Lancet Hiv最新文献

{"title":"Lenacapavir licenses will not deliver on all opportunities.","authors":"The Lancet Hiv","doi":"10.1016/S2352-3018(24)00273-X","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00273-X","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"11 11","pages":"e717"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548453","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":"Pre-exposure prophylaxis in the perinatal period.","authors":"Sheree Schwartz, Friday Saidi","doi":"10.1016/S2352-3018(24)00244-3","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00244-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"11 11","pages":"e720-e721"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548454","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":"Initiation and continued use of oral pre-exposure prophylaxis among pregnant and postpartum women in South Africa (PrEP-PP): a demonstration cohort study.","authors":"Dvora Leah Joseph Davey, Rufaro Mvududu, Nyiko Mashele, Kalisha Bheemraj, Nehaa Khadka, Leigh F Johnson, Sarah Schoetz Dean, Pamina Gorbach, Linda-Gail Bekker, Thomas J Coates, Landon Myer","doi":"10.1016/S2352-3018(24)00240-6","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00240-6","url":null,"abstract":"<p><strong>Background: </strong>When used effectively, oral pre-exposure prophylaxis (PrEP; tenofovir disoproxil fumarate and emtricitabine) prevents maternal HIV acquisition and reduces the risk of vertical transmission. Our study aimed to better understand PrEP initiation, continued use, and adherence in pregnant and postpartum women.</p><p><strong>Methods: </strong>The PrEP in Pregnancy and Postpartum (PrEP-PP) study is a demonstration cohort study that enrolled pregnant women aged 16 years and older without HIV attending their first antenatal care visit in Cape Town, South Africa, between Aug 29, 2019, and Oct 10, 2021. Eligible, consenting women were followed up quarterly up to 12 months postpartum with regular HIV testing and offer of PrEP with ongoing adherence counselling. The primary outcome was distribution of women across the PrEP cascade (ie, initiation and continuation up to 12 months postpartum) with crude and adjusted hazard ratios (HRs). We also report on HIV incidence by pregnancy and postpartum status.</p><p><strong>Findings: </strong>Overall, 1195 pregnant women were recruited and followed up (median age 26 years, IQR 23-31; median gestational age 21 weeks, IQR 15-31); 1009 (84·4%) started PrEP at enrolment. Among women who initiated PrEP at enrolment, 668 (67·5%) of 990 continued PrEP at the 1-month follow-up, 485 (49·9%) of 972 continued at 3 months, 392 (39·4%) of 994 at 6 months, and 275 (27·4%) of 1005 at 12 months. Of 186 women who did not accept PrEP at enrolment, 70 (37·6%) of 186 subsequently initiated PrEP. Overall, 200 (18·6%) of 1076 women continued PrEP at 12 months postpartum. Of 186 women who did not initiate PrEP at baseline, 70 (37·6%) subsequently initiated PrEP during the study. Factors associated with PrEP discontinuation up to 12 months postpartum included being married or cohabiting (adjusted HR 1·32, 95% CI 1·16-1·50), condomless sex since last visit (1·43, 1·23-1·65), reporting intimate partner violence (2·03, 1·59-2·59), or depression in the past 12 months (1·53, 1·14-2·05). Overall, 16 women seroconverted over 1673·8 woman-years (HIV incidence rate 0·96 per 100 woman-years, 95% CI 0·49-1·42); 14 discontinued PrEP use and two never initiated PrEP. HIV incidence was 0·28 per 100 woman-years during pregnancy (95% CI 0·22-0·33), and the incidence rate ratio was 1·77 per 100 woman-years (0·53-5·90) 0-6 months postpartum and 2·19 per 100 woman-years (0·61-7·83) 6-12 months postpartum compared with pregnant women.</p><p><strong>Interpretation: </strong>There is an urgent need for the integration of PrEP into antenatal and postnatal care and interventions that address barriers to continued use, including targeted counselling during pregnancy and postpartum to reduce PrEP discontinuation.</p><p><strong>Funding: </strong>National Institute of Mental Health and Fogarty International, US National Institutes of Health.</p><p><strong>Translation: </strong>For the French translation of the abstract see Supplementary ","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"11 11","pages":"e746-e755"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548451","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":"Addressing HIV prevention and the PrEP gap among migrants.","authors":"Christiana Nöstlinger","doi":"10.1016/S2352-3018(24)00272-8","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00272-8","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631086","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":"Interventions to ensure access to and continuity of HIV care for international migrants: an evidence synthesis.","authors":"Alena Kamenshchikova, Charlotte M M Peters, Christiana Nöstlinger, Brian Rice, Nathan Ford, Giovanni Ravasi, Fiona Burns, Milosz Parczewski, Christian J P A Hoebe, Nicole Dukers, Farah Seedat, Antons Mozalevskis, Linda-Gail Bekker, Jean Berchmans Tugirimana, Weiming Tang, Gifty Marley, Denis Onyango, Monica C Thormann Peynado, Teymur Noori, Sally Hargreaves","doi":"10.1016/S2352-3018(24)00175-9","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00175-9","url":null,"abstract":"<p><p>International migrants, especially those belonging to key populations, face a considerable HIV burden. However, continuity of HIV care for this group is often challenged along the migration route. We assess the available evidence on the existing interventions that aim to strengthen community and health systems to ensure the continuity of HIV care for international migrants. We did a systematic search of PubMed for publications from 1989 until 2023 focused on different stages of the HIV care continuum regardless of the geographical region. The literature was reviewed with a thematic approach. Globally, legal regulations can restrict access to HIV care and fuel fear of deportation among undocumented migrants. The intersection of HIV-related and migration-related stigma creates further challenges for uninterrupted access to HIV care along the migration route, with negative clinical and public health consequences. Different potential interventions were identified including: provision of HIV care regardless of migration status; utilisation of mobile health, mobile units, and community-led initiatives to bring HIV care to migrants; and utilisation of participatory and co-creation methods to develop tailored and sustainable HIV-related interventions with migrant communities. Improving access to the continuity of care for migrants requires a shift towards intersectional policies rooted in co-creation approaches to address the underlying multiple and mutually reinforcing inequalities.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631171","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":"Antiretrovirals and obesity.","authors":"Nikos Pantazis, Kholoud Porter, Caroline A Sabin, Fiona Burns, Giota Touloumi","doi":"10.1016/S2352-3018(24)00298-4","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00298-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564959","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":"Ensuring the right to health for migrants and refugees.","authors":"Andrea L Wirtz, Kathleen R Page, Paul B Spiegel","doi":"10.1016/S2352-3018(24)00275-3","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00275-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631094","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":"Humanising and optimising HIV health care for refugees and asylum seekers.","authors":"Claudia P Cortes, Omar Sued, William C W Wong, Annick Borquez, Charles Ssonko, Miłosz Parczewski, Jocelyn DeJong, Vonthanak Saphonn, Animesh Sinha, Báltica Cabieses","doi":"10.1016/S2352-3018(24)00233-9","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00233-9","url":null,"abstract":"<p><p>Displaced populations living with HIV, including refugees and asylum seekers, face substantial challenges across various regions globally. The intersection of forced migration and HIV presents both shared challenges and region-specific differences. Key issues include little access to health care, pervasive stigma, discrimination, and disruptions in the continuity of HIV care. Refugees often encounter barriers such as legal, cultural, and economic disparities that impact their overall health outcomes. Although HIV prevalence differs across regions, displaced populations consistently face disproportionate challenges including high-risk environments and little health-care access. Addressing these challenges requires a focus on equitable health-care access, with both actionable local interventions and broader global policy changes and an emphasis on long-term sustainability. Reliable and continuous drug supplies, interagency collaboration, and holistic health-care approaches are essential. International collaboration, robust evidence generation, and comprehensive responses are urgently needed to address the complex interplay between forced migration and HIV among vulnerable populations.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631167","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":"Screening for chlamydia and incidence of symptomatic infections.","authors":"Thibaut Vanbaelen, Achilleas Tsoumanis, Chris Kenyon","doi":"10.1016/S2352-3018(24)00270-4","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00270-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564961","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":"Sex as a biological variable in HIV-1 and schistosome co-infection.","authors":"Jane K Maganga, Khanh Pham, John M Changalucha, Jennifer A Downs","doi":"10.1016/S2352-3018(24)00234-0","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00234-0","url":null,"abstract":"<p><p>The sex of people living with HIV-1 infection, schistosome infection, or both, is a fundamental determinant of their clinical outcomes and of how these two infections interact in the host. Data from longitudinal and cross-sectional human studies and animal models indicate that males with HIV-1 and schistosome co-infection excrete fewer schistosome eggs and might have higher HIV-1 RNA viral loads and greater liver damage. Females with schistosome infection appear to have higher risk of HIV-1 acquisition than females without, particularly in Schistosoma haematobium infection, and a greater risk of death in HIV-1 and schistosome co-infection. Greater transmission of HIV-1 to partners has been shown in both sexes in those with schistosome infection. Biological sex is a consequential factor affecting pathophysiological and clinical responses in HIV-1 and schistosome co-infection. Designing future analyses to incorporate sex is vital to optimise research and care for people living with HIV-1, schistosomes, and HIV-1 and schistosome co-infection.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570253","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}