Journal of the International AIDS Society最新文献

{"title":"Cause of Death and Risk of Death for People Living With HIV Admitted to Hospital: A Systematic Review and Meta-Analysis","authors":"Rachael M. Burke,&nbsp;Nadia Sabet,&nbsp;Jayne Ellis,&nbsp;Hannah M. Rickman,&nbsp;Ajay Rangaraj,&nbsp;David S. Lawrence,&nbsp;Joseph N. Jarvis,&nbsp;Jane Falconer,&nbsp;Lillian Tugume,&nbsp;Rebecca H. Berhanu,&nbsp;Nathan Ford,&nbsp;Peter MacPherson","doi":"10.1002/jia2.70134","DOIUrl":"10.1002/jia2.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite increasing access to HIV treatment and care, HIV-associated deaths remain high. We aimed to summarize global and regional trends in risk and causes of death among people living with HIV (PLHIV) admitted to hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic search across eight databases on 23 April 2023, identifying studies that reported cause of hospital admission or death among hospitalized PLHIV from first January 2014 onwards. We extracted data on age, geographical region, type of ward, antiretroviral treatment use, CD4 cell count, risk of death, cause of death and method of ascertainment of cause of death. We grouped studies into mutually exclusive groups: adults in medical wards by world region; adults in intensive care; and children. We used a Bayesian multilevel meta-regression model to pool data on causes of death. We additionally estimated temporal trends in risk of death among hospitalized PLHIV between 2000 and 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 67 studies (59,013 participants) reporting risk of death among hospitalized PLHIV between 2014 and 2023. The overall risk of in-hospital death was 16% (95% credible interval [CrI]: 8%–27%). Mortality risk was highest among adults in Africa (19%, 95% CI: 15%–24%) and adults in intensive care units (44%, 95% CI: 34%–55%). Among 40 studies reporting cause of death in 6,838 participants, AIDS-related conditions predominated (72% of deaths, 95% CrI: 57%–85%), including tuberculosis deaths (27% of deaths, 95% CrI: 15%–40%). Bacterial infections were the second leading cause of death (25% of deaths, 95% CrI: 9%–47%). There was no strong evidence of risk of death changing between 2000 and 2023 (−2.2 percentage point decrease, 95% CrI −16.1 to +17.0 percentage points).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite advances in HIV treatment, AIDS-related illnesses and bacterial infections remain the leading causes of in-hospital death among PLHIV. Our analysis reveals that in most regions, the risk of death for hospitalized PLHIV has remained largely unchanged in the past 23 years. These findings underscore the critical need to prioritize high-quality hospital care for opportunistic infections to reduce AIDS-related deaths.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 6","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203461","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":"Qualitative Insights on Client and Provider Barriers and Facilitators to Using a Novel Online HIV Pre- and Post-Exposure Delivery Model in Kenya","authors":"Phelix Okello,&nbsp;Nicholas Thuo,&nbsp;Stephanie D. Roche,&nbsp;Arden L. Saravis,&nbsp;Daniel Mwai,&nbsp;Paulami Naik,&nbsp;Catherine Kiptinness,&nbsp;Tabitha Kareithi,&nbsp;Melissa L. Mugambi,&nbsp;Monisha Sharma,&nbsp;Kenneth Ngure,&nbsp;Katrina F. Ortbald","doi":"10.1002/jia2.70133","DOIUrl":"10.1002/jia2.70133","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;Online delivery of HIV pre- and post-exposure prophylaxis (PrEP and PEP) could address persistent access barriers, yet implementation across Africa remains limited. The ePrEP Kenya Pilot (NCT05377138) integrated PrEP and PEP services into an existing e-pharmacy platform and identified client- and provider-level barriers and facilitators to use.&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;In the pilot, clinicians screened adults (age 18+) in Nairobi and Mombasa Counties for PrEP and PEP eligibility via telehealth; pharmaceutical technologists courier-delivered HIV testing services (including self-testing) and dispensed PrEP or PEP to eligible clients who paid 150–250 KES (∼$1–2 USD) for HIV testing, ≤149 KES (∼$1 USD) for courier delivery and nothing for telehealth consultation or PrEP/PEP drugs. We conducted monthly check-in calls with providers and, near study endline, in-depth interviews (IDIs) with purposively sampled clients and all providers. We analysed verbatim call transcripts and IDIs inductively, then mapped identified barriers and facilitators to the Consolidated Framework for Implementation Research (CFIR).&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;From February to November 2023, we conducted 10 check-in calls and interviewed 30 clients (10 PEP, 10 PrEP with 1+ refill, 10 PrEP with no refills) and 10 providers (4 clinicians, 6 pharm techs). Clients had a median age of 27 years (IQR 25–30) and providers 28 years (IQR 27–31); 53% (16/30) of clients and 30% (3/10) of providers were female. In the Outer Setting CFIR domain, providers identified motorcycle manoeuvrability as a delivery facilitator but noted that traffic, poor road infrastructure, bad weather and personal safety concerns posed challenges. In the Inner Setting domain, providers identified information-sharing practices and collegiality as facilitators. In the Individuals domain, clients’ capability, opportunity and motivation to use online PrEP/PEP services was reportedly facilitated by app-guided HIV self-testing, broad delivery zones and enhanced privacy, but hindered by low awareness of these services, limited access to internet-enabled devices, data security concerns and uncertainties around couriers’ pharmacy credentials. Recommendations included reducing client costs, expanding delivery coverage and hours, and offering alternative delivery options (e.g. medication pick-up lockers).&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;Online PrEP and PEP delivery is a promising differentiated service model, especially if partial","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 6","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161074","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":"Disparities in Awareness, Willingness and Uptake of Biomedical HIV Prevention Among Bisexual and Gay Men: A Systematic Review and Meta-Analysis","authors":"Qidi Zhou,&nbsp;Xinlong Sun,&nbsp;Sylvia Chaires,&nbsp;Verena Klein,&nbsp;Roger Ingham,&nbsp;Heather L. Armstrong","doi":"10.1002/jia2.70132","DOIUrl":"10.1002/jia2.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The field of HIV/STI prevention research has primarily focused on gay men, leaving bisexual men overshadowed in broader discussions on sexual minority men's health. Although also at increased risk of HIV acquisition, bisexual men are less likely to access biomedical HIV prevention. This systematic review and meta-analysis summarizes the prevalence of implementation of biomedical HIV prevention strategies among bisexual men as compared with gay men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PsycINFO, CINAHL, Scopus, PubMed and Web of Science for studies published between 1 January 2012 and 1 February 2024, with prevalence data of specified HIV biomedical prevention strategies (awareness, intention, adherence and use of pre-exposure prophylaxis [PrEP], post-exposure prophylaxis [PEP] and U = U). Studies that did not provide bisexual-specific data were excluded. We conducted six random-effect meta-analysis models to analyse PrEP awareness, PrEP intention, PrEP use and U = U use among bisexual men and gay men. We conducted trend analyses to determine variations in the prevalence of PrEP awareness, intention and use, fitted by locally estimated scatterplot smoothing regression and linear regression. This study was registered with PROSPERO (CRD42024519650).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data were extracted from 114 articles, encompassing 514,543 participants, including 94,004 bisexual men (18.3%) and 420,539 gay men (81.7%). The overall pooled prevalence of PrEP awareness (g: 61.4% vs. b: 42.9%), any PrEP use (g: 22.5% vs. b: 15.2%), lifetime PrEP use (g: 21.5% vs. b: 11.9%), current PrEP use (g: 20.9% vs. b: 16.0%) and U = U use (g: 76.3% vs. b: 69.3%) among gay men was significantly higher than among bisexual men, with odds ratios ranging from 1.52 to 2.77. There was no difference for PrEP intention (g: 55.6% vs. b: 56.7%). For both gay and bisexual men, the trends for PrEP awareness and use generally increased, while the trend for PrEP intention decreased over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results demonstrate that bisexual men are engaging less than gay men with biomedical HIV prevention strategies, indicating the need for increased dissemination, awareness, and tailored policies and strategies for bisexual men.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 6","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148147595","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 in Gaza: From Chronic Under-Detection to Acute Collapse","authors":"Rafał Majka,&nbsp;Samer Abuzerr","doi":"10.1002/jia2.70130","DOIUrl":"10.1002/jia2.70130","url":null,"abstract":"&lt;p&gt;In Gaza, the devastation of the healthcare system following years of blockade and recurrent armed conflict has transformed HIV from a chronically under-detected condition into an acute, invisible public-health emergency. Prior to the 2023 escalation of violence, the Palestinian Ministry of Health had officially documented 125 people living with HIV (PLHIV) and AIDS in Palestine, including 50 in Gaza [&lt;span&gt;1&lt;/span&gt;]. Even then, this figure reflected long-standing structural barriers to detection—stigma, limited screening and fragile surveillance—rather than relatively low acquisition rates or the successful public health management of HIV/AIDS. Today, following the destruction of medical infrastructure, displacement of healthcare personnel and depletion of essential medicines, the actual number of PLHIV and AIDS in Gaza is unknown. The breakdown of testing, treatment and reporting systems has erased epidemiological visibility and placed those requiring continuous care at immediate risk [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Before the 2023 escalation, HIV care in Gaza existed within a constrained but functioning public health framework. Despite chronic underfunding and the effects of an ongoing blockade, HIV diagnosis and treatment were formally integrated into the Palestinian health system. The Ministry of Health, supported by international partners such as World Health Organization (WHO), United Nations Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA), the Global Fund, Global Fund to Fight AIDS, Tuberculosis and Malaria, the United Nations Population Fund (UNFPA), United Nations International Children's Emergency Fund (UNICEF) and the European Union, provided free HIV testing, antiretroviral therapy (ART) and limited patient support, involving sexually transmitted infection counselling, condom distribution, peer-to-peer education, psychosocial support following an HIV diagnosis, or HIV/AIDS awareness campaigns [&lt;span&gt;4&lt;/span&gt;]. Routine HIV screening was implemented for blood donors and select occupational groups. The most recent pre-2023 data, from 2021, indicate that approximately 42,000 Palestinians were tested for HIV, hepatitis B and C, and syphilis through blood-bank channels rather than voluntary or community-based initiatives [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;However, this pre-2023 conflict system was marked by systematic under-detection. Testing among key and priority populations, antenatal women and the general population remained limited. Stigma, fear of disclosure and moralized perceptions of HIV strongly discouraged voluntary testing. Surveys conducted before 2023 consistently showed low levels of comprehensive HIV knowledge and widespread misconceptions about transmission [&lt;span&gt;5&lt;/span&gt;]. As a result, the officially low prevalence of HIV in Gaza reflected a combination of political containment, social stigma and weak surveillance capacity rather than epidemiological certainty.&lt;/p&gt;&lt;p&gt;During and after the 2023 escalation, thes","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 6","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.70130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040146","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148090262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148086261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148083073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148062428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148077824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 5","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148077035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}