AIDS最新文献

{"title":"Partnering with traditional healers to increase HIV testing in Senegal, West Africa.","authors":"Noelle A Benzekri, Jacques F Sambou, Yaya Diedhiou, Mamadou Lamine Sagna, Ibrahima Tito Tamba, Stephen E Hawes, Noël Magloire Manga, Geoffrey S Gottlieb, Moussa Seydi","doi":"10.1097/QAD.0000000000004301","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004301","url":null,"abstract":"<p><p>The goal of this study was to implement and evaluate a traditional healer administered HIV rapid diagnostic testing and referral system in Senegal. Twenty traditional healers were enrolled. Traditional healers offered testing to 1284 individuals. There were no refusals. Of the 1284 individuals who underwent testing, 53 (4.1%) had a positive result. Of the 53 with a positive result, 53 (100%) were referred to clinic. Of the 53 referred to clinic, 38 (71.7%) presented to clinic. Of the 38 who presented to clinic, 31 (81.6%) were confirmed HIV-positive and received ART. This approach provides an acceptable and feasible strategy to increase HIV testing and linkage to care in the region.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 13","pages":"1978-1981"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retention in care and viral suppression in pregnant/postpartum vs. nonpregnant/nonpostpartum women with HIV.","authors":"Ellen Moseholm, Lars H Omland, Terese L Katzenstein, Gitte Pedersen, Isik S Johansen, Merete Storgaard, Nina Weis","doi":"10.1097/QAD.0000000000004275","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004275","url":null,"abstract":"<p><strong>Objective: </strong>To investigate retention in care, viral suppression, and virological failure in pregnant and postpartum women with HIV compared to nonpregnant/nonpostpartum women with HIV in Denmark, and to explore factors associated with adverse HIV care outcomes.</p><p><strong>Design: </strong>A nationwide registry-based cohort study.</p><p><strong>Methods: </strong>All women with HIV, who delivered in Denmark from 2000 to 2019, alongside a comparison group of nonpregnant/nonpostpartum women with HIV were included from the Danish HIV Birth Cohort and the Danish HIV Cohort Study and linked to national health registries. We assessed outcomes: retention in care (two HIV RNA or CD4+ measurements ≥90 days apart within a year), viral suppression (HIV RNA <200 copies/ml at the latest measurement), and virological failure (two consecutive HIV RNA measurements >200 copies/ml or one >1000 copies/ml). Incidence rate ratios evaluated group differences, and logistic regression analyzed factors linked to adverse outcomes.</p><p><strong>Results: </strong>We included 564 pregnant and 1705 nonpregnant/nonpostpartum women with HIV. Retention in care was significantly lower during pregnancy, especially for deliveries before 2014, and in the second postpartum year. No significant differences in viral suppression were found between groups after stratification by delivery year or in women with more than 1 year since HIV diagnosis. Pregnant women had higher rates of virological failure, while postpartum women had lower rates, significant only in the second postpartum year for women delivering before 2010.</p><p><strong>Conclusion: </strong>Based on CD4+/HIV RNA measurements, retention in care was lower in pregnant and postpartum women, particularly in the second year. Reassuringly, viral suppression and virological failure rates were comparable.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 13","pages":"1936-1945"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poverty and protection: the relationship between multidimensional poverty, social protection interventions, and HIV viral load.","authors":"Amrita Ayer, Rutendo W Mukondwa, César Avilés-Guamán, Kudakwashe Takarinda, Nora West, Tatenda Makoni, Sinokuthaba Mukungwa, Waraidzo Mukuwapasi, Mollie Hudson, Canice Christian, Karen Webb, Priya B Shete","doi":"10.1097/QAD.0000000000004276","DOIUrl":"10.1097/QAD.0000000000004276","url":null,"abstract":"<p><strong>Objectives: </strong>Social protection can mitigate poverty's effects on HIV, but program implementation may influence impact. We explored relationships between multidimensional poverty, social protection programming, and HIV viral load among an adult population with HIV (PWH) in Zimbabwe.</p><p><strong>Design: </strong>A sequential explanatory mixed methods study.</p><p><strong>Methods: </strong>We analyzed retrospective cross-sectional data from client satisfaction surveys collected between January and July 2023 among adult PWH receiving care in 15 districts of Zimbabwe. We employed descriptive analyses, generalized estimated equations, and moderation analyses to evaluate relationships between multidimensional poverty, social protection, and viral load nonsuppression. Between August and September 2023, we conducted semi-structured in-depth interviews (IDIs) with adults regarding access to tuberculosis care and social protection interventions. We applied the Exploration, Preparation, Implementation, and Sustainment framework for qualitative analysis and integrated results at the interpretation phase.</p><p><strong>Results: </strong>Among 13 722 PWH [65.4% women, median age 44 years (interquartile range: 36-52)], 44.4% were multidimensionally poor. Only 18% had ever received social protection. Poverty was associated with viral load nonsuppression [adjusted prevalence ratio (aPR) = 1.55; 95% confidence interval (CI): 1.13-2.13], as was social protection receipt [aPR = 1.67; 95% CI: 1.07-2.62)]. IDIs showed that PWH experienced significant impoverishment, had little information about and access to social protection, and reported limited quantities and durations of receipt.</p><p><strong>Conclusion: </strong>We observed a high burden of poverty and tenuous access to social protection. Multidimensional poverty was associated with virologic nonsuppression, as was social protection receipt, which may signal significant vulnerability in our population and inadequacy of social protection coverage and responsiveness.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1926-1935"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating a mental health referral system within adolescent HIV clinics in Tanzania.","authors":"Dana Chow, Paul Pronyk, Rainald Mgimba, Winner Elimwaria, Regina Ndaki, Aloyce Ambokile, Blandina T Mmbaga, Dorothy Dow","doi":"10.1097/QAD.0000000000004279","DOIUrl":"10.1097/QAD.0000000000004279","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the acceptability and feasibility of integrating a mental health stepped-care referral pathway for young people with HIV (YPWH) who screened positive for mental health distress using task-sharing and stepped-care approaches.</p><p><strong>Design: </strong>This is a longitudinal nested study within the Sauti ya Vijana (SYV: The Voice of Youth) randomized controlled trial, describing an integrated referral pathway created within adolescent HIV clinics. SYV is a peer-led, group-based mental health intervention for YPWH. The study includes youth enrolled between March and September 2023 who completed a 6-month visit by March 2024.</p><p><strong>Methods: </strong>YPWH who knew their HIV status, received antiretroviral therapy, and could attend 10-weekly intervention sessions were included. Enrolled youth responded to interviewer-guided mental health screening questionnaires at every study visit. Automatic referral alerts were generated if a YPWH had a total score ≥10 on the Patient Health Questionnaire (PHQ-9) or General Anxiety Disorder (GAD-7) Questionnaire, reported sexual abuse, self-harm, or suicidal ideation. An interviewer could self-refer a participant if they had a separate mental health concern. Site-specific mental health referrals were tracked using a REDCap database. Data were analyzed for incidence of mental health referrals, attendance to referral appointment, and outcome.</p><p><strong>Results: </strong>Of 349 YPWH included in this study, 62 (18%) generated referral alerts. Most attended their appointment ( n  = 50, 81%) and many ( n  = 28, 56%) experienced resolution of distress after one visit. Eight participants required stepped-up care to a mental health professional.</p><p><strong>Conclusion: </strong>The integration of a mental health stepped-care referral pathway was acceptable and feasible for YPLW within existing primary adolescent HIV clinics in Tanzania.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1920-1925"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of immunosuppression and HIV control with Kaposi sarcoma among patients on antiretroviral therapy.","authors":"Anna E Coghill, Zachary Thompson, Laura Bamford, Greer Burkholder, Joseph Enron, Satish Gopal, Mari M Kitahata, Kenneth H Mayer, Richard Moore, George Yendewa, Brittney L Dickey, Elizabeth Yanik, Chad Achenbach","doi":"10.1097/QAD.0000000000004303","DOIUrl":"10.1097/QAD.0000000000004303","url":null,"abstract":"<p><strong>Objective: </strong>Access to antiretroviral therapy (ART) has resulted in a decline in Kaposi sarcoma incidence among people with HIV (PWH). However, Kaposi sarcoma is still occurring among PWH receiving ART, and it is important to understand the degree to which risk of Kaposi sarcoma is impacted by response to ART.</p><p><strong>Methods: </strong>We examined the changing epidemiology of Kaposi sarcoma among more than 20, 000 PWH receiving HIV care between 1996 and 2016 in the Center for AIDS Research Network of Integrated Clinical Systems (CNICS). We evaluated the association of Kaposi sarcoma with CD4 + T-cell count and HIV viral load at ART initiation, within 6-12 months of ART initiation, and during clinical follow-up after ART initiation.</p><p><strong>Results: </strong>A total of 344 PWH were diagnosed with Kaposi sarcoma. CD4 + T-cell count less than 200 cells/μl at ART initiation was associated with a more than six-fold increased Kaposi sarcoma risk. Likewise, an HIV viral load more than 50, 000 copies/ml at ART initiation was associated with a more than three-fold increased Kaposi sarcoma risk. For every 100 cells/μl increase in CD4 + T-cell count or log-unit decrease in HIV viral load during the 12-18 months after ART initiation, we observed 11 and 7% lower Kaposi sarcoma risk, respectively. During clinical follow-up after ART initiation, every 10% increase in time with a CD4 + T-cell count greater than 350 cells/μl or an HIV viral load less than 500 copies/ml was associated with 24 and 26% lower Kaposi sarcoma risk, respectively. All results reported here were statistically significant at the P  < 0.05 threshold.</p><p><strong>Conclusion: </strong>Kaposi sarcoma risk among PWH receiving HIV care was significantly impacted by not only CD4 + T-cell count and viral load at ART initiation but also by long-term suppression of HIV after ART initiation.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1963-1969"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlations among quantitative assays that measure the size of HIV reservoirs in people with HIV receiving antiretroviral therapy.","authors":"Adeline B Sewack, Maegan R Manning, Jana Blazkova, Jesse S Justement, Victoria Shi, Lauren Praiss, Sonali Dasari, Kathleen Gittens, Catherine A Seamon, Paul A Wender, Michael C Sneller, Susan Moir, Tae-Wook Chun","doi":"10.1097/QAD.0000000000004297","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004297","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 13","pages":"1982-1984"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left behind? A longitudinal analysis of need for preexposure prophylaxis services among middle-aged and older adults in South Africa.","authors":"Maja E Marcus, Elizabeth Zhang, Jennifer Hove, Hannah Jordan, Till Bärnighausen, Stephen Tollman, Kathleen Kahn, Julia K Rohr, Brendan Maughan-Brown, Jennifer Manne-Goehler","doi":"10.1097/QAD.0000000000004283","DOIUrl":"10.1097/QAD.0000000000004283","url":null,"abstract":"<p><strong>Introduction: </strong>Despite 1.3 million cumulative preexposure prophylaxis (PrEP) initiations in South Africa, 150 000+ people newly acquire HIV every year. A significant proportion of these are middle-aged adults, a population not previously prioritized for PrEP. Evidence on how many middle-aged and older adults in South Africa may benefit from PrEP services is needed.</p><p><strong>Methods: </strong>We estimate the need for PrEP counseling in a sample of 40+ year-old, rural South Africans in 2018 and 2022, using \"Health and Aging in Africa: A Longitudinal Study in South Africa (HAALSI)\" data. We first identify potential PrEP eligibility based on a negative HIV status and a body weight of 35+ kg. Within this sample, we define the population that should be counselled on PrEP as per South African Guidelines for the Provision of PrEP based on a recent history of having had sex without a condom. We estimate cross-sectional and longitudinal need for PrEP counseling at the pooled level and disaggregated by sex and age.</p><p><strong>Results: </strong>Of the 1654 individuals considered potentially eligible for PrEP in 2022, 39.6% overall, 55.7% of men, 26.7% of women, and 63.3% of 40-49 year-olds should be counseled on PrEP. Longitudinally, 29.9 and 22.9% should be counseled on PrEP in both waves or only one wave respectively. Further, we found significantly higher odds of need for PrEP counseling in male, younger, and married individuals.</p><p><strong>Conclusion: </strong>We find a high need for PrEP counseling among middle-aged and older South Africans, calling for greater attention to HIV prevention, including targeted PrEP for these age groups.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1946-1953"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cancer screening in women with HIV: an audit of clinical care.","authors":"Patricia M Griffiths, Ranjit Samra, Geoffrey Lester, Phil Rawson-Harris, Jennifer F Hoy, James H McMahon","doi":"10.1097/QAD.0000000000004266","DOIUrl":"10.1097/QAD.0000000000004266","url":null,"abstract":"<p><strong>Objectives: </strong>Women with HIV (WHV) have an increased prevalence of cervical cancer and are recommended three yearly cervical cancer screening. This is compared with five yearly screening their counterparts. We aimed to describe cervical cancer screening practices for WHV receiving HIV care at a large tertiary hospital.</p><p><strong>Methods: </strong>We performed a retrospective audit on all women who were in HIV care up until January 2023 at the Alfred Hospital, a tertiary hospital in Melbourne, Australia, specializing in HIV care. Cervical cancer screening results for Medicare eligible people are recorded in The National Cervical Cancer Screening Register (NCCSR) and these were extracted for women in care. Screening was categorized as up-to-date and consistent with national screening guidelines or overdue.</p><p><strong>Results: </strong>We identified 156 WHV in care of which 115 were included in the analysis. Of these, 57 (49.6%) had cervical screening on time and consistent with national guidelines, including 49 (86%) who had a normal last result and 8 (14%) with an abnormal last result. Half the women, 58 (50.4%) were overdue screening. Of those overdue, 52 (89.7%) were more than 6 months and 45 (76.3%) were more than 12 months overdue. Among the women overdue, 47 (81%) had a normal last result and 7 (12.1%) an abnormal last result.</p><p><strong>Conclusion: </strong>We found that over half of the women included were overdue for their cervical screening test, with the vast majority being overdue by more than twelve months. Improved access to cervical cancer screening is needed in this population to achieve national guidelines targets.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1907-1912"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kaposi sarcoma: today, yesterday, and tomorrow.","authors":"James J Goedert","doi":"10.1097/QAD.0000000000004194","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004194","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 13","pages":"1972-1974"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Risk of Cardiovascular Disease Events (PREVENT) score accuracy among people with HIV in the multicenter CNICS cohort.","authors":"Matthew S Durstenfeld, Robin M Nance, Raymond Jones, Rebecca Abelman, Alexander P Hoffmann, Greer Burkholder, Priscilla Y Hsue, Chris T Longenecker, Peter W Hunt, Michael S Saag, Joseph A C Delaney, Matthew J Feinstein, Heidi M Crane","doi":"10.1097/QAD.0000000000004331","DOIUrl":"10.1097/QAD.0000000000004331","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) are at elevated cardiovascular risk, but existing calculators have suboptimal calibration for this population. The American Heart Association developed new prediction equations (PREVENT) to replace the pooled cohort equations (PCE). PREVENT has not been validated among PWH.</p><p><strong>Methods: </strong>Within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort, we included individuals aged 40-75 without myocardial infarction or stroke at baseline from 2001 to 2021. We calculated predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk at baseline using the PCE and the PREVENT 10-year ASCVD base equation. Myocardial infarction and stroke were systematically adjudicated. To assess discrimination, we calculated Harrell's C -index and to assess calibration we used the Greenwood-Nam-D'Agostino goodness-of-fit tests.</p><p><strong>Results: </strong>We included 13 135 individuals from five sites across the United States. Mean age at enrollment was 44 ± 9 years and 18% were female. Mean predicted 10-year ASCVD risk was 5.8% by PCE and 2.9% by PREVENT. Over 5.7 ± 3.5 years of follow-up, 628 individuals had myocardial infarction or stroke. Discrimination was improved with PREVENT compared to PCE, with Harrell's C -indexes of 0.722 (95% CI 0.701, 0.741) and 0.708 (95% CI 0.687, 0.729), respectively ( P  = 0.008). Both equations underpredicted risk: the observed-to-expected ratio was 2.69 for PREVENT ( P  < 0.001) and 1.35 for PCE ( P  < 0.001). Calibration slopes were 1.998 for PREVENT and 0.932 for PCE, respectively.</p><p><strong>Conclusions: </strong>Among this cohort of PWH, the PREVENT 10-year ASCVD equations were poorly calibrated and underestimated composite risk for myocardial infarction and stroke, with observed risks more than double predicted risks.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"F5-F11"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}