Lancet Hiv最新文献

{"title":"The 3 moments for U=U education.","authors":"Phan Thi Thu Huong, Asia Nguyen, Do Thi Nhan, Eric J Dziuban, Todd M Pollack","doi":"10.1016/S2352-3018(25)00013-X","DOIUrl":"10.1016/S2352-3018(25)00013-X","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e170-e172"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434108","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":"Trauma-informed HIV prevention for forcibly displaced adolescents and young adults.","authors":"Catherine L Chantre, Trace Kershaw, Sarah R Lowe, J L Davis, Antonio Suleman, Sten H Vermund, Jennifer J Mootz","doi":"10.1016/S2352-3018(24)00313-8","DOIUrl":"10.1016/S2352-3018(24)00313-8","url":null,"abstract":"<p><p>The number of people forcibly displaced due to conflict is rising rapidly each year. Previous studies have documented associations between mental ill health, HIV risk, and poor engagement with HIV care in conflict-affected populations. Most people forced to migrate are adolescents and young adults, who might already be affected by a high burden of mental ill health due to factors such as high trauma exposure during the developmental period. Adolescent girls (aged 15-19 years) and young men (aged 20-24 years) are highly vulnerable populations for HIV acquisition. Trauma and migration stress can further exacerbate the burden of mental ill health on forcibly displaced adolescents and young adults. Given the high level of vulnerability this population faces, delivery of trauma-informed HIV prevention to this group is crucial, through combined mental health and HIV interventions that are tailored to their unique developmental and socioenvironmental contexts. Trauma-informed HIV prevention is key to controlling and ending the HIV epidemic among adolescents and young adults affected by crises.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e234-e238"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068885","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":"Safety of combined long-acting injectable cabotegravir and long-acting injectable rilpivirine in virologically suppressed adolescents with HIV (IMPAACT 2017/MOCHA): a phase 1/2, multicentre, open-label, non-comparative, dose-finding study.","authors":"Carolyn Bolton Moore, Kristin Baltrusaitis, Brookie M Best, John H Moye, Ellen Townley, Avy Violari, Barbara Heckman, Sarah Buisson, Rodica M Van Solingen-Ristea, Edmund V Capparelli, Mark A Marzinke, Elizabeth D Lowenthal, Shawn Ward, Chelsea Krotje, Ryan Milligan, Allison L Agwu, Jenny Huang, S Y Amy Cheung, Cynthia McCoig, Dwight E Yin, Gilly Roberts, Herta Crauwels, Veerle Van Eygen, Sara Zabih, Gaerolwe Masheto, Pradthana Ounchanum, Linda Aurpibul, Violet Korutaro, Aditya H Gaur","doi":"10.1016/S2352-3018(24)00344-8","DOIUrl":"10.1016/S2352-3018(24)00344-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Long-acting cabotegravir and long-acting rilpivirine constitute a completely intramuscular antiretroviral therapy (ART) regimen for adults with HIV. We aimed to assess the safety, antiviral activity, and pharmacokinetics of oral cabotegravir and rilpivirine followed by a combination of long-acting cabotegravir and long-acting rilpivirine in virologically suppressed adolescents with HIV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The IMPAACT 2017/MOCHA study is a phase 1/2, multicentre, open-label, non-comparative, dose-finding trial being conducted at 18 sites across Botswana, South Africa, Thailand, Uganda, and the USA. In cohort 2 of this study, adolescents (aged 12-18 years; weight ≥35 kg) with HIV and no serious comorbidities who were receiving stable combination ART with confirmed virological suppression and had either previously enrolled in the first cohort or had not previously participated in the study were eligible for inclusion. Participants stopped their background combination ART and received oral cabotegravir 30 mg once daily and oral rilpivirine 25 mg once daily orally for 4-6 weeks, followed by long-acting injectable cabotegravir 600 mg (3 mL) and long-acting injectable rilpivirine 900 mg (3 mL) intramuscularly at weeks 4 and 8, and every 8 weeks thereafter. The primary outcome was safety, including all adverse events, at week 24. Primary safety outcome measures were summarised as frequencies, percentages, and exact Clopper-Pearson 95% CIs in the evaluable analysis population, which included participants who were treated exclusively with the regimen and either completed all scheduled treatments or experienced severe adverse events, permanently discontinued the treatment, or died, whichever occurred first; and in the all-treated analysis population, which included all participants who received at least one dose of any study product. This study is registered with ClinicalTrials.gov (NCT3497676) and is ongoing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between July 26, 2021, and Aug 27, 2022, 44 (80·0%) of 55 adolescents who participated in cohort 1 and 100 (87·0%) of 115 screened study-naive adolescents were enrolled in cohort 2. 74 (51·4%) participants were female and 70 (48·6%) were male. Overall, 15 (10·8% [95% CI 6·2-17·2]) of all 139 participants in the evaluable analysis population had at least one adverse event of grade 3 or above by week 24. Among 142 participants who received at least one injection, 43 (30%) experienced at least one injection site reaction (ISR). All 106 ISRs were either grade 1 (98 [92·5%]) or grade 2 (eight [7·5%]), and 97 (91·5%) resolved within 7 days. No participant experienced a drug-related serious adverse event or prematurely discontinued treatment due to a drug-related adverse event.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Long-acting injectable cabotegravir and long-acting injectable rilpivirine, administered to adolescents at recommended adult dosages every 8 weeks, showed no unanticipa","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 3","pages":"e191-e200"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574299","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":"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":"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":"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":"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}