (100%) had ongoing mild (Grade 1) scarring, with additional findings of hyperpigmentation (14%), induration (6%) and hypopigmentation (3%). By study exit, scarring persisted in all participants (median duration: 623 days; IQR: 579-819), while hyperpigmentation and induration remained in two and one participant, respectively. Acceptability ratings for implant visibility were similar at enrolment and month 12 (77.1% vs. 75.0%), as were ratings for pain (68.6% vs. 78.1%). Side effects due to ISRs received the highest \"very unacceptable\" ratings, in 37.1% of participants at enrolment and 21.9% at study exit. Scarring was considered acceptable by 65.7% of participants at enrolment, increasing to 78.1% at exit. Perceived partner interest in the various PrEP products aligned with participant interest. A palpable 12-month implant was acceptable to most participants, whereas increased length, width or stiffness reduced the likelihood of use. Preferred PrEP options were a 12-monthly implant (38.2% at enrolment vs. 50.0% at month 12), a 6-monthly injection (29.0% vs. 37.5%) and daily oral PrEP tablets (12.0% vs. 3.0%).</p><p><strong>Conclusions: </strong>Mild but persistent scarring was observed following TAF implant removal, with limited cases of hyperpigmentation and induration. Despite these local side effects, a 12-monthly implant remained the most preferred PrEP option among women previously enrolled in the TAF implant trial.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 4","pages":"e70107"},"PeriodicalIF":4.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687456","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":"Progress towards the elimination of vertical transmission of HIV, syphilis and hepatitis B in 21 high-burden countries","authors":"Melanie M. Taylor,&nbsp;Rania A. Tohme,&nbsp;Robert McDonald,&nbsp;Michele Montandon","doi":"10.1002/jia2.70091","DOIUrl":"10.1002/jia2.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Elimination of mother-to-child transmission (EMTCT) of HIV, syphilis and hepatitis B by 2030 is a global goal endorsed by countries. To achieve EMTCT, countries need to meet targets for programme and impact indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined progress and gaps in service delivery across the three infections among 21 countries with a high burden of HIV, syphilis and/or hepatitis B. We summarized national coverage of interventions to prevent vertical transmission of HIV, hepatitis B and syphilis. Service coverage indicators were extracted from public data sources for the most recent available years (2014−2024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Antenatal care (ANC) coverage (at least one visit) ranged from 62% to 99%; 14 countries (67%) had coverage ≥90%. Twelve countries (57%) had ANC HIV testing coverage above 90%; 13 countries (62%) reported antiretroviral treatment coverage ≥90%. Eight countries (38%) reported ANC syphilis testing coverage ≥90%; ten countries (48%) reported ≥90% treatment coverage among pregnant women diagnosed with syphilis. All 21 countries have introduced three infant doses of hepatitis B vaccine (HepB3), and six countries have introduced the hepatitis B birth dose vaccine (HepB-BD) in their national immunization schedule. Among the six countries that provide HepB-BD, only four reported coverage with timely HepB-BD given within 24 hours of birth (range 52–70%). Seven (33%) countries have achieved HepB3 coverage ≥ 90%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Antenatal service delivery for prevention of mother-to-child transmission of syphilis and hepatitis B lags behind that of HIV. Despite the availability of ANC platforms for the delivery of HIV, syphilis and hepatitis B services, many countries face new and ongoing implementation and funding challenges in reaching global targets for EMTCT of these infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Integrating HIV, syphilis and hepatitis B prevention of vertical transmission services into ANC and maintaining support for EMTCT efforts is critical to close these gaps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 4","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519440","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":"Reach, Acceptability, Feasibility and Impact of a Brief Community Health Worker-Administered Index Case Testing Screening Tool “cICT” on Paediatric HIV Case Identification: Results From Malawi","authors":"Katherine R. Simon,&nbsp;Steven Masiano,&nbsp;Albert Kaonga,&nbsp;Dhrutika Vansia,&nbsp;Elizabeth Wetzel,&nbsp;Elijah Kavuta,&nbsp;Rose Nyirenda,&nbsp;Khumbo Namachapa,&nbsp;Brown Chiwandira,&nbsp;Carrie M. Cox,&nbsp;Brigid E. O'Brien,&nbsp;Rachael Manyeki,&nbsp;Linley Hauya,&nbsp;Maria H. Kim,&nbsp;Tapiwa A. Tembo,&nbsp;Saeed Ahmed","doi":"10.1002/jia2.70095","DOIUrl":"10.1002/jia2.70095","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Despite global initiatives to improve access to life-saving antiretroviral treatment (ART), only 54% of over 900,000 children living with HIV (CLHIV) received treatment in 2021, compared to 85% of women (WLHIV). Without timely ART, half of these children could die before age 2. We describe the design, implementation and outcomes of a child index case testing tool (cICT) that identifies WLHIV with untested children and embeds paediatric follow-up into their HIV care to identify and test their untested children.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The cICT was a card used to gather information about WLHIV and their children, including ages and HIV status (living with HIV, uninfected, exposed or unknown). Community health workers (CHWs) screened WLHIV 15 years and older at 95 ART clinics in Malawi from September 2020 to August 2023 and referred untested children to HIV testing services. De-identified data were entered in SurveyCTO (Dobility, Inc., MA) to determine WLHIV screened, children's baseline HIV status, new HIV testing completed and newly identified CLHIV. Outcomes included reach (percentage of cohort offered screening), acceptability (percentage accepting cICT) and feasibility (percentage screened who completed child testing). Impact measured the proportion of women with untested children at baseline versus study conclusion, proportion of untested children tested; new CLHIV diagnosed and HIV testing yield.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of an estimated cohort of 116,000 WLHIV active in care, 101,273 were offered and screened (87% reach, 100% acceptability), 75,262 had at least one child 0–19 years old, with 24% (18,175/75,262) of women having at least one child with unknown HIV status. At study conclusion, only 5% (4606/101,273) of WLHIV had children with unknown status. A total of 193,402 children were listed among 75,262 WLHIV who identified as having children; 39,124 (20%) of the 193,402 children listed were untested. By study conclusion, 28,808/39,124 (74%) of them were tested. Of these, 27,934 children were confirmed HIV uninfected, while 486 were newly diagnosed CLHIV, a 1.7% testing yield.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The cICT was acceptable and feasible to implement, revealing nearly a quarter of WLHIV had children with unknown HIV status. The tool's simplicity and scalability make it a high-impact approach for HIV programmes to quantify, track and confirm the status of HIV-exposed untested children and facilitate timely identification of CLHIV by ","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 4","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519468","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":"Confronting the TB-HIV Syndemic in Adolescents and Young Adults: A Call to Action in a Time of Crisis","authors":"Leslie A. Enane,&nbsp;Adam Leonard,&nbsp;Lameck Diero,&nbsp;Olivier Marcy,&nbsp;Marcel Yotebieng","doi":"10.1002/jia2.70100","DOIUrl":"10.1002/jia2.70100","url":null,"abstract":"&lt;p&gt;Tuberculosis (TB), as the leading infectious cause of death globally and the most common opportunistic infection among people with HIV, imposes a profound burden on adolescents and young adults (AYA, ages 10–24 years) [&lt;span&gt;1&lt;/span&gt;]. Although preventable and curable, TB remains a leading cause of death for AYA in endemic settings, the predominant cause of morbidity and mortality in AYA living with HIV (AYALHIV)—even in the era of antiretroviral therapy (ART)—and an increasingly recognized driver of long-term disability and diminished quality of life [&lt;span&gt;2, 3&lt;/span&gt;]. Developing TB during adolescence or young adulthood may impact future health, educational attainment, livelihoods, and mental and social wellbeing [&lt;span&gt;2&lt;/span&gt;]. Approximately 2 million AYA developed TB in 2024, representing ∼18% of all people who fell ill with TB (Figure 1). Despite their TB burden, AYA remain underrepresented in surveillance, clinical trials and programmatic priorities, and critical gaps in prevention, treatment and post-TB care for this vulnerable group remain unaddressed.&lt;/p&gt;&lt;p&gt;Current literature on TB in AYA is limited; however, it is clear that AYA face distinct vulnerabilities to TB and challenges in TB prevention and treatment [&lt;span&gt;2&lt;/span&gt;]. Physiologic changes in adolescence drive markedly increased risk for progression to active TB and development of adult-type cavitary disease [&lt;span&gt;4&lt;/span&gt;]. Further developmental, behavioural and environmental factors impacting TB risk in AYA include high mobility, congregate environments (such as schools and dormitories), malnutrition (related to ongoing growth and food insecurity), air pollution (given its impact on lung development) and substance use. Once established, TB diagnosis is frequently delayed, resulting in ongoing transmission and advanced illness [&lt;span&gt;3&lt;/span&gt;]. TB treatment in AYA is complicated by stigma and mental health burdens, adherence challenges and greater loss to follow-up (LTFU) from treatment than in other age groups [&lt;span&gt;3, 5-9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Among AYA, those living with HIV face the greatest TB risk, driven by immunosuppression, gaps in ART, and convergent developmental and social barriers to care engagement. Although TB preventive therapy (TPT) is recommended for all people with HIV in TB-endemic settings [&lt;span&gt;10, 11&lt;/span&gt;], AYALHIV experience low TPT uptake and completion. A recent study in Kenya found that only 42% of AYALHIV initiated TPT, and of those with ≥6 months of follow-up, just 54% completed it—representing a critical missed opportunity [&lt;span&gt;10&lt;/span&gt;]. When TB does occur, management may be complicated by severe or disseminated disease presentation, pill burden and drug interactions, as well as the psychosocial burdens of compounded isolation and stigma. Ultimately, AYALHIV face higher LTFU from TB treatment and TB mortality than their HIV-negative peers [&lt;span&gt;5-8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Even after successful treatment, emerging data show adolescents experience pre","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502674","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":"Overcoming barriers, driving progress: Clinical science at IAS 2025","authors":"Ezequiel Cordova,&nbsp;Simiso Sokhela,&nbsp;Jasmini Alagaratnam,&nbsp;Juan Ambrosioni","doi":"10.1002/jia2.70088","DOIUrl":"10.1002/jia2.70088","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The 13th IAS Conference on HIV Science, held in Kigali, Rwanda (13–17 July 2025), highlighted key advances in clinical research. Presentations focused on sustaining HIV treatment and prevention amid financial constraints, innovations in long-acting oral antiretrovirals, and the management of comorbidities and co-infections, particularly tuberculosis (TB) and mpox.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Significant progress was reported on long-acting oral antiretrovirals, including a weekly treatment regimen and a promising monthly option for pre-exposure prophylaxis. These strategies could expand the current antiretroviral therapy (ART) portfolio to better meet individual needs. Additionally, the use of currently available long-acting regimens in non-suppressed individuals warrants further exploration, supported by growing evidence of their potential in this clinical context. Intermittent ART, previously studied as a means to reduce toxicity, is now gaining attention as a potential cost-saving strategy. However, more research is needed to define its role across diverse settings. While data from high-income countries is encouraging, results have been less favourable in resource-limited settings and among key populations such as adolescents. Two-drug and injectable regimens, increasingly used and supported by international guidelines in high-income settings, are now being explored in resource-limited contexts and incorporated into clinical guidelines—narrowing the gap between recommendations for high- and low-income regions. As the ART portfolio evolves towards regimens without tenofovir, hepatitis B reactivation emerged as a key topic at the conference. Management of TB, a long-standing clinical challenge, was also addressed in Kigali with trial data supporting early empiric TB treatment and the safety of same-day ART initiation in selected clinical scenarios. The UNITY trial on tecovirimat for mpox treatment showed no significant clinical benefit, underscoring the need to revise current management guidelines. Research on comorbidities examined ART-associated weight gain, showing that switching ART once obesity is established has a limited impact on weight outcomes. Studies in paediatric populations highlighted predictors of treatment failure and the benefits of dolutegravir-based regimens.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In the face of growing economic pressures, innovation in HIV treatment and prevention remains essential. The conference emphasized the importance of sustainable public health strategies and individualized care approaches to ensure continued progress in the globa","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497064","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":"Integrating HIV services in an era of global change","authors":"Jirair Ratevosian,&nbsp;Linda-Gail Bekker,&nbsp;Robyn Eakle,&nbsp;Stefan Baral,&nbsp;Javier Cepeda,&nbsp;Lara Dugas,&nbsp;Mark Dybul,&nbsp;George Alleyne,&nbsp;Serge Paul Eholie,&nbsp;Kene Esom,&nbsp;Anna Grimsrud,&nbsp;Diane Havlir,&nbsp;Adeeba Kamarulzaman,&nbsp;Parastu Kasaie,&nbsp;Michel Kazatchkine,&nbsp;Nduku Kilonzo,&nbsp;Michael Klag,&nbsp;Marina Klein,&nbsp;Sharon Lewin,&nbsp;Chewe Luo,&nbsp;Keletso Makofane,&nbsp;Natasha Martin,&nbsp;Kenneth Mayer,&nbsp;Gregorio Millett,&nbsp;Ntobeko Ntusi,&nbsp;Loyce Pace,&nbsp;Peter Piot,&nbsp;Birgit Poniatowski,&nbsp;Demetre Daskalakis,&nbsp;Anton Pozniak,&nbsp;Thomas Quinn,&nbsp;Carolyn Reynolds,&nbsp;Jürgen Rockstroh,&nbsp;Serra Sippel,&nbsp;Bruno Spire,&nbsp;Ann Starrs,&nbsp;Steffanie Strathdee,&nbsp;Mauro Schechter,&nbsp;Nicholas Thomson,&nbsp;Peter Vickerman,&nbsp;Brian Weir,&nbsp;Chris Beyrer","doi":"10.1002/jia2.70087","DOIUrl":"10.1002/jia2.70087","url":null,"abstract":"&lt;p&gt;In 2018, the International AIDS Society (IAS) Lancet Commission examined the integration of HIV services into broader health systems as a pathway to achieving sustainable health outcomes and advancing the Sustainable Development Goals [&lt;span&gt;1&lt;/span&gt;]. Since then, a series of shocks—including post-COVID-19 fiscal contractions, geopolitical instability, major U.S. government aid retrenchment, and rapid biomedical and digital innovations—have made integration less a long-term aspiration and more an operational necessity.&lt;/p&gt;&lt;p&gt;The 2018 Commission also highlighted the vulnerability of vertical HIV programming and funding, maintaining the importance of disease-specific expertise while simultaneously leveraging HIV investments to strengthen broader health systems [&lt;span&gt;2&lt;/span&gt;]. Yet, as a result of many variables—including the COVID-19 pandemic, new innovations, and shifting global priorities and declining resources for vertical programmes—the move towards more integrated, sustainable health services has significantly progressed.&lt;/p&gt;&lt;p&gt;In the most recent decades of the HIV response, the pandemic has shifted to a chronic condition, and many countries have adopted models that integrate HIV care with broader chronic disease management programmes. People living with HIV face a heightened risk of non-communicable diseases (NCDs) due to factors like chronic infection, inflammation and metabolic dysfunction associated with older antiretroviral therapy (ART) regimens and ageing. South Africa has leveraged HIV programming to integrate NCD care into other services, including the nationwide Central Chronic Medicines Dispensing and Distribution programme, and medical adherence clubs in Cape Town [&lt;span&gt;3-5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The future of an integrated global HIV response is being shaped by converging epidemiological, funding, geopolitical and population-level shifts that demand urgent adaptation to sustain progress and maintain political support. In early 2025, overnight cuts made by the U.S. government to foreign aid, such as President's Emergency Plan for AIDS Relief (PEPFAR), combined with dismantling of the U.S. Agency for International Development (USAID), reductions by other donors, as well as rising political instability, have caused catastrophic disruptions to funding and HIV services [&lt;span&gt;1, 6-8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;This sudden upheaval has weakened health systems and curtailed the health workforce, increasing the global risk of being unable to respond effectively to HIV and future pandemics. At the same time, scientific and technological breakthroughs—from long-acting HIV prevention and treatment to digital and artificial intelligence (AI)-enabled service delivery—create new opportunities to redesign care in ways that are more efficient, resilient and people-centred. Against this backdrop, this paper examines four major, inter-related forces shaping the next phase of HIV integration and assesses what they mean for the future of the global HIV response, un","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388877","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":"Navigating the Data Gaps of Ageing Among Women Living With HIV","authors":"Caroline A. Sabin,&nbsp;Nomathemba Chandiwana,&nbsp;Anchalee Avihingsanon,&nbsp;Nicoletta Policek","doi":"10.1002/jia2.70094","DOIUrl":"10.1002/jia2.70094","url":null,"abstract":"&lt;p&gt;In its 2025 Global AIDS Update [&lt;span&gt;1&lt;/span&gt;], UNAIDS estimates that over half (53%) of the 40.8 million people living with HIV globally were women or girls, who also accounted for 45% of new HIV acquisitions. This sex-based disparity is pronounced in Africa, where women and girls accounted for 63% of all new acquisitions. Where women are diagnosed and receive optimal antiretroviral therapy (ART), life expectancy has improved. As women live longer with HIV, prolonged ART exposure and chronic immune activation increasingly intersect with ageing, bringing an increased risk of age-associated non-communicable conditions (AANCCs), including cardiovascular, metabolic, bone and renal disease.&lt;/p&gt;&lt;p&gt;Women may experience a unique range of AANCCs compared to men. In the Dutch ATHENA cohort, women developed multi-morbidity at younger ages than men, with higher mortality rates in women following each morbidity event [&lt;span&gt;2&lt;/span&gt;]. In the United States, a combined analysis of the Women's Interagency HIV Study and the Multicenter AIDS Cohort Study demonstrated increasing multi-morbidity with age in both sexes, regardless of HIV status. However, among those with HIV, women consistently exhibited a higher comorbidity burden at all ages. Importantly, women had higher rates of bone and lung disease (primarily asthma) and diabetes, but lower rates of hypertension, psychiatric illness, dyslipidaemia, liver disease and non-AIDS cancers when compared to men [&lt;span&gt;3&lt;/span&gt;]. Differences in co-morbidity profiles are projected to continue until at least 2030 [&lt;span&gt;4&lt;/span&gt;], although profiles vary by ethnicity and injection drug use, emphasizing the contribution of social and structural inequalities to AANCC development [&lt;span&gt;3&lt;/span&gt;]. Women in the D:A:D/RESPOND cohort collaboration [&lt;span&gt;5&lt;/span&gt;] experienced high rates of human papillomavirus-related, breast and lung cancers, as well as non-Hodgkin's lymphoma, with geographical variations in some cancers, particularly cervical cancer, raising concern about differential access to vaccination and other preventive interventions.&lt;/p&gt;&lt;p&gt;Over the past decade, while we have learned much about the ageing process in men living with HIV, the same cannot be said for women. A systematic review of published articles from 2010 to 2020 [&lt;span&gt;6&lt;/span&gt;] confirmed a high burden of age-related morbidity among women with HIV, including acute cardiovascular disease, reduced bone mineral density, cognitive impairment and renal disease. However, the review highlighted substantial gaps in our understanding of why these differences exist, noting poor female representation in studies with few sex-stratified analyses, a lack of geographical diversity, and inadequate adjustment for key socio-demographic and lifestyle confounders, limiting interpretability.&lt;/p&gt;&lt;p&gt;Differences in AANCC among women may partly reflect sex-hormone-related factors, which change at key times during a woman's life, including pregnancy, lactation and menopaus","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363439","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":"The Promise of Integration of HIV Into Primary Care: Challenges and Opportunities","authors":"Wafaa M. El-Sadr,&nbsp;Joey Platt","doi":"10.1002/jia2.70093","DOIUrl":"10.1002/jia2.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Remarkable progress has been made in response to the global HIV epidemic, yet critical gaps and inequities remain, combined with challenges stemming from the current threats to global funding, complacency and competing global health priorities. These constraints threaten to unravel the hard-won gains and to stall progress towards control of the HIV epidemic. In response to this rapidly changing landscape, the integration of HIV services into primary care has emerged as a potential solution to this crisis that would bring possible efficiencies and sustainability of the response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Recognition that persons with HIV often experience a range of other health challenges over their lifetime has compelled the need for integration of non-HIV services into HIV programmes to allow for delivery of comprehensive person-centred care. However, most attention at present is centred on the integration of HIV treatment into primary care, raising concerns about whether this might risk the quality of care for persons with HIV. The limited availability of primary care services that offer comprehensive and effective continuity care in many low- and middle-income countries presents a major challenge to providing such care. Nonetheless, such integration offers a historic opportunity to enhance healthcare for all people with chronic health conditions, including for persons with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The integration of non-HIV services into HIV programming is recognized as necessary to meet the needs of persons with HIV, enhancing their quality of life and health outcomes. At the same time, the imperative for integration of HIV treatment into primary care programmes raises an important question. Can primary care programmes be transformed to allow for the provision of the necessary continuity care with the required supportive services that persons with HIV need? Accomplishing this goal may present a pathway to sustaining the HIV response in the current resource-constrained context while enabling the long-desired transformation of primary care services to effectively deliver on their potential for advancing the health of all people.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363388","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":"Correction to “What is not measured cannot be improved: the urgency to understand causes of HIV-related deaths in Latin America”","authors":"","doi":"10.1002/jia2.70092","DOIUrl":"10.1002/jia2.70092","url":null,"abstract":"<p>Lopez-Villalba, B., Alonso-Gonzalez, M., Nuche-Berenguer, B., Castrodeza-Sanz, J.J. and Sued, O. (2025), What is not measured cannot be improved: the urgency to understand causes of HIV-related deaths in Latin America. <i>J Int AIDS Soc</i>., 28: e70065. https://doi.org/10.1002/jia2.70065</p><p>In the article, there is a correction in the acknowledgements.</p><p>The statement reads:</p><p><b>ACKNOWLEDGEMENTS</b></p><p>The authors thank the organizations that contribute to improving the quality of life for people living with HIV and those who conduct research to prevent these deaths and the spread of the disease.</p><p>This should read:</p><p><b>ACKNOWLEDGEMENTS</b></p><p>The authors thank Unitaid for the support of Zero AIDS Deaths by 2030 PAHO project and other organizations that contribute to improving the quality of life for people living with HIV and those who conduct research to prevent these deaths and the spread of the disease.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363467","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":"Zero discrimination in practice: resisting anti-trans backlash in the global HIV response","authors":"Tonia C. Poteat,&nbsp;L. Leigh Anne van der Merwe,&nbsp;Laylla Monteiro,&nbsp;Sari L. Reisner","doi":"10.1002/jia2.70083","DOIUrl":"10.1002/jia2.70083","url":null,"abstract":"&lt;p&gt;Since its launch by UNAIDS in 2014, Zero Discrimination Day has been observed every March around the world [&lt;span&gt;1&lt;/span&gt;]. This observance calls for the eradication of discrimination in all forms and affirms the right of every person to live with dignity—without fear of violence and free from internalized, interpersonal, social and structural stigma. The goal of zero discrimination responds to mounting evidence that punitive laws and abrogation of human rights are not only patently unacceptable but are also significant barriers to engagement in HIV prevention, care and treatment [&lt;span&gt;2&lt;/span&gt;]. Achieving this goal will require removing harmful laws, ensuring legal protections and supporting the empowerment of communities most affected by HIV. The HIV community can be a powerful catalyst for change, with a long history of activism and advocacy that have shaped medical, legal and social landscapes of the global HIV response [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The 2024 UNAIDS report found that, globally, transgender women bear a 20-fold higher burden of HIV than the general adult population [&lt;span&gt;4&lt;/span&gt;]. While data regarding transgender men are limited, existing evidence also reflects their seven-fold greater burden of HIV [&lt;span&gt;5&lt;/span&gt;]. Data on HIV prevalence among gender nonbinary individuals are scant; however, a recent study across 20 European countries found a self-reported HIV prevalence of 5.6%, also much higher than their general populations [&lt;span&gt;6&lt;/span&gt;]. Despite elevated HIV prevalence, access to and uptake of biomedical HIV services are low [&lt;span&gt;5&lt;/span&gt;]. These inequities are driven by stigma, discrimination and social exclusion, and intensified by growing legal, policy, rhetorical and physical attacks across the world that threaten hard-won gains in the global HIV response. In 2025, UNAIDS warned of the most serious setback in decades due to funding disruptions and deteriorating human rights conditions, including the first rise in countries criminalizing gender diversity and same-sex relationships since 2008 [&lt;span&gt;7&lt;/span&gt;]. These developments directly impede access to HIV services, particularly for transgender communities already experiencing disproportionate HIV burden and structural barriers to prevention and care.&lt;/p&gt;&lt;p&gt;Across Europe and Central Asia, Transgender Europe's 2025 Trans Rights Index documented an unprecedented reversal: setbacks in transgender rights now outweigh progress, with bans or restrictions on legal gender recognition and diluted antidiscrimination protections in multiple countries [&lt;span&gt;8&lt;/span&gt;]. While some advances occurred (e.g. Germany's self-determination law [&lt;span&gt;9&lt;/span&gt;]), the aggregate trajectory is regressive and tied to broader democratic erosion.&lt;/p&gt;&lt;p&gt;In the United States, a record volume of anti-transgender bills are targeting healthcare, education, civil rights and daily public participation. By late 2025, more than 1000 bills had been introduced across 49 of 50 states, with over 100 e","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147300439","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}