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

{"title":"Cardiovascular Disease Risk and Falls in Men and Women Living With and Without HIV in MACS/WIHS Combined Cohort Study.","authors":"Elizabeth Vásquez, Mark H Kuniholm, Allison A Appleton, Mirza Ishrat Noor, Anjali Sharma, Michael T Yin, Seble G Kassaye, Phyllis C Tien, Ryan D Ross, Gypsyamber D'Souza, Michelle Floris-Moore, Igho Ofotokun, Deborah L Jones, Jenni M Wise, Todd T Brown, Jared W Magnani, Jordan E Lake, Frank J Palella, Deborah Gustafson","doi":"10.1097/QAI.0000000000003844","DOIUrl":"10.1097/QAI.0000000000003844","url":null,"abstract":"<p><strong>Background: </strong>We examined the cross-sectional relationship between cardiovascular disease (CVD) risk, history of falls, and the number of falls in the past year in the US multicenter MACS/WIHS Combined Cohort Study (2020-2022) of men and women without HIV (MWOH/WWOH) and men and women with HIV (MWH/WWH).</p><p><strong>Setting/methods: </strong>CVD risk was assessed by pooled cohort equation 10-year risk scores and categorized into 4 levels. Self-reported falls outcomes (recent fall, not recent fall, one fall, multiple falls) were assessed using a standardized protocol. Odds ratios of falls were measured using multinomial regression models stratified by sex and adjusted for ethnicity, education attainment, alcohol consumption, body-mass index, fall-risk medications, physical activity, and HIV serostatus.</p><p><strong>Results: </strong>There were 2723 participants, 35% were men (577 MWH, 360 MWOH) with a median age of 58 (IQR: 14) years. Women represented 65% (1271 WWH, 515 WWOH) with a median age of 55 (IQR: 11) years. In sex stratified multinomial adjusted models, among men, high CVD risk (vs. low risk) was significantly associated with a recent fall (vs. never fall) (aOR: 3.12, 95% CI: 1.59 to 6.13) and one fall (vs. no fall) in past year (aOR: 3.66; 95% CI: 1.45 to 9.21). Among women, high CVD risk was only significantly associated with multiple falls (vs. no fall) in past year (aOR: 2.06; 95% CI: 1.24 to 3.43).</p><p><strong>Conclusion: </strong>Our findings highlight the importance of integrating fall-risk assessments into CVD management, particularly for men and women with living with HIV and high CVD risk, and the need for targeted, gender-responsive fall prevention strategies in clinical practice.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"612-619"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109454","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":"Clinical and HIV Surveillance Data to Determine Care Status for People With HIV in Washington, DC.","authors":"Lauren O'Connor, Shannon Hammerlund, Lisa Mele, Amanda Castel, Alan Greenberg, Rachel Denyer, Anne Monroe","doi":"10.1097/QAI.0000000000003846","DOIUrl":"10.1097/QAI.0000000000003846","url":null,"abstract":"<p><strong>Background: </strong>We examined factors related to being out of care (OOC) or reentering care after clinic transfer among people with HIV in Washington, DC using clinical and linked surveillance data from the DC Department of Health (DC Health).</p><p><strong>Methods: </strong>Using DC Cohort HIV care encounters and laboratory results, linked surveillance data, and chart review, we determined if participants were (1) engaged in care; (2) OOC; (3) died; (4) withdrew; (5) clinic-reported transfer; (6) surveillance-based transfer (using DC Health data); and (7) undetermined. Of the clinic-reported transfers, we used surveillance data to determine whether participants reentered care after transfer. We evaluated associations between participant characteristics, being OOC, and reentering care using logistic regression.</p><p><strong>Results: </strong>We evaluated 12,563 DC Cohort participants, 6557 (52.5%) were engaged in care, 748 (6.0%) OOC, 1893 (15.0%) clinic-reported transfers, 1692 (13.5%) surveillance-based transfers, 1418 (11.0%) died, 41 (0.3%) withdrew, and 214 (1.7%) were undetermined. Of clinic-reported transfers, 832 (44.0%) reentered care, with 80.9% achieving viral suppression (<200 copies/mL). In the adjusted analysis, females, older age, non-Hispanic Black race, longer time since HIV diagnosis, CD4 ≥ 500 cells/µL, former or never smoking, and public insurance were associated with being engaged in care. Similarly, non-Hispanic Black race, non-Hispanic White race, nonviral suppression, Ryan White clinic, former alcohol abuse, and temporary/unstable housing were associated with reentering care among the clinic-reported transfers, after adjusting for covariates.</p><p><strong>Conclusions: </strong>Individual, clinical, and structural factors were associated with being OOC or care reentry. Targeted interventions addressing these factors may improve sustained HIV care and reduce transmission.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"620-632"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146169155","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":"Long COVID Between People With and Without HIV: A Statewide Cohort Analysis.","authors":"Fanghui Shi, Huiyi Xia, Xiaoming Li, Bankole Olatosi, Sharon Weissman, Xueying Yang","doi":"10.1097/QAI.0000000000003840","DOIUrl":"10.1097/QAI.0000000000003840","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the risks of a panel of long COVID (LC) manifestations between people with HIV (PWH) and people without HIV (PWoH).</p><p><strong>Methods: </strong>Using integrated statewide electronic health record data from the HIV cohort and COVID-19 tester cohort, we identified COVID-19-positive individuals by HIV status between March 02, 2020, and January 15, 2022, in South Carolina. A total of 13 diagnosis groups encompassing 131 potential LC categories were identified. We used inverse probability weighting based on propensity scores to balance covariates between the PWH and PWoH, including age, sex, race, and vaccination status. Cox Proportional Hazard regression models were used to estimate the risk of each diagnosis group examined.</p><p><strong>Results: </strong>Among a total of 838,520 COVID-19-positive individuals, 2662 were with HIV and 835,858 were without HIV. The prevalence of any LC diagnosis was 16.3% and 10.6% for PWH and PWoH, respectively. Compared with PWoH, PWH were found to be at a higher risk of at least one of the LC diagnosis groups (hazard ratio [HR] = 1.29, 95% confidence interval [95% CI]: 1.09 to 1.54) and the highest risk was for diseases of the nervous system (HR = 2.04, 95% CI: 1.42 to 2.92), followed by mental disorders (HR = 1.78, 95% CI: 1.12 to 2.82) and respiratory system (HR = 1.78, 95% CI: 1.18 to 2.69).</p><p><strong>Conclusions: </strong>Our study highlights the consistent and elevated LC burden in PWH, emphasizing the importance of sustained follow-up for COVID-19 survivors to improve their clinical outcomes and prevent morbidity of LC.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"604-611"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121735","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":"A Comparison of F/TAF and F/TDF as HIV Pre-Exposure Prophylaxis in a Predominantly Cisgender Women Population in East and South Africa: A Randomized, Factorial, Noninferiority Trial.","authors":"Sheena McCormack, David Dunn, Sylvia Kusemererwa, Patricia Munseri, Nishanta Singh, Wiston William, Gertrude Mutonyi, Henry Bern, Lauriane Goldwirt, Cherry Kingsley, Arne Kroidl, Christian Holm Hansen, Song Ding, Rachel Kawuma, Mary Amondi, Ubaldo Bahemuka, Deus Buma, Daniel Clutterbuck, Zakir Gaffoor, Angus Jennings, Agricola Joachim, Ayoub Kakande, Berna Kalanzi, Abisai Kisinda, Mabela Matsoso, Thomas Miller, Neetha Morar, Jacqueline Musau, Jane Nabbuto, Ayanda Nzuza, Doreen Pamba, Simona Salomone, Thandiwe Sithole, Edith Tarimo, Kubashni Woeber, Kundai Chinyenze, Glenda Gray, Eligius Lyamuya, Muhammad Bakari, Said Aboud, Lucas Maganga, Gustavo Doncel, Janet Seeley, Jonathan Weber, Pontiano Kaleebu, Julie Fox, Eugene Ruzagira","doi":"10.1097/QAI.0000000000003845","DOIUrl":"10.1097/QAI.0000000000003845","url":null,"abstract":"<p><strong>Background: </strong>F/TAF was shown to be noninferior to F/TDF as pre-exposure prophylaxis (PrEP) in men, but approval was not extended to cisgender women. We report the results of PrEPVacc, in which a predominantly female population was randomly allocated to receive daily oral F/TDF or F/TAF for ∼6 months within a HIV-1 prophylactic vaccine trial.</p><p><strong>Setting: </strong>Four study sites in 3 African countries (Uganda, Tanzania, South Africa).</p><p><strong>Methods: </strong>The 2 regimens were compared by the averted infections ratio (AIR)-the proportion of infections averted by F/TAF relative to F/TDF. The counterfactual HIV incidence, an essential component of this metric, was derived from a preceding registration cohort. Dried blood spots (DBS) were collected at regular time points for later assessment of tenofovir diphosphate levels in selected subpopulations.</p><p><strong>Results: </strong>1380 participants (697 F/TDF, 683 F/TAF) were included in the primary analysis (total follow-up 709.2 person-years); 87% were cisgender women. Three HIV infections (0.86/100 person-years) occurred in the F/TAF group versus 2 in the F/TDF group (0.56/100 person-years). The counterfactual HIV incidence was estimated to be 2.59/100 person-years (90% CI: 1.86 to 3.52), giving an AIR of 0.85 (90% CI: 0.31 to 1.66). Based on the week 8 DBS sample, only an estimated 14% of participants were classified as taking 2-3 tablets per week and 9% ≥4 tablets per week.</p><p><strong>Conclusions: </strong>Despite similar HIV incidence rates, the noninferiority of F/TAF was not demonstrated, probably because of low statistical power primarily driven by low adherence. However, there is compelling evidence from multiple studies supporting the efficacy of F/TAF as PrEP regardless of sex.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"655-662"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133969","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":"Evaluating the Impact of Blood-Brain Barrier-Penetrant ACE Inhibitors on HIV-Associated Neurocognitive Disorders.","authors":"Tammy H Cummings, Joseph Magagnoli, Sasha Sikirzhytskaya, Ilya Tyagin, Ilya Safro, Michael D Wyatt, Michael Shtutman, S Scott Sutton","doi":"10.1097/QAI.0000000000003847","DOIUrl":"10.1097/QAI.0000000000003847","url":null,"abstract":"<p><strong>Background: </strong>As people with HIV (PWH) live longer because of effective antiretroviral therapy, age-related comorbidities-including cognitive impairment-are increasingly prevalent. HIV-associated neurocognitive disorders (HAND) remain a major cause of morbidity. In prior work, we identified an association between blood-brain barrier (BBB)-penetrant angiotensin-converting enzyme inhibitors (ACEi) and reduced risk of dementia in PWH. We are now expanding our work and methodology to more the effects of BBB ACEi on the risk of HAND.</p><p><strong>Methods: </strong>Using the Veterans Affairs Informatics and Computing Infrastructure, we conducted a retrospective cohort study to evaluate the association between BBB ACEi exposure and incident HAND among PWH. We used natural language processing to identify clinically documented HAND cases-including HIV-associated dementia, mild neurocognitive disorder, and asymptomatic neurocognitive impairment-from unstructured electronic medical notes. Eligible patients initiated ACEi therapy after HIV diagnosis between 2000 and 2024. Cox proportional hazards models, propensity score matching, and inverse probability treatment weighting were used to estimate adjusted hazard ratios.</p><p><strong>Results: </strong>Among 10,512 eligible PWH, 10,110 were exposed to BBB ACEi and 402 to non-BBB ACEi. In the unmatched cohort, HAND incidence was similar between groups (5.13% vs. 5.47%). However, after propensity score matching (n = 349 per group), BBB ACEi exposure was associated with a significantly lower risk of HAND (hazard ratio = 0.401; 95% confidence interval: 0.175-0.917).</p><p><strong>Conclusions: </strong>BBB-penetrant ACEi were associated with a reduced risk of incident HAND in a propensity score-matched cohort of PWH. These findings support further investigation into repurposing centrally acting ACEi as a potential neuroprotective strategy in the HIV population.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"663-670"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146169207","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":"Increasing Syphilis Prevalence Among MSM Across India Despite Improvements in the HIV Care Continuum.","authors":"Matthew M Hamill, Mihili P Gunaratne, Allison M McFall, Hussain Syed Iqbal, Canjeevaram K Vasudevan, Santhanam Anand, Sunil S Solomon, Shruti H Mehta, Aylur K Krishnan, David D Celentano, Gregory M Lucas","doi":"10.1097/QAI.0000000000003860","DOIUrl":"10.1097/QAI.0000000000003860","url":null,"abstract":"<p><strong>Introduction: </strong>Syphilis rates have increased in many regions, especially in men who have sex with men (MSM). Yet data are sparse from low- and middle-income countries. We characterized changes in syphilis prevalence across serial respondent-driven sampling surveys in 10 Indian cities between 2012 and 2024.</p><p><strong>Methods: </strong>We used respondent-driven sampling of MSM in 2012-2013 (10 cities), 2016-2017 (same 10 cities), and 2023-2024 (3 of 10 cities). Participants were ≥18 years, male, and reported sex with a man in the prior 12 months. Participants completed a survey, had a rapid HIV antibody test, with reflex HIV RNA and rapid plasma regain confirmed by Treponema pallidum hemagglutination on stored specimens. We assessed syphilis (rapid plasma regain and Treponema pallidum hemagglutination positive) correlates for the 2016-2017 time period using multilevel Poisson regression models, estimating prevalence ratios.</p><p><strong>Results: </strong>Of 9991, 9993, and 2249 participants, median ages were 25, 29, and 28 years, respectively. Almost 50% reported recent condomless anal sex across all rounds. Syphilis prevalence was 2.9%, 7.4%, 15.6% respectively. Less than 10% of participants with positive serology reported a prior diagnosis of syphilis. During the same period, HIV prevalence and viral load suppression doubled. In multivariable analysis, living with HIV (vs. not), ≥2 recent male sexual partners, self-reported history of syphilis, and recent anogenital ulceration was associated with syphilis.</p><p><strong>Discussion: </strong>Syphilis prevalence dramatically increased among MSM over a decade. Concurrently, HIV viremia substantially declined. These data suggest barriers to syphilis testing in urban Indian MSM. Innovations including dual rapid HIV/syphilis antibody tests may increase detection rates.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"633-642"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719318","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":"Cancer Screening Rates, Disparities by Immigration Status, and Predictors of Cancer Screening Among Black Women With HIV.","authors":"Vanessa Ayafor, Alicia Downes, Shakeila Lewis-Chery, Howard J Cabral, Xiyuan Zhang, Rahab Goodwin, LaShonda Y Spencer, Serena Rajabiun","doi":"10.1097/QAI.0000000000003837","DOIUrl":"10.1097/QAI.0000000000003837","url":null,"abstract":"<p><strong>Introduction: </strong>People with HIV have a higher incidence and mortality from screenable cancers than the general population. Among women, the 4 most common cancers are breast, colorectal, lung, and cervical cancers. This study examined breast, colorectal, lung, and cervical cancer screening rates among Black women with HIV and disparities that exist by immigration status.</p><p><strong>Methods: </strong>With a sample of 604 women, we examined cancer screening rates for breast, colorectal, lung, and cervical cancers and examined the rates by country of origin. Generalized linear mixed models were used to examine potential factors affecting these rates and the odds of screening by country of origin: US-born women (USBW) and non-US-born women (NUSBW).</p><p><strong>Results: </strong>Cancer screening rates were low for all cancer categories for both groups. A screening rate of 48.7% was estimated for breast cancer (NUSBW-35.9% versus USBW-50.4%), 6.3% for lung cancer, 25.5% for colorectal cancer, and 72.8% for cervical cancer. NUSBW had lower screening rates for all 4 cancers compared with USBW. Possible predictors for cancer screenings were years of living with HIV [odds ratios (OR) 1.11; 95% CI: 1.07 to 1.14] and no viral suppression (OR 0.34; 95% CI: 0.15 to 0.76).</p><p><strong>Conclusion: </strong>Black women with HIV and much more immigrant subgroups may face additional barriers to accessing required cancer screening services in addition to being disproportionately affected by HIV. This emphasizes the urgent need for tailored, culturally relevant outreach and education to enhance cancer screening.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"597-603"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055960","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":"Brief Report: Intersecting Vulnerabilities: The Role of Housing Instability and Methamphetamine Use on HIV Acquisition.","authors":"Marjan Javanbakht, Allison D Rosen, Eden Moore, Steven Shoptaw, Pamina M Gorbach","doi":"10.1097/QAI.0000000000003836","DOIUrl":"10.1097/QAI.0000000000003836","url":null,"abstract":"<p><strong>Background: </strong>This study examines the synergistic impact of housing instability and methamphetamine use on the incidence of HIV infection.</p><p><strong>Setting: </strong>Data are from a prospective cohort study of men who have sex with men in Los Angeles, CA. Participants were recruited from a university-based research clinic and a community sexual health/HIV clinic, where both recruitment and study activities were conducted.</p><p><strong>Methods: </strong>Eligible participants were 18-45 years of age, male, reported HIV transmission-potential sexual behaviors, and tested HIV-negative at baseline. At semiannual visits, participants reported housing status and substance use and underwent HIV testing. Unstable housing was defined as ≥1 day without a regular place to stay. Methamphetamine use (past 6 months) was reported as daily, weekly, monthly, less often, or never. Survival analysis with time varying covariates assessed incidence and factors associated with HIV seroconversion.</p><p><strong>Results: </strong>This analysis included 277 participants enrolled between 2014 and 2022 with ≥1 follow-up visit through January 2025 [n = 2453 study visits; median follow-up 4.6 years (IQR: 1.1-7.6)]. Past 6-month methamphetamine use was 32%, and unstable housing was 34%. Twenty one participants tested positive for HIV at follow-up [incidence 1.6/100 person-years (PY), highest among those with unstable housing and daily methamphetamine use (7.7/100 PY)]. Daily methamphetamine use and unstable housing were both associated with HIV seroconversion (HR = 3.1, 95% CI: 1.1 to 8.6; HR = 2.1, 95% CI: 0.9 to 5.3, respectively).</p><p><strong>Conclusions: </strong>These findings demonstrate the potential synergy between housing instability and daily methamphetamine use on HIV risk and underscore the need for integrated prevention strategies that address these factors.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"575-579"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055971","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":"Brief Report: Optimizing STI Prevention: Barriers, Behaviors, and Broader Impacts of Doxycycline Postexposure Prophylaxis (DoxyPEP).","authors":"Nicholas Eynon, Karan Prasad, Helen Bassett, Jordan Johnson, Riley Smith, Ariana Johnson, Susanne Doblecki-Lewis","doi":"10.1097/QAI.0000000000003849","DOIUrl":"10.1097/QAI.0000000000003849","url":null,"abstract":"<p><strong>Background: </strong>Doxycycline postexposure prophylaxis (DoxyPEP) is a novel strategy for preventing sexually transmitted infections (STIs). Although its clinical efficacy is established, less is known about its implementation, accessibility, and associated behavioral adaptations. This study evaluated these factors at the University of Miami Rapid Access Wellness clinic, which offers preexposure prophylaxis, non-occupational post-exposure prophylaxis (nPEP), HIV care, and, since May 2023, DoxyPEP.</p><p><strong>Methods: </strong>From February to November 2024, clients at the Rapid Access Wellness Clinic were recruited to complete electronic surveys assessing DoxyPEP awareness, barriers, behaviors, and satisfaction. Survey responses were linked to medical records for analysis.</p><p><strong>Results: </strong>Among 135 participants (mean age 36 years), 77% identified as men, 16% as transgender, 69% as Hispanic/Latino, and 13% as Black/African American. The median number of sexual partners at intake was 5. DoxyPEP awareness was high (89%), with 77% actively using it. Most felt comfortable discussing DoxyPEP with doctors (92%), friends (60%), and sexual partners (55%). Cost was not a reported barrier for 68%. Nearly half (46%) reported behavioral changes because of DoxyPEP, including increased sexual partners (20%), reduced condom use (17%), and more anal sex (15%). More than half (55%) felt less concerned about STI exposure. Most (90%) were likely to discuss DoxyPEP with others, with 84% having already recommended it, primarily to friends (67%). In total, 94% planned to continue its use.</p><p><strong>Conclusions: </strong>DoxyPEP was widely accepted, accessible, and frequently promoted through peer networks, indicating a potential mechanism for broadening awareness of DoxyPEP among priority populations. Further study of associated behavioral changes may help optimize its role in STI prevention.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"643-648"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146169166","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 SGLT2 Inhibitors on Kidney Function Among People With HIV: A US Prospective Multisite Study.","authors":"Lara Haidar, Heidi M Crane, Robin M Nance, Malcolm B Doupe, Christine Leong, Laura Bamford, Greer Burkholder, Edward Cachay, Katerina Christopoulos, Alexander Commanday, Laila Aboulatta, Joseph A C Delaney, Lydia N Drumright, Carolyn A Fahey, Sonya Heath, Robert Kalayjian, Mari M Kitahata, Ryan P Kyle, Kenneth H Mayer, Richard D Moore, April C Pettit, Sonia Napravnik, Stephanie A Ruderman, Michael S Saag, Amanda L Willig, Bridget M Whitney, Sherif Eltonsy","doi":"10.1097/QAI.0000000000003854","DOIUrl":"10.1097/QAI.0000000000003854","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are nephroprotective but are associated with early eGFR decline, also termed \"eGFR dip.\" Despite elevated risk of kidney disease, this phenomenon is understudied among people with HIV (PWH).</p><p><strong>Methods: </strong>In a 1:1 propensity score-matched cohort study using data from 9 Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites, we compared new SGLT2i users with new users of other antihyperglycemic classes. We estimated adjusted hazard ratios (aHRs) for time to ≥10% and ≥30% eGFR decline using multivariable Cox proportional hazards models and analyzed eGFR change using multivariable linear mixed models. In addition, longer-term eGFR trends over 24 months were visualized using locally weighted scatterplot smoothing (LOWESS) curves.</p><p><strong>Results: </strong>Among 1554 eligible PWH, we obtained 295 matched pairs. Over 6 months, eGFR decline incidence of ≥10% and ≥30% was higher among users of SGLT2i versus other antihyperglycemic classes (58.2% vs. 37.4%; aHR: 1.79; 95% CI: 1.40%-2.28%; and 17.3% vs. 9.8%; aHR: 1.69; 95% CI: 1.05-2.73; respectively). The adjusted mean eGFR change at 6 months was -2.62 mL/min/1.73 m 2 for SGLT2i versus 0.05 mL/min/1.73 m 2 for other classes. Long-term eGFR trends revealed an expected initial decline after SGLT2i initiation, followed by stabilization and a slower subsequent decline compared with other classes.</p><p><strong>Conclusions: </strong>Acute eGFR dips were more common among PWH initiating SGLT2i relative to other antihyperglycemic classes, although overall declines were small, transient, and consistent with the general population. Further research is needed to explore the long-term effects of SGLT2i in PWH.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":"680-687"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286845","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}