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

{"title":"Influence of Housing Status on Health Outcomes for Reproductive-Age Women With and Without HIV in the Southern United States.","authors":"Shreya Ganguly, Olivia Christman, Qian Yang, Christina Mehta, Tina Tisdale, Ayako Wendy Fujita, Deborah Konkle-Parker, Maria L Alcaide, Aadia Rana, Seble Kassaye, Elizabeth Topper, Daniel Westreich, Anandi N Sheth","doi":"10.1097/QAI.0000000000003722","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003722","url":null,"abstract":"<p><strong>Background: </strong>Housing instability is a modifiable determinant of health outcomes among people with HIV. Reproductive-age women face unique challenges and are underrepresented in HIV research. We characterized housing status among reproductive-age women with and without HIV (WWH/WWoH) and evaluated its associations with health outcomes.</p><p><strong>Setting: </strong>The Study of Treatment and Reproductive Outcomes (STAR) examines women ages 18-45 years old with and without HIV in six Southern US sites.</p><p><strong>Methods: </strong>We analyzed baseline data from March 2021-August 2023. We compared demographic, psychosocial, and clinical characteristics by HIV and housing status. We examined associations between housing status and health outcomes using logistic regression models, adjusting for age, race, socioeconomic status, depressive symptoms, and illicit drug use.</p><p><strong>Results: </strong>Among 759 women (473 with HIV, 286 without HIV), 64.4% had stable housing, 28.9% had dependent housing, and 6.9% had unstable housing. In adjusted models, unstably/dependently housed women were significantly less likely to attend a healthcare visit in the last year compared to stably housed women (OR 0.40, Cl 0.18-0.90). Unstably/dependently housed WWH were significantly more likely to miss at least one HIV visit in the past year (OR 2.35, Cl 1.02-5.41) and be virally non-suppressed (OR 2.92, Cl 1.08-7.87) than stably housed WWH.</p><p><strong>Conclusion: </strong>Housing instability was associated with adverse health outcomes, even after adjusting for traditional sociodemographic and psychosocial risk factors. This emphasizes its role as a key health determinant that must be addressed. Further research to assess the potential pathways for this association will inform acceptable and scalable housing interventions to improve outcomes for reproductive-age women.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652055","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":"Entering HIV Medical Care with AIDS in the Era of Immediate Access to Antiretroviral Treatment.","authors":"Allan E Rodriguez, Valeria Botero, Anjalie Geffrard, Russell G Saltzman, Victoria Alvarez, Michael A Kolber","doi":"10.1097/QAI.0000000000003725","DOIUrl":"10.1097/QAI.0000000000003725","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in rapid HIV care access, a significant portion of people living with HIV (PLWH) still enter care with advanced disease (AIDS). Test and Treat/ Rapid Access (TTRA) programs focused on rapid detection and treatment are widespread in the US. However, a significant proportion of patients enter care through the traditional standard of care where, after a case manager evaluation an initial appointment is generated for an HIV provider, a process that could take 2-4 weeks.</p><p><strong>Objectives: </strong>This study conducted at the University of Miami/JMH (UM/JMH) Adult HIV Outpatient Clinic-the largest single-site clinic in Miami Dade, a central hub of the HIV epidemic-analyzes individuals that enrolled during the initial two years of our TTRA program.</p><p><strong>Methods: </strong>We compared the clinical outcomes of patients diagnosed with AIDS entering through the TTRA versus those using the Standard of Care (SOC).</p><p><strong>Results: </strong>Our findings indicate substantial improvements in HIV viral loads and CD4 counts for both groups. However, patients entering through SOC, who were more likely to have had prior hospitalizations due to opportunistic infections, tended to be older and predominantly contracted HIV through heterosexual transmission. In contrast, those entering TTRA experienced quicker virologic suppression and superior immunologic recovery.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652053","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":"Effectiveness of a national reflex laboratory cryptococcal antigen screening programme for people with advanced HIV disease in South Africa: a nationwide-sampled cohort study (CAST-NET).","authors":"Nelesh P Govender, Greg S Greene, Kathy Huppler Hullsiek, Daniel DeSanto, Ananta S Bangdiwala, Rudzani Mashau, Charlotte Sriruttan-Nel, Caleb P Skipper, David R Boulware, Radha Rajasingham","doi":"10.1097/QAI.0000000000003724","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003724","url":null,"abstract":"<p><strong>Background: </strong>Cryptococcal antigen (CrAg) screening and pre-emptive treatment of antigenaemia can reduce mortality among people living with HIV.</p><p><strong>Setting: </strong>We evaluated the effectiveness of a national CrAg screening program in South Africa.</p><p><strong>Methods: </strong>We enrolled a retrospective cohort of adults aged ≥18 years with a CD4 count <100 cells/µL and antigenaemia at 442 facilities in a stratified-random sample of 27 sub-districts, 2017-2019. We determined a composite outcome of incident cryptococcal meningitis or death through 6-months.</p><p><strong>Results: </strong>Overall, 99% (85,791/86,274) of eligible patients had CrAg testing in the study sub-districts; 5,124 (6.0%) tested CrAg-positive. Among 1,651 with imaged medical records and without concurrent meningitis, 76% (1,261/1,651) were outpatients. CrAg results were documented in records for 75% (1,245/1,651). Only 39% (649/1,651) had a meningitis symptom review documented at a median of 14 days (IQR, 5-44) from their CrAg blood draw. Fluconazole was dispensed for 50% (827/1,651) but only 32% (523/1,651) had an adequate daily dose of ≥800 mg dispensed. The proportion with meningitis or death within 6-months was 23% (382/1,651; 95%CI, 19%-27%). Hospitalised patients had a 2.29 higher adjusted odds of meningitis/death within 6-months versus outpatients (95% CI, 1.72-3.04; p<0.001).</p><p><strong>Conclusion: </strong>Nationwide reflex laboratory CrAg screening was successfully implemented. However, challenges existed for healthcare providers to act on positive CrAg results to exclude meningitis and dispense pre-emptive antifungal therapy. Our findings emphasise the critical need for improved linkage from reflex CrAg screening to clinical care, in both ambulatory and in-patient settings, to maintain the effectiveness of this intervention.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645204","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":"Adults Aged ≥50 Years Reached by the CDC's HIV Programs Including HIV Testing, PrEP Referrals, and Linkage to Care in the U.S., Puerto Rico, and the U.S. Virgin Islands, 2019-2022.","authors":"Mariette Marano-Lee, Weston Williams, Songli Xu, Gary Uhl","doi":"10.1097/QAI.0000000000003723","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003723","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults (defined as adults who are 50 and over) accounted for 1 in 6 persons newly diagnosed with HIV in 2022. The objectives of this analysis were to present the most currently available data about older adults reached by the Centers for Disease Control and Prevention's (CDC) HIV programs.</p><p><strong>Methods: </strong>From 2019 through 2022, CDC funded 61 health departments and 160 community-based organizations in the United States and Puerto Rico and the U.S. Virgin Islands to provide HIV testing, pre-exposure prophylaxis (PrEP) referrals, and linkage to HIV medical care and report on their program outcomes to CDC. We conducted descriptive analysis as well as multivariable robust Poisson regression analysis to assess the association between demographic characteristics and outcomes of HIV tests among older adults.</p><p><strong>Results: </strong>Between 2019 and 2022, the percentage of CDC-funded HIV tests provided to older adults increased, (16.9% in 2019, 17.3% in 2020, 18.3% in 2021, and 18.4% in 2022). In 2022, older adults accounted for 11% of new diagnoses. Among those, (876), 779 people had linkage data, and of those, 579 (74.1%) were linked to HIV medical care within 30 days after diagnosis. Of those older adults with a negative test result and available data, 90,422 (41.3%) were eligible for a PrEP referral and 39,382 (44.3%) were referred to a PrEP provider.</p><p><strong>Discussion: </strong>Continued efforts are needed to provide focused HIV prevention messaging specifically for older adults and to make available relevant information about HIV to health care providers.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629432","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":"Prenatal Antiretroviral Exposure and Concomitant Neurodevelopmental Problems among 5-year-old Children who are HIV-Exposed and Uninfected.","authors":"Tzy-Jyun Yao, Joel Zhang, Kathleen Malee, Renee Smith, Mabel L Rice, Sean M Redmond, Paige L Williams","doi":"10.1097/QAI.0000000000003720","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003720","url":null,"abstract":"<p><strong>Background: </strong>Atazanavir (ATV) has been a preferred protease inhibitor prescribed to pregnant women with HIV, often given with tenofovir disoproxil fumarate (TDF)/emtricitabine. Studies have reported associations of prenatal exposure to ATV with early neurodevelopmental problems among children HIV-exposed but uninfected (CHEU).</p><p><strong>Setting: </strong>Prospective US-based multisite cohort study of CHEU.</p><p><strong>Methods: </strong>Monolingual English-speaking CHEU from the Surveillance Monitoring for ART Toxicities study were evaluated for cognition, language and behavior at age 5 years. Exploratory factor analyses using ten composite scores were performed to estimate underlying factors reflecting covariation of these domains. Mean differences of standardized factor scores were compared between CHEU exposed to TDF/emtricitabine with/without ATV versus zidovudine/lamivudine without ATV using linear generalized estimating equations, adjusting for confounders and accounting for clustering by site. Separate analyses were conducted by timing of maternal ART initiation (pre-conception versus post-conception).</p><p><strong>Results: </strong>585 CHEU were exposed to TDF/emtricitabine with/without ATV, or zidovudine/lamivudine without ATV, and had valid composite scores. Two factors were identified, explaining 27-88% variability of individual composite scores. Factor 1 contributed to cognitive and language domains; Factor 2 contributed to the behavioral domain. Differences in factor scores among ART exposure groups were not observed for cognition/language, but CHEU exposed to TDF/emtricitabine with/without ATV had worse behavioral functioning factor scores compared to zidovudine/lamivudine without ATV in the post-conception strata, especially for those exposed to TDF/emtricitabine/ATV when ARVs were initiated in trimester 1.</p><p><strong>Conclusion: </strong>Prenatal exposure to TDF/emtricitabine/atazanavir was associated with factor scores reflecting parent-reported behavioral concerns among CHEU whose mothers initiated ARVs during pregnancy.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478482","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":"Preferences for HIV PrEP Products and Delivery Models Among Cisgender Men, Transgender Persons, and Non-binary Individuals Who Have Sex with Men in Seattle, Washington: A Discrete Choice Experiment.","authors":"Lauren R Violette, Jakar Delacruz, Lisa A Niemann, Chase Cannon, Joanne D Stekler, David A Katz","doi":"10.1097/QAI.0000000000003718","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003718","url":null,"abstract":"<p><strong>Background: </strong>Understanding preferences for HIV pre-exposure prophylaxis (PrEP) products and delivery models could better meet the needs of populations likely to benefit from PrEP and ultimately increase uptake.</p><p><strong>Setting: </strong>Public Health - Seattle & King County Sexual Health Clinic.</p><p><strong>Methods: </strong>Between August 2022-December 2023, a convenience sample of individuals seeking HIV testing and participating in Project DETECT2 completed a discrete choice experiment (DCE). We used a D-efficient blocked fractional design and asked participants to choose between two hypothetical PrEP options composed of five attributes (modality, efficacy, dosing frequency, prescriber, and monitoring appointment format). We used multinomial logistic regression to estimate preference weights and relative importance overall and stratified by PrEP experience.</p><p><strong>Results: </strong>325 participants completed the DCE; 96 (29.5%) were PrEP-naïve and 229 (70.5%) were PrEP-experienced. Ninety-nine percent efficacy (weight=0.848, 95%CI= 0.769-0.927), 6-month dosing interval (weight=0.381, 95%CI= 0.293-0.469) and pills (weight=0.173, 95%CI= 0.085-0.261) were most preferred. There was a strong preference for PrEP delivery within a pharmacy (weight=0.144, 95%CI= 0.059-0.228) or community-based organization (weight=0.097, 95%CI= 0.011-0.183). Preference for combination online/in-person (weight=0.086, 95%CI= 0.017-0.154) and in-person only monitoring appointments (weight=0.061, 95%CI= -0.023-0.144) was similar. Efficacy had the highest relative importance (52.1%). Stratifying by PrEP experience did not change preference.</p><p><strong>Conclusions: </strong>Participants preferred products with high efficacy and longer dosing intervals delivered in non-clinical spaces with in-person or online follow-up appointments. These data suggest that, while highly efficacious, longer-acting products are preferred, a range of different modalities, prescribers, and monitoring methods may be needed to reach everyone who may benefit from PrEP.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478481","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":"Clinical documentation of social determinants of health and its relationship with COVID-19 outcomes among people with and without HIV.","authors":"Xueying Yang, Jiajia Zhang, Yunqing Ma, Shujie Chen, Rena C Patel, Daniela B Friedman, Brooks Yelton, Bankole Olatosi, Sharon Weissman, Xiaoming Li","doi":"10.1097/QAI.0000000000003717","DOIUrl":"10.1097/QAI.0000000000003717","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the clinical documentation of social determinants of health (SDoH) data and its associations with COVID-19 clinical outcomes among people with HIV (PWH) and people without HIV (PWoH) in the United States (US) using the nationally sampled electronic health records (EHR) repository called the National COVID Cohort Collaborative (N3C).</p><p><strong>Methods: </strong>Information on all adult COVID-19 cases was retrieved in the N3C platform from 2020 through 2023. Under the Super-Utilizer Model, we categorized SDoH measures (identified by ICD-10-CM diagnosis codes [\"Z codes\"]) into different domains, i.e., community/social domain, socioeconomic domain, and environmental domain. Logistic regression models were employed for analysis.</p><p><strong>Results: </strong>Among 41,759 PWH and 6,795,369 PWoH with a COVID-19 infection, 49.8% and 24.0% had at least one Z code documented in the EHR, respectively. For both PWH and PWoH, problems related to employment and housing in the socioeconomic domain and problems related to legal and psychosocial circumstances in the community/social domain were the most commonly documented Z codes associated with severe COVID-19 outcomes; while problems related to upbringing in community/social domain and economic issues in socioeconomic domain were associated with reduced risk of severe COVID-19 outcomes.</p><p><strong>Conclusion: </strong>While documented Z code associations with severe COVID-19 outcomes were similar between PWH or PWoH, they varied between SDoH factors. Identification of Z code associations with severe COVID-19 related outcomes allows for intervention at the population health level, and even more broadly for tracking and resource allocation by public health officials or policymakers.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334806","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":"Impact of Depressive Symptom Severity on Stroke Risk in a US Cohort of People with HIV.","authors":"Jimmy Ma, Robin M Nance, Stephanie A Ruderman, Lydia N Drumright, L Sarah Mixson, Felicia C Chow, Joseph Zunt, Christina M Marra, Maile Karris, Emily L Ho, Kyra Becker, Rizwan Kalani, Andrew Huffer, Rob Fredericksen, Sonia Napravnik, Richard D Moore, Barbara Gripshover, Amanda Willig, Jacklyn D Foley, Greer Burkholder, Michael S Saag, Katerina Christopoulos, Mari M Kitahata, David Tirschwell, Joseph A C Delaney, Heidi M Crane","doi":"10.1097/QAI.0000000000003710","DOIUrl":"10.1097/QAI.0000000000003710","url":null,"abstract":"<p><strong>Background: </strong>Depression is a common psychiatric condition and an independent stroke risk factor among people with HIV (PWH). The impacts of depressive symptom severity on stroke are not clear in PWH.</p><p><strong>Methods: </strong>We studied adult PWH in clinical care at five CNICS sites with ≥1 assessment for depressive symptoms (PHQ-9) from 2010-2022. We used Cox models to evaluate: (1) associations between time-varying depressive symptom severity and adjudicated incident stroke, serially adjusted for clinical factors; (2) modification of this association by age and sex. Participants were followed from 6 months after first CNICS visit or date the CNICS site began stroke adjudication (baseline) (whichever later) until the first stroke, death, loss to follow-up, last clinic visit, or study end.</p><p><strong>Results: </strong>Among 13,817 PWH (mean age 45 years, 19% female, 58% non-white race/ethnicity), 23% screened positive for depression at baseline and 173 had an incident stroke during follow up (mean follow-up 7.6 years). Time-varying depressive symptom severity (per 5-points PHQ-9 score) was associated with higher stroke risk (aHR 1.16, P=0.01) with greater impact in PWH <50y than ≥50y (Interaction P=0.02) but no significant difference by sex. Adjusting for combinations of sociodemographic, cardiovascular, HIV, and substance use factors only slightly attenuated estimates.</p><p><strong>Conclusions: </strong>Depressive symptom severity was an independent risk factor for stroke with higher severity depressive symptoms predicting higher stroke risk and greater impact in PWH <50 years. Depression may be a modifiable risk factor for stroke and should be studied further to understand, develop, and target interventions to reduce stroke risk, especially in younger PWH.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334808","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":"Mycobacterium tuberculosis Infection and Acute or Subclinical Coronary Artery Disease: the Swiss HIV Cohort Study.","authors":"Anina Hilfiker, Isabella C Schoepf, Emma F Avery, Bruno Ledergerber, Eugénie Colin-Benoit, Carlotta Riebensahm, Catia Marzolini, Christian R Kahlert, Enos Bernasconi, Matthias Cavassini, Annalisa Marinosci, Huldrych F Günthard, Roger Kouyos, Johannes Nemeth, Philip E Tarr","doi":"10.1097/QAI.0000000000003714","DOIUrl":"10.1097/QAI.0000000000003714","url":null,"abstract":"<p><strong>Background: </strong>In tuberculosis medium/high prevalence countries, Mycobacterium tuberculosis (MTB) infection has been associated with acute coronary artery disease (CAD) events and subclinical atherosclerosis. We aimed to examine whether MTB infection contributes to clinical and subclinical CAD in people with HIV (PWH) in tuberculosis low incidence settings.</p><p><strong>Methods: </strong>Regarding CAD events, cases were Swiss HIV Cohort Study (SHCS) participants with a first CAD event (2000-2022). CAD-free SHCS controls were matched on sex, age and observation time. Regarding subclinical atherosclerosis, SHCS participants underwent (2013-2019) non-contrast CT for detection of coronary artery calcification (CAC) and coronary CT angiography (CCTA) for the detection of coronary soft, mixed, or high-risk plaque (SMHRP). We obtained univariable/multivariable odds ratios (OR) for CAD events, CAC, and SMRHP, in participants with negative TB status, MTB infection, and active TB, analyzed in the context of traditional and HIV-related CAD risk factors.</p><p><strong>Results: </strong>We included 465 patients with acute CAD events and 1123 controls (median age 56 years, 14% women, 86% with suppressed HIV RNA). MTB infection was not associated with CAD events in multivariable analysis (odds ratio [95% confidence interval], 0.92 [0.55-1.52]) vs. participants with negative TB status. In 402 participants undergoing CAC/CCTA (median age 53 years, 14% women, 96% with suppressed HIV RNA), MTB infection was not associated with SMHRP (OR=0.55 [0.19-1.55]) or with CAC (OR=0.38 [0.1-1.41]) in multivariable analysis.</p><p><strong>Conclusions: </strong>In PWH in Switzerland, a tuberculosis low prevalence country, we found no evidence of any association between MTB infection and acute CAD events or subclinical coronary atherosclerosis.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334809","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":"Young men's experiences of violence and poverty and the relationship to sexually transmissible HIV: a cross sectional study from rural South Africa.","authors":"Andrew Gibbs, Esnat Chirwa, Guy Harling, Natsayi Chimbindi, Jaco Dreyer, Carina Herbst, Nonhlanhla Okesola, Ngundu Osee Behuhuma, Nondumiso Mthiyane, Kathy Baisley, Thembelihle Zuma, Theresa Smit, Nuala McGrath, Lorraine Sherr, Janet Seeley, Maryam Shahmanesh","doi":"10.1097/QAI.0000000000003709","DOIUrl":"10.1097/QAI.0000000000003709","url":null,"abstract":"<p><strong>Background: </strong>Young men are inadequately engaged in HIV prevention and treatment globally, including in South Africa, increasing the likelihood of them having sexually transmissible HIV (i.e. living with HIV but with high viral loads). We sought to understand how men's experiences of poverty and violence, impacted on transmissible HIV, directly or indirectly via mental health and substance misuse.</p><p><strong>Setting: </strong>Rural communities in northern KwaZulu-Natal, South Africa.</p><p><strong>Methods: </strong>Cross-sectional population-based sample (September 2018-June 2019), assessing transmissible HIV (living with HIV and viral load ≥400 copies/mL, compared to individuals either not living with HIV, or living with HIV and viral load <400 copies/mL) via dried blood spots, and socio-demographic data. Structural equation models (SEM), assessed direct and indirect pathways from food insecurity and violence experience to transmissible-HIV, with mediators common mental disorders, alcohol use, gender inequitable attitudes and perceptions of low life chances.</p><p><strong>Results: </strong>2,086 (ages 13-35 years) men and 8.6%(n=178) men had transmissible HIV. There was no direct pathway from food insecurity, or violence experience, to transmissible HIV. Low perceptions of life chances mediated the relationship between food insecurity and transmissible HIV. Additionally increased poor mental health, via increased alcohol use, also mediated these relationships.</p><p><strong>Conclusions: </strong>Transmissible HIV was common among young men. The analysis highlights the need to address the proximate 'drivers' of low perceptions of life chances and substance misuse, and men's experiences of poverty and violence. Building multicomponent interventions that engage these multiple challenges is critical for improving HIV among young men.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334811","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}