Lancet Hiv最新文献

{"title":"PEPFAR halt puts millions at risk in global HIV fight.","authors":"Vijay Shankar Balakrishnan","doi":"10.1016/S2352-3018(25)00037-2","DOIUrl":"10.1016/S2352-3018(25)00037-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e175-e177"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426508","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":"Planning for the virtual elimination of HIV in Australia: a Delphi consensus.","authors":"Tiffany R Phillips, Habib Taouk, Phyllis M Lau, Reuben Kiggundu, Andrew E Grulich, Aaron Cogle, Scott Harlum, Dash-Heath Paynter, Darryl O'Donnell, Jason J Ong","doi":"10.1016/S2352-3018(24)00315-1","DOIUrl":"10.1016/S2352-3018(24)00315-1","url":null,"abstract":"<p><p>Australia has seen a steady decline in HIV notifications since 2013 and has one of the fastest declining rates of HIV transmission in the world. Australia is now in a globally unique position to plan for a near future of virtual elimination of HIV transmission. Through community involvement for every stage of this Delphi consensus process, we ensured the statements drafted reflect the needs of the community and highlight the gaps in the HIV response that will be essential to address if virtual elimination is to be achieved. The targeted strategies developed address how to reduce HIV transmission at every stage and facet of the HIV response (including prevention, testing, treatment, reducing HIV stigma, and enhancing the community-led response and research), resulting in a list of specific and essential priorities for the next stage of Australia's HIV response. Essential to achieving virtual elimination is the need for continued collaboration from community organisations, clinicians, researchers, and funding agencies. As Australia is one of the few countries in the world to be able to plan for HIV elimination in the near future, this Position Paper will be a useful guide for other countries as they plan for their own HIV response.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e223-e233"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426449","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":"Association of life-course events with predictors of HIV risk behaviour and HIV acquisition in Manicaland, Zimbabwe: a longitudinal analysis of a population cohort.","authors":"Michael Pickles, Simon Gregson, Louisa Moorhouse, Rufurwokuda Maswera, Blessing Tsenesa, Freedom Dzamatira, Phyllis Mandizvidza, Sophie Bagnay, Tawanda Dadirai, Brian Kumbirai Moyo, Owen Mugurungi, Constance Nyamukapa, Timothy B Hallett","doi":"10.1016/S2352-3018(24)00317-5","DOIUrl":"10.1016/S2352-3018(24)00317-5","url":null,"abstract":"<p><strong>Background: </strong>An individual's HIV risk, and consequently their HIV prevention needs, change over time. In this study we aimed to quantify these changes, examine which life-course events were associated with them, and investigate the extent to which those life-course events were associated with HIV acquisition.</p><p><strong>Methods: </strong>We used longitudinal data from eight rounds of a general population cohort in Manicaland province, eastern Zimbabwe, on sociodemographic and HIV risk behaviours, as well as HIV serostatus from the first seven rounds. We first visualised how HIV risk behaviours, comprised of having multiple, concurrent, non-regular, or transactional partners, condom non-use, drug use, and visiting bars, changed for individuals over time using Sankey diagrams. We then examined whether logistic regression models incorporating life-course events-namely, changes in marital or employment status, in-migration, or birth of a child-were more strongly associated with changes in HIV risk behaviour than models using only sociodemographic variables. Finally, we compared how well sociodemographic, HIV risk behaviour, and life-course events were associated with the person's risk of HIV acquisition as follows: we used logistic regression to identify which states (divided into sociodemographic, HIV risk behaviour, and life-course events) were most strongly associated with risk of HIV acquisition; based on this we use three models (corresponding to the three divisions) to identify the top 20% of individuals predicted to be at risk of acquiring HIV by each model, and computed what proportion of the actual HIV infection events occurred in that group.</p><p><strong>Findings: </strong>Between 1998 and 2021, 21 213 individuals were interviewed at least twice, contributing a total of 34 212 participant observations. In this setting, individuals had periods of HIV risk lasting less than 3 years; only 12·3% (102 of 831) of those reporting transactional sex had also reported this in the previous round. We found that life-course events such as changes in marital status, employment status, and in-migrant status were associated with these changes in HIV risk behaviour. Using life-course events, particularly ones related to changes in marital status, 23% and 30% more HIV acquisitions were identified than using HIV risk behaviours or sociodemographic information, respectively.</p><p><strong>Interpretation: </strong>HIV risk changes dynamically in this population, and life-course events could be a powerful way to understand changes in HIV risk behaviour and risk of HIV acquisition.</p><p><strong>Funding: </strong>Bill and Melinda Gates Foundation, UK Medical Research Council, and Department for International Development.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e214-e222"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442465","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":"Reflections from the frontline of the HIV/AIDS response.","authors":"Andrew Green","doi":"10.1016/S2352-3018(25)00015-3","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00015-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531056","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":"Controversial chronicler of LGBTQ rights.","authors":"Talha Burki","doi":"10.1016/S2352-3018(25)00016-5","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00016-5","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415907","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":"Thank you to The Lancet HIV's statistical and peer reviewers in 2024.","authors":"The Lancet Hiv Editors","doi":"10.1016/S2352-3018(25)00008-6","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00008-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 2","pages":"e88-e91"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366308","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":"Preventing HIV in young women in Africa.","authors":"Tanuja N Gengiah, Quarraisha Abdool Karim","doi":"10.1016/S2352-3018(24)00309-6","DOIUrl":"10.1016/S2352-3018(24)00309-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e83-e84"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839951","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":"Costs and outcomes of routine HIV oral pre-exposure prophylaxis implementation across different service delivery models and key populations in South Africa: a retrospective cohort study.","authors":"Cheryl Hendrickson, Kamban Hirasen, Constance Mongwenyana, Mariet Benade, Rutendo Bothma, Chantal Smith, Johan Meyer, Brooke E Nichols, Lawrence C Long","doi":"10.1016/S2352-3018(24)00295-9","DOIUrl":"10.1016/S2352-3018(24)00295-9","url":null,"abstract":"<p><strong>Background: </strong>Despite several service delivery models that aim to improve uptake and persistence of pre-exposure prophylaxis (PrEP) in sub-Saharan Africa, the full costs of daily oral PrEP provision in routine care settings remain largely unknown. We aimed to evaluate outcomes and costs of daily oral PrEP delivery among key and priority populations at in-facility and community outreach programmes in South Africa.</p><p><strong>Methods: </strong>This retrospective cohort study was done at seven urban sites across South Africa with in-facility or community outreach PrEP service delivery models. We did top-down and bottom-up microcosting, from the provider perspective, of routine oral PrEP provision in programmes focusing on men who have sex with men (MSM), female sex workers, and adolescent girls and young women (aged 15-24 years) who initiated oral PrEP between March 12, 2018, and Aug 13, 2019. The primary outcome was PrEP in-hand at 6 months, defined as having sufficient PrEP drug dispensed at the last visit to have the drug available 6 months after PrEP initiation. A subset of enrolled participants with sufficient potential follow-up were included in a 12-month outcome analysis. We report the cost per client initiated on PrEP in 2021 US dollars.</p><p><strong>Findings: </strong>We enrolled 1281 people aged at least 15 years who initiated oral PrEP in either in-facility or community outreach programmes between March 12, 2018, and Aug 13, 2019. The proportion of participants with PrEP in-hand at 6 months varied from 41·8% (95% CI 31·9-52·2; 41 of 98 participants) at one MSM-focused clinic to 0% (0-6·7; 0 of 53 participants) in an MSM-focused outreach programme. Among 633 clients receiving oral PrEP with the potential for 12 months follow-up, 86 (13·6%) had PrEP in-hand at 12 months. The mean average 6-month costs per client initiating oral PrEP ranged from US$29 (95% CI 26-31) to $590 (488-692), with higher costs generally observed for in-facility programmes ($152, 140-164) than for outreach programmes ($84, 79-88). The mean average monthly cost per client with PrEP in-hand at 6 months ranged from $18 (15-21) to $160 (126-194).</p><p><strong>Interpretation: </strong>Costs and outcomes of daily oral PrEP provision across several populations and service delivery models in real-world settings show substantial variability. Policy makers should consider this variability when planning further scale-up of oral PrEP programmes in South Africa and the sub-Saharan Africa region to maximise opportunities to improve efficiency based on local context.</p><p><strong>Funding: </strong>The US President's Emergency Plan for AIDS Relief, the US Agency for International Development, and the National Institutes of Health.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 2","pages":"e130-e142"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365535","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":"Thank you to The Lancet HIV's statistical and peer reviewers in 2024.","authors":"The Lancet Hiv Editors","doi":"10.1016/S2352-3018(25)00008-6","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00008-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 2","pages":"e88-e91"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371151","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":"Steps toward quick and equitable roll-out of lenacapavir.","authors":"The Lancet Hiv","doi":"10.1016/S2352-3018(25)00007-4","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00007-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 2","pages":"e81"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366023","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}