Journal of the International AIDS Society最新文献

{"title":"Nationwide Molecular Epidemiology of HIV-1 in Uruguay (2007–2021): Lineage Diversity, BF1 Recombinant Complexity and Epidemiological Patterns","authors":"Agustina A. Podchibiakin, Rosa Flieller, Dora Ruchansky, Maria Brasesco, Maria N. Cortinas, Andrés Lizasoain, Héctor Chiparelli, Susana Cabrera, Gonzalo Bello, Ana M. Soler, Daiana Mir","doi":"10.1002/jia2.70157","DOIUrl":"10.1002/jia2.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Uruguay has one of the highest HIV incidence rates in Latin America, yet its molecular epidemiology remains underexplored. Characterizing the diversity, temporal and geographic dynamics of circulating HIV-1 lineages is essential to detect lineage-specific patterns across population groups and regions, inform tailored prevention and surveillance strategies, and understand cross-border connectivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>HIV-1 <i>pol</i> (PR/RT) genotyping data from 1268 people living with HIV, generated during 2007–2021 through nationwide routine genotyping, were analysed. Viral lineages and recombinants were classified using automated subtyping tools, maximum-likelihood phylogenies and recombination analyses. Associations with demographic and exposure characteristics were evaluated using Z-tests and Fisher's exact tests, and temporal trends were assessed using Pearson correlations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen recognized HIV-1 lineages were identified, including four subtypes/sub-subtypes (B, C, A1 and F1) and twelve circulating recombinant forms (CRFs). Subtype B was the most frequent lineage (39.3%), followed by CRFs 12_BF (27.8%) and 38_BF1 (12.9%). An additional 8.5% of sequences formed a well-supported B/F1 recombinant clade, provisionally designated BF1.UY and not assignable to any known CRF. Temporal analyses showed opposing trends, with a significant decline in subtype B and an increasing contribution of BF1 recombinants within the genotyped dataset. Subtype B was associated with men and transmission among men who have sex with men; 38_BF1 was enriched among women and people reporting injection-related exposures; and BF1.UY predominate in reported heterosexual transmission. Geographic patterns suggested regional connectivity: 12_BF predominated in the West and the Atlantic coastal East, consistent with Argentina-linked border and tourism-related mobility, whereas Brazilian-associated variants (subtype C, 31_BC and F1) were more frequent in the Northeast and East.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In Uruguay, HIV-1 molecular diversity was largely shaped by sustained circulation of subtype B and BF1 recombinants, which showed distinct associations with gender, transmission-route category and geography. These lineage-specific patterns are consistent with partially overlapping transmission networks among Uruguayan subpopulations and viral exchange across border areas. The growing contribution of BF1 recombinants within the genotyped datase","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589531","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":"Persistence on Oral HIV Pre-Exposure Prophylaxis Among Key Populations at a Centre in Buenos Aires: A Survival Analysis of a Real-World Cohort","authors":"Julian L. Garcia,&nbsp;Diego Salusso,&nbsp;Gissella Mernies,&nbsp;María M. Sandoval,&nbsp;Carla Petriglieri,&nbsp;Felipe Bilbao,&nbsp;Daniela Parera,&nbsp;Carolina Perez,&nbsp;Adriana Duran,&nbsp;Ines Aristegui,&nbsp;Maria Ines Figueroa,&nbsp;Carina Cesar","doi":"10.1002/jia2.70175","DOIUrl":"10.1002/jia2.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although HIV pre-exposure prophylaxis (PrEP) has been rapidly scaled up in Argentina to reach key populations with high HIV burden, evidence on real-world persistence is lacking. Understanding who remains engaged in care, and why others discontinue, is essential to ensure the effectiveness of PrEP. This study evaluated oral PrEP persistence and identified demographic and behavioural factors associated with discontinuation in a cohort of individuals initiating PrEP in Buenos Aires.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study including all users initiating daily or event-driven oral PrEP at our centre between September 2021 and July 2025. The cohort consisted of transgender women (TGW), men who have sex with men (MSM) and cisgender women engaged in sex work (cSW), in line with national PrEP guidelines. Persistence on PrEP was defined as the time to first discontinuation (TFD), either self-reported or estimated as the date when the last dispensed PrEP pill would have been exhausted if taken daily. Categories for discontinuation included participant-reported causes and loss to follow-up (LTFU). TFD was evaluated using survival analysis. Cox proportional hazards models were fitted to examine associations between TFD and sociodemographic and behavioural factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 970 individuals initiated PrEP: 69% MSM, 24% TGW and 6% cSW. Median age was 31 years (IQR 26–36). During follow-up, 447 participants (46%) discontinued PrEP. Persistence declined steadily over time: 91% at 1 month, 81% at 6 months, 72% at 12 months, 58% at 24 months and 43% at 36 months. Main categories for discontinuation were LTFU (44%), user decision or perceived low risk (46% combined) and adverse events (10%). In the multivariable model, younger age, identifying as TGW or cSW, cocaine use in the last month before baseline and the absence of basal/follow-up syphilis or other bacterial sexually transmitted infections were associated with PrEP discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nearly half of the cohort discontinued PrEP over 3 years, with differences across key populations. These findings highlight the need for differentiated community-tailored PrEP delivery models that address structural and behavioural barriers to improve long-term PrEP engagement among key populations in Argentina and wider Latin America.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589613","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":"Optimizing HIV Spending Among Key Populations in Five Latin American and Caribbean Countries: A Mathematical Modelling Study","authors":"Debra ten Brink,&nbsp;Anna L. Bowring,&nbsp;Rowan Martin-Hughes,&nbsp;Nisaa Wulan,&nbsp;Kelvin Burke,&nbsp;Cielo Yaneth Ríos Hincapie,&nbsp;Ricardo Luque Núñez,&nbsp;Brenda Cáceres-Mejía,&nbsp;Rosa Victoria Sánchez,&nbsp;José Pablo Montoya Calvo,&nbsp;Sandra Margarita Nuñez Rubio,&nbsp;Maria Petro Brunal,&nbsp;Nick Scott","doi":"10.1002/jia2.70171","DOIUrl":"10.1002/jia2.70171","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;From 2010 to 2024, the Latin America region experienced a 13% increase in new HIV acquisitions, while progress in reducing HIV acquisitions has slowed in the Caribbean. We conducted allocative efficiency studies for five countries in the Latin America and Caribbean region, aiming to estimate how HIV spending could be optimally allocated for maximal impact.&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;Between 2021 and 2025, we collaborated with national partners in Colombia, Costa Rica, Dominican Republic, El Salvador and Honduras to develop national Optima HIV models incorporating country-specific key populations. Prevention, testing and antiretroviral therapy (ART) interventions were parameterized using country-specific unit costs, coverage estimates and effectiveness values. For each country, we projected HIV incidence, mortality and treatment resource needs from 2025 to 2030 for multiple scenarios: fixed intervention coverage (status quo), fixed spending allocations (counterfactual), and most recent spending optimized across interventions to minimize cumulative HIV acquisitions and HIV-related deaths.&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;With the status quo continued, HIV incidence was projected to decline by 2030 in two countries, stabilize in two and increase in one country. Transgender women and men who have sex with men have the highest incidence rate. Due to ongoing increases in the number of diagnosed people living with HIV, by 2030, annual ART resources will need to increase by 1%–15% to maintain the existing treatment coverage.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Compared with the counterfactual (fixed spending) scenario, optimization of existing resources could avert 18%–33% of new HIV acquisitions and 5%–31% of HIV-related deaths over 2025–2030 by prioritizing primarily ART. If modelled ART unit costs reduce by 25%, then 23%–69% of projected HIV acquisitions and 8%–61% of HIV-related deaths could be averted by reinvesting savings to scale-up interventions for country-specific key populations instead of lower-yield interventions such as untargeted HIV testing.&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;This multi-country modelling study demonstrates the potential to reduce new HIV acquisitions and HIV-related deaths across Latin America and the Caribbean without increasing total spending. Recent reductions in treatment costs provide greater flexibility to invest in key population-focused services which could amplify epidemic impact. The findings underscore the importance of al","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589569","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":"Social Media Messaging to Reduce HIV-Related Stigma Among Young Adults in Peru: A Randomized Controlled Study","authors":"Queen Balina,&nbsp;Alyson Nunez,&nbsp;Milagros Wong,&nbsp;Marguerite Curtis,&nbsp;Kristin Kosyluk,&nbsp;Jerome T. Galea,&nbsp;Renato Errea,&nbsp;Molly F. Franke","doi":"10.1002/jia2.70168","DOIUrl":"10.1002/jia2.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>HIV-related stigma undermines prevention and treatment efforts, particularly among young adults. Social media offers a scalable platform for stigma-reduction efforts; however, empirical evidence of its effectiveness remains limited. Social media influencers may enhance the effectiveness of stigma reduction messages delivered via social media.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From November 2024 to January 2025, we conducted a randomized controlled study in Lima, Peru, among young adults aged 18–29 years to evaluate the impact of brief exposure to tailored social media content designed to reduce HIV-related stigma. Content featured widely recognized Peruvian influencers or young adult residents filmed in recognizable places in Lima. Participants were randomized to a simulated social media feed containing one of four HIV stigma-reduction videos, including one featuring a top Peruvian influencer, or a control video. Stigma was evaluated using the Bogardus social distance scale, scored using standard and intensity-based methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hundred and sixty-seven persons participated (53% male, median age: 21 years). Median social distance pre-randomization score was 1 in controls (fifth–95th percentile: 1–7), 1 in Arm 1 (fifth–95th: 1–7), 1 in Arm 2 (fifth–95th: 1–6), 1 in Arm 3 (fifth–95th: 1–5) and 1 in Arm 4 (fifth–95th: 1–7). Comparisons of pre- and post-changes by study arm supported modest intervention effects. Controls showed a median change of 0 (fifth–95th: –1–2). Arm 1, featuring influencer-generated content, showed a median change of 0 (fifth–95th: –6–0), with a Wilcoxon rank-sum test indicating a statistically significant difference from controls (<i>p</i> = 0.001). Arm 2 showed a median change of 0 (fifth–95th: –1–0, <i>p</i> = 0.08). Arm 3 showed a median change of 0 (fifth–95th: –2–0, <i>p</i> = 0.01). Arm 4 showed a median change of 0 (fifth–95th: –3–0, <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Brief exposure to culturally tailored social media content led to modest reductions in HIV-related stigma among young adults in Peru immediately after viewing. Findings reinforce the potential role of social media and influencers in HIV stigma reduction efforts. Future research should examine whether social media interventions can reduce stigma among those with the most stigmatizing beliefs and identify dosing and delivery strategies that achieve durable reductions in stigma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589748","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":"Pharmaceutical Sovereignty as HIV Justice: Colombia's Dolutegravir License and the Future of ART Access in Latin America","authors":"Laura M. Cifuentes,&nbsp;Julien B. Brisson,&nbsp;Aarón Zea,&nbsp;Pierre-Marie David","doi":"10.1002/jia2.70137","DOIUrl":"10.1002/jia2.70137","url":null,"abstract":"&lt;p&gt;Access to antiretroviral therapy (ART) remains one of the most pressing challenges in Latin America's HIV response. Despite major biomedical advances, persistent inequalities in affordability, availability and regional production of ART continue to impede progress towards the UNAIDS 95-95-95 targets [&lt;span&gt;1&lt;/span&gt;]. Latin America has an estimated 2.3 million people living with HIV, of whom approximately 73% are receiving ART and only 67% have achieved viral suppression [&lt;span&gt;1&lt;/span&gt;]. Access remains closely tied to health systems financing, as ART costs constitute a substantial share of national HIV budgets. In Colombia, for instance, HIV-related expenditures reached USD 194.6 million in 2022 [&lt;span&gt;2&lt;/span&gt;]. Recent international HIV funding cuts are projected to exacerbate structural vulnerabilities, increasing the risk of ART access interruptions and inequities across the region [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;These vulnerabilities stem from systemic barriers—high drug prices, restrictive patent and procurement regimes, and limited domestic manufacturing—constraining equitable HIV treatment in the region [&lt;span&gt;4&lt;/span&gt;]. At the same time, HIV distribution in Latin America remains uneven: gay, bisexual and other men who have sex with men, transgender women, sex workers, migrants and people in prisons or other closed settings face disproportionately high acquisition rates and unmet treatment needs, exacerbated by stigma, discrimination and criminalization [&lt;span&gt;5, 6&lt;/span&gt;]. When those most affected are marginalized or deprioritized, chronic underinvestment perpetuates exclusion. Ensuring reliable, affordable ART access is not merely logistical but a matter of social justice, requiring states to uphold the rights and dignity of populations pushed to the margins of public health priorities.&lt;/p&gt;&lt;p&gt;Against this backdrop, Colombia's April 2024 compulsory license for government use of dolutegravir represents a pivotal shift in regional HIV governance [&lt;span&gt;7&lt;/span&gt;]. It reflects a deliberate political move towards pharmaceutical sovereignty: the ability of states to ensure equitable, sustainable access to essential medicines through legal, regulatory and manufacturing capacity, and public-interest decision-making [&lt;span&gt;8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;By reducing the annual cost per person of a WHO-recommended first-line antiretroviral drug by 96%—from approximately USD 1160 to USD 42 [&lt;span&gt;9&lt;/span&gt;]—the compulsory license simultaneously disrupts pricing inequities and affirms the primacy of the right to health over commercial claims. Although Brazil's 2007 compulsory license for efavirenz set a precedent, no Latin American country had taken similar measures in nearly two decades. Thus, Colombia's action goes beyond policy innovation: it declares ART access a fundamental entitlement rather than a market-dependent privilege, underscoring that equitable ART access is inseparable from broader struggles for justice and the right to health in Latin America.&lt;/p&gt;&lt;p&gt;Colo","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589795","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 Caribbean, Central and South America Network for HIV Epidemiology: 20 Years of HIV Research in the Region","authors":"Jessica L. Castilho,&nbsp;Stephany N. Duda,&nbsp;Bryan E. Shepherd,&nbsp;Timothy R. Sterling,&nbsp;Anna K. Person,&nbsp;Peter F. Rebeiro,&nbsp;William C. Wester,&nbsp;John R. Koethe,&nbsp;Jesse Carlson,&nbsp;Rachael A. Pellegrino,&nbsp;Karu Jayathilake,&nbsp;Fernanda Maruri,&nbsp;Hilary Vansell Riley,&nbsp;Amanda Garcia De Matos Amaral,&nbsp;Marina Cruvinel Figueiredo,&nbsp;Paridhi Ranadive,&nbsp;Megan Turner,&nbsp;Gustavo Amorim,&nbsp;Vickie Myers,&nbsp;Heather Burgess,&nbsp;Shengxin Tu,&nbsp;Liping Du,&nbsp;Danni Shi,&nbsp;Zhouhui Liang,&nbsp;Kaixing Liu,&nbsp;Chao Yan,&nbsp;Beatriz Grinsztejn,&nbsp;Valdilea G. Veloso,&nbsp;Paula M. Luz,&nbsp;Sandra Wagner Cardoso,&nbsp;Ruth Friedman,&nbsp;Ronaldo I. Moreira,&nbsp;Monica Derrico Pedrosa,&nbsp;Hugo Perazzo,&nbsp;Rodrigo Moreira,&nbsp;Maria Pia Diniz Ribeiro,&nbsp;Mario Sergio Pereira,&nbsp;Emilia Moreira Jalil,&nbsp;Thiago Silva Torres,&nbsp;Carolina Coutinho,&nbsp;Mayara Secco Torres Silva,&nbsp;Flaviana Pavan Victoriano,&nbsp;Jorge Pinto,&nbsp;Flavia Ferreira,&nbsp;Marcelle Maia,&nbsp;Victoria Bocardi,&nbsp;Julia Caporali,&nbsp;Flavia Fonseca,&nbsp;Mateus Westin,&nbsp;Regina Célia de Menezes Succi,&nbsp;Daisy Maria Machado,&nbsp;Aida de Fátima Barbosa Gouvêa,&nbsp;Fabiana Bononi do Carmo,&nbsp;Claudia P. Cortes,&nbsp;Maria Fernanda Rodriguez,&nbsp;Gabriel Castillo-Rozas,&nbsp;Fabio Paredes,&nbsp;Georgina Estadella,&nbsp;Jean William Pape,&nbsp;Vanessa Rouzier,&nbsp;Adias Marcelin,&nbsp;Jodany Bernadin,&nbsp;Stanley Cadet,&nbsp;Marco Tulio Luque,&nbsp;Diana Varela,&nbsp;Magda Chavez,&nbsp;Ada Mailhot,&nbsp;Eduardo Gotuzzo,&nbsp;Fernando Mejia,&nbsp;Gabriela Carriquiry,&nbsp;Claudia Nuñez Mochizaki,&nbsp;Brenda Crabtree Ramirez,&nbsp;Juan Sierra Madero,&nbsp;Yanink Caro Vega,&nbsp;Álvaro López Iñiguez,&nbsp;Ana Fernanda Ramos Menchelli,&nbsp;Paola Alarcón Murra,&nbsp;Geovanna Coello,&nbsp;Guadalupe Muñuzuri Nájera,&nbsp;Rodrigo Ville Benavides,&nbsp;Jessica Mejía,&nbsp;Távata Bejarano,&nbsp;Nancy Sierra,&nbsp;Valeria Fink,&nbsp;Florencia Cahn,&nbsp;Ines Aristegui,&nbsp;Maria Ines Figueroa,&nbsp;Nicolas Doudtchitzky,&nbsp;Javier Mariani,&nbsp;Mariela Ceschel,&nbsp;Gissella Mernies,&nbsp;Agustin Nava,&nbsp;Carina Cesar,&nbsp;Pedro Cahn,&nbsp;Caribbean, Central and South America network for HIV Epidemiology (CCASAnet) of the International epidemiology Databases to Evaluate AIDS (IeDEA)","doi":"10.1002/jia2.70169","DOIUrl":"10.1002/jia2.70169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Latin America is a key region in advancing efforts to end the HIV epidemic globally. Despite breakthroughs in HIV treatment and prevention in the last 20 years, as well as region-wide improvements in health infrastructure and policies, there has been a 13% increase in new acquisitions in Latin America from 2010 to 2024. The Caribbean, Central and South America network for HIV epidemiology (CCASAnet), established in 2006, is one of seven regions in the International epidemiology Databases to Evaluate AIDS (IeDEA). CCASAnet contributes substantially to regional science and the development of national and region-wide policies. Here, we describe data sources and operational methodologies employed by CCASAnet, as well as the current state of the cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CCASAnet data are collected using standardized data elements, including demographic information, HIV disease history, laboratory data, antiretroviral regimens, co-infections and comorbidities. Data collection has expanded to include prospective data such as substance use, antiretroviral therapy adherence, geriatric syndromes and tuberculosis treatment. All clinical sites retain ownership of their data, and CCASAnet data contribute as able to global IeDEA-level projects. Robust data quality initiatives and statistical methods have strengthened the cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CCASAnet consists of nine clinics across seven countries (Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru). Over 61,000 adults and children living with HIV have contributed observational data through December 2023. While CD4 at enrolment has remained largely unchanged, time to antiretroviral therapy initiation has decreased, retention in care has improved and the proportion with undetectable HIV RNA has dramatically increased. Co-infections and AIDS-defining malignancies remain a cause of morbidity and mortality, but non-communicable diseases have also increased. Overall mortality trends in the region have improved over time, with some notable exceptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Underscoring the importance of maintaining longitudinal collaborations and data collection, CCASAnet remains the largest source of high-quality data for HIV epidemiology in Latin America and serves as an important evidence base for informing global and regional policy and stakeholder decisions related to the HIV epidemic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589826","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":"Latin America and the Caribbean: Challenges and Opportunities for HIV Treatment and Prevention","authors":"Mateo Prochazka,&nbsp;Kelika A. Konda,&nbsp;Omar Sued,&nbsp;Hortencia Peralta,&nbsp;Andrea Boccardi,&nbsp;Thiago S. Torres,&nbsp;Monica Alonso,&nbsp;Valdilea Veloso,&nbsp;Beatriz Grinsztejn","doi":"10.1002/jia2.70170","DOIUrl":"10.1002/jia2.70170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In Latin America, there are rising numbers of new HIV acquisitions, while the Caribbean has achieved decreases in both new acquisitions and AIDS-related deaths. The Latin American and Caribbean (LAC) region has worked towards widely available treatment for people with HIV (PWHIV) within public health systems and, in Latin America, has relied principally on domestic financing to do so.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>While new methods of prevention are in the process of being incorporated into regional HIV programmes, the HIV cascade of care remains below the UNAIDS goals. Only 17 of the 32 LAC countries (53%) report on the three pillars. Only Chile achieved &gt;95% in two of the three pillars, with 95% of PWHIV knowing their status and 95% of people on treatment having a suppressed viral load. However, only 75% of those who know their status were on treatment. In the Caribbean, very little data is available, with all three cascade pillars missing for six of the countries. Only the Bahamas reached the 95% threshold for any of the cascade steps. Additionally, in the Caribbean, the viral suppression step of the cascade is much lower on average than in Latin America, with no countries reaching 80%. Biomedical HIV prevention with pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) is still being adopted and scaled up among populations in need. Scale-up of prevention efforts remains hindered by structural limitations of the health system, legal and policy limitations such as continuing to require informed consent for HIV testing and policies that block task-shifting, as well as persistent stigma. Recent reductions in international funding for HIV may adversely influence HIV programmes in LAC, which have relied on these for initial scale-up of innovations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Accelerating differentiated and simplified delivery of PrEP and PEP, alongside sustained progress towards universal treatment coverage and viral suppression, are all essential for translating existing scientific advances into measurable progress towards HIV elimination in the region.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589434","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 Into Sexual and Reproductive Health Services for Female Sex Workers in Buenos Aires, Argentina: A Comprehensive Model Designed Through Intersectional Collaboration","authors":"María Macarena Sandoval,&nbsp;Inés Aristegui,&nbsp;Virginia Zalazar,&nbsp;Silvina Vulcano,&nbsp;María Victoria Iannantuono,&nbsp;Agustina Argüello,&nbsp;Emilia Frontini,&nbsp;Ana C. Zeltman,&nbsp;Agustín Nava,&nbsp;Nadir F. Cardozo,&nbsp;Marcela Romero,&nbsp;Georgina Orellano,&nbsp;Carolina F. Pérez,&nbsp;María Inés Figueroa,&nbsp;Adriana Durán,&nbsp;Sharon Walmsley,&nbsp;Valeria Fink,&nbsp;the “MAS por Nosotras” study team","doi":"10.1002/jia2.70167","DOIUrl":"10.1002/jia2.70167","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;Female sex workers (FSWs) are at higher risk of sexually transmitted infections (STIs), including HIV, due to occupation-related factors further exacerbated by gender-specific vulnerability and marginalization. Stigma and fear of disclosing their occupation pose multiple barriers that limit access to sexual and reproductive health (SRH) services, as well as HIV testing, prevention and treatment. We describe the implementation of a tailored comprehensive SRH-HIV prevention and care model for FSWs, and report HIV prevalence, pre-exposure prophylaxis (PrEP) uptake and HIV treatment outcomes in our cohort.&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;“MAS por Nosotras” adopted a co-creation and co-production approach including a formative phase (focus groups with FSWs and semistructured interviews with stakeholders), and a prospective cohort of FSWs at a non-governmental organization (NGO) in Argentina. Our conceived model focused on HIV treatment and combination prevention, including STI testing, cancer screening, contraception counselling and vaccination. Demographic, psychosocial and clinical information were collected.&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;Between June 2023 and March 2024, 200 cisgender and transgender FSWs were enrolled in the prospective cohort, with a 66.5% retention rate at 6 months. HIV prevalence was 18.5% (34.3% in transgender women [TGW] and 3% in cisgender women [CGW]), with only one incident case during follow-up. Among those with known HIV, 61% had a viral load &lt;50 copies/mL. PrEP acceptance was higher in TGW (55.6%) versus 30.5% in CGW, but PrEP persistence was low (69% discontinued), especially in CGW. Nearly 78.5% of participants indicated they would be very likely to recommend the care package to their peers.&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;“MAS por Nosotras” implemented a community-linked, gender-informed integrated SRH-HIV model of care, articulated with community-based organizations, public health and an NGO research centre that facilitated access to HIV testing, prevention and treatment initiation or re-engagement. We found a high prevalence of HIV, particularly among TGW, and low PrEP knowledge and use, especially among CGW. Our data reflect the need of expanding and tailoring HIV prevention strategies with a community-focused approach. This proposed integrated SRH-HIV model addressed these needs and generated preliminary evidence regarding operational feasibility and acceptability that may inform models to help close prevention and treatmen","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589462","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":"Data-Driven, Patient-Centred HIV Care Supports Sustained Viral Suppression: A Retrospective Programme Analysis From the Medical Research Foundation of Trinidad and Tobago","authors":"Nyla P. Lyons,&nbsp;Gregory G. Boyce,&nbsp;K. M. Harvey,&nbsp;Wendy Samaroo-Francis,&nbsp;Brendon M. Bhagwandeen,&nbsp;Robert J. Edwards","doi":"10.1002/jia2.70166","DOIUrl":"10.1002/jia2.70166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Achieving and sustaining viral suppression among people living with HIV remains central to global HIV control efforts. Despite global 95–95–95 targets and the scale-up of differentiated service delivery (DSD) models, many programmes continue to face structural and system-level barriers to sustained treatment outcomes. Evidence on longitudinal HIV treatment outcomes using routinely collected programme data remains limited in Caribbean settings. This study aimed to describe longitudinal trends in HIV treatment outcomes at the Medical Research Foundation (MRF), a large HIV treatment site in Trinidad and Tobago.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective descriptive analysis was conducted using de-identified electronic medical record (EMR) data for all clients receiving antiretroviral therapy (ART) at MRF. Data were analysed across seven fiscal quarters (FY2024 Q2–FY2025 Q4). The programme delivers differentiated, patient-centred HIV care supported by routine EMR monitoring and quarterly programme performance reviews. Key indicators included ART coverage, viral load (VL) testing coverage, viral suppression (VL &lt;1000 copies/mL) and treatment interruptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The ART cohort ranged from 4913 to 5202 clients over the study period. VL testing coverage remained consistently high, ranging from 95% to 98% per quarter. Viral suppression was sustained at 94%–95%, reaching 95% in three quarters (FY2024 Q3, FY2025 Q3 and FY2025 Q4). Treatment interruptions declined by approximately 50% over time, while the number of clients active on ART remained stable with a gradual increase in later quarters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates sustained high viral suppression and VL testing coverage within a large HIV treatment programme delivering DSD in Trinidad and Tobago. The reduction in treatment interruptions alongside stable high viral suppression highlights the value of routine programme data for monitoring HIV service delivery in real-world settings. These findings provide implementation-relevant insights for strengthening differentiated HIV care models and contribute to the limited evidence base on longitudinal treatment outcomes in Caribbean programme settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S3","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589517","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":"Potential Use of Neisseria meningitidis Serogroup B Vaccines to Prevent Neisseria gonorrhoeae Infection: Epidemiological Considerations","authors":"Sami L. Gottlieb,&nbsp;Jane Rowley,&nbsp;Nuria Balibrea,&nbsp;Dominique A. Caugant,&nbsp;Ray Borrow,&nbsp;Antoine Durupt,&nbsp;Helen S. Marshall,&nbsp;Maeve B. Mello,&nbsp;Marco Aurelio Sáfadi,&nbsp;Marie-Pierre Preziosi","doi":"10.1002/jia2.70155","DOIUrl":"10.1002/jia2.70155","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;Clinical trials are evaluating the efficacy of serogroup B meningococcal (MenB) outer membrane vesicle (OMV) vaccines in preventing gonorrhoea. We assessed the global epidemiology of gonorrhoea and MenB invasive meningococcal disease (IMD) and reviewed national MenB-OMV vaccination policies to inform potential use of these vaccines.&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;We included country-specific epidemiologic data from 2015 through October 2025. Gonorrhoea prevalence data for general populations of women were extracted from published systematic reviews and case reports taken from well-established reporting systems. Country-specific MenB IMD incidence rates were drawn from published reviews and surveillance reports. National MenB-OMV immunization policies were obtained from published reviews and databases from the World Health Organization and vaccine manufacturers.&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;Forty-two countries had ≥1 gonorrhoea prevalence study. Mean prevalence was &lt;1.0% in 19 (45%) countries, 1.0%−2.49% in 10 (24%), 2.5%−4.99% in 10 (24%) and ≥5% in three (7%), with higher prevalences mostly in the WHO African Region. MenB IMD incidence was reported in 62 countries: 17 (27%), mainly in the WHO African Region, had no cases; 28 (45%) had incidence &lt;0.25/100,000; 14 (23%) had incidence 0.25−0.49/100,000; and only three had incidence ≥0.5/100,000 annually. Only 15 countries had data for both conditions. Case-report data showed gonorrhoea incidence peaking at ages 20–24 and being substantially higher among men who have sex with men (MSM). MenB IMD incidence was highest among children &lt;4 years, with a second peak among 15- to 24-year-olds in some countries. Twenty-one countries incorporated MenB-OMV vaccines into infant immunization programmes and seven into adolescent programmes. One country had a targeted MenB-OMV vaccination programme (MSM at high-risk) for gonorrhoea prevention.&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;Epidemiologic data were lacking in many countries; only a handful had a substantial burden of both gonorrhoea and MenB IMD. Low- and middle-income countries with high gonorrhoea prevalence typically reported no MenB IMD or lacked data, whereas high-income countries with higher MenB IMD incidence and MenB-OMV vaccine use had low gonorrhoea prevalence but high rates in subpopulations like MSM.&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;If tr","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583152","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}