The Lancet Regional Health: Western Pacific最新文献

{"title":"Post-pandemic excess mortality of COVID-19 in Hong Kong: a retrospective study","authors":"Kehang Li ,&nbsp;Yuchen Wei ,&nbsp;Chi Tim Hung ,&nbsp;Carlos King Ho Wong ,&nbsp;Xi Xiong ,&nbsp;Paul Kay Sheung Chan ,&nbsp;Shi Zhao ,&nbsp;Zihao Guo ,&nbsp;Guozhang Lin ,&nbsp;Qiaoge Chi ,&nbsp;Carrie Ho Kwan Yam ,&nbsp;Tsz Yu Chow ,&nbsp;Conglu Li ,&nbsp;Xiaoting Jiang ,&nbsp;Shuk Yu Leung ,&nbsp;Ka Li Kwok ,&nbsp;Eng Kiong Yeoh ,&nbsp;Ka Chun Chong","doi":"10.1016/j.lanwpc.2025.101554","DOIUrl":"10.1016/j.lanwpc.2025.101554","url":null,"abstract":"<div><h3>Background</h3><div>As the COVID-19 pandemic shifted into the post-pandemic period in early 2023, following the COVID-19 normalization with relaxation of stringent control measures and high vaccination coverage in Hong Kong, its long-term impact on mortality remains challenging with necessary needs of data-driven insights. This study examined the pattern of post-pandemic excess mortality in Hong Kong.</div></div><div><h3>Methods</h3><div>We analyzed weekly inpatient death data from public hospitals from January 1, 2013, to June 1, 2024, using a mixed model with over-dispersed Poisson regression. Expected mortality was estimated as the difference between observed mortality and baseline derived from pre-pandemic data. Age-stratified analyses of overall and cause-specific mortality were conducted across the pre-Omicron pandemic, Omicron, and post-pandemic periods.</div></div><div><h3>Findings</h3><div>In the post-pandemic period, the excess mortality declined but remained six-fold higher (37.66 [95% CI: 32.72–42.60] per 100,000) than pre-Omicron level, maintaining significance after adjusting for age (32.79 [95% CI: 28.13–37.46] per 100,000). The older population experienced sustained excess mortality, with crude estimates of 100.51 and 586.74 per 100,000 among those aged 65–79 years and ≥80 years, respectively, primarily due to respiratory diseases. Younger population showed near-zero overall excess mortality, whereas increased excess mortality among them occurred in heart disease, cerebrovascular disease, and injuries.</div></div><div><h3>Interpretation</h3><div>Our findings highlight the lasting mortality impact of pandemic among vulnerable populations, specifically the older population, possibly due to the post-COVID conditions and circulating COVID-19, suggesting the need for targeted interventions for this group.</div></div><div><h3>Funding</h3><div><span>Health and Medical Research Fund</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101554"},"PeriodicalIF":7.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864083","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":"Recent advances in breast cancer screening and treatment in the Western Pacific: challenges and opportunities","authors":"Jia-Wern Pan,&nbsp;Mei-Chee Tai","doi":"10.1016/j.lanwpc.2025.101538","DOIUrl":"10.1016/j.lanwpc.2025.101538","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101538"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887827","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":"Universal health coverage for immigrants in Japan","authors":"Soichiro Saeki","doi":"10.1016/j.lanwpc.2025.101539","DOIUrl":"10.1016/j.lanwpc.2025.101539","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101539"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748583","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":"Identifying and visualising temporal trajectories of hospitalisations for traditional and non-traditional complications in people with type 2 diabetes: a population-based study","authors":"Hongjiang Wu ,&nbsp;Haobin Zhou ,&nbsp;Chuiguo Huang ,&nbsp;Aimin Yang ,&nbsp;Eric S.H. Lau ,&nbsp;Xinge Zhang ,&nbsp;Juliana N.M. Lui ,&nbsp;Baoqi Fan ,&nbsp;Mai Shi ,&nbsp;Ronald C.W. Ma ,&nbsp;Alice P.S. Kong ,&nbsp;Elaine Chow ,&nbsp;Wing-Yee So ,&nbsp;Juliana C.N. Chan ,&nbsp;Andrea O.Y. Luk","doi":"10.1016/j.lanwpc.2025.101532","DOIUrl":"10.1016/j.lanwpc.2025.101532","url":null,"abstract":"<div><h3>Background</h3><div>People with type 2 diabetes are increasingly susceptible to complications that are not specific to diabetes. We aimed to examine the temporal trajectories of hospitalisations for traditional and non-traditional complications in people with type 2 diabetes.</div></div><div><h3>Methods</h3><div>We included 758,254 people with incident type 2 diabetes between 2002 and 2018 in Hong Kong, followed up until 2019. We included hospitalisations for 72 selected diseases and all-cause deaths. We derived the temporal trajectories of hospitalisations based on pairs of disease associations and identified trajectory clusters using Markov Cluster Algorithm.</div></div><div><h3>Findings</h3><div>During a median follow-up of 7.8 (IQR: 4–12) years, 57.6% of people experienced a hospitalisation for any of the 72 selected diseases and 22.6% of people died. Among the 5184 directional disease pairs, 95 were identified as having a significant and directional association. The three most common disease pairs were hospitalisations for urinary tract infection followed by pneumonia, ischemic heart disease followed by heart failure, and ischemic stroke followed by pneumonia. Cardiovascular and kidney diseases were predominant in the hospitalisation trajectories. However, these traditional complications had complex associations both among themselves and with various non-traditional complications across multiple systems. Three distinct trajectory clusters were identified, with heart failure/chronic kidney disease, pneumonia, and urinary tract infection as central diseases.</div></div><div><h3>Interpretation</h3><div>Cardiovascular and kidney diseases interacted with a broad set of non-traditional complications to influence the overall patterns of hospitalisation progression in people with diabetes, highlighting the need to broaden diabetes care to consider complications beyond the traditional focus.</div></div><div><h3>Funding</h3><div>Direct Grant for Research from <span>The Chinese University of Hong Kong</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101532"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737893","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":"Immunotherapy in nasopharyngeal carcinoma: current status and unanswered questions","authors":"Xu Liu ,&nbsp;Jun Ma","doi":"10.1016/j.lanwpc.2025.101547","DOIUrl":"10.1016/j.lanwpc.2025.101547","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101547"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776471","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-adjusted breast screening: an Australian perspective and considerations for the Western Pacific","authors":"Carolyn Nickson ,&nbsp;Louiza S. Velentzis ,&nbsp;G. Bruce Mann ,&nbsp;Paul Grogan ,&nbsp;Deborah Bateson ,&nbsp;Karen Canfell","doi":"10.1016/j.lanwpc.2025.101520","DOIUrl":"10.1016/j.lanwpc.2025.101520","url":null,"abstract":"<div><div>Breast cancer is the most common cancer in females globally, and the leading cause of female cancer deaths. The 2023 World Health Organisation Global Breast Cancer Initiative Framework aims to prevent 2·5 million deaths from breast cancer by 2040. Early detection of breast cancer is central to this goal, and population-based breast screening is key to early detection. A more risk-adjusted approach to screening within current target age ranges, whether risk-stratified (tailoring population-wide screening protocols based on risk) or risk-targeted (prioritising available screening services to higher risk females) is likely to prevent further deaths. This article presents a review of the risk-adjusted screening initiative in Australia (the Roadmap to Optimising Screening in Australia (ROSA) Project) and explores a potential framework for advancing risk-adjusted strategies for breast screening throughout the Western Pacific region.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101520"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887829","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":"Informing health system planning for biomarker-based treatment: statistical prevalence projections for solid cancers with key pan-tumour biomarkers (dMMR, MSI, high TMB) in Australia to 2042","authors":"Yoon-Jung Kang ,&nbsp;Qingwei Luo ,&nbsp;Joachim Worthington ,&nbsp;Anna Kelly ,&nbsp;Jeff Cuff ,&nbsp;John Zalcberg ,&nbsp;Karen Canfell ,&nbsp;Julia Steinberg","doi":"10.1016/j.lanwpc.2025.101537","DOIUrl":"10.1016/j.lanwpc.2025.101537","url":null,"abstract":"<div><h3>Background</h3><div>Targeted cancer treatment based on mismatch repair deficiency (dMMR), microsatellite instability (MSI), or high tumour mutational burden (TMB) holds promise for improving patient outcomes, but presents substantial healthcare costs.</div></div><div><h3>Methods</h3><div>Using validated statistical methods, we projected 1-year to 5-year prevalence of individuals diagnosed with solid tumours exhibiting these biomarkers in Australia to 2042, for all solid cancers combined and 23 individual cancer types/groups, and separately for all stages combined, advanced disease at diagnosis (here, distant metastasis/lymph node involvement), and advanced disease after progression post-diagnosis.</div></div><div><h3>Findings</h3><div>The 5-year prevalence of individuals diagnosed with any solid cancer regardless of biomarker status is estimated to increase by 54·2%, from 438,346 in 2018 to 675,722 in 2042 (advanced disease at diagnosis: by 37·6% from 109,855 to 151,199), primarily due to population growth and ageing. The 5-year prevalence of individuals whose tumours exhibit a biomarker is estimated to increase accordingly, e.g. for advanced disease at diagnosis, from 3983 to 5448 for dMMR, from 2484 to 3553 for MSI, and from 13,310 to 17,893 for high TMB (representing 3·6%, 2·3% and 11·8% of 5-year prevalence of individuals with advanced disease at diagnosis, respectively; noting considerable overlap in the presence of these biomarkers).</div></div><div><h3>Interpretation</h3><div>We present the first long-term projections for cancer prevalence associated with key pan-tumour biomarkers in Australia, to inform health policy and healthcare planning for targeted therapies.</div></div><div><h3>Funding</h3><div>Medical Research Future Fund—Preventive and Public Health Research Initiative—2019 <span>Targeted Health System</span> and <span>Community Organization Research</span> Grant Opportunity (MRF1200535), <span>Cancer Institute NSW</span> Career Development Fellowship (2022/CDF1154), <span>National Health and Medical Research Council of Australia</span> Investigator Grant (APP1194679).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101537"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769096","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":"Area-level socioeconomic inequalities in hypertension care cascade in China: a nationwide population-based study based on the ChinaHEART project","authors":"Wenyao Peng ,&nbsp;Siqi Lin ,&nbsp;Xuan Liu ,&nbsp;Bowang Chen ,&nbsp;Xueke Bai ,&nbsp;Chaoqun Wu ,&nbsp;Xiaoyan Zhang ,&nbsp;Yang Yang ,&nbsp;Jianlan Cui ,&nbsp;Wei Xu ,&nbsp;Lijuan Song ,&nbsp;Hao Yang ,&nbsp;Wenyan He ,&nbsp;Yan Zhang ,&nbsp;Xi Li ,&nbsp;Jiapeng Lu","doi":"10.1016/j.lanwpc.2025.101544","DOIUrl":"10.1016/j.lanwpc.2025.101544","url":null,"abstract":"<div><h3>Background</h3><div>Socioeconomic status (SES) is one of key social determinants of health. Compared to individual-level SES, the association between area-level SES and hypertension management has been understudied and under-recognised. In this study, we aimed to assess the association between area-level SES and hypertension awareness, treatment, combination therapy and control, and the modification effect of individual characteristics on the associations.</div></div><div><h3>Methods</h3><div>During Dec 2015 and Dec 2022, 1,559,748 residents with hypertension aged 35–75 years from 31 provinces in the China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) were included. The composite value of area-level SES was generated from national census data and categorized into tertiles. Multivariable mixed models with random effects to account for county-level administrative area were fitted to compute odds ratios (OR) and 95% confidence intervals (CIs) for the independent and interactive associations of both area- and individual-level SES with hypertension management (awareness, treatment, combination therapy and control) and their disparities across different population subgroups.</div></div><div><h3>Findings</h3><div>Among the included participants with hypertension aged 59·1 ± 9·1 years, 794,675 (50·95%), 650,485 (41·70%) and 206,103 (13·21%) were aware, treated, and controlled, respectively. Compared with the high area-level SES group, the low group was significantly associated with a lower odds of hypertension awareness (OR: 0·75, 95% CI: 0·65–0·86), treatment (0·69, 0·59–0·81), combination therapy (0·65, 0·51–0·84), and control (0·62, 0·51–0·75). Participants with low SES at both individual and area level had the lowest odds of hypertension management. Area-level SES had stronger influences on hypertension awareness, treatment and control, but a weaker influence on combination therapy, in the young and those with high individual-level SES.</div></div><div><h3>Interpretation</h3><div>Area-level SES on plays a key role in the awareness, treatment, combination therapy and control of hypertension, with different magnitude of associations. Integrated action to improve area-level circumstances and promote targeted interventions to hypertension care cascade are needed to reduce health inequalities in China.</div></div><div><h3>Funding</h3><div>The <span>CAMS Innovation Fund</span> for Medical Science; the <span>National High Level Hospital Clinical Research Funding</span>; the <span>National Natural Science Foundation of China</span> of China; the <span>Ministry of Finance</span> of China and <span>National Health Commission</span> of China; the 111 Project from the <span>Ministry of Education of China</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101544"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776279","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":"Mapping residual malaria transmission in Vietnam","authors":"Michael A. McPhail ,&nbsp;Yalemzewod Assefa Gelaw ,&nbsp;Xuan Thang Nguyen ,&nbsp;Win Han Oo ,&nbsp;Freya J.I. Fowkes ,&nbsp;Duc Thang Ngo ,&nbsp;Thi Hong Phuc Nguyen ,&nbsp;Tasmin L. Symons ,&nbsp;Dan J. Weiss ,&nbsp;Peter W. Gething","doi":"10.1016/j.lanwpc.2025.101545","DOIUrl":"10.1016/j.lanwpc.2025.101545","url":null,"abstract":"<div><h3>Background</h3><div>Vietnam, as one of the countries in the Greater Mekong Subregion, has committed to eliminating all malaria by 2030. Declining case numbers highlight the country's progress, but challenges including imported cases and pockets of residual transmission remain. To successfully eliminate malaria and to prevent reintroduction of malaria transmission, geostatistical modelling of vulnerability (importation rate) and receptivity (quantified by the reproduction number) of malaria is critical.</div></div><div><h3>Methods</h3><div>Case data from 2019 to 2022 was used to train a range of network and geostatistical models, from which strategically useful metrics were computed. These metrics include vulnerability, which was estimated from the abundance of imported cases, and receptivity, which was estimated based on a transmission model linking cases as well as environmental covariate data.</div></div><div><h3>Findings</h3><div>There is considerable spatiotemporal heterogeneity in the computed metrics. Importations are concentrated in the South Central Coast and Central highlands regions. The importation rate of <em>Plasmodium falciparum</em> is around 2.5 times higher than that of <em>P. vivax.</em> The mean computed reproduction number is less than one, which is consistent with the historical decline in cases and eventual elimination. There are, however, places where the estimated reproduction number can temporarily exceed one, which explains the seasonal case resurgence observed in the case data. The reproduction number is typically higher in forested areas.</div></div><div><h3>Interpretation</h3><div>Receptivity and vulnerability to malaria is spatiotemporally heterogeneous in Vietnam. Despite the average reproduction number being less than one, the spatial pockets and temporal windows of elevated reproduction number could prevent timely elimination of malaria or even lead to a reversal of progress. The predictive maps presented in this paper can inform appropriate intervention strategies to advance goals of malaria elimination.</div></div><div><h3>Funding</h3><div>This work was supported, in whole or in part, by the <span>Bill &amp; Melinda Gates Foundation</span> [INV-055192 and INV-009390/OPP1197730]. The conclusions and opinions expressed in this work are those of the author(s) alone and shall not be attributed to the Foundation. Under the grant conditions of the Foundation, a <span>Creative Commons</span> Attribution 4.0 License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. Please note works submitted as a preprint have not undergone a peer review process. This work also includes funding support from the <span>Australian Government</span>, <span>National Health and Medical Research Council</span> (Award No: GNT2025280) and <span>Telethon Trust</span>, Western Australia.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101545"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807412","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":"Progress towards the UNAIDS 2030 HIV prevention target in New South Wales, Australia: a population-based study","authors":"Phillip Keen ,&nbsp;Steven J. Nigro ,&nbsp;Curtis Chan ,&nbsp;Benjamin R. Bavinton ,&nbsp;Htein Linn Aung ,&nbsp;Martin Holt ,&nbsp;Rebecca Guy ,&nbsp;Janaki Amin ,&nbsp;Timothy R. Broady ,&nbsp;Jane Costello ,&nbsp;Anthony D. Kelleher ,&nbsp;Carla Treloar ,&nbsp;Rick Varma ,&nbsp;Matthew Vaughan ,&nbsp;Valerie Delpech ,&nbsp;Andrew E. Grulich ,&nbsp;HIV Prevention Research, Implementation Science and Monitoring (PRISM) Partnership","doi":"10.1016/j.lanwpc.2025.101535","DOIUrl":"10.1016/j.lanwpc.2025.101535","url":null,"abstract":"<div><h3>Background</h3><div>The UNAIDS ending AIDS strategy includes a 2030 prevention target of a 90% reduction in new infections from 2010. We report progress towards this goal in gay, bisexual and other men who have sex with men (GBM) in New South Wales (NSW), Australia.</div></div><div><h3>Methods</h3><div>We report HIV notification data for people newly diagnosed by exposure category, with a focus on GBM who comprised more than three-quarters of diagnoses. We report HIV testing, pre-exposure prophylaxis, HIV treatment, and undetectable viral load based on surveys of community-based GBM and data from a sentinel surveillance network of 50 clinics. We report trends between 2010 and 2022, including by geography grouped by postcodes with high-, medium- and low-prevalence of gay residents. Trends were assessed using the chi-square test for linear trend.</div></div><div><h3>Findings</h3><div>Statewide, annual notifications declined by 56% in GBM, and declines were much greater in inner-Sydney postcodes with a high percentage of gay residents compared to postcodes with a low percentage (88% and 32%). Among community-recruited GBM, annual HIV testing and PrEP uptake increased over time and by 2022 were higher in the high- (91% and 82%) than low-gay prevalence postcodes (78% and 61%). In the clinic sample, HIV testing and PrEP use increased but there was no evidence that they differed by geography. In both samples, among GBM living with HIV, the percentages on HIV treatment and with undetectable viral load increased over time, and by 2022 were greater than 95%.</div></div><div><h3>Interpretation</h3><div>HIV notifications in GBM in NSW have dropped by more than half since 2010. In inner Sydney areas with a high prevalence of gay men, prevention uptake was highest, and the decline in notifications approached 90%. Declines in HIV notifications were more modest elsewhere, and prevention uptake lower. Currently available prevention interventions, if extended population-wide, can enable a 90% reduction in new HIV infections in GBM, consistent with the ending AIDS target.</div></div><div><h3>Funding</h3><div>This project was funded by the <span>National Health and Medical Research Council</span> and the <span>NSW Ministry of Health</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101535"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820546","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}