Journal of acquired immune deficiency syndromes (1999)最新文献

{"title":"Brief Report: The \"PrEP APPEAL\" of Less Frequent Dosing: Acceptability of Six-Monthly Long-Acting Injectable PrEP Among Gay and Other Men Who Have Sex With Men and Transgender Women in Asia.","authors":"Heather-Marie A Schmidt, Curtis Chan, Jason J Ong, Warittha Tieosapjaroen, Nittaya Phanuphak, Kimberly E Green, Michael M Cassell, Midnight Poonkasetwattana, Hua Boonyapisomparn, Nicky Suwandi, Lei Zhang, Benjamin R Bavinton","doi":"10.1097/QAI.0000000000003852","DOIUrl":"10.1097/QAI.0000000000003852","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) use in Asia is 3% of estimated need. Lenacapavir, a highly efficacious new six-monthly long-acting injectable (LAI) PrEP option, could bridge this gap.</p><p><strong>Methods: </strong>Data were derived from PrEP APPEAL, an online cross-sectional survey among HIV-negative men who have sex with men (MSM) and transgender women (TGW) 18 years or older, in 15 and 11 Asian countries/territories, respectively, in May-November 2022. Survey items included PrEP awareness, willingness to use, and top preference for different PrEP products. Multivariable logistic regression examined factors associated with preference for a six-monthly LAI versus other PrEP products.</p><p><strong>Results: </strong>Among 15,099 MSM and 1233 TGW, PrEP awareness was 80.1% and 77.9%, respectively. Willingness to use PrEP was 92.2% and 96.4% in MSM and TGW, respectively, while willingness to use a six-monthly LAI was 33.8% and 31.6%, compared with 60.6% and 59.6%, respectively, for oral PrEP, and varied substantially between countries. A six-monthly LAI was the top preference for 18.8% and 20.6% of MSM and TGW, lower than oral PrEP at 43.7% and 47.8%, respectively. Substantial variation was observed between countries, with the lowest willingness in Cambodia (19.9% for MSM and 11.8% for TGW), while in Singapore (42.1%) and Malaysia (54.6%) among MSM and TGW, respectively.</p><p><strong>Conclusions: </strong>Approximately one-third of Asian MSM and TGW were willing to use six-monthly LAI-PrEP, and it was the top preference for almost 20%. Offering a six-monthly LAI PrEP as an additional prevention choice could increase PrEP coverage and help meet unmet PrEP demand in Asia.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"649-654"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Dual Burden of Stigma in People With Multidrug-Resistant Tuberculosis and HIV co-infection in South Africa: A mixed-methods, Prospective Cohort Study.","authors":"Karl Reis, Xuan Lu, Boitumelo Seepamore, Allison Wolf, Mbali Zulu, Hlengiwe Nyilana, Kevin Guzman, Ken Cheung, Gerald Friedland, Jacquelyn Yushkov, Rubeshan Perumal, Kogieleum Naidoo, Nesri Padayatchi, Amrita Daftary, Jennifer Zelnick, Max R O'Donnell, K Rivet Amico","doi":"10.1097/QAI.0000000000003835","DOIUrl":"10.1097/QAI.0000000000003835","url":null,"abstract":"<p><strong>Background: </strong>Addressing stigma is a key priority of the WHO End TB Strategy. However, gaps persist in our understanding of stigma associated with multidrug/rifampin-resistant tuberculosis (MDR/RR-TB), particularly in people living with HIV.</p><p><strong>Methods: </strong>Adults with MDR/RR-TB and HIV on antiretroviral therapy and starting bedaquiline-containing regimens in KwaZulu-Natal, South Africa, were prospectively enrolled. TB- and HIV-related stigma were evaluated using adapted questionnaires, with exploratory factor analysis (EFA) to develop stigma scales. In-depth interviews were recorded in isiZulu, translated into English, coded, and thematically analyzed.</p><p><strong>Results: </strong>From 2018 to 2020, 113 participants completed stigma questionnaires. EFA identified 6-item MDR/RR-TB and HIV stigma scales capturing internal and external stigma (Cronbach alpha 0.86 and 0.83). Stigma related to MDR/RR-TB and HIV was reported by 49.6% (56/113) and 33.7% (37/113) of participants, respectively. In adjusted models, female sex, unemployment, and hospitalization were associated with HIV-related stigma, and alcohol use was associated with TB-related stigma. HIV- and MDR/RR-TB-related external stigma were associated with mortality (hazards ratio 3.14 [95% CI: 0.91 to 10.78]), 3.75 (95% CI: 1.14 to 12.35). Qualitative analysis revealed that TB stigma stemmed from fear of infection and led to social isolation and economic loss. HIV stigma was driven by mistrust. Participants demonstrated greater resilience against HIV-related stigma compared with MDR/RR-TB stigma.</p><p><strong>Conclusion: </strong>Among MDR/RR-TB and people living with HIV in South Africa, MDR/RR-TB-related stigma exceeded HIV-related stigma and external stigma was associated with increased mortality. Strategic efforts to address stigma, particularly for key and vulnerable populations, is critical to advancing human rights and improving treatment outcomes.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"586-596"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial DNA Patterns Among Individuals Living With HIV-1 on Dolutegravir With Hyperglycemia.","authors":"Allan Buzibye, Ahmet Hoke, Robert C Bollinger, Denis Omali, Sangwon F Kim, Ik-Rak Jung, Eva Laker, Bernard S Bagaya, Barbara Castelnuovo, Yukari C Manabe","doi":"10.1097/QAI.0000000000003838","DOIUrl":"10.1097/QAI.0000000000003838","url":null,"abstract":"","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"e13-e15"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109531","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":"Brief Report: National HIV Molecular Cluster Detection Supports Local Cluster Detection.","authors":"Kevin Johnson, Rachael Billock, Camden Hallmark, Anne Marie France, Mary Plaster, Nivedha Panneer","doi":"10.1097/QAI.0000000000003839","DOIUrl":"10.1097/QAI.0000000000003839","url":null,"abstract":"<p><strong>Introduction: </strong>CDC and state/local health departments analyze HIV sequences to identify molecular clusters representing rapid transmission. Local analyses can be timelier, but are limited to sequences available in the local surveillance system, and thus may miss all or part of clusters spanning multiple jurisdictions. We assessed the added value of national analyses for clusters missed or only partially detected by local analyses.</p><p><strong>Methods: </strong>We reviewed national quarterly analyses of HIV sequences (September 2021-June 2023) that identified priority clusters (defined as ≥5 diagnoses in the past 12 months within a genetic distance of ≤0.005 substitutions per site among people with HIV diagnosed during the most recent 3 years). For each cluster, we simulated whether and when single-jurisdiction analysis would meet priority threshold and calculated the proportion of cluster members that could be identified locally.</p><p><strong>Results: </strong>Of 149 clusters detected in the national analysis, 91 clusters (61%) would have been detected concurrently by local analysis, 27 (18%) would have delayed detection (median: 59 days), and 31 (21%) would not have been detected locally. In clusters detected by both approaches, an average of 91% of cluster members identified in the national analysis would have also been identified in the local analysis.</p><p><strong>Conclusions: </strong>National analyses detected clusters that local analyses missed, identified additional cluster members, and found certain clusters earlier. National cluster detection plays a vital role in enhancing local detection activities.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"571-574"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109556","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":"Real-World Positive Predictive Value and False Positive Rates of Laboratory-Based HIV Antigen/Antibody Testing by Age and Sex-United States, 2019-2024.","authors":"Weiming Zhu, Patricia Bessler, Allison Lale, Kevin Delaney, Jesse O'Shea, Ya-Lin A Huang, Athena P Kourtis, Karen W Hoover","doi":"10.1097/QAI.0000000000003823","DOIUrl":"10.1097/QAI.0000000000003823","url":null,"abstract":"<p><strong>Background: </strong>The Centers for Disease Control and Prevention (CDC) recommends testing for HIV using a laboratory-based HIV antigen/antibody (Ag/Ab) test with confirmatory testing for reactive results. However, the positive predictive value (PPV) of screening may vary across populations with differing HIV prevalence. We evaluated age- and sex-specific false positive rates (FPRs) and PPV of HIV Ag/Ab tests in a large real-world national laboratory data set.</p><p><strong>Methods: </strong>Data from the Quest Diagnostics national HIV laboratory database from January 2019 through June 2024 were analyzed. Excluding persons with prevalent HIV infection, we examined the completed CDC diagnostic algorithm results to assess performance of HIV Ag/Ab screening tests. FPR and PPV of the Ag/Ab test were estimated by year, sex, age, and census region.</p><p><strong>Results: </strong>Among 21.9 million HIV Ag/Ab tests, the overall FPR was 0.14% [95% confidence interval (CI): 0.14 to 0.14], with higher FPRs among older adults (0.22% for aged 65-74 years and 0.27% for ≥75 years). The overall PPV was 68.4% (95% CI: 68.1 to 68.7). PPV was lowest among adolescents, at 26.7% (95% CI: 19.1 to 34.3) for those aged 13-14 years and 31.9% (95% CI: 29.1 to 34.6) for those aged 15-17 years. Low PPVs were also observed among women of childbearing age (15-44 years) and persons aged ≥75 years.</p><p><strong>Conclusions: </strong>Real-world PPV of HIV Ag/Ab testing varies substantially across age and sex groups, suggesting that the opt-out routine screening strategy may be less efficient among young adolescents aged 13-14 years and persons aged ≥75 years. CDC recommends HIV testing when clinical suspicion or individual risk is present.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"513-519"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795985","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":"Anxiety Symptom Ratings Before and During the Interruption of Antiretroviral Therapy as Part of HIV Cure-related Studies.","authors":"John A Sauceda, Nadra Lisha, Ali Ahmed, Fang Wan, Rebecca Hoh, Michael Peluso, Karine Dubé","doi":"10.1097/QAI.0000000000003834","DOIUrl":"10.1097/QAI.0000000000003834","url":null,"abstract":"<p><strong>Background: </strong>An analytical treatment interruption (ATI) is a critical component of HIV cure research, allowing researchers to assess potential strategies aimed at durable antiretroviral treatment-free viral control. However, pausing antiretroviral treatment during an ATI may lead to uncertainty and psychological distress. Limited empirical data exist on the mental health impact of an ATI, specifically anxiety symptoms.</p><p><strong>Methods: </strong>We conducted a longitudinal study to assess self-reported anxiety levels before and during an ATI in two HIV cure-related research studies at the University of California, San Francisco. Study 1 was an observational ATI study (NCT04359186), whereas study 2 was an interventional HIV cure trial (NCT04357821). Anxiety was measured at multiple time points using the Generalized Anxiety Disorder-7 and the State-Trait Anxiety Inventory. We analyzed changes in anxiety scores over time using interrupted time-series models.</p><p><strong>Results: </strong>In study 1, anxiety was elevated at baseline and gradually declined over time but remained within the mild severity range. In study 2, anxiety increased significantly from before the ATI and during ATI, with higher peak anxiety levels compared with study 1. Anxiety was highly prevalent in both studies and increased during the ATI in study 2.</p><p><strong>Conclusions: </strong>The uncertainty with an ATI may contribute to increased mild anxiety. However, this uncertainty can be measured and with resources, easily addressed to reduce risks for psychological harm.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"496-502"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014167","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":"Availability of Screening for Blood-Borne Viruses, Sexually Transmitted Infections, and HIV Pre-Exposure Prophylaxis at US Substance Use Treatment Facilities Treating Stimulant Use Disorder.","authors":"Samuel R Bunting, Nitin Vidyasagar, Jessica Wang, Raj Shetty, Aniruddha Hazra","doi":"10.1097/QAI.0000000000003833","DOIUrl":"10.1097/QAI.0000000000003833","url":null,"abstract":"<p><strong>Objective: </strong>Stimulant misuse is associated with greater incidence of HIV, Hepatitis C virus (HCV), and sexually transmitted infections (STIs). Substance use treatment facilities are an important site of care for people with stimulant use disorder (StUD). Accessible testing for HIV, HCV, and STIs, and HIV treatment, pre-exposure prophylaxis (PrEP), and HCV treatment are essential for controlling these syndemics.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of the 2024 National Substance Use and Mental Health Services Survey (N-SUMHSS) to describe availability of HIV, HCV, and STI testing, and HIV treatment, PrEP, and HCV treatment at substance use treatment facilities treating StUD. In addition, we compared the percentage of facilities with each service available between 2021 and 2024.</p><p><strong>Results: </strong>Of included facilities (N = 12,118), HIV testing was available at 36.2%, HCV testing at 35.1%, STI testing at 31.0%. HIV treatment was available at 15.9%, PrEP at 11.2%, and HCV treatment at 17.9% of facilities. Of facilities that did not offer HIV or HCV testing, 9.50% and 8.60% had the capacity to collect blood samples, respectively. Of facilities without available STI testing, 87.2% had the capacity to collect urine samples. There were 759 facilities with HIV and 1063 with HCV treatment without PrEP availability. Between 2021 and 2024, the percentage with each service increased, however, the gaps between service availability also remained constant.</p><p><strong>Conclusions: </strong>Few substance use treatment facilities provided HIV, HCV, and STI testing, PrEP, and treatment. Yet, many collect biospecimens required for testing or management of PrEP. Expansion of these services and colocation with treatment facilities are crucial strategies for prevention, early diagnosis, and timely treatment of HIV, HCV, and STI in individuals with StUD.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"503-512"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss to Follow-Up and Visit Nonadherence in an HIV Incidence Cohort in Kisumu, Kenya.","authors":"Elisavet Serti, Danielle Bartolanzo, Seth Frndak, John Owuoth, Adam Yates, Tyler Hamby, Chiaka Nwoga, June Otieno, Hunter J Smith, Glenna Schluck, Christina S Polyak, Valentine Sing'oei, Trevor A Crowell","doi":"10.1097/QAI.0000000000003825","DOIUrl":"10.1097/QAI.0000000000003825","url":null,"abstract":"<p><strong>Background: </strong>Adherence to study visits enhances safety and validity of human research studies. We identified characteristics associated with missed visits in a Kenyan HIV incidence study to inform retention strategies.</p><p><strong>Methods: </strong>We enrolled volunteers 18-35 years of age, without HIV, who reported 2+ sex partners into a study with visits every 3 months for 24 months. We used zero-inflated Poisson regression to assess sociobehavioral and demographic characteristics associated with missed visits and loss-to-follow-up. Latent class analysis (LCA) identified clusters of characteristics associated with each outcome.</p><p><strong>Results: </strong>Among 619 participants without HIV, 278 (44.9%) were women with median age of 24 years (interquartile range: 21-28). During follow-up, 134 (21.6%) missed 1+ and 84 (13.6%) missed 2+ visits. Missed visits were more common among participants with 3+ sexual partners than among 2 partners (adjusted risk ratio: 1.50, 95% confidence interval: 1.13 to 1.97) and less common in participants who completed secondary school (aRR: 0.74, 95% CI: 0.56 to 0.99, compared with some primary school or less). Women were more likely to be lost to follow-up (aRR: 1.85, 95% CI: 1.05 to 3.26). LCA showed that missed visits were more likely among women aged 24+ years with less than secondary education who reported transactional sex than among largely younger unmarried men with less than secondary education and 3+ sexual partners (RR: 1.24, 95% CI: 1.01 to 1.54) and poorly educated, largely older married men (RR: 1.41, 95% CI: 1.05 to 1.90).</p><p><strong>Conclusion: </strong>Older unmarried women with less education, more sexual partners, and transactional sex may benefit from targeted retention strategies such as optimizing accessibility to testing and prevention services and frequent visit reminders.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"526-533"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835810","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":"Diagnostic Performance of Fatty Liver Index for Hepatic Steatosis and its Association With Fibrosis in People Living With HIV.","authors":"Ahmed Cordie, Ahmed M Kamel, Rahma Mohamed, Shimaa Mohamed Ebrahim, Lamiaa Al Sehemy, Naeema El Garhy, Andrew Saweres, Mohamed S Nagy, Remon Atef, Aya M Al-Sharif, Awad Reham Awad, Engy El Khateeb, Gamal Esmat","doi":"10.1097/QAI.0000000000003809","DOIUrl":"10.1097/QAI.0000000000003809","url":null,"abstract":"<p><strong>Introduction: </strong>Steatotic liver disease (SLD) and liver fibrosis are significant comorbidities in people living with HIV (PLHIV). Early detection is essential for effective management. This study evaluated the utility of the Fatty Liver Index (FLI) in detecting hepatic steatosis (HS) using Controlled Attenuation Parameter (CAP) measurements as the reference.</p><p><strong>Methods: </strong>This cross-sectional study included 446 PLHIV recruited from Cairo University Hospitals. HS was defined as CAP values exceeding 248 dB/m. FLI cut-off points were determined using the Youden index with bootstrapping validation. Performance metrics and kappa concordance statistics were calculated.</p><p><strong>Results: </strong>The study cohort (78.7% male, median age 35) showed HS in 27.1% (n = 121) and significant liver fibrosis in 6.5% (n = 29). Optimal FLI cut-off of 45 yielded 71% sensitivity and 72% specificity (receiver operating characteristic = 0.77), while the 60 cut-off provided 57% sensitivity and 80% specificity. Despite similar overall prevalence estimates between methods (30.3% by FLI vs. 27.1% by CAP), significant discordance existed (P < 0.001) with only low-moderate agreement (73.5% agreement, κ = 0.465). Nearly half (49%) of participants with CAP-defined HS were misclassified as having no SLD when using FLI. Importantly, HS was associated with significant liver fibrosis when identified by CAP (P < 0.05) but not when identified by FLI (κ = 0.078, P > 0.05).</p><p><strong>Conclusion: </strong>FLI demonstrates substantial limitations as a screening tool for HS in people living with HIV, missing nearly half of CAP-defined cases. The poor concordance with CAP and particularly weak performance in lean individuals-who represent a significant proportion of PWH-indicate that FLI cannot reliably identify HS in this population and should not be used as a standalone diagnostic tool.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":"101 5","pages":"547-554"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lost and Not Found: Determinants and Patterns of Loss to Follow-Up Among Men Who Have Sex With Men in the Dutch HIV Pre-Exposure Prophylaxis Pilot Program.","authors":"Daphne A van Wees, Danja Sarink, Birgit H B van Benthem, Karlijn Kampman, Colette van Bokhoven, Fleur van Aar","doi":"10.1097/QAI.0000000000003818","DOIUrl":"10.1097/QAI.0000000000003818","url":null,"abstract":"<p><strong>Introduction: </strong>One of the challenges of a national HIV pre-exposure prophylaxis (PrEP) program is continuation of PrEP use and retention in care. The aim of this study was to explore determinants of loss to follow-up (LTFU) among men who have sex with men (MSM) in the Dutch national PrEP pilot program.</p><p><strong>Methods: </strong>Data from the national STI surveillance database between July 1, 2019, and December 31, 2022, were used of all 3-monthly PrEP pilot consultations among MSM who had at least 2 consultations. LTFU was defined as having no consultation for ≥7 months, and was further divided into \"missed consultation/restarted\" and \"definitive LTFU.\" We used mutually adjusted, multivariable, multistate, time-homogenous Markov models to analyze demographic and behavioral associations with LTFU.</p><p><strong>Results: </strong>A total of 8948 participants (62,158 consultations) were included, of which 30% were LTFU at some point. Young participants and on-demand/nonrecent PrEP users (ie, in the past 3 months) were more likely to become LTFU. Participants who had ≥6 partners (vs 0-2) in the past 6 months or were ≥25 years of age (vs <25) were less likely to become LTFU. In addition, non-Dutch origin was associated with missed consultation/restarted and definitive LTFU. Furthermore, having had no (condomless) anal sex in the past 6 months was associated with missed consultation/restarted.</p><p><strong>Conclusions: </strong>Specific characteristics of MSM who were LTFU, such as young age, non-Dutch origin, and on-demand PrEP use, may be used to implement targeted interventions to increase PrEP retention and possibly prevent new HIV infections among PrEP users.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"455-463"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777088","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}