Journal of the International AIDS Society最新文献

{"title":"Correction to Evaluation of point-of-care diagnostics for sexually transmitted infection on oral PrEP initiation and persistence among young people in South Africa: a randomized controlled study","authors":"","doi":"10.1002/jia2.26519","DOIUrl":"https://doi.org/10.1002/jia2.26519","url":null,"abstract":"<p>Joseph Davey, D., Fynn, L., Rousseau, E., Macdonald, P., Leonard, B., Lebelo, K., Kolisa, A., Little, F. and Bekker, L.-G. (2025), Evaluation of point-of-care diagnostics for sexually transmitted infection on oral PrEP initiation and persistence among young people in South Africa: a randomized controlled study. J Int AIDS Soc., 28: e26488. https://doi.org/10.1002/jia2.26488</p><p>In the article, one of the author names was incorrect and should be changed to <i>Keitumetse Lebelo</i> from Keitumese Lebelo.</p><p>The online version of the article was corrected.</p><p>We apologize for this error.</p>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 6","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26519","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220183","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":"Measuring mobility in HIV research in sub-Saharan Africa: a scoping review","authors":"Aleya Khalifa,&nbsp;Sara Wallach,&nbsp;M. Kate Grabowski,&nbsp;Dustin T. Duncan,&nbsp;Fred Nalugoda,&nbsp;Quarraisha Abdool Karim,&nbsp;Barun Mathema","doi":"10.1002/jia2.26508","DOIUrl":"https://doi.org/10.1002/jia2.26508","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;Mobility—from overnight travel to permanent migration—can reduce service access and increase HIV risk, driving the epidemic in sub-Saharan Africa (SSA). This scoping review described mobility measures used in HIV research to identify gaps and guide research on mobility to strengthen HIV responses in SSA.&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;Literature from three databases (PubMed, Embase, Web of Science) were systematically screened to identify research articles examining relationships between mobility and individual-level HIV-related outcomes in SSA from 2014 through 2023. Key terms for mobility included “mobility,” “movement,” “migration” and “travel.” Measures were first extracted according to International Organization of Migration definitions of migration (a change in the place of usual residence) and travel (movement between geographies). Then, metrics used to categorize or quantify mobility were organized by the stage (origin, transit, destination, return) and dimension (spatial, temporal, socio-structural) of the movement captured. Measures were analysed within three research contexts: the HIV outcome(s) of interest, study population and local geographies. Outcomes included HIV acquisition, AIDS-related death, and indicators along the prevention, care and treatment cascade.&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;We identified 69 studies after screening 5343 titles/abstracts and 200 full texts for eligibility. Studies included research from 16 countries, mostly representing general adult populations in eastern and southern Africa. Most studies measured migration (51) versus travel (21) and examined relationships with HIV prevalent infection (29) or care and treatment indicators (44) compared to other epidemiological and programmatic outcomes. Studies employed a range of metrics, mostly of the duration of stay at the destination (28), the number of mobility events (12) or the geographic boundaries across which individuals moved (14). Socio-structural dimensions like the motivation for movement were measured less often. Only 15 studies examined more than one dimension.&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;Mobility measures varied widely and were inconsistently studied across research contexts. Future studies should fill evidence gaps, standardize reporting and develop multidimensional mobility measures tailored to local settings and HIV outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 ","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 6","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220181","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":"Risk of suicide in people living with HIV: A nationwide, retrospective population-based cohort study in South Korea","authors":"Tak Kyu Oh,&nbsp;Kyoung-Ho Song,&nbsp;Eunjeong Heo,&nbsp;Hye Yoon Park,&nbsp;In-Ae Song","doi":"10.1002/jia2.26521","DOIUrl":"https://doi.org/10.1002/jia2.26521","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is a paucity of studies that compare suicide- and non-suicide-related deaths, with strict adjustments for people living with human immunodeficiency virus (HIV; PLWH) and those without HIV. We, therefore, aimed to determine whether the risk of suicide differs between these groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included all PLWH diagnosed with HIV in South Korea between 1 January 2017 and 31 December 2017. Individuals who had never been diagnosed with HIV were selected as controls using 1:10 stratified random sampling, considering age and sex. The heterogeneity of covariates between PLWH and controls was decreased by 1:5 propensity score matching. The endpoint of the study was death by suicide, with follow-up from 1 January 2018 to 31 December 2022. Death that was not ruled as a suicide was categorized as being due to other causes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After propensity score matching, 22,415 PLWH (mean age 45.9 years; 91% male) and 96,790 controls (mean age 45.8 years; 90.5% male) were included in the final analysis. Within 5 years, 104 (0.5%) of PLWH and 246 (0.3%) of controls died by suicide. Cox regression analysis revealed a 1.84-fold higher risk of suicide among PLWH compared with controls (hazard ratio [HR], 1.84; 95% confidence interval [CI], 1.46–2.31; <i>p</i> &lt; 0.001). Moreover, 836 (3.7%) of 22,415 PLWH and 2882 (3.0%) of 96,790 controls died of other causes within 5 years. Cox regression analysis also revealed a 1.26-fold increase in the risk of mortality due to other causes among PLWH (HR: 1.26; 95% CI, 1.17–1.36; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This analysis of a South Korean cohort found higher rates of death due to suicide and other causes among people living with and without HIV. The risk of death by suicide was higher than that of other causes among PLWH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 6","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26521","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220182","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":"Analytical treatment interruption among women with HIV in southern Africa who received VRC01 or placebo in the Antibody Mediated Prevention Study: ATI stakeholder engagement, implementation and early clinical data","authors":"Shelly Karuna,&nbsp;Fatima Laher,&nbsp;Sufia Dadabhai,&nbsp;Pei-Chun Yu,&nbsp;Doug Grove,&nbsp;Catherine Orrell,&nbsp;Joseph Makhema,&nbsp;Mina C. Hosseinipour,&nbsp;Carrie-Anne Mathew,&nbsp;William Brumskine,&nbsp;Nyaradzo Mgodi,&nbsp;Philip Andrew,&nbsp;Lucio Gama,&nbsp;Carissa Karg,&nbsp;Gail Broder,&nbsp;Kagisho Baepanye,&nbsp;Jonathan Lucas,&nbsp;Michele Andrasik,&nbsp;Simbarashe Takuva,&nbsp;Manuel Villaran,&nbsp;Azwidihwi Takalani,&nbsp;Randall Tressler,&nbsp;Lydia Soto-Torres,&nbsp;Amanda S. Woodward Davis,&nbsp;Ames Dhai,&nbsp;Ian M. Sanne,&nbsp;Myron S. Cohen,&nbsp;Lawrence Corey,&nbsp;Glenda Gray,&nbsp;Allan C. deCamp,&nbsp;Katharine J. Bar","doi":"10.1002/jia2.26495","DOIUrl":"https://doi.org/10.1002/jia2.26495","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;Antiretroviral therapy (ART) prevents and treats, but does not eradicate, HIV. Early ART initiation is associated with post-ART virologic control, particularly among African women, and anti-HIV-1 broadly neutralizing antibodies (bnAbs) may modulate immune responses to HIV. We evaluate whether early ART with or without anti-HIV-1 bnAb VRC01, present at HIV acquisition, is associated with later ART-free control in African women and we assess potential associations with observed control.&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;Stakeholder engagement informed analytical treatment interruption (ATI) study design and implementation. Participants who received placebo or VRC01 and acquired HIV in the Antibody Mediated Prevention efficacy trial were assessed for ATI eligibility, including HIV acquisition within 8 weeks of receiving VRC01 or placebo, followed by early ART initiation and ≥1 year of viral suppression. Participation facilitators and barriers were assessed. From May 2021 to February 2024, participants enrolled, stopped ART and received frequent viral load and CD4+ T-cell count monitoring for safety and assessment of meeting ART reinitiation criteria.&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;Thirteen women enrolled from southern Africa. No ATI-related serious adverse events (AEs), HIV transmissions, pregnancies or ≥Grade 2 AEs were observed. Eight sexually transmitted infections were diagnosed in seven women during ATI. Two participants had tenofovir levels consistent with use during ATI; 2/11 (18%) who completed ATI without antiretroviral use exhibited ART-free control for ≥32 weeks. The median time to confirmed VL≥200 was 5.4 weeks (range 2.7−112). The most common ART reinitiation criterion met was virologic (&lt;i&gt;n&lt;/i&gt; = 7). VRC01 receipt proximate to HIV acquisition was not associated with control. Controllers versus non-controllers did not differ by early post-acquisition viral load kinetics, acquired virus characteristics, or time from estimated acquisition to closest infusion or to ART initiation.&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 a safe, well-tolerated ATI, 18% of 11 African women exhibited post-intervention control. Design and implementation lessons inform future ATIs in Africa. Analyses of peri-acquisition and post-ATI host and viral characteristics can inform the development of interventions for HIV cure, prevention and treatment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Clinical Trial Registration&lt;/h3&gt;\u0000 ","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 6","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206736","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":"Postnatal prophylaxis and the use of presumptive HIV therapy for the prevention of vertical transmission of HIV in Canada 1997–2020","authors":"Jeanne Brochon,&nbsp;Terry Lee,&nbsp;Jason Brophy,&nbsp;Joel Singer,&nbsp;Marie-Elaine Metras,&nbsp;Jeannette Comeau,&nbsp;Alena Tse-Chang,&nbsp;Athena McConnell,&nbsp;Deborah Money,&nbsp;Isabelle Boucoiran,&nbsp;Laura J. Sauve,&nbsp;Ari Bitnun,&nbsp;Fatima Kakkar","doi":"10.1002/jia2.26510","DOIUrl":"https://doi.org/10.1002/jia2.26510","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Presumptive HIV therapy (PHT) is recommended for post-natal HIV prophylaxis (PNP) in situations at high risk of HIV vertical transmission (VT), for both prevention of transmission and as early treatment in cases of in utero transmission. The objective of this study was to describe the risk of VT and use PHT among newborns in Canada, and specifically, factors associated with the use of PHT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were analysed for all mother-infant pairs (MIPs) in the Canadian Perinatal HIV Surveillance Program (1997−2020), collected annually from 22 perinatal HIV centres in Canada. Infants were categorized as high risk (delivery viral load [dVL] ≥1000 copies/ml or maternal combined antiretroviral [cART] &lt;4 weeks prior to delivery), moderate risk (dVL detectable and &lt;1000 copies/ml, and maternal cART ≥4 weeks prior to delivery) and low risk (dVL undetectable and maternal cART ≥4 weeks prior to delivery). Neonatal prophylaxis and HIV transmission risk were compared between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4743 MIPs were included in the analysis. Overall, 13.3% of newborns received PHT; the most prescribed PHT regimens included combinations using zidovudine, lamivudine and nelfinavir (48.5%) or nevirapine (41.9%). While the most significant risk factor for transmission on univariate analysis was a detectable dVL ≥1000 copies/ml versus undetectable (odds ratio [OR] 27.91 [11.20−69.54]), the risk remained significantly increased at dVL between 400 and 999 copies/ml (OR 31.71 [8.31−120.98], but not at dVL between 50 and 399 copies/ml (OR 3.03 [0.72−12.81]). At dVL 50–399 copies/ml, 29.8% of infants received PHT, increasing to 46.7% at dVL 400–999 copies/ml, and 64.4% of infants at dVL≥1000 copies/ml. The overall risk of transmission was 6% in the high-risk group, 0.5% in the moderate-risk group and 0.2% in the low-risk group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PHT has been widely used in Canada in situations at high risk of VT, with 25% of newborns in this risk group receiving PHT as PNP. While PHT may reduce the risk of VT in high-risk situations and may be of benefit in cases of VT, these data also highlight ongoing gaps in perinatal HIV prevention in Canada.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 6","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206737","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":"Epidemiological impact and cost-effectiveness analysis of PrEP provision expansion among MSM in the Netherlands","authors":"Haoyi Wang,&nbsp;Stephanie Popping,&nbsp;David van de Vijver,&nbsp;Kai J. Jonas","doi":"10.1002/jia2.26516","DOIUrl":"https://doi.org/10.1002/jia2.26516","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;Several European countries show potential for pre-exposure prophylaxis (PrEP) provision expansion, with many men who have sex with men (MSM) on waiting lists. In the Netherlands, approximately 15,000 PrEP-eligible/intending MSM are awaiting PrEP access. We modelled the epidemiological and economic impact of extending PrEP provision considering several PrEP provision routes (National PrEP Programme and alternative PrEP providers).&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 calibrated our HIV transmission model among the Dutch MSM epidemic. PrEP was expanded from 2022 onwards, covering an additional 3000 MSM on the waiting list and in addition one-third (5000), two-thirds (10,000), and all (15,000) PrEP-eligible/intending MSM by 2024, compared to a non-expansion scenario. The epidemiological impact was projected by 2030. Costs were calculated from a third-party payer's perspective over 40 years with Dutch-specific quality-adjusted life years (QALY). Additionally, a budget impact analysis was performed over 5 years.&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;Covering the 3000 waiting-list MSM, one-third, two-thirds and all PrEP eligible/intending MSM by 2024 will avert 17 (5.7%), 46 (15.2%), 88 (29.1%) and 115 (37.9%) cumulative new HIV acquisitions compared to the base-case scenario. Consequently, 4, 2, 0 and 0 new HIV acquisitions will result by 2030, respectively. The epidemiological impact of PrEP expansion is sensitive to the users’ PrEP adherence, but overall minimal by PrEP targeting strategies, given the strongly declining epidemic. Increasing the National PrEP Programme's capacity incurred more costs to the payer (short-term budget impact ranging from €2.25 to €45.29 million). PrEP expansion can be cost-saving when all PrEP-eligible/intending MSM are covered and fully provided by alternative PrEP providers, with an incremental cost-effectiveness ratio of −€2160/QALY over 40 years. This scenario dominated over all other scenarios. Our cost-effectiveness analysis is most sensitive to the individual co-payment for PrEP-related testing when accessing PrEP via alternative PrEP providers and on-demand PrEP use.&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;Expanding PrEP coverage is crucial to reduce HIV acquisitions further and reach zero new acquisitions by 2030. As the Dutch National PrEP Programme reached capacity limits, PrEP expansion through alternative routes should be encouraged. Nevertheless, balancing out-of-pocket expenses and reimbursed care is key for healthcare equity.&lt;/p&gt;\u0000 ","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 6","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26516","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206738","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":"HIV post-exposure prophylaxis in community settings and by lay health workers or through task sharing: a systematic review of effectiveness, case studies, values and preferences, and costs","authors":"Caitlin E. Kennedy,&nbsp;Rahel Dawit,&nbsp;Ping Teresa Yeh,&nbsp;Michelle Rodolph,&nbsp;Nathan Ford,&nbsp;Heather-Marie A. Schmidt,&nbsp;Robin Schaefer,&nbsp;Rachel Baggaley,&nbsp;Virginia Macdonald","doi":"10.1002/jia2.26448","DOIUrl":"https://doi.org/10.1002/jia2.26448","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;Post-exposure prophylaxis (PEP) for HIV prevention has been inadequately promoted, provided and used. Expanded access and task sharing could increase the HIV prevention impact of PEP, but scientific evidence to inform programmatic and policy decisions has not been synthesized.&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;To inform World Health Organization guidelines, we conducted a systematic review of studies examining the provision of PEP in community settings, and by trained lay health workers or through task sharing. We searched CINAHL, PsycINFO, PubMed, EMBASE and scientific conferences for studies published between January 2012 and October 2023. We screened abstracts and extracted data in duplicate. The effectiveness review included randomized controlled trials and comparative observational studies; risk of bias was assessed using Cochrane Collaboration and Evidence Project tools, and the certainty of the evidence was assessed using GRADE. We also summarized implementation case studies, values and preferences studies, and cost and cost-effectiveness studies.&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;For provision of PEP in community settings, we identified one effectiveness study, three case studies, one values and preferences study, and one cost study. Very low certainty evidence from one study in Kenya and Uganda suggested that PEP uptake, when offered as part of a dynamic prevention package, was highest in the community setting (vs. outpatient or antenatal care settings). For provision of PEP by trained lay health workers or task sharing, we identified three effectiveness studies, two case studies, four values and preferences studies, and one cost study. Very low certainty evidence from Kenya, Uganda and the United States suggested that engagement of lay providers or pharmacists increased PEP uptake and completion and decreased HIV acquisition. Studies from six countries found most health workers supported PEP provision by non-specialist providers. One modelling study suggested community-based provision may be cost-effective or cost-saving in Africa.&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;Evidence on expanding PEP access through community delivery or task sharing is limited but generally suggests positive outcomes, feasibility, acceptability and cost-effectiveness of these approaches. Indirect evidence from HIV treatment and pre-exposure prophylaxis further supports these approaches.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt;","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148622","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 lavender purge","authors":"Kenneth H. Mayer","doi":"10.1002/jia2.26509","DOIUrl":"https://doi.org/10.1002/jia2.26509","url":null,"abstract":"&lt;p&gt;In May 1933, the Nazis looted Berlin's Institute for Sexual Science, founded by the highly regarded researcher, Dr. Magnus Hirschfeld, destroying his archives in a book burning. Hirschfeld recognized that although most humans are cisgender heterosexuals, sexual and gender minorities have existed throughout human history, and their behaviours and identities needed to be considered as part of the human continuum [&lt;span&gt;1&lt;/span&gt;]. Sexual orientation, gender identity and sexual behaviours do not necessarily overlap in uniform and predictable ways; each domain may vary throughout the life course, and may be expressed in different ways in diverse cultures.&lt;/p&gt;&lt;p&gt;Over the past few months, the Trump Administration has issued Executive Orders from the President that have promulgated policies that are detrimental to the lives of sexual, gender, racial and ethnic minorities, as well as people living in low- and middle-income countries who have been affected by HIV and other major public health challenges. One manifestation of these orders has been that hundreds of researchers have received notices from several United States government agencies, including the National Institutes of Health (NIH, the major funder of health research in the United States), as well as the Centers for Disease Control and Prevention (the major funder of public health programmes in the United States), that stated: “This award no longer effectuates agency priorities. Research programs based primarily on artificial and nonscientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.” The Trump Administration terminated studies that it deemed to be too focused on “gender ideology” and “diversity, equity and inclusion.” The spate of NIH grant terminations for research studies that addressed sexual behaviour, gender identity, discrimination and health equity among other proscribed topics (e.g. climate change) is reminiscent of earlier regressive periods.&lt;/p&gt;&lt;p&gt;The studies that were terminated had undergone the rigorous process of peer review, wherein applications were examined by external experts, scored and discussed with NIH project officers who then determined which projects were fundable after discussions with their institutes’ leadership. The process is rigorous and highly competitive. Only 10–20% of applications that are submitted for consideration ultimately get funded, so the terminations eliminated research that was deemed to be highly promising after careful assessment. The same rigor applied to the programmes funded by the CDC, USAID and PEPFAR, resulting in the abrupt elimination of needed services for millions.&lt;/p&gt;&lt;p&gt;The recent NIH, PEPFAR and USAID terminations have not been based on objective evidence. A prime example of how the Trump Administration actions have been p","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131550","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":"Feasibility and acceptability of peer-delivered HIV and syphilis self-test kits and assisted partner notification services for gay, bisexual and other men who have sex with men: a qualitative study in Uganda","authors":"Stephen Okoboi,&nbsp;Andrew Mujugira,&nbsp;Deborah Ekusai-Sebatta,&nbsp;Adeline Twimukye,&nbsp;Peninah Tumuhimbise,&nbsp;Brian Aliganyira,&nbsp;Barbara Castelnuovo,&nbsp;Rachel King","doi":"10.1002/jia2.26456","DOIUrl":"https://doi.org/10.1002/jia2.26456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is a need to combine different approaches to tackle the HIV epidemic, particularly in high-incidence populations. We explored the feasibility and acceptability of using peer-delivered HIV self-testing (HIVST), syphilis self-testing (SST) and assisted partner notification (APN) services among gay, bisexual and other men who have sex with men (GBMSM) in Uganda.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From November 2023 to March 2024, we conducted in-depth interviews with 20 purposively selected GBMSM peers and 10 healthcare workers (HCWs). The GBMSM and HCWs interviews explored their perspectives on (1) the feasibility, acceptability and preferences for peer-delivered interventions (HIVST, SST and APN) and (2) strategies and methods of reaching individuals who had not been tested or tested more than 6 months before the interview. We used a content analysis approach to define and organize codes deductively and inductively to identify themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of the 20 GBMSM peers was 27 years (interquartile range [IQR], 22–35 years), and 37 years (IQR, 25–52) for the 10 HCWs, of whom seven were female. We identified four emerging categories: (1) <i>Trust</i>: GBMSM peers and HCWs expressed trust in the peer delivery of self-test kits (HIVST and SST) to obtain same-day results effectively. HCWs were preferred over peers for APN services in reaching sexual contacts of index clients for testing; (2) <i>Intimate partner violence (IPV)</i>: Although initial concerns about IPV were raised concerning both HIVST programmes and peer APN strategies, such incidents were rarely reported in practice; (3) <i>Entry point</i>: Similar to HIVST, SST was a self-administered activity that served as an entry point for HIV testing discussions among GBMSM who had either never undergone or had postponed testing. Self-test kits could also facilitate pre-sexual testing among GBMSM; (4) <i>Social media</i>: Campaigns on social media dedicated to promoting self-testing could expand testing coverage services to GBMSM vulnerable to HIV and syphilis acquisition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HCWs and GBMSM peers preferred delivery of self-test kits through peers over facility-based approaches; however, they favoured HCWs for providing APN services. Integrating peer-delivered self-testing programmes into differentiated testing models and leveraging social media influencers could expand testing coverage among GBMSM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144091810","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":"Dosing forgiveness of oral PrEP for cisgender women remains uncertain","authors":"Mia Moore,&nbsp;David Glidden,&nbsp;Peter Anderson,&nbsp;Craig Hendrix,&nbsp;Dobromir Dimitrov","doi":"10.1002/jia2.26496","DOIUrl":"https://doi.org/10.1002/jia2.26496","url":null,"abstract":"&lt;p&gt;Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) has been proven safe and effective for preventing HIV acquisition, when taken daily, in men and transgender women who have sex with men (MSM/TGW) and cisgender women (hereafter, women). Based on existing evidence, we can have high confidence that as few as 4 pills per week reduce HIV incidence by at least 90% in MSM/TGW. In addition, a “2-1-1” regimen in which two pills are taken prior to a potential HIV exposure followed by one pill in each of the two following days has been clinically proven to substantially reduce HIV incidence in MSM/TGW. However, the same level of support is not yet available for either dosing forgiveness or the efficacy of “2-1-1” event-driven PrEP in women.&lt;/p&gt;&lt;p&gt;One of the most controversial notions in HIV therapeutics is whether women require different adherence or dosing strategies compared with MSM/TGW by virtue of differences in drug distribution between the female genital tract and rectal tissue [&lt;span&gt;1, 2&lt;/span&gt;]. The TDF/FTC adherence-efficacy curve has previously been established in MSM/TGW using levels of intraerythrocytic tenofovir-diphosphate (TFV-DP) in incident cases of HIV and matched controls from iPrEx, iPrEx OLE and recently reinforced with HPTN 083 [&lt;span&gt;3-5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Four secondary analyses have assessed the relationship between TDF/FTC adherence and HIV incidence in women [&lt;span&gt;5-8&lt;/span&gt;]. These analyses have prompted renewed discussion on the dosing forgiveness in this population and their potential to benefit from on-demand PrEP [&lt;span&gt;2, 9, 10&lt;/span&gt;]. Here, we outline the methodological differences in the latest studies and discuss potential implications for clinical practice guidelines.&lt;/p&gt;&lt;p&gt;Of the four analyses, three concluded that women need to adhere to daily dosing to achieve a 90% reduction in HIV incidence (Figure 1). Two subgroup analyses of non-randomized cohorts of PrEP users compared HIV incidence in those with high adherence to low adherence [&lt;span&gt;5, 8&lt;/span&gt;]. First, women enrolled in HPTN 084 and MSM/TGW enrolled in HPTN 083 had their adherence assessed with intraerythrocytic TFV-DP, which quantifies adherence over the prior 1–2 months. HIV incidence in those assessed to take &lt;2, 2–3, 4–6 or 7 pills per week was compared to HIV incidence in those with no quantifiable TFV-DP [&lt;span&gt;5&lt;/span&gt;]. Although the confidence intervals were wide, this analysis suggested that women need to adhere to daily pills to gain the same benefit from PrEP as MSM/TGW taking 2–3 pills per week. Second, a meta-analysis analysed the adherence of 6296 women enrolled in 11 demonstration projects over 8 years [&lt;span&gt;8&lt;/span&gt;]. HIV incidence was calculated in four sub-populations based on adherence which was assessed by various methods including self-report and drug concentrations. The reduction in HIV incidence among those taking 4–6 and 7 pills per week compared to those taking &lt;2 was comparable to","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085504","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}