HIV AIDS-Research and Palliative Care最新文献

{"title":"Early and Long-Term Retention in Facility-Based HIV Pre-Exposure Prophylaxis Service Delivery Model Among Women at High Risk of HIV Acquisition in Tanga, Tanzania.","authors":"Wigilya P Mikomangwa, Kåre Moen, Elia J Mmbaga, Emmy Metta, Melkizedeck T Leshabari, Stephen M Kibusi, Christopher R Sudfeld, Muhammad Bakari, Appolinary A R Kamuhabwa, Gideon Paul Kwesigabo","doi":"10.2147/HIV.S604257","DOIUrl":"10.2147/HIV.S604257","url":null,"abstract":"<p><strong>Introduction: </strong>Retention in HIV pre-exposure prophylaxis (PrEP) care among key populations is crucial to realize its benefits. Evidence is scarce on retention in PrEP care outcomes and associated factors among at-risk women in sub-Saharan Africa. We, therefore, evaluated the retention outcomes in the facility-based PrEP services delivery model and their associated factors among female sex workers in the city of Tanga, Tanzania.</p><p><strong>Methods: </strong>We analyzed data of 313 female sex workers of a control arm of a pragmatic trial. Participants were followed for 16 months from 2022 to 2023. We categorized retention in care outcomes PrEP services as being early and long-term. A multivariable log-binomial regression model was used to determine factors affecting retention in PrEP services at p<0.05.</p><p><strong>Results: </strong>Early and long-term retention in PrEP care was 38.0% (95% CI: 33.25-43.04) and 11.0% (95% CI: 7.67-15.61), respectively. Having sex work as the only source of income negatively affected early retention compared to those with alternative sources of income (aRR 0.58, 95% CI: 0.36-0.94, p=0.028). Having 10-29 sexual clients/month was 34% times lower risk of being retained compared to those with less than 10 sexual clients per month (aRR 0.66, 95% CI: 0.47-0.92, p=0.014). Self-perceived \"high\" PrEP stigma negatively affected long-term retention compared to perceiving \"low\" PrEP stigma (aRR 0.16, 95% CI: 0.03-0.99, p=0.049) and self-perceived \"moderate\" HIV risk was associated with increased retention compared to self-perceived \"high\" HIV risk (aRR 5.03, 95% CI: 1.37-18.47, p=0.015).</p><p><strong>Conclusion: </strong>The retention in facility-based HIV PrEP care among female sex workers was low. Having sex work as the only source of income, having sex with 10-29 clients, and self-perceived \"high\" PrEP stigma negatively affected retention in PrEP care. Self-perceived \"moderate\" HIV risk positively affected retention in PrEP care. Establishing client-centred approaches targeting PrEP stigma and HIV risk awareness is crucial to optimize retention in facility-based PrEP services.</p><p><strong>Trial registration: </strong>Pan African Clinical Trials Registry PACTR202003823226570.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"604257"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Evaluation of the HIV Knowledge Questionnaire-18 in a Black Canadian Population.","authors":"Agatha Nyambi, Elizabeth Alvarez, Laura N Anderson, Fatimah Jackson-Best, Wangari Tharao, Egbe B Etowa, Shamara Baidoobonso, Maureen Owino, Pascal Djiadeu, Daeria O Lawson, Lawrence Mbuagbaw","doi":"10.2147/HIV.S607376","DOIUrl":"10.2147/HIV.S607376","url":null,"abstract":"<p><strong>Introduction: </strong>This cross‑sectional study examined HIV/AIDS knowledge as a determinant of preventative and self‑protective sexual behaviour. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) is one of the most widely used HIV knowledge scales. The objective of this study was to test the psychometric properties of the HIV-KQ-18 in Black people in Ontario.</p><p><strong>Methods: </strong>We analyzed the data from 1302 participants who completed the HIV-KQ-18 in a study conducted among Black people in Ontario. We estimated the internal consistency of this scale using Cronbach's alpha. We analyzed the construct validity of the scale, testing hypotheses about HIV knowledge and age, education, employment status, gender, language and city using one-way ANOVA and independent sample <i>t</i>-tests.</p><p><strong>Results: </strong>Cronbach's alpha for the scale was 0.82 (95% CI: 0.80-0.84) suggesting good internal consistency. We observed significant differences in HIV knowledge scores across age, employment status, education, and gender. Higher HIV knowledge scores were also observed among participants residing in Toronto compared to Ottawa and among those who completed the questionnaire in English compared to French.</p><p><strong>Conclusion: </strong>The HIV-KQ-18 is a valid instrument to assess the level of HIV/AIDS knowledge among Black Ontarians, with robust internal consistency and construct validity. The HIV-KQ-18 identified important differences in HIV knowledge based on the characteristics examined, indicating the need for targeted initiatives to increase HIV-related knowledge.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"607376"},"PeriodicalIF":2.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Trends in HIV-Associated Nephropathy (HIVAN) from 2015 to 2025: A Bibliometric Analysis Using CiteSpace.","authors":"Shaowei Huang, Xiaofeng Wei","doi":"10.2147/HIV.S600050","DOIUrl":"10.2147/HIV.S600050","url":null,"abstract":"<p><strong>Background: </strong>In recent years, HIV-associated nephropathy (HIVAN) has significantly impacted the compliance, quality of life, and treatment outcomes for patients with AIDS. This study employs CiteSpace bibliometric analysis to predict emerging topics and research trends, thereby offering clear scientific navigation and strategic recommendations for HIVAN research.</p><p><strong>Methods: </strong>We retrieved publications related to HIVAN from the Web of Science Core Collection covering the period from 2015 to 2025. Utilizing CiteSpace, we analyzed the co-occurrence network, clustering,and timeline of research trends in this field to illustrate the knowledge evolution surrounding HIVAN.</p><p><strong>Results: </strong>A total of 1,470 publications were included from 2015 to 2025. The United States maintained its dominant position in medical research, while countries such as the United Kingdom, South Africa, France, and China emerged as key contributors in the field. Prominent institutions, including the University of California system, Johns Hopkins University, and University of the London, were central to HIVAN research. Scholars such as Estrella, Michelle M. Shlipak, Michael G. and Kopp, Jeffrey B exhibited substantial academic output and garnered considerable citation attention. Leading journals, including \"Clinical Infectious Diseases\", \"PLOS ONE\" and \"AIDS\" served as premier venues for review articles, providing essential platforms and establishing foundations for ongoing research. The research activity and academic impact of HIVAN within the sub-discipline of nephrology currently represent prominent areas of inquiry.</p><p><strong>Conclusion: </strong>This study examined the knowledge network structure of HIVAN from 2015 to 2025 examined bibliometric analysis. Future research should focus on enhancing international collaboration, particularly in resource limited regions, to investigate various intervention strategies aimed at improving compliance, quality of life, and treatment outcomes for HIVAN patients.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"600050"},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Condom Use Among HIV-Positive Adolescents in Eastern Uganda.","authors":"Benjamin Betunga, Lilian Nuwabaine, Joseph Kawuki","doi":"10.2147/HIV.S585843","DOIUrl":"10.2147/HIV.S585843","url":null,"abstract":"<p><strong>Background: </strong>Adolescents increasingly contribute to the global HIV epidemic, and the low HIV testing rates heighten transmission risks. Condom use is crucial in preventing HIV transmission and drug-resistant strains, yet its consistency among HIV-positive adolescents on antiretroviral therapy (ART) remains uncertain. This study investigates the prevalence of condom use and predictors among HIV-positive adolescents attending ART clinic in Uganda.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from January to March 2025 among 165 HIV-positive adolescents (aged 10-19 years) at Tororo General Hospital ART clinic. Structured questionnaires were used for data collection, and multivariable logistic regression was used to determine predictors of condom use, using SPSS version 27.</p><p><strong>Results: </strong>Condom use prevalence was low at 10.9% among HIV-positive adolescents. On multivariable logistic regression, significant predictors of condom use included urban residence (aOR 2.67, 95% CI: 1.42-4.98), older age (15-19 years) (aOR 1.48, 95% CI: 1.12-2.36), secondary education (aOR 1.31, 95% CI: 1.02-2.62), Muslim religion (aOR 3.76, 95% CI: 1.98-6.75), having three or more sexual partners (aOR 2.17, 95% CI: 1.14-3.87), being on ART for more than five years (aOR 3.73, 95% CI: 1.15-6.21), and drug use (aOR 1.37, 95% CI: 1.16-2.11). Nearly all participants (99.4%) reported lack of access to free condoms, while 75.8% had never received counseling on condom use.</p><p><strong>Conclusion: </strong>Condom use among HIV-positive adolescents in Tororo district remains alarmingly suboptimal. Enhancing access to condoms, integrating targeted sexual health education, and addressing sociocultural barriers through community-based interventions are critical. Future research should explore tailored strategies to improve condom adherence in this population.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"585843"},"PeriodicalIF":2.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anemia in HIV-Infected Children on ART in Uganda: High Risk Associations with Malaria, Opportunistic Infections, and Poor Adherence.","authors":"Christopher Lyatinga Anyelwisye, Jimmy Kata Ogwal, Simon Evarist Kadogosa, Rauben Timuzigu, Cricent Anyetaba, Robert Wagubi, Clinton Olong, Elizabeth A John, Enoch Muwanguzi, Benson Okongo","doi":"10.2147/HIV.S609192","DOIUrl":"10.2147/HIV.S609192","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the prevalence and associated factors of anemia among HIV-positive children receiving antiretroviral therapy (ART) at two urban clinics in Mbarara City, Southwestern Uganda.</p><p><strong>Patients and methods: </strong>We conducted a cross-sectional study among 293 HIV-positive children (<18 years) attending ART clinics at Mbarara Municipal Health Center IV and Holy Innocent Children's Hospital between July and September 2025. A structured questionnaire captured sociodemographic and clinical data. Venous blood were collected for complete blood count (CBC) analysis, and stool samples were examined for intestinal parasites. Data on CD4 count and viral load were abstracted from medical records. Anemia was defined using age-specific WHO criteria. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with anemia, with statistical significance set at p ≤ 0.05.</p><p><strong>Results: </strong>The overall prevalence of anemia was 6.14% (95% CI: 3.4% - 8.9%). Normocytic normochromic anemia was the predominant morphological type (72.2%). In the multivariate analysis, a recent episode of malaria (AOR = 9.61; 95% CI: 3.26-28.34), the presence of an opportunistic infection (AOR = 6.78; 95% CI: 1.28-35.83), and poor adherence to ART (AOR = 14.75; 95% CI: 1.31-165.65) were independently and significantly correlated with anaemia.</p><p><strong>Conclusion: </strong>While the prevalence of anemia in this cohort of HIV-infected children on ART was lower than global averages, it remains a significant clinical concern. The strong associations with malaria, opportunistic infections, and suboptimal ART adherence highlight critical areas for intervention. Targeted strategies, including integrated malaria control, enhanced prevention and management of OIs, and reinforced adherence support, are required to decrease the anaemia burden and optimize health outcomes in this at-risk population.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"609192"},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Led Peer Support Groups Improve Anti-Hypertensive Drugs Access for Adults Living with HIV and Hypertension in Rural Uganda - A Cross-Sectional Study.","authors":"Mucunguzi Atukunda, Brian Twinamatsiko, Michael Ayebare, Elizabeth Arinitwe, Aida N Kawuma, Ronald Kiguba, Joanita Nangendo, Gerald Mutungi, Fred C Semitala, Moses R Kamya, Jane Kabami","doi":"10.2147/HIV.S597371","DOIUrl":"10.2147/HIV.S597371","url":null,"abstract":"<p><strong>Introduction: </strong>People living with HIV (PLHIV) often have poorly controlled hypertension due to medication non-adherence, primarily caused by limited access to antihypertensive drugs. Peer support groups are being explored to improve access. We evaluated the feasibility and acceptability of peer support groups to improve access to anti-hypertensive drugs for PLHIV with hypertension.</p><p><strong>Methods: </strong>From December 2022 to April 2023, we conducted a cross-sectional survey and measurement of blood pressure among PLHIV in 26 health facilities to assess the accessibility of anti-hypertensive drugs in the peer support groups. The collected data was summarized using descriptive statistics.</p><p><strong>Results: </strong>Eight out of 26 health facilities formed peer support groups. Among 163 PLHIV interviewed only 64 participated in the peer support groups. Among those who participated in peer support groups, 57% reported accessing anti-hypertensive drugs through the group. The peer support groups were affordable for most participants. Around 60% found the contributions manageable, with 79% contributing $1.3 or less. Most participants expressed satisfaction in the performance of the peer support groups. And blood pressure control was higher among survey participants in peer support groups (53.1%) compared to those not in such groups (33.3%), with an overall control rate of 41.1%.</p><p><strong>Conclusion: </strong>The results of the study suggest that patient-led peer support groups are a feasible intervention to improve access to antihypertensive medications for PLHIV with Hypertension.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"597371"},"PeriodicalIF":2.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral Load Suppression After Intensive Adherence Counselling Among Previously Non-Suppressed Adolescents and Young People with HIV in East-Central Uganda.","authors":"David Livingstone Ejalu, Peter Simon Okello, Sean Steven Puleh, Joanita Nangendo, Jonathan Izudi, Sabrina Bakeera-Kitaka, Achilles Katamba, Anne R Katahoire, Joan N Kalyango, Adithya Cattamanchi, Fred C Semitala, Moses R Kamya","doi":"10.2147/HIV.S588885","DOIUrl":"10.2147/HIV.S588885","url":null,"abstract":"<p><strong>Background: </strong>Viral load suppression remains suboptimal among adolescents and young people living with HIV in Uganda (AYPLHIV). Although Intensive Adherence Counselling is recommended for individuals who remain virally non-suppressed while on antiretroviral therapy, its contribution to suppression among AYPLHIV is not well understood. This study aimed to determine the level of viral load suppression achieved following intensive adherence counselling among previously non-suppressed AYPLHIV in east central Uganda.</p><p><strong>Methods: </strong>We conducted a sequential explanatory mixed methods study among 580 participants aged 10-24 years receiving care at 32 health facilities. Quantitative data were abstracted covering a five-year period from 2019-2024. Suppression levels and subgroup differences were assessed using chi-square tests. A qualitative study was conducted with 12 purposively selected participants and thematic analysis were guided by the Capability, Opportunity, Motivation and Behavior framework.</p><p><strong>Results: </strong>Participants had a median age of 16.4 years and a median ART duration of 4 years. Overall, out of the 580 participants, 313 (53.9%) achieved viral load suppression after counselling. Participants living more than 5 km compared to less than 5km from a health facility (p=0.003) and those counselled by counsellors rather than nurses (p<0.001) had significantly higher suppression level. Lower suppression level was observed among participants who had not disclosed their HIV status versus those who disclosed (p=0.011) and those reporting fear or stigma compared to those not reporting (p=0.010). Qualitative findings indicated that understanding the purpose and benefits of intensive adherence counselling (Capability), financial barriers and provider interactions (Opportunity), and non-disclosure (Motivation) influenced suppression outcomes among AYPLHIV.</p><p><strong>Conclusion: </strong>IAC resulted in modest improvements in VL suppression among AYPLHIV. Low retention and contextual barriers, including distance, stigma and non-disclosure, limited its effectiveness. Tailored IAC strategies addressing subgroup-specific barriers are needed to improve VL suppression.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"588885"},"PeriodicalIF":2.4,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternative Administration of Antiretroviral Therapy in People with HIV Unable to Swallow: A Scoping Review.","authors":"Hilal Abdessamad, Christina Baroody, Karolina Pogorzelski, Wassim Jamaleddine, Monicah Syomiti Kitonga, Habib Omar, Seth Adu Amankrah, Kristine Allen-Brown, Dima Dandachi","doi":"10.2147/HIV.S580990","DOIUrl":"10.2147/HIV.S580990","url":null,"abstract":"<p><strong>Purpose: </strong>To review published evidence on alternative administration methods for antiretroviral therapy in patients unable to swallow tablets.</p><p><strong>Methods: </strong>We conducted a scoping review using PubMed, Web of Science, and Google Scholar databases from 2011 to 2025. We included studies reporting pharmacokinetic data, clinical outcomes, or safety data on crushed, dispersed, or enterally administered antiretroviral formulations. Four independent reviewers screened 1,474 articles after duplicate removal, with 12 studies meeting selection criteria.</p><p><strong>Results: </strong>We identified 12 studies (8 case reports, 2 case series, 2 cohort studies) describing alternative administration of antiretrovirals. Key findings included: (1) Bictegravir/emtricitabine/tenofovir alafenamide was associated with viral suppression when dissolved and administered enterally; (2) Dolutegravir/abacavir/lamivudine crushed via nasogastric tube was associated with viral suppression within 10 months; (3) Dolutegravir requires separation from enteral feeds containing polyvalent cations to avoid chelation and reduced absorption. (4) Most nucleoside reverse transcriptase inhibitors (NRTIs) could be crushed or dissolved, while non-nucleoside reverse transcriptase inhibitors (NNRTIs) showed variable stability. (5) Therapeutic drug monitoring was recommended for integrase inhibitors administered enterally.</p><p><strong>Conclusion: </strong>This review provides evidence suggesting the use of modified ART formulations when standard oral administration is not possible. In situations where swallowing difficulties prevent the use of whole tablets, alternative methods such as crushing, or dissolving may offer a practical approach to maintain treatment continuity. Alternative administration ART, namely INSTI-based regimens and NRTIs, may help maintain viral suppression in these settings, provided that drug-specific pharmacokinetic considerations and enteral feeding interactions are addressed. Further prospective studies with therapeutic drug monitoring are needed to establish standardized protocols.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"580990"},"PeriodicalIF":2.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of HIV RNA Viral Load, CD4 Counts, HPV Detection, and Cytology Support Co-Testing for Cervical Cancer Screening Among Women Living with HIV.","authors":"Carmen D Zorrilla, Cecilia V Olmo-Lopez, Adriana M Hernández Garayua, Jessica Ibarra, Hiram A Santiago-Rivera, Ana M Mosquera, Karen Martinez-Robles","doi":"10.2147/HIV.S553851","DOIUrl":"10.2147/HIV.S553851","url":null,"abstract":"<p><strong>Introduction: </strong>This study addresses a research gap in cervical cancer screening for Women Living with HIV (WLHIV) in Puerto Rico, evaluating the associations between viral load (VL) thresholds, CD4 count, HPV detection, and the benefits of co-testing with cytology.</p><p><strong>Methods: </strong>We analyzed the HIV viral load (VL), HPV infection, CD4 counts, and cervical cytology in 354 WLHIV receiving consecutive comprehensive care, including Highly Active Antiretroviral Therapy (HAART). Retrospective data were obtained from visits from 2018 to 2023. Consecutive visits with ThinPrep co-testing for cytology and HPV were evaluated. Only one observation per woman was included to maintain a cross-sectional dataset. HPV was detected using Hologic ThinPrep Pap Test and PCR-based genotyping.</p><p><strong>Results: </strong>The prevalence of any HPV was 27% which correlated inversely with CD4 counts: 42.9% (≤200 cells/mm³), 35.5% (201-499 cells/mm³), and 23.2% (>500 cells/mm³) (p=0.017). Multivariate analysis demonstrated that HPV positivity was significantly associated with the likelihood of having an abnormal Pap result (OR = 6.35; 95% CI: 3.22-12.52; p < 0.001). Cytologic abnormalities were more frequent with lower CD4 counts: 32.1% (≤200 cells/mm³), 11.8% (201-499 cells/mm³), and 11.2% (>500cells/mm³) (p=0.007). HPV was detected more frequently among women with detectable VL > 201 copies/mL (35.4% vs 26.1%). Abnormal cytology occurred in 22.9% of women with VL > 201 copies/mL versus 11.4% with VL ≤ 200 copies/mL (p=0.028) and among 34.8% of women with negative HPV tests, underscoring the value of co-testing.</p><p><strong>Conclusion: </strong>WLHIV demonstrate higher HPV prevalence and abnormal cytology rates, with persistence inversely related to CD4 counts. Viral suppression correlates with lower HPV prevalence and fewer cytologic abnormalities. Co-testing identified 34.8% of WLHIV with abnormal cytology and HPV-negative results. This study supports consideration of co-testing for cervical cancer screening in WLHIV, even among those with high ART uptake. Further prospective and multi-site studies are warranted to confirm these observations and inform policy or guideline changes.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"553851"},"PeriodicalIF":2.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake and Timing of Viral Load Testing and Frequency of Viraemic Episodes During Pregnancy in South Africa.","authors":"Nelly Jinga, Karl-Günter Technau, Kate Clouse, Nkosinathi Blessing Ngcobo, Cornelius Nattey, Candice Hwang, Anna Grimsrud, Amy Wise, Nicola Van Dongen, Thalia Ferreira, Maanda Mudau, Mhairi Maskew","doi":"10.2147/HIV.S560792","DOIUrl":"10.2147/HIV.S560792","url":null,"abstract":"<p><strong>Background: </strong>Repeated monitoring of viral load (VL) among pregnant women living with HIV (WLWH) is critical in vertical transmission prevention. For women who are newly diagnosed with HIV during pregnancy, a subsequent VL is recommended three months after ART initiation, and for all women living with HIV, follow-up VL is required every six months throughout pregnancy and breastfeeding. Here, we describe the uptake and timing of VL testing and frequency and distribution of viraemic episodes during pregnancy.</p><p><strong>Methods: </strong>We linked prospective cohort data from WLWH whose infants were born at Rahima Moosa Mother and Child Hospital (RMMCH) in Johannesburg, South Africa (2013-2018) to laboratory data from the National Health Laboratory Services national HIV cohort. We report the uptake and timing of VL testing, and frequency of viremia and viral suppression. We applied the log binomial regression, to explore factors associated with having at least one or more VL test. Crude relative risks (RR) and adjusted relative risks (aRR) with 95% confidence intervals (CI) relative risk were reported.</p><p><strong>Results: </strong>Data from 4064 women with known dates of entry into antenatal care and delivery during the study period were analysed. Overall, less than half (46%) completed VL testing during pregnancy. Most VLs were conducted during the third trimester (67%). Only 5% (n = 100) were during the first trimester and 11% within 7 days of delivery. Three-quarters of tests during pregnancy indicated viral suppression (VL < 400 copies/mL), 7% viraemic (VL 400-1000 copies/mL), and 19% high-grade viraemia (VL > 1000 copies/mL). We found that being older (≥35) and being engaged in HIV care prior to pregnancy were significantly associated with VL testing during pregnancy.</p><p><strong>Conclusion: </strong>With less than half of pregnant women living with HIV in this study having a VL measure during their pregnancy, and VL testing occurring late in pregnancy, this study highlights critical gaps in providing quality HIV care to women and prevention of vertical transmission.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"18 ","pages":"560792"},"PeriodicalIF":2.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}