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

{"title":"Plasma NfL and sCD14 Are Associated with Polypharmacy and Recurrent Falls in Virally Suppressed Older People with HIV.","authors":"Priya Kosana, Allison Grubman, Gloria Shen, Kunling Wu, Katherine Tassiopoulos, Qing Ma, Scott Letendre, Kristine M Erlandson, Shelli F Farhadian","doi":"10.1097/QAI.0000000000003935","DOIUrl":"10.1097/QAI.0000000000003935","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) are living longer due to effective antiretroviral therapy (ART) but face accelerated aging, accumulating comorbidities, and high rates of polypharmacy. Whether neuroinflammatory biomarkers are associated with polypharmacy and adverse clinical outcomes such as falls in this population is unknown.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of baseline data from 600 virally suppressed PWH ≥40 years enrolled in the ACTG A5322 HAILO cohort. Plasma neurofilament light chain (NfL), neopterin, and soluble CD14 (sCD14) were measured. Multivariable logistic regression examined associations between each biomarker and polypharmacy (five or more non-ART medications), recurrent falls (two or more falls/6 months), and slow gait speed less than one m/s), adjusting for age, sex, and comorbidity burden.</p><p><strong>Results: </strong>The median age was 54 years, 78% of participants were male, and 232 participants (39%) had polypharmacy. Elevated NfL was independently associated with polypharmacy in multivariable analysis (aOR 1.16 [95% CI 1.07-1.26]). In the total population, elevated NfL (OR 1.24 [1.05-1.46]) and sCD14 (OR 1.12 [1.01-1.23]) were each associated with recurrent falls. Among participants with polypharmacy, only elevated sCD14 remained associated with recurrent falls on stratified multivariable analysis (OR 1.15 [1.02-1.30]). No biomarker was significantly associated with slow gait speed.</p><p><strong>Conclusions: </strong>In older virally suppressed PWH, plasma NfL and sCD14 are associated with distinct adverse clinical phenotypes-medication burden and fall risk, respectively, and may serve as complementary biomarkers of distinct biological pathways relevant to aging in HIV.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551883","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":"Neurocognitive Performance and Depressive Mood in People With HIV: The Role of Prescription Opioids Use.","authors":"Enrico Ripamonti, Qing Ma, Anya Umlauf, Scott Letendre, Ronald J Ellis","doi":"10.1097/QAI.0000000000003841","DOIUrl":"10.1097/QAI.0000000000003841","url":null,"abstract":"<p><strong>Background: </strong>The issue of potential adverse reactions or toxicities of pharmacotherapies used for chronic diseases in people with HIV is still to be clarified.</p><p><strong>Methods: </strong>This study targeted potential effects on neurocognition and mood from prescription opioids, alone or in combination with other classes of drugs, using cross-sectional data from 400 participants in the multicenter CNS HIV Anti-Retroviral Therapy Effects Research study.</p><p><strong>Results: </strong>We found that prescription opioid use alone was not associated with neurocognitive performance (β = -1.05, Standard error [SE] = 0.80, P = 0.18) or depressive mood (β = -0.08, SE = 0.19, P = 0.65). However, if used in combination with antidepressants, prescription opioid use significantly correlated with reduced neurocognitive performance (β = -2.58, SE = 1.17, P = 0.03). Also, combinations of prescription opioids and antidepressants with statins (β = -2.87, SE = 1.49, P = 0.05) or lipid-lowering agents other than statins (β = -2.88, SE = 1.39, P = 0.04) were associated with lower neurocognitive performance. The interaction of prescription opioid use with the presence of distal sensory polyneuropathy (DSP) was significant ( P = 0.03). In those without DSP, prescription opioid use was associated with better neurocognitive performance (β = 4.25, SE = 2.13, P = 0.04); by contrast, in those with DSP, the direction of the effect was reversed. No modifying effect on neurocognition was obtained considering distal neuropathic pain, lifetime substance disorder, lifetime major depression diagnosis, or detectable viral load.</p><p><strong>Conclusions: </strong>These findings underscore the importance of neurocognition impact from drug combinations and careful consideration of opioid prescriptions in combination with other medications in the management of people with HIV.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"768-776"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109573","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":"Sleep Quality by Reproductive Stage Among Women Living With HIV in the United States Enrolled in the Health Outcomes Around Pregnancy and Exposure to HIV/Antiretrovirals (HOPE) Study.","authors":"Rusul Al-Ani, Paige L Williams, Jessica Lee, Deborah Kacanek, Sara R Schenkel, Mariam Davtyan, Shamika Baker, Suzanne Siminski, Mary E Paul, Denise L Jacobson, Sharon Nichols, Kathleen M Powis","doi":"10.1097/QAI.0000000000003856","DOIUrl":"10.1097/QAI.0000000000003856","url":null,"abstract":"<p><strong>Background: </strong>Sleep quality significantly affects health. Despite evidence that women living with HIV experience higher rates of poor sleep quality than women who are HIV seronegative, few studies have explored sleep quality among women with HIV by reproductive stage.</p><p><strong>Setting: </strong>HOPE is an observational study of women living with HIV (WLHIV) ages 18-45 years, enrolled at 14 sites across the United States and Puerto Rico.</p><p><strong>Methods: </strong>At entry, participants reported reproductive stage as nulliparous, pregnant, within 1-year postpartum, or >1-year postpartum (parous). Participants completed the Brief Pittsburgh Sleep Quality Index (B-PSQI), with poor sleep quality defined as a score >5. Log-binomial models were fit to estimate poor sleep quality adjusted prevalence ratios (aPRs) by reproductive stage and predictors of poor sleep quality overall and within each reproductive stage.</p><p><strong>Results: </strong>Of 689 participants completing the entry visit between August 2022 and February 2025, 500 (73%) had evaluable sleep quality data. Prevalence of poor sleep quality was highest among postpartum and parous women (54% and 53%, respectively), compared with nulliparous and pregnant women (48% and 44%, respectively). There was no difference in poor sleep quality prevalence by reproductive stage after adjusting for potential confounders. Screening positive for moderate/severe depression, moderate/severe anxiety, and/or post-traumatic stress disorder, as well as experiencing high perceived stress or homelessness, were associated with higher prevalence of poor sleep quality for all groups.</p><p><strong>Conclusions: </strong>Poor sleep quality was common in this cohort of WLHIV, regardless of reproductive stage. This work can inform interventions to improve sleep quality among WLHIV.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"777-786"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655610","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: Real-World Uptake and Clinical Outcomes of Long-Acting Injectable Cabotegravir/Rilpivirine in the United States, 2021-2023.","authors":"Jesse O'Shea, Abigail Derton, James Henson, Kashif Iqbal, Melissa Briggs-Hagen, Athena P Kourtis, Kate Buchacz","doi":"10.1097/QAI.0000000000003855","DOIUrl":"10.1097/QAI.0000000000003855","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable antiretroviral therapy offers an alternative to daily oral regimens for people with HIV. We assessed national uptake and characteristics of persons prescribed injectable cabotegravir/rilpivirine (CAB/RPV) in the United States from 2021 to 2023.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using HealthVerity Marketplace, a national claims database with pharmacy, medical, and laboratory data. People with HIV with ≥1 closed, approved prescription claim for CAB/RPV or oral ART were identified. Demographic, clinical, and payer characteristics, viral load (VL), and CD4 counts were examined.</p><p><strong>Results: </strong>From 2021 to 2023, 4087 individuals were prescribed CAB/RPV (21,698 prescriptions), comprising 1.3% of all ART prescriptions by 2023. CAB/RPV recipients were more likely to be aged 25-44 and enrolled in Medicaid. CAB/RPV prescribing was disproportionately low in the Southern United States and among adults 55 years and older, despite higher HIV prevalence in these groups. Among individuals with a detectable VL at initiation (52.2%), 7.2% had viremia (≥200 copies/mL). Among those with ≥1 follow-up VL (n = 2234), 1.8% experienced confirmed virologic failure, defined as ≥2 VLs ≥200 copies/mL. CD4 counts remained stable, with median values near 700 cells/mm 3 pre- and postinitiation.</p><p><strong>Conclusion: </strong>While CAB/RPV uptake is increasing, its use remains modest and uneven. High rates of virologic suppression support its real-world effectiveness, but disparities by age, region, and payer point to persistent barriers. Continued real-world monitoring and targeted implementation strategies are critical to fully realizing the potential of long-acting injectable ART.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"750-755"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314487","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":"Effects of HIV and Adverse Childhood Experiences on Neurocognition.","authors":"Elizabeth M Inman, Candice W Ramsammy, Alisa Kalegina, Reuben N Robbins, Avy Violari, Rachel Kidman","doi":"10.1097/QAI.0000000000003858","DOIUrl":"10.1097/QAI.0000000000003858","url":null,"abstract":"<p><strong>Background: </strong>Both HIV and adverse childhood experiences (ACEs) can affect neurocognitive performance. Among youth with perinatal HIV (PHIV), living with a chronic viral infection and experiencing ACEs simultaneously may result in an interaction between the 2 and downstream effects on neurocognition. The purpose of this study was to test the effects of PHIV, childhood adversity, and their interaction on neurocognition in a sample of South African adolescent boys.</p><p><strong>Setting: </strong>Soweto, South Africa.</p><p><strong>Methods: </strong>Adolescent boys aged 15-19 years enrolled in a longitudinal study between November 2020 and June 2023. Recruitment was stratified by HIV status. At baseline, participants completed the ACE measure. Six months later they completed a battery of neurocognitive assessments ( NeuroScreen ). We created several regression models to examine the effects of HIV status, ACEs, and their interaction on neurocognition. We also built several exploratory models to probe the effects of viral suppression and various kinds of ACEs.</p><p><strong>Results: </strong>Participants living with PHIV scored significantly lower than those without HIV on several neurocognitive domains. Among those living with PHIV, participants with a detectable viral load during the study exhibited significantly lower performance on several domains than those who were consistently virally suppressed. We found no support for the effect of ACEs or a significant HIV*ACEs interaction on neurocognition.</p><p><strong>Conclusions: </strong>Our results underscore the importance of medication adherence and viral suppression among youth living with HIV.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"725-732"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346154","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":"Implementation of Health Insurance Navigation for Racial/Ethnic Minority Men Who Have Sex With Men Presenting for Community-Based HIV Testing.","authors":"Katherine B Roland, Craig B Borkowf, Ilya Teplinskiy, Ellen Almirol, Rebecca Eavou, John A Schneider, Stephen A Flores","doi":"10.1097/QAI.0000000000003876","DOIUrl":"10.1097/QAI.0000000000003876","url":null,"abstract":"<p><strong>Objective: </strong>Being uninsured is a barrier to accessing HIV prevention and treatment. This study assesses the implementation of health insurance navigation.</p><p><strong>Design: </strong>Randomized structural intervention conducted from 2018 to 2020 in Chicago, IL. Black/African American and Hispanic/Latino men who have sex with men presenting for community-based HIV testing (N = 230) were offered a single session of health insurance navigation immediately after their HIV test, regardless of HIV test result.</p><p><strong>Methods: </strong>Using descriptive statistics, we present sociodemographic characteristics, health insurance navigation uptake, and immediate health insurance outcomes resulting from navigation.</p><p><strong>Results: </strong>Most participants were 18-34 years of age (n = 175, 76.0%), most identified as non-Hispanic Black/African American (n = 202, 87.8%), and most were insured (n = 164, 71.3%). Half (n = 115, 50.0%) accepted navigation. Of those 115, 10 uninsured participants enrolled in health insurance (8.7%) and 21 uninsured participants had incomplete enrollment (18.3%); 80 insured participants reviewed their current plan (69.6%) and 4 insured participants changed to a plan better suited to their HIV care needs (3.5%). Almost all 115 were satisfied with the amount of time they had with the navigator (n = 114, 99.1%) and the services they received (n = 107, 93.0%).</p><p><strong>Conclusions: </strong>Providing health insurance navigation at the time of HIV testing was an acceptable and feasible method to engage Black/African American and Hispanic/Latino men who have sex with men in health insurance education and enrollment. Community-based structural interventions are essential to reaching national public health and Ending the HIV Epidemic goals.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"717-724"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597698","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":"Associations of Plasma and Breast Milk HIV RNA and Tenofovir Concentrations With Risk of Postnatal HIV Transmission During Breastfeeding Among Women With and Without ARV Exposure.","authors":"Maxensia Owor, Kristin Baltrusaitis, Patricia DeMarrais, Lisa M Frenkel, Brookie M Best, Lynda S Chibanda, Dhayendre Moodley, Avy Violari, Brenda Kakayi, Sheila Styrchak, Ingrid A Beck, Jeremiah D Momper, Patricia M Flynn, Mary G Fowler","doi":"10.1097/QAI.0000000000003863","DOIUrl":"10.1097/QAI.0000000000003863","url":null,"abstract":"<p><strong>Background: </strong>We assessed the association of vertical HIV transmission during breastfeeding with HIV viral load (VL) and tenofovir (TFV) concentrations in maternal plasma and breast milk.</p><p><strong>Setting: </strong>A case-control study nested within the IMPAACT multisite PROMISE trial.</p><p><strong>Methods: </strong>Each case (mother-infant pairs with infants with a positive HIV test) was matched to 2 controls (pairs with HIV-negative infants) by infant sex, study site, PROMISE component (postpartum randomization or observational follow-up), and maternal age. Maternal plasma and breast milk collected near the case infant's infection date were assayed for RNA VL. TFV concentrations were measured in the subset of mothers who received a TFV-containing regimen. Odds ratios and 95% confidence intervals (CIs) were calculated using conditional logistic regression.</p><p><strong>Results: </strong>Thirty one cases and 62 controls included mothers with median age of 25 years. Median infant age at HIV diagnosis was 6 (3, 14) months. Plasma and breast milk RNA were above the lower limit of quantification (LLOQ) in 28 of 31 (90%) and in 17 of 31 (55%) maternal cases vs. 25 of 62 (45%) and 7 of 62 (11%) controls. Odds of vertical transmission were 9.1 (95% CI: 2.67 to 30.88) times higher for plasma RNA VL > LLOQ and 9.4 (95% CI: 2.73 to 32.58) times higher for breast milk RNA VL > LLOQ compared with RNA VL ≤ LLOQ. Among mothers who received a TFV-containing regimen, only 3 of 14 (21%) cases had detectable TFV concentrations in their plasma and breast milk vs. 31 of 37 (84%) in plasma and 29 of 37 (78%) in breast milk for controls. In breast milk, the odds of being a case was 90% lower (95% CI: 0.01 to 0.76; P = 0.027; n = 31) for each log 10 increase in TFV.</p><p><strong>Conclusions: </strong>Odds of breast milk HIV-1 transmission is associated with higher maternal plasma and breast milk RNA VL and lower breast milk TFV concentrations.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"795-802"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470779","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":"Population Viral Load Suppression and Associated Factors in Tanzania: Findings From 2 Sequential Tanzania HIV Impact Surveys of 2016-2017 and 2022-2023.","authors":"Abbas Ismail, Prosper Njau, Alice Wang, Alexander Kailembo, Samwel Sumba, Baraka Revocatus, Eliezer Taluka, Mary Mayige, Tepa Nkumbula, Elias Bukundi, Haji Faki Faki, Emilian Karugendo, Fahima Issa, Nyambura Moremi, Malewo Optatus, Geofrey Mchau, Rebecca L Laws, Divya Patel, Haruka Maruyama, Wafaa El-Sadr, Shannon M Farley, George Mgomella, Mahesh Swaminathan, Sarah E Porter, Jerome Kamwela","doi":"10.1097/QAI.0000000000003861","DOIUrl":"10.1097/QAI.0000000000003861","url":null,"abstract":"<p><strong>Background: </strong>Antiretroviral therapy improves outcomes for people living with HIV (PLHIV) and prevents transmission through viral load suppression (VLS). To evaluate progress toward HIV epidemic control, VLS prevalences and correlates among PLHIV were analyzed from Tanzania HIV Impact Assessment Surveys (THIS), independent, cross-sectional using stratified-cluster design, conducted in 2016-2017 (S1) and 2022-2023 (S2).</p><p><strong>Methods: </strong>Participants 15 years and older provided consent, completed an interviewer-administered questionnaire, and tested for HIV using the national rapid testing algorithm. HIV-positive specimens were tested for viral load. Prevalence of population VLS (<1000 copies/mL) was determined irrespective of HIV-knowledge or antiretroviral therapy status. Modified Poisson Regression Model was used. We reported percentages (%) and adjusted prevalence ratios with 95% confidence intervals (CIs) accounting for complex survey design.</p><p><strong>Results: </strong>We analyzed data from 1830 PLHIV in S1 and 1849 in S2. Population VLS prevalence increased by 26.1% (95% CI: 22.1 to 30.2, P < 0.0001) between surveys. In both surveys, women were more likely to experience VLS [S1: 1.43 (95% CI: 1.25 to 1.63), S2: 1.15 (95% CI: 1.06 to 1.24)] than men. In both surveys, PLHIV 35 years and older were more likely to experience VLS than those 15-24 years, [S1 35-49 years: 1.46 (95% CI: 1.13 to 1.90), 50 years and older: 1.69 (95% CI: 1.28 to 2.23), and S2 35-49 years: 1.31 (95% CI: 1.06 to 1.62), 50 years and older: 1.42 (95% CI: 1.15 to 1.76)].</p><p><strong>Conclusion: </strong>Tanzania has made progress toward HIV epidemic control, as evidenced by the significant increase in VLS prevalence in 6 years. Targeted sex-age strategies are essential for HIV epidemic control.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":"101 7","pages":"733-739"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240954","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: Intersectional Stigma Associations With Long-Acting Injectable PrEP Willingness and Preference Among Cisgender Gay, Bisexual, and Other Men Who Have Sex With Men: A Brief Quantitative Report.","authors":"Jennifer L Glick, Danielle F Nestadt, Travis Sanchez, Irah L Lucas, Mariah Valentine-Graves, Thomas Carpino, Duygu Islek, Kaitlyn Atkins, Sarah M Murray, Stefan Baral, Supriya Sarkar, Leigh Ragone, Vani Vannappagari","doi":"10.1097/QAI.0000000000003850","DOIUrl":"10.1097/QAI.0000000000003850","url":null,"abstract":"<p><strong>Background: </strong>Gay, bisexual, and other men who have sex with men (GBMSM) in the United States are disproportionately affected by the HIV epidemic. Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) represents a novel HIV prevention strategy. However, stigma remains a barrier to HIV-related prevention and care. We investigated the role of intersectional stigma in LAI-PrEP preferences among past-year PrEP-naive, HIV-negative US cisgender GBMSM.</p><p><strong>Methods: </strong>The 2022 American Men's Internet Survey enrolled cisgender GBMSM online between October 2022 and October 2023. Using bivariate and multivariable adjusted Poisson regression with robust variance and a modified Intersectional Discrimination Index to examine associations between several forms of stigma-anticipated, day-to-day, social systems exclusion, and violence and harassment-and LAI-PrEP willingness and preference.</p><p><strong>Results: </strong>Among participants (N = 1196), 705 (59.0%) were willing to use any PrEP modality and 393 (32.9%) were willing to use LAI-PrEP, among whom 211 (29.9%) reported a preference for LAI-PrEP. On average, participants experienced 1.8 of 7 anticipated discrimination items, 3.9 of 7 day-to-day discrimination items, 0.2 of 3 social systems exclusion items, and 0.9 of 4 violence/harassment items. Willingness to use LAI-PrEP was associated with anticipated stigma (adjusted prevalence ratio [aPR] = 1.06; 95% confidence interval [CI] = 1.02 to 1.10; P < 0.01). Preference for LAI-PrEP was associated with anticipated stigma (aPR = 1.06; 95% CI = 1.00 to 1.12; P = 0.04), day-to-day (aPR = 1.09; 95% CI = 1.02 to 1.15; P = 0.01) stigma, and violence/harassment (aPR = 1.09; 95% CI = 1.01 to 1.18; p-0.03).</p><p><strong>Conclusions: </strong>Given disproportionate HIV burden among GBMSM, a range of HIV PrEP modality options combined with efforts to address intersectional anticipated and enacted stigma among GBMSM is critical to ensure PrEP access, uptake, and adherence.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"580-585"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146169171","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":"Alterations to the Bronchial Gene-Expression Effects of Tobacco Smoking in People Living With HIV.","authors":"Minyi Lee, Alex Olson, Richard T Pickering, Michael H Ieong, Dena Kivett, Samantha Roche, Xiaohui Xiao, Gang Liu, Archana Asundi, Nina H Lin, Marc E Lenburg","doi":"10.1097/QAI.0000000000003853","DOIUrl":"10.1097/QAI.0000000000003853","url":null,"abstract":"<p><strong>Background: </strong>Although acquired immunodeficiency syndrome-related mortality has decreased since the introduction of antiretroviral therapy, the incidence of lung cancer in patients living with HIV (PLWH) remains high. Understanding the effects of tobacco smoke on airway gene expression in PLWH may provide insights into the elevated lung cancer risk associated with HIV.</p><p><strong>Methods: </strong>Airway epithelial brushings were collected from 12 PLWH who smoke and 19 PLWH who have never smoked and profiled using RNA-seq. Linear models were used to identify genes differentially expressed between people who smoke and have never smoked and between people who previously smoked and have never smoked. Gene set enrichment analysis was used to validate smoking-related gene signatures across data sets. Data were integrated with gene expression data from a cohort of patients without HIV to identify genes differentially modulated by both smoking and HIV status.</p><p><strong>Results: </strong>We found that previous smoking-related gene signatures are similarly associated with smoking in PLWH, including the persistent differential expression of a subset of \"irreversibly altered\" genes in people who previously smoked compared with people who have never smoked. We also identified and validated 2 gene signatures specifically modulated in people who smoke without HIV.</p><p><strong>Conclusions: </strong>Many of the effects of smoking on bronchial gene expression are shared between PLWH and non-HIV individuals. However, HIV-specific modulation of pathways linked to oxidative stress and epithelial integrity suggests potential mechanisms that may contribute to smoking-related outcomes that are more prevalent in PLWH, such as lung cancer.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"671-679"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12951687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286750","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}