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

{"title":"Impact of implementation process on long-acting cabotegravir/rilpivirine prescription at 9 HIV clinics, 2021-2024.","authors":"Sita Lujintanon, Catherine R Lesko, Nel Jason L Haw, Matthew D Hickey, Lauren C Zalla, Christin Kilcrease, Janet Grochowski, Lucas A Hill, Edward R Cachay, Jehan Z Budak, Heidi M Crane, Julia Fleming, Kenneth H Mayer, Sarah E Rutstein, Barbarajean Turner, Christa Nevin, Greer A Burkholder, Nan Wang, George A Yendewa, Ryan Moss, April Pettit, Allan E Rodriguez, Mallory O Johnson, Katerina A Christopoulos","doi":"10.1097/QAI.0000000000003970","DOIUrl":"10.1097/QAI.0000000000003970","url":null,"abstract":"<p><strong>Background: </strong>Implementation of long-acting cabotegravir/rilpivirine (LA-CAB/RPV) has been challenging and may limit its uptake. We describe the number of people with HIV (PWH) prescribed LA-CAB/RPV at 9 US academic HIV clinics in the Center for AIDS Research Network of Integrated Clinical Systems and clinic-level variation in LA-CAB/RPV prescriptions.</p><p><strong>Methods: </strong>Using a sequential explanatory mixed methods design, we analyzed clinical cohort data of PWH prescribed LA-CAB/RPV, then conducted key informant surveys to ascertain each clinic's Exploration-Preparation-Implementation-Sustainment phase in conjunction with implementation determinants mapped to the Consolidated Framework for Implementation Research. We stratified the cohort analysis by phase.</p><p><strong>Results: </strong>Between 21-Jan-2021 and 30-Sep-2024, 1,451 (6%) of 22,379 PWH in care were prescribed LA-CAB/RPV. Among those prescribed, 15% had baseline viral load ≥200 copies/mL (200/1,451). Two sustainment-phase clinics that experienced fewer insurance-related barriers, planned prior to LA-CAB/RPV availability, had a pharmacy team coordinating LA-CAB/RPV services, and customized the electronic health record (EHR) system to track insurance approvals and/or injection appointments prescribed LA-CAB/RPV to 16% (924/5,638) of PWH in care. Four sustainment-phase clinics that had a mix of payor coverage and insurance plans, and adequate staffing prescribed to 3% (213/8,154). Three implementation-phase clinics with difficulty procuring LA-CAB/RPV due to restrictive insurance coverage and/or hospital policy and staffing challenges prescribed to 4% (314/8,587).</p><p><strong>Conclusions: </strong>Barriers related to insurance coverage and drug procurement impacted the number of PWH prescribed LA-CAB/RPV as did processes to plan for, and adapt to, these barriers. Scale-up efforts should consider team coordination and EHR-facilitated tracking to support the growing number of PWH on LA-CAB/RPV.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868888","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":"A Prospective, Youth-Led Mystery Shopper Assessment of Six Ending the HIV Epidemic Jurisdictions in Florida.","authors":"José A Bauermeister, Seul Ki Choi, Willey Lin, Andrea Cheshure, Rebecca Giguere, Sara K Shaw Green, Jonathan Morgan, Milo St Ives, Isaac Richardson, Iván C Balán, M Isabel Fernández, Sylvie Naar","doi":"10.1097/QAI.0000000000003969","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003969","url":null,"abstract":"<p><strong>Background: </strong>Ensuring culturally responsive HIV testing is essential to advancing the goals of the Ending the HIV Epidemic (EHE) initiative, particularly among young sexual minority men (YSMM), who continue to experience disproportionate HIV incidence.</p><p><strong>Methods: </strong>We conducted a youth-led mystery shopping study across six Florida counties between 2023 and 2025 to assess the quality of publicly funded HIV Counseling, Testing, and Referral (CTR) services. Using a validated assessment tool, trained YSMM completed 301 visits and evaluated site-level performance across ten domains.</p><p><strong>Results: </strong>While many sites demonstrated strengths in provider respect, visual inclusion, and PrEP information, consistent deficits emerged in safer sex counseling, relationship-centered dialogue, and medical form inclusivity across the state.</p><p><strong>Conclusions: </strong>Youth-led mystery shopping captured experiential aspects of service quality often missed by traditional metrics and surfaced actionable gaps in prevention counseling. Our findings offer a rigorous diagnostic of Florida's HIV prevention infrastructure, underscoring how community-engaged quality assurance methods might be embedded in EHE strategies to ensure services are accessible, affirming and effective for those most at risk.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868862","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":"Cellular immune response of COVID-19 vaccines in people living with HIV: a systematic review and meta-analysis.","authors":"Shi Zou, Yajun Yan, Jiuhong Ye, Jie Liu, Yuting Tan, Shihui Song, Qian Du, Jing Chen, Jinding Zheng, Songjie Wu, Ke Liang","doi":"10.1097/QAI.0000000000003961","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003961","url":null,"abstract":"<p><strong>Background: </strong>Available data indicate that people living with HIV (PLWH) have weaker humoral immune responses to COVID-19 vaccines compared to the general population. However, data on cellular immune responses in this group has yet to be established.</p><p><strong>Methods: </strong>We searched the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases and included studies reporting cellular immune response rates in PLWH after receiving COVID-19 vaccines. The random-effects models of proportions were performed.</p><p><strong>Results: </strong>Out of the 2,598 articles identified in the initial search, 18 studies met the inclusion criteria for the meta-analysis. Among these, 4 studies assessed cellular immune responses using the interferon-γ enzyme-linked immunospot assay (ELISPOT), 12 studies utilized the interferon-γ enzyme-linked immunosorbent assay (ELISA), and 2 studies employed flow cytometric analysis. Following second dose, 63% (95% CI 47-78%) of PLWH demonstrated a cellular immune response, which increased to 88% (95% CI 79-95%) after the third dose. Overall, the pooled response rates varied across assay types, with ELISPOT assays showing 86%, ELISA 73%, and flow cytometric analysis 73% in the respective pooled estimates. The pooled cellular immune response rates were comparable for mRNA and viral vector vaccines (81% vs 83%) but were significantly lower for inactivated vaccines (49%). A pooled odds ratio (OR) of 0.65 (95% CI 0.44-0.97) revealed a lower cellular immune response in PLWH compared to healthy controls.</p><p><strong>Conclusion: </strong>Although COVID-19 vaccines can significantly enhance and sustain a stable cellular immune response, this response remains lower in PLWH compared to healthy controls. Greater attention should be paid to the assessment of cellular immune responses among PLWH in future vaccination studies.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835634","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":"Factors associated with viral suppression and antiretroviral therapy adherence among adolescents and young adults living with HIV in the African Cohort Study.","authors":"Marie A Brault, Aima A Ahonkhai, Seth Frndak, Susannah Colt, Trevor A Crowell, Ajay Parikh, Emma R Duff, Valentine Sing'oei, John Owuoth, Jonah Maswai, Zahra Parker, Emmanuel Bahemana, Hannah Kibuuka, Sten H Vermund, Neha Shah, Julie A Ake","doi":"10.1097/QAI.0000000000003959","DOIUrl":"10.1097/QAI.0000000000003959","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents and young adults living with HIV (AYLHIV) experience poor outcomes across the care continuum, and most reside in sub-Saharan Africa. The African Cohort Study (AFRICOS) provides an opportunity to examine HIV outcomes in this population across Kenya, Nigeria, Tanzania, and Uganda.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of AYLHIV aged 15-29 years, enrolled in AFRICOS 2013-2023, and on antiretroviral therapy (ART) ≥ six months. Primary outcomes were HIV viremia and 30-day ART non-adherence. Factors included HIV acquisition route, ART duration, ART class, and site. We used multivariate robust Poisson regression to estimate relative risks (RRs) and 95% confidence intervals (CIs). Site directors were surveyed to assess youth-friendly services.</p><p><strong>Results: </strong>Among 656 participants, the median age was 20.0 years (IQR 17.5-23.3); 41.6% were male, 61.6% had perinatally-acquired HIV, and median duration since HIV diagnosis was nine years. At enrollment, 83.8% had viral suppression (<200 copies/mL) and 80.2% were ART adherent. ART regimen and clinic site were associated with viral suppression: youth on integrase vs. protease inhibitor-based regimens (adjusted relative risk (aRR) 0.38, CI 0.23-0.63, p<0.001), and in Uganda (aRR 0.42, CI 0.20-0.90, p=0.026) or Kisumu, Kenya (aRR 0.40, CI 0.22-0.76, p=0.005) had lower likelihood of non-suppression. Compared to Nigeria, participants from other sites were less likely to report non-adherence (unadjusted RR 0.31-0.44). Youth-friendly service provision varied.</p><p><strong>Conclusions: </strong>Viral suppression and ART adherence were high among AYLHIV in AFRICOS. Clinic site and ART regimen were associated with outcomes, highlighting the importance of health system factors.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815508","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":"Pharmacokinetic modeling to support WHO-weight band dosing of a new pediatric darunavir/ritonavir (120/20 mg) fixed-dose combination tablet for children at least 3 years old and weighing 10 to less than 35 kg.","authors":"Seef Abdalla, Marc Lallemant, Alexandra Compagnucci, Alessandra Nardone, Carlo Giaquinto, Diana Gibb, Chishala Chabala, David Burger, Déborah Hirt, Tim R Cressey","doi":"10.1097/QAI.0000000000003956","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003956","url":null,"abstract":"<p><strong>Background: </strong>Darunavir boosted with ritonavir (DRV/r) is the preferred HIV protease inhibitor for children, but no child-friendly fixed-dose combination (FDC) exists. A generic DRV/r 120/20 mg FDC tablet (6:1 ratio) is under development; however, dosing guidance across WHO weight bands is lacking. We performed a pharmacokinetic (PK) modeling/simulation study to inform dosing of the DRV/r FDC tablet in children.</p><p><strong>Methods: </strong>Darunavir/ritonavir plasma concentration data from three pediatric HIV trials (DELPHI, ARIEL and CHAPAS-4), administered as separate formulations, were pooled to update a pediatirc population PK model. Simulations were performed for children ≥3 years old weighing 10-<35 kg, evaluating doses of the 120/20 mg DRV/r tablets once- and twice daily per WHO-weight bands. The PK target was a geometric mean DRV exposure (AUC0-tau) within 80%-130% of adult values.</p><p><strong>Results: </strong>Data from 162 children 3-16 years old were included. Darunavir PK was described using a 2-compartment model, with differing absorption lag-time between formulations. Clearance and volume of distribution were allometrically scaled according to weight. Alpha-1-acid glycoprotein concentrations inversely influenced DRV clearance. Simulations predicted the following DRV/r doses achieved target exposures: DRV/r once daily: 480/80 mg (4 tablets) from 10 to <14 kg and 600/100 mg (5 tablets) from 14 to <35 kg. DRV/r twice daily: 240/40 mg (2 tablets) from 10 kg to <14 kg; 360/60 mg (3 tablets) from 14 kg to <25 kg; and 480/80 mg (4 tablets) from 25kg to <35 kg.</p><p><strong>Conclusion: </strong>Model-based dosing supports once- and twice-daily of the pediatric DRV/r 120mg/20mg FDC tablet across WHO-weight bands.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805217","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 Mothers Clubs\": Prevention of Mother-to-Child HIV Transmission Among Pregnant Adolescent Girls and Young Women in Haiti.","authors":"Rose-Cardelle B Riche, Nao Haba, Tatiana Bell, Venise Joseph, Edline Alexis, Daniel W Fitzgerald, Marie Marcelle Deschamps, Jean W Pape, Margaret L McNairy, Lindsey K Reif, Vanessa Rouzier","doi":"10.1097/QAI.0000000000003957","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003957","url":null,"abstract":"<p><strong>Background: </strong>Pregnant adolescent girls and young women (AGYW) living with HIV face substantial barriers to antiretroviral therapy (ART) adherence, retention in care, and prevention of mother-to-child transmission (PMTCT), especially in resource-limited settings. Stigma, limited social support, and fragmented services contribute to suboptimal maternal and infant outcomes.</p><p><strong>Setting: </strong>This pilot intervention was implemented at the GHESKIO HIV clinic in Port-au-Prince, Haiti.</p><p><strong>Methods: </strong>We analyzed routinely collected clinical data from 50 pregnant AGYW aged 15-24 years living with HIV who were enrolled in Young Mothers Clubs between February 2018 and August 2019. Young Mothers Clubs are a midwife-led, cohort-based PMTCT care model providing biweekly community-based sessions that integrated peer support, reproductive health counseling, parenting and HIV education, and individual clinical assessments. All participants initiated or continued ART at enrollment. The primary outcome was a composite of maternal retention in HIV care and infant HIV-negative status at 18 months postpartum.</p><p><strong>Results: </strong>The median maternal age was 21 years; 64% were ART-experienced and 43% were virally suppressed at enrollment. At 18 months postpartum, 85% of mothers were retained in HIV care, and 69% among all eliegible mothers were virally suppressed. Among 45 live-born infants, one acquired HIV, and 69% were retained in care at 18 months. Overall, 60% of mother-infant pairs achieved the primary outcome. Eight infants (18%) died from non-HIV causes, and six (13%) were lost to follow-up.</p><p><strong>Conclusion: </strong>Young Mothers Clubs demonstrated high maternal retention and low HIV transmission. Persistent infant mortality and attrition underscore the need for enhanced postnatal support.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805179","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":"Breaking the Chain: HIV-1 Transmission Clusters among People who Inject Drugs in North Carolina, 2010 to 2023.","authors":"Theppharit Panichsillapakit, Cara J Broshkevitch, Kimberly Enders, Annalea Greifinger, Shuntai Zhou, Simon D W Frost, Erik Volz, Joseph J Eron, Victoria Mobley, Erika Samoff, Ann M Dennis","doi":"10.1097/QAI.0000000000003955","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003955","url":null,"abstract":"<p><strong>Background: </strong>Injection drug use (IDU) remains a major mode of HIV transmission in the United States, with rising use putting more people who inject drugs (PWID) at risk for HIV. Understanding HIV transmission clusters in this population can inform public health outreach strategies. We examined factors associated with linkage to HIV clusters among PWID in North Carolina (NC).</p><p><strong>Setting: </strong>NC maintains a statewide molecular HIV surveillance system, enabling identification of transmission clusters across diverse urban and rural communities.</p><p><strong>Methods: </strong>We analyzed data from people ≥13 years old, diagnosed with HIV, residing in NC, with ≥1 HIV sequence collected between April 2010 and March 2023. Genetic clusters were defined as ≥2 sequences with a pairwise genetic distance <1.5%. Poisson regression was used to estimate prevalence ratios for factors associated with cluster linkage. A logistic generalized additive model was then used to analyze the trend in cluster linkage among PWID over time.</p><p><strong>Results: </strong>Among 21,245 people with a sequence, 1,526 clusters were identified; 284 (19%) included ≥1 PWID (size range 2-218). Cluster linkage was associated with non-Hispanic White race/ethnicity, recent sequence collection, and factors associated with early HIV infection (high CD4 T-cell count, high viral load, and acute infection). The proportion of PWID linked to a cluster increased by year of HIV sequence collection.</p><p><strong>Conclusion: </strong>Early HIV testing and care are important for reducing transmission among PWID. Increased linkage of PWID to clusters likely reflects expansion of sequencing, which supports use of molecular clustering to identify groups needing additional outreach.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805198","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":"Association of under-reporting of alcohol use with HIV viral non-suppression and an all-cause mortality risk score among people with HIV on antiretroviral therapy.","authors":"Cristina Espinosa da Silva, Robin Fatchm, Nneka Emenyonu, Aaron Scheffler, Winnie R Muyindike, Julian Adong, Evgeny Krupitsky, Elena Blokhina, Kaku So-Armah, Brian Beesiga, Kara Marson, Frank J Palella, Gabriel Chamie, Isabel E Allen, Phyllis C Tien, Judith A Hahn","doi":"10.1097/QAI.0000000000003952","DOIUrl":"10.1097/QAI.0000000000003952","url":null,"abstract":"<p><strong>Background: </strong>Unhealthy alcohol use contributes to poor HIV-related outcomes. Alcohol under-reporting may be associated with HIV viral non-suppression and all-cause mortality risk, especially at the high end of the spectrum. We evaluated whether alcohol under-reporting was associated with these outcomes among PWH with unhealthy alcohol use who were receiving ART.</p><p><strong>Methods: </strong>We pooled data from six studies of PWH in Uganda (ADEPT-T, DIPT, Extend), United States (MWCCS), and Russia (Russia ARCH 1, St Peter). We included PWH on ART who engaged in unhealthy drinking as determined by the alcohol biomarker phosphatidylethanol (PEth)≥50ng/mL. Self-reported alcohol use was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). We defined under-reporting of high-risk alcohol use as PEth≥200ng/mL and AUDIT-C score<6, and examined HIV viral non-suppression (≥200copies/mL or limit of assay detection) and an all-cause mortality risk score (Veterans Aging Cohort Study [VACS] Index 1.0) as outcomes. We explored level of -under-reporting of alcohol use using a continuous variable.</p><p><strong>Results: </strong>In our sample of 1,435 PWH with unhealthy drinking, 24% under-reported high-risk alcohol use (prevalence range 1-34% across studies). We observed positive, non-significant associations between under-reporting of high-risk alcohol use and viral non-suppression and all-cause mortality risk score. An exploratory continuous under-reporting variable was significantly positively associated with all-cause mortality risk.</p><p><strong>Conclusions: </strong>Our findings indicate that under-reporting of high-risk alcohol use is common among PWH and suggest that under-reporting of alcohol use may mask other health issues, as reflected by increased mortality index scores. Low-cost methods to improve alcohol use are needed.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805130","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":"A Meta-synthesis on Perceptions of Possibility for HIV Infection Among Cisgender and Heterosexual Women.","authors":"Emily R Alpert, Jacqueline Kent-Marvick, Omaris Caceres, Aidan Perner, Florence M Momplaisir, Sarita Sonalkar, Shimrit Keddem","doi":"10.1097/QAI.0000000000003950","DOIUrl":"10.1097/QAI.0000000000003950","url":null,"abstract":"<p><strong>Introduction: </strong>Nineteen percent of new HIV diagnoses in the United States in 2022 occurred in women. One barrier to HIV prevention is low perception of possibility of infection. We explored the qualitative data on perception of chances of HIV infection in women to elucidate how women conceive potential for infection.</p><p><strong>Methods: </strong>Included articles were published between 2014 and 2024 with information on women, HIV, and perception of potential for infection. The codebook was created from emerging and theoretical constructs. Articles were coded using Dedoose. Codes were reviewed for cross-cutting themes and summaries created. Confidence in review findings was assessed with the CERQual approach.</p><p><strong>Results: </strong>The meta-synthesis included twenty papers. These included four papers focused on women engaged in substance use and five focused on Black individuals. Four themes emerged: women controlled aspects of their lives and altered possible exposures with the use of condoms or needle exchange programs, women knew they could not control all their potential exposures, misinformation and incomplete information affected women's ability to assess their exposures, and perceptions of potential for infection were dynamic and dependent on current priorities in their lives.</p><p><strong>Conclusions: </strong>Women assessed their possibility for HIV based on their perception of control, their access to information, and based on life circumstances. Understanding how women think about their potential for infection can allow healthcare professionals to better counsel women on their chances of HIV transmission, leading to greater HIV prevention.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805155","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":"Cumulative Low-Level Viraemia Is Not Associated with Endothelial Function in Black African Adults With HIV.","authors":"Roland VAN Rensburg, Innocent Maposa, Camilla Pennefather, Chantel Schreuder, Lauren Jennings, Tracy Kellermann, Khethiwe Motha, Giovanni Schifitto, Catherine Orrell, Monica Gandhi, Gert VAN Zyl, Eric Decloedt","doi":"10.1097/QAI.0000000000003949","DOIUrl":"10.1097/QAI.0000000000003949","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) experience excess cardiovascular disease (CVD) risk with persistent inflammation considered a key driver, despite antiretroviral therapy (ART). Low-level viraemia (LLV) may contribute to inflammation and vascular injury, but data in sub-Saharan Africa are limited. We assessed correlates of endothelial function among Black African PWH with a history of viraemia despite ART use.</p><p><strong>Methods: </strong>We conducted a cross-sectional sub-study within the South African UTRA trial (NCT05333679). Endothelial function was measured with EndoPAT using the natural log-transformed reactive hyperaemia index (LnRHI); endothelial dysfunction was defined as LnRHI≤0.51. The primary exposure was 12-month cumulative HIV viral load (VL) area-under-the-curve (AUC). Body-mass index (BMI), waist-to-hip ratio (WHR), and body roundness index (BRI) were modelled using adjusted natural cubic splines with robust standard errors. We evaluated associations of various covariates, including these body composition metrics, with LnRHI via multivariable regression.</p><p><strong>Results: </strong>Of 120 participants (median age 46 years, 69% women), 26% met criteria for endothelial dysfunction despite low 10-year CVD risk. Median LnRHI was 0.69 (IQR 0.50-0.94). Mean cumulative VL AUC was 1.55 log10 copy-years/mL (IQR 1.30-2.20), consistent with LLV. Cumulative VL was not associated with endothelial function after adjustment. In contrast, LnRHI varied significantly and non-linearly across BMI, WHR, and BRI, with an overall downward trend with increasing adiposity.</p><p><strong>Conclusions: </strong>In this cross-sectional analysis of Black African PWH with LLV, no association between cumulative VL and endothelial dysfunction was observed. However, higher adiposity was consistently associated with declining endothelial function. Our data adds to the growing evidence on the importance of addressing body composition as a multifactorial risk determinant and important correlate of early vascular risk in PWH.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805152","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}