Lancet Hiv最新文献

{"title":"Crisis and resilience in the Pacific's HIV emergency","authors":"Vijay Shankar Balakrishnan","doi":"10.1016/s2352-3018(26)00060-3","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00060-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"15 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502061","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":"Service needs of people living with HIV in the UK (Positive Voices 2022): a cross-sectional survey.","authors":"Anne Williamson,Fiona C Lampe,Adamma Aghaizu,Annegret Pelchen-Matthews,Alex Sparrowhawk,Ben Cromarty,Janey Sewell,Clare Humphreys,Tom Fernandez,Stephen Taylor,Alison J Rodger,Meaghan Kall,Colette J Smith, ","doi":"10.1016/s2352-3018(25)00332-7","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00332-7","url":null,"abstract":"BACKGROUNDDespite accessible and effective HIV treatment, the health and wellbeing of people with HIV can be negatively affected by social and economic disadvantage and stigma. We assessed needs and unmet needs for health and welfare services among people with HIV in the UK.METHODSPositive Voices 2022 is a questionnaire study of 4622 adults, conducted between April 11, 2022, and March 31, 2023, at 101 clinics in the UK. Participants self-completed a confidential questionnaire, including questions on sociodemographics, HIV-related factors, lifestyle factors, mental and physical health, and health and social care service needs; we included participants who provided sociodemographic data, year of HIV diagnosis, and at least one response about health care and other needs (4326 [93·6%] of 4622). 27 health and welfare services were grouped into five categories: HIV-related services; mental health services; welfare services; lifestyle services; and drug services. We assessed the association of sociodemographic factors with those who reported a service need, and those with an unmet need among those with a service need, using logistic regression, adjusted for age group, sociodemographic group, and year of HIV diagnosis.FINDINGSFor the 4326 participants, the median age was 53 years (IQR 44-60) and 996 (22·3%) were diagnosed with HIV between 2014 and 2023. The study population was predominantly gay, bisexual, and other men who have sex with men ([GBMSM] 2564 [59·3%]) and men of any sexual orientation (3237 [74·8%]). 260 (6·0%) were Black African heterosexual men and 360 (8·3%) were heterosexual men of other ethnicity. Of the 1031 women, 574 (13·3%) were Black African women, 457 (10·6%) were women of other ethnicities; and 2·6% (111) people were from other or undisclosed gender identities or sexualities. The most common reported needs were HIV-related (2779 [64·2%]), followed by mental health services (1877 [43·4%]), lifestyle (1492 [34·4%]), and welfare services (1492 [34·4%]). Need for drug services was lower (305 [7·1%]). For each area, service need was greater for younger people, those facing financial hardship, and those not in employment (compared with those who were employed or retired). GBMSM had lower need for HIV-related, welfare, and lifestyle services than most other sociodemographic groups but higher need for drug services. Heterosexual men had the lowest need for mental health services. Among those with a service need, unmet need was lower for HIV-related services (1153 [41·5%] of 2779) than other service categories (from 66·2% to 70·3%), and was associated with younger age, financial hardship, and demographic group.INTERPRETATIONA substantial proportion of people with HIV who have mental health, welfare, and lifestyle needs in the UK are not receiving these services. Regular assessment of such needs, with referral and service signposting to appropriate services, should be implemented to benefit the wellbeing of this population.FUNDINGUK Nation","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"89 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483463","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":"Histoplasmosis: a missing piece in the global efforts to end HIV deaths","authors":"Alessandro C Pasqualotto, Thuy Le, Tarsila Vieceli, Lottie Brown, Rita Oladele, Nathan C Bahr","doi":"10.1016/s2352-3018(26)00006-8","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00006-8","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"59 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147447211","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":"Brazil eliminates vertical transmission of HIV","authors":"Tony Kirby","doi":"10.1016/s2352-3018(26)00055-x","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00055-x","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"1 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392367","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":"Funding relief, but conditions temper optimism","authors":"","doi":"10.1016/s2352-3018(26)00035-4","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00035-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"107 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147360556","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":"Structural stigma: an urgent intervention priority in Africa.","authors":"Sarah K Calabrese","doi":"10.1016/s2352-3018(25)00359-5","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00359-5","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"45 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359276","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":"The impact of HIV stigma and discrimination on HIV testing, antiretroviral treatment, and viral suppression in Africa: a pooled analysis of population-based surveys.","authors":"Carla M Doyle,Salome Kuchukhidze,James Stannah,Jorge Luis Flores Anato,Yiqing Xia,Carmen H Logie,Arlette Simo Fotso,Mabel Carabali,Gideon Kye-Duodu,Sharmistha Mishra,Anatole Mian,Fern Terris-Prestholt,Oksana Kovtun,Aditya Singh,Jack Stone,Serge Niangoran,Adelina Artenie,Peter Vickerman,Marie-Claude Boily,Mathieu Maheu-Giroux","doi":"10.1016/s2352-3018(25)00325-x","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00325-x","url":null,"abstract":"BACKGROUNDUNAIDS' ending AIDS targets include ensuring that less than 10% of people with HIV, at risk of HIV, or affected by HIV experience HIV stigma and discrimination. We aimed to estimate the effect of HIV stigma and discrimination on the HIV care cascade in eastern, southern, central, and western Africa-regions with the largest HIV burden worldwide.METHODSWe used population-based surveys in countries in eastern, southern, central and western Africa from 2000 onward identified through previous reviews and data catalogues. Surveys eligible for inclusion were screened and selected if they contained at least one measure of HIV stigma and discrimination, and at least one HIV outcome (ie, HIV testing, antiretroviral therapy [ART] use, or viral suppression). The individual-level data from all included surveys were pooled for our analyses. We assessed three community-level HIV stigma exposures (continuous): discriminatory attitudes, perceived stigma, and shame of association with people with HIV. Among people with HIV, we examined individual-level, past-year anticipated, or experienced stigma in health-care settings (binary). Using Poisson regression, we estimated adjusted prevalence ratios (aPRs) for the effect of each stigma measure on past-year HIV testing, ART use, and viral suppression. We used segmented regression with a median breakpoint to model non-linear effects of community-level stigma.FINDINGSWe identified 124 surveys in 38 countries published between 2000 and 2023. Stigma towards people with HIV was high. 51% of participants held discriminatory attitudes, 71% perceived HIV stigma, and 43% reported shame of association. Among people with HIV, 34% had anticipated, and 8% experienced, health-care stigma. Where the prevalence of community-level discriminatory attitudes was equal to or above the median, people were less likely to have tested for HIV (aPR 0·88 per 10% increase, 95% CI 0·87-0·88), and people with HIV had lower ART use (0·96 per 10% increase, 0·94-0·97) and viral suppression (0·96, 0·95-0·98). Similarly, communities with higher (≥median) shame of association levels had lower testing (aPR 0·97 per 10% increase, 95% CI 0·96-0·98) and viral suppression (0·98, 0·96-1·00). People with HIV who anticipated or experienced health-care stigma were 7% (95% CI 4-10) less likely to be on ART and 10% (6-14) less likely to be virally suppressed, possibly reaching 14% (7-21) and 16% (9-23) when adjusted for selection bias.INTERPRETATIONHIV stigma and discrimination have measurable, widespread, negative effects on the full cascade of care: HIV testing, treatment, and viral suppression. These effects are most pronounced in communities with the highest levels of stigma. Stigma reduction strategies should be prioritised to improve health outcomes and reduce health inequities.FUNDINGCanadian Institutes of Health Research, Canada Research Chairs Program, and Wellcome Trust.","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"14 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359277","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":"Lasting impact of COVID-19 on HIV testing in the USA.","authors":"Thomas J O'Grady, James M Tesoriero","doi":"10.1016/S2352-3018(25)00322-4","DOIUrl":"10.1016/S2352-3018(25)00322-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e145-e147"},"PeriodicalIF":13.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208031","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":"Racial, ethnic, and regional disparities in HIV testing during the COVID-19 pandemic in the USA: a nationwide, retrospective, observational study using National Clinical Cohort Collaborative data.","authors":"Haishan Yang, Duolan Han, Eric Hurwitz, Jerrod Anzalone, Cara D Varley, Sandra E Safo, Jing Sun, Dongmei Li, Marlene Camacho-Rivera, Nada Fadul, Zachary Butzin-Dozier, Bohdan Nosyk, Rena C Patel, Xiao Zang","doi":"10.1016/S2352-3018(25)00302-9","DOIUrl":"10.1016/S2352-3018(25)00302-9","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic caused major disruptions to health care, affecting the delivery of HIV care and prevention services. We aimed to determine the impact of the pandemic on HIV testing rates in medical settings across regions and racial and ethnic populations in the USA.</p><p><strong>Methods: </strong>In this retrospective cohort study, we used data from the National Clinical Cohort Collaborative (N3C) from Jan 1, 2018, to Dec 31, 2022, of individuals aged 15-64 years with active health-care records. In this dataset, COVID-19 cases were matched (1:2) to COVID-negative controls on the basis of age, sex, and race and ethnicity within each site. We used interrupted time-series analyses to estimate changes in the monthly HIV testing rate, measured as the number of individuals tested per 10 000 people in four geographical regions (midwest, northeast, south, and west) among four racial and ethnic groups (White [non-Hispanic], Black [non-Hispanic], Hispanic, other). We estimated these changes in three time periods: prepandemic (January, 2018, to February, 2020), early pandemic (March, 2020, to August, 2020), and late pandemic (September, 2020, to December, 2022).</p><p><strong>Findings: </strong>9 704 278 individuals were included and had a mean age of 41·2 years (SD 13·5). 5 667 609 (58·4%) of 9 704 278 individuals were female and 4 036 669 (41·6%) were male. Most individuals were White, followed by other, Black, and Hispanic, with notable geographical differences in racial and ethnic composition. Prepandemic, HIV testing rates were relatively stable, although levels varied by region and racial and ethnic group. The impact on testing rates differed substantially during the early and late pandemic, with the west experiencing the sharpest and most prolonged decline (-30·94 per 10 000 people, 95% CI -42·29 to -19·59). Among racial and ethnic groups, the Black population showed the greatest reduction in testing at the onset of the pandemic across all four regions, and specifically in the northeast, which decreased by 53·09 per 10 000 people (95% CI -73·43 to -32·77). The decline was more modest among White individuals at the national level (-13·55 per 10 000 people, -20·27 to -6·84) and no racial or ethnic groups showed a significant decline in the south. Testing rates rebounded to varying degrees during the late pandemic.</p><p><strong>Interpretation: </strong>The COVID-19 pandemic, particularly early on, caused substantial disruptions in HIV testing rates across the USA, with pronounced racial, ethnic, and regional disparities. These findings highlight the need for targeted interventions to mitigate the impact of public health emergencies on communities disproportionately affected by pre-existing health inequities, including expanding mobile testing units, supporting community-based outreach, and investing in culturally responsive care to improve access to testing during future public health disruptions.</p><p><strong>F","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e185-e193"},"PeriodicalIF":13.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208041","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":"Fixed-dose daily doravirine (100 mg) with islatravir (0·25 mg) versus bictegravir, emtricitabine, and tenofovir alafenamide for initial HIV-1 therapy: 48-week results of a phase 3, randomised, controlled, double-blind, non-inferiority trial.","authors":"Jürgen K Rockstroh, Sheetal Kassim, Roger Paredes, Christopher Bettacchi, Gary Sinclair, Anchalee Avihingsanon, Nelly Mugo, Jean-Michel Molina, Brenda Crabtree Ramírez, Hiroyuki Gatanaga, Yayun Xu, Stephanie O Klopfer, Tracy L Diamond, Mary Vesnesky, Luisa M Stamm, Michelle C Fox, Mary L Pisculli","doi":"10.1016/S2352-3018(26)00033-0","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00033-0","url":null,"abstract":"<p><strong>Background: </strong>Doravirine and islatravir is a two-drug regimen being investigated for the treatment of HIV-1. This study evaluated efficacy and safety of once daily doravirine and islatravir versus bictegravir, emtricitabine, and tenofovir alafenamide in adults with HIV-1 who were treatment-naive.</p><p><strong>Methods: </strong>MK-8591A-053 is a phase 3, randomised, double-blind, active-controlled, non-inferiority study being done at 116 research, community, and hospital-based clinics across 20 countries. Adults aged at least 18 years with HIV-1 RNA of 500 copies per mL or more never previously treated for HIV-1 were randomly assigned (1:1), stratified by screening HIV-1 RNA viral load and CD4-cell count, to received either doravirine (100 mg) and islatravir (0·25 mg) or bictegravir (50 mg), emtricitabine (200 mg), and tenofovir alafenamide (25 mg) orally once daily. The primary endpoint was percentage of participants with HIV-1 RNA less than 50 copies per mL at week 48 (FDA snapshot; prespecified non-inferiority margin -10%). Participants who received at least one dose of study intervention were analysed for safety. This trial is ongoing and is registered with ClinicalTrials.govNCT05705349.</p><p><strong>Findings: </strong>We screened 756 participants for eligibility between March 8, 2023, and Oct 11, 2024. 269 participants were treated with doravirine-islatravir and 267 with bictegravir-emtricitabine-tenofovir. The last study visit for this analysis occurred on Oct 13, 2025. Median age was 32 years (IQR 26-40), 134 (25%) participants were assigned female at birth, 225 (42%) were White, 92 (17%) had CD4 counts less than 200 cells per μL, 197 (37%) had an HIV-1 RNA greater than 100 000 copies per mL, and 314 (59%) had pre-existing resistance-associated mutations. At week 48, doravirine-islatravir was non-inferior to bictegravir-emtricitabine-tenofovir: 247 (91·8%) of 269 versus 242 (90·6%) of 267 had HIV-1 RNA less than 50 copies per mL (estimated difference 1·2%, 95% CI -3·7 to 6·2). Mean increase in CD4 count was 218 cells per μL in the doravirine-islatravir group and 226 cells per μL in the bictegravir-emtricitabine-tenofovir group (estimated difference -6·8, 95% CI -35·8 to 22·2). Two participants in the doravirine-islatravir group and one in the bictegravir-emtricitabine-tenofovir group with pretreatment HIV-1 RNA greater than 1 million copies per mL and CD4 counts less than 200 cells per μL acquired treatment-emergent mutations. Phenotypic analysis revealed resistance to doravirine in two participants treated with doravirine-islatravir. 38 (14%) of 269 participants in the doravirine-islatravir group and 48 (18%) of 267 in the bictegravir-emtricitabine-tenofovir group had treatment-related adverse events: the most common were increased weight (7, 3%), headache (6, 2%), and dizziness (5, 2%) in the doravirine-islatravir group and increased weight (9, 3%), headache (9, 3%), and decreased estimated glomerular filtration rate (","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":13.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322359","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}