AIDS最新文献

{"title":"LDL-C target achievement in people living with HIV: impact of combination lipid-lowering therapy. A retrospective cohort analysis.","authors":"Marcella Manicardi, Jovana Milic, Giuseppe Esposito, Marianna Menozzi, Giuseppe Mancini, Gian Luca Cuomo, Lorenzo Benassi, Elisabetta Delmonte, Severino Ambrosio, Cristina Mussini, Giuseppe Boriani, Giovanni Guaraldi","doi":"10.1097/QAD.0000000000004594","DOIUrl":"10.1097/QAD.0000000000004594","url":null,"abstract":"<p><strong>Background: </strong>Real-world low-density lipoprotein cholesterol (LDL-C) target attainment remains low in people with HIV (PWH). Updated ESC/EAS 2025 guidelines underscore the need to reassess treatment patterns in clinical practice.</p><p><strong>Methods: </strong>Retrospective observational longitudinal study including PWH ≥40 years, evaluated twice between 2020 and 2025 at the Modena HIV Metabolic Clinic, with complete laboratory and clinical follow-up data. Objective was to evaluate the real-world use and effectiveness of different lipid-lowering therapy (LLT) regimens in achieving guideline-based LDL-C targets.</p><p><strong>Results: </strong>Among 588 PWH (71.8% male), median age was 60 years (IQR 56-64) and 97.4% had suppressed HIV viral load. According to cardiovascular (CV) risk classification, 29.3% were at moderate risk, 52% at high risk, 12.4% at very high risk and 6.3% at extreme risk. LDL-C target attainment increased from 19.6% at baseline to 28.8% at follow-up. Achievement rates declined with increasing CV risk. In multivariable analysis, combination LLT was the strongest predictor of LDL-C target attainment (odds ratio 5.7, 95% confidence interval 3.7-9.0, P  < 0.0001), whereas statin dose escalation was not. Diabetes was also associated with greater odds of reaching LDL-C goals.</p><p><strong>Conclusions: </strong>LDL-C control remains suboptimal in PWH, particularly among those at higher cardiovascular risk. Combination lipid-lowering therapy markedly increases the likelihood of achieving LDL-C targets, supporting broader adoption of combination strategies in routine HIV care.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786944","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":"Viral suppression in models of care for improving engagement of antiretroviral therapy in postpartum women living with HIV.","authors":"Mustafa Shuaib, Jasantha Odayar, Tamsin K Phillips, Thokozile R Malaba, Elaine J Abrams, Landon Myer","doi":"10.1097/QAD.0000000000004603","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004603","url":null,"abstract":"<p><strong>Objective: </strong>To compare viral suppression between two models of care [adherence club and integrated maternal and child healthcare (MCH)] for improving engagement of postpartum women with HIV (WWH) to antiretroviral therapy (ART).</p><p><strong>Design: </strong>Individual participant data network meta-analysis (IPD-NMA) of two randomized controlled trials in Cape Town, South Africa [Postpartum Adherence Clubs for Antiretroviral Therapy (PACART) comparing adherence clubs to standard of care (primary healthcare ART clinics, SOC), and MCH-ART comparing integrated MCH for the duration of breastfeeding to SOC].</p><p><strong>Methods: </strong>One-step IPD-NMA using generalized linear mixed effects models was performed to indirectly compare viral suppression (viral load<50 copies/ml) between adherence clubs and integrated MCH at 6 and 12 months postpartum, linked by SOC as a comparator.</p><p><strong>Results: </strong>Overall, 882 women were included: 471 enrolled in MCH-ART and 411 in PACART. In MCH-ART, 87 and 79% of women in intervention arm had viral suppression at 6 and 12 months postpartum, compared to 70 and 54% in SOC. In PACART, 87 and 74% of women had viral suppression at 6 and 12 months in intervention arm, compared to 79 and 67% in SOC. Adjusting for age, parity, socioeconomic status, tuberculosis (TB) history, HIV diagnosis time, ART duration, and viral load less than 400 copies/ml at enrolment, relative odds of viral suppression in integrated MCH versus adherence clubs were 2 [95% confidence interval (CI): 0.88-4.53] at 6 months and 2.89 (CI: 1.42-5.90) at 12 months.</p><p><strong>Conclusion: </strong>In this setting, an integrated MCH model for delivering ART postpartum achieved higher levels and more sustained effect on viral suppression compared to adherence clubs, a popular differentiated service delivery (DSD) model for ART.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817129","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":"Distinct associations of peripheral mtDNA copy number and bioenergetic function with cognition in women with HIV and psychiatric comorbidities.","authors":"Hannah Stadtler, Leah H Rubin, Gretchen N Neigh","doi":"10.1097/QAD.0000000000004597","DOIUrl":"10.1097/QAD.0000000000004597","url":null,"abstract":"<p><strong>Background: </strong>Women with HIV (WWH) are disproportionately affected by cognitive impairment across multiple domains, with learning and memory consistently among the most vulnerable. Mechanistic investigations into the increased burden of cognitive impairment in people with HIV have highlighted mitochondrial dysfunction as a potential contributor. This study examined associations between two peripheral markers of mitochondrial health, mitochondrial DNA copy number (mtDNAcn) and mitochondrial bioenergetic function, and cognitive function in WWH. We hypothesized that mtDNAcn and mitochondrial function metrics would demonstrate distinct associations with cognitive outcomes, particularly learning and memory.</p><p><strong>Methods: </strong>Fifty-eight WWH completed 12 neuropsychological tests assessing - verbal learning, verbal memory (recall and recognition), attention, working memory, executive function, fluency, processing speed, and motor function. Peripheral blood mononuclear cells (PBMCs) were isolated, and mitochondrial health was assessed using qPCR (mtDNAcn) and the Seahorse Cell Mito Stress Test (mitochondrial function). Pearson correlations examined associations between mitochondrial health and cognitive domain scores.</p><p><strong>Results: </strong>Participants were on average 54.9 years old (SD = 8.2), 94.8% were Black, 58.6% had a lifetime diagnosis of major depressive disorder, and 63.7% met criteria for cognitive impairment in ≥2 domains. Higher mitochondrial proton leak was significantly associated with worse verbal memory including recall ( r  = -0.396, P  = 0.002) and recognition ( r  = -0284, P  = 0.031), as well as poorer working memory ( r  = -0.261, P  = 0.048). No significant associations were observed between mtDNAcn and cognition.</p><p><strong>Conclusions: </strong>These findings identify peripheral mitochondrial proton leak as a potential biological correlate of verbal and working memory difficulties in WWH and highlight the importance of assessing multiple dimensions of mitochondrial health when investigating cognitive impairment.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676705","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":"Reframing analytical treatment interruption through participants' and decliners' eyes: insights from an HIV remission trial.","authors":"Sarah Lefebvre, Cécile Goujard, Laurence Meyer, Christine Durier, Mélanie Jaudon, Joséphine Tine, Lucie De Gastines, Nicolas Leturque, Vincent Meiffredy, Bruno Spire, Asier Saez-Cirion, Christel Protiere","doi":"10.1097/QAD.0000000000004602","DOIUrl":"10.1097/QAD.0000000000004602","url":null,"abstract":"<p><strong>Objectives: </strong>This study explored how participants and decliners perceived the French ANRS-175-RHIVIERA-01 trial, which evaluated HIV control during analytical treatment interruption (ATI) among individuals treated with antiretroviral treatment (ART) since acute HIV infection, virologically suppressed, and carrying the HLA-B35/53Bw4TTC2 genotype. It also explored how participants' experiences evolved over follow-up.</p><p><strong>Methods: </strong>Between 2023 and 2024, semi-structured interviews were conducted with decliners and participants. Interviews were analyzed using interpretative description and thematic analysis.</p><p><strong>Results: </strong>We interviewed 13 participants (3 women) and 3 decliners (all men). Median age was 51, and median time since diagnosis was 10 years. Participants described the trial as 'good news', hoped for personal benefit, and expressed a sense of moral obligation toward healthcare providers (HCPs). Decliners perceived no personal benefit and considered ATI too risky. Most participants experienced ART interruption positively, although only women described it as a 'relief'. Most appreciated the home-based blood sampling option. Experiences evolved during viral rebound, shaped by HCPs' discourses, viral load levels, and symptoms. Those who resumed ART experienced it as a disappointment, and sometimes as a 'failure'. Participants mobilized three forms of experiential knowledge: physical, clinical, and theoretical. All were satisfied with their decision to participate.</p><p><strong>Conclusion: </strong>Our findings show that ATI is not a homogeneous experience but a dynamic process comprising three successive phases: ART interruption, viral rebound, and, for some, ART resumption. Moreover, they highlight the need for careful semantic framing in interactions with eligible individuals, exploration of HCPs' emotional investment, and integration of gender-related considerations in future research.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719608","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":"Clusters and outbreaks contribute disproportionately to future HIV transmission in the United States.","authors":"Nivedha Panneer, Anne Marie France, Rachael M Billock, Md Hafizul Islam, Karen Schlanger, Robert A Bonacci, Alexandra M Oster, Paul G Farnham, Chaitra Gopalappa","doi":"10.1097/QAD.0000000000004609","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004609","url":null,"abstract":"<p><strong>Objectives: </strong>Quantify future transmission associated with clusters of rapid transmission and among all persons with HIV (PWH); estimate the role of undiagnosed infection and diagnosed but unsuppressed infection in future transmissions.</p><p><strong>Design: </strong>Network simulation model of sexually transmitted HIV in the United States that includes a cluster generation algorithm to simulate clusters of rapid transmission and associated networks.</p><p><strong>Methods: </strong>Clusters were defined as at least three persons with diagnosed HIV in 2017 and with sequences, connected using a 0.5% genetic distance threshold. The cluster generation algorithm was then applied to all PWH (including persons with undiagnosed infection) to identify full clusters. We calculated cumulative transmissions, defined as the number of new infections during 2018-2022 per 100 PWH in 2017, overall and stratified by cluster membership, diagnosis, and viral suppression status. We simulated 1300 trials (130 runs; 10 replicates/run); medians and ranges are presented.</p><p><strong>Results: </strong>Cumulative transmissions per 100 PWH were 19 [16, 22] for all PWH and 49 [0, 238] for full clusters. In full clusters, cumulative transmissions for persons with undiagnosed infection or diagnosed but virally unsuppressed infection were 85 [0, 633] and 61 [0, 300], respectively. Among all PWH, cumulative transmissions for persons with undiagnosed infection or diagnosed but virally unsuppressed infection were 59 [49, 74] and 23 [16, 29], respectively.</p><p><strong>Conclusions: </strong>Given high HIV transmission in the 5 years following cluster detection, intervening in clusters could have an outsized impact on averting future infections. Focusing testing, prevention, and care activities on persons in clusters and their networks is essential to achieve this goal.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817150","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":"Changes in neurodevelopmental outcomes from 24 to 36 months among children HIV-exposed uninfected (CHEU) and HIV-unexposed (CHU).","authors":"Ruchi Tiwari, Brent R Collett, Irene Oucho, Collins Otieno, Priscah Lihanda, Ariana Magedson, Mareme Diakhate, Grace C John-Stewart, Grace M Aldrovandi, Dalton Wamalwa, Benson O Singa, Sarah Benki-Nugent, Christine J McGrath","doi":"10.1097/QAD.0000000000004608","DOIUrl":"10.1097/QAD.0000000000004608","url":null,"abstract":"<p><strong>Objective: </strong>To compare neurodevelopment through 36 months between breastfed children who are HIV-exposed and uninfected (CHEU) exposed to maternal dolutegravir (DTG)-based antiretroviral therapy (ART) and children born to mothers without HIV (CHU).</p><p><strong>Methods: </strong>We enrolled a prospective cohort of pregnant women with and without HIV in Migori, Kenya, and followed infants to 36 months. Neurodevelopment was assessed at 24 and 36 months using the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4). Outcomes included cognitive, language, and motor z-scores, domain-specific delay (z-score<-1SD), and any delay. Multivariable linear and Poisson regression compared CHEU and CHU, and mixed-effects models evaluated developmental trajectories.</p><p><strong>Results: </strong>Among 293 children (CHEU = 149; CHU = 144), 49% were female and 9% were preterm. Breastfeeding at 12 months was similar between groups. Most CHEU (89%) were DTG-exposed in-utero. At 24 months, 43% had any delay (42% CHEU; 44% CHU), with similar prevalence at 36 months (37% CHEU; 35% CHU). Risk of fine motor delay was significantly higher among CHEU in unadjusted analyses but not after adjustment. Bayley-4 scores and trajectories did not differ between groups.</p><p><strong>Conclusion: </strong>Fine motor delay was more common among CHEU, but lack of difference in adjusted analyses suggests these delays were likely attributable to socio-demographic rather than biologic factors. The high prevalence of delays in both groups underscores the strong influence of environmental and nutritional factors on early child development.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719578","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":"Longitudinal trends in copy-years viremia associated with mpox acquisition but not mpox severity in people with HIV.","authors":"Lauren O'Connor, Anne Monroe, Yun Ji, Anuja Baskaran, Amanda D Castel, Angelo Elmi","doi":"10.1097/QAD.0000000000004606","DOIUrl":"10.1097/QAD.0000000000004606","url":null,"abstract":"<p><strong>Objectives: </strong>High viral load and low CD4+ cell count may be associated with increased risk of mpox acquisition. However, prior studies have not evaluated whether longitudinal trends in HIV lab measures, measured as the slope over time, are associated with mpox acquisition or severe mpox. Therefore, we evaluated whether longitudinal trends in CD4+ cell count (cells/μl), viral load (copies/ml), and copy-years viremia (CYV) (copies × years/ml) were associated with increased risk of mpox acquisition.</p><p><strong>Design: </strong>We conducted a nested case-control study among participants in the DC Cohort, a longitudinal study on people with HIV (PWH) in Washington, DC.</p><p><strong>Methods: </strong>Cases were defined as participants with mpox and were matched to five controls using risk set-sampling. Both two-stage modeling and joint modeling approaches were used to evaluate whether longitudinal trends in CD4+ cell count, viral load, and CYV were associated with mpox acquisition.</p><p><strong>Results: </strong>We evaluated 53 cases of mpox and 248 matched controls, with 13.7% of cases having severe mpox. An increased slope of CYV was associated with an increased risk of mpox acquisition based on the joint modeling approach, after adjusting for AIDS and known antiretroviral regimen [hazard ratio (95% CI): 1.11 (1.04-1.18)].</p><p><strong>Conclusion: </strong>Clinicians should consider a patient's entire history of viral load, not just viral load measured at one point in time, when evaluating risk of mpox.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721420","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":"Sex differences in long-acting cabotegravir trough concentrations in the SEARCH study in Kenya and Uganda.","authors":"Catherine A Koss, Moses R Kamya, Marilyn Nyabuti, Hideaki Okochi, Jane Kabami, David V Glidden, Elijah Kakande, Laura B Balzer, Moses Akuno, Hellen N Atuhaire, Karen Kuncze, Gordon Orori, Stella Kabageni, Alex R Rinehart, Gabriel Chamie, Elizabeth A Bukusi, Maya L Petersen, Diane V Havlir, Monica Gandhi, James Ayieko","doi":"10.1097/QAD.0000000000004605","DOIUrl":"10.1097/QAD.0000000000004605","url":null,"abstract":"<p><strong>Objective: </strong>Long-acting cabotegravir (CAB-LA) pre-exposure prophylaxis (PrEP) is highly effective. In Phase 2a trials, males had higher CAB pharmacokinetic (PK) trough concentrations than females after the first injection but lower troughs than females after subsequent injections. We report the first analysis of sex differences in CAB PK in a high HIV-burden setting: Kenya and Uganda.</p><p><strong>Methods: </strong>The SEARCH Dynamic Choice HIV Prevention study provided CAB-LA 600 mg intramuscularly (IM) as an HIV prevention option. Among randomly-sampled participants with injections ≤28 days after target date, plasma CAB trough concentrations were measured, compared by sex, and analyzed in relation to published targets of protein-adjusted concentrations for 90% inhibition of virus (PAIC 90 ).</p><p><strong>Results: </strong>Among 97 participants, at week 4, median CAB troughs were higher among men (2.1 μg/ml, IQR 1.4-2.5) than women (1.5, 1.0-1.8, P  = 0.001). Median CAB levels were lower among men than women at weeks 24 (1.1, 0.4-1.7 vs. 1.8, 1.3-2.9, P  < 0.001) and 48 (1.1, 0.6-2.1 vs. 1.8, 1.5-2.4, P  = 0.02). At least 80% of participants had CAB levels ≥4× PAIC 90 at weeks 4-16. At weeks 24 and 48, CAB levels were ≥4× PAIC 90 among 92% of women and 68% of men. No participants receiving CAB-LA acquired HIV.</p><p><strong>Conclusions: </strong>In the first PK study of CAB-LA PrEP in East Africa, CAB concentrations were lower among men than women after the second and later injections. By weeks 24 and 48, fewer men than women had CAB troughs above published PK targets, though no participants acquired HIV. Findings highlight the importance of examining sex differences and real-world forgiveness in PK with long-acting PrEP scale-up.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720244","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":"Initiating semaglutide therapy reduces tobacco cigarette smoking intensity among people with HIV.","authors":"Stephanie A Ruderman, Heidi M Crane, Lara Haidar, Lydia N Drumright, Bridget M Whitney, Geetanjali Chander, Karen L Cropsey, Kristina Crothers, Sherif Eltonsy, Sonya L Heath, Maile Karris, Ryan P Kyle, Y Joseph Hwang, Kenneth H Mayer, Sonia Napravnik, Bruce Oddson, April C Pettit, Allan Rodriguez, Michael S Saag, George A Yendewa, Conall O'Cleirigh, Diana L Alba, Mari M Kitahata, Joseph A C Delaney","doi":"10.1097/QAD.0000000000004596","DOIUrl":"10.1097/QAD.0000000000004596","url":null,"abstract":"<p><strong>Background: </strong>Smoking remains a major public health issue in people with HIV (PWH). Given the recent uptake of semaglutide for weight management and/or diabetes treatment in PWH and emerging evidence of antiaddictive properties, we studied changes in tobacco cigarette smoking among PWH initiating semaglutide in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort.</p><p><strong>Methods: </strong>We conducted a prepost within-person study examining changes in tobacco cigarette intensity (cigarettes/day) among PWH who reported currently smoking tobacco cigarettes at the time of semaglutide initiation between 04/2018-11/2025 across 10 CNICS sites. Smoking intensity was collected via the CNICS clinical assessment of patient reported instruments administered during routine clinical visits. We used linear mixed models adjusted for age, sex, race/ethnicity, and time to estimate the average change in smoking intensity level following initiation of semaglutide.</p><p><strong>Results: </strong>There were 123 PWH who reported current smoking at the time of semaglutide initiation, with an average of 10.5 cigarettes/day. The mean age was 51 years, 24% were female, and 95% were virally suppressed (<200 copies/mL). Most (93%) had a standard indication for semaglutide therapy, including 77% of PWH with a body mass index ≥30 kg/m2 and 61% with diabetes at baseline. We found a reduction of -2.5 (95% confidence interval: -3.7 to -1.3) cigarettes smoked per day among PWH after semaglutide initiation.</p><p><strong>Conclusion: </strong>New use of the GLP-1 medication semaglutide in PWH who smoked resulted in a mean decrease of 2.5 cigarettes per day representing a 24% drop in total smoking intensity, and 21% reported not smoking at the end of follow-up.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676783","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":"Evolving drivers of preexposure prophylaxis discontinuation among US MSM, 2018-2024.","authors":"Samuel M Jenness, Bevin Manuelpillai, Steven M Goodreau, Julia L Marcus, Eva A Enns, Irah L Lucas, Cristian Acero Martinez, Aaron J Siegler, Travis Sanchez","doi":"10.1097/QAD.0000000000004593","DOIUrl":"10.1097/QAD.0000000000004593","url":null,"abstract":"<p><strong>Objective: </strong>To examine temporal trends in reasons for stopping preexposure prophylaxis (PrEP) among MSM from 2018 to 2024, including how reasons co-occur and vary by demographics.</p><p><strong>Design: </strong>Pooled repeated cross-sectional analysis of seven annual waves of the American Men's Internet Survey (AMIS), a national behavioral survey of US cisgender MSM (N = 54 612).</p><p><strong>Methods: </strong>Among 3074 noncurrent PrEP users who reported reasons for stopping, we collapsed checklist items into six thematic categories and estimated adjusted prevalence by survey year using multivariable logistic regression with g-computation. Latent class analysis (LCA) identified subgroups with distinct discontinuation profiles.</p><p><strong>Results: </strong>The most common reason was Altered Sexual Activity (55%), followed by Side Effects (31.6%) and Financial/Access (29.4%). After demographic adjustment, Altered Sexual Activity rose from 46.2% in 2018 to 61.2% in 2024 [adjusted odds ratio (aOR) 1.93], and Privacy/Discrimination roughly doubled from 5.6 to 11.3%, the only reason with a significant linear trend (aOR 1.14 per year; P = 0.003). Financial/Access remained stable at approximately 29% across all 7 years. LCA identified three classes: Changed Circumstances (35.1%), Structural Barriers (23.8%), and Clinical/Multi-Barrier (41.1%). Being uninsured was the strongest predictor of financial discontinuation (aOR 4.31).</p><p><strong>Conclusions: </strong>Over 7 years of PrEP scale-up, circumstance-driven discontinuation grew increasingly dominant while stigma-related discontinuation doubled and cost barriers persisted. Three distinct discontinuation profiles argue for tailored approaches: re-engagement pathways for those whose circumstances change, financial navigation for structural barriers, and comprehensive clinical support for those experiencing multiple challenges.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676733","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}