AIDS最新文献

{"title":"Drug resistance testing at regimen failure in individuals diagnosed with HIV-1 between 2010 and 2018 in Israel.","authors":"Tali Wagner, Itzchak Levy, Anat Wieder-Finesod, Marina Wax, Yael Gozlan, Daniel Elbirt, Eynat Kedem, Karen Olshtain-Pops, Hila Elinav, Michal Chowers, Valery Istomin, Rozalia Smolyakov, Natasha Matus, Shirley Girshengorn, Rotem Marom, Dan Turner, Orna Mor","doi":"10.1097/QAD.0000000000004138","DOIUrl":"10.1097/QAD.0000000000004138","url":null,"abstract":"<p><strong>Objective: </strong>Assess virological failures, analyze the results of resistance testing (RET), and investigate factors associated with acquired drug resistance mutations (aDRM).</p><p><strong>Design: </strong>A retrospective longitudinal cohort study.</p><p><strong>Methods: </strong>Virological failures (viral load >50 copies/ml) from a cohort of 1130 individuals, diagnosed with HIV-1 in 2010-2018 and followed up until 2020, were included. Demographic, clinical, and virological data were collected. A piecewise exponential additive mixed model was employed to estimate the association of various factors with aDRM.</p><p><strong>Results: </strong>Only 82 individuals had virological failure, 20/82 had multiple virological failures. The majority of virological failures (77%) were men, 48% were Israeli-born,79% were diagnosed in 2010-2014. Only 18% initiated with second-generation integrase-inhibitor (INI) based regimens. Although no baseline differences were identified between those with single and multiple virological failures, the latter had lower CD4 + levels before first virological failure. NRTI M184IV and INI N155H were identified in more than 10% of the cases. In those with additional failures, INI N155H was more prominent in cases with subtype B compared to those with non-B subtypes ( P  = 0.039). Diagnoses with CD4 + cell count less than 200 cells/μl and AIDS [hazard ratio = 3.46, 95% confidence interval (95% CI): 1.51-7.92, P  = 0.003], second-generation INI at the first virological failure (HR = 0.32, 95% CI: 0.11-0.91, P  = 0.033), and RET at baseline (hazard ratio = 0.34, 95% CI: 0.13-0.86, P  = 0.022) had a significant and persistent relative effect on aDRM.</p><p><strong>Conclusion: </strong>The risk for aDRM is reduced in those who are treated with second-generation INI-based regimens. Diagnosis with low CD4 + cell counts and AIDS is associated with detection of aDRM.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"760-765"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253998","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":"Adipose tissue transcriptome in patients switching efavirenz or a protease inhibitor to raltegravir compared to people without HIV.","authors":"Anna M Hanttu, Maheswary Muniandy, Birgitta W van der Kolk, Hanna Lindgren, Bhagwan Yadav, Jussi Sutinen, Kirsi H Pietiläinen","doi":"10.1097/QAD.0000000000004131","DOIUrl":"10.1097/QAD.0000000000004131","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this article is to study the subcutaneous adipose tissue (SAT) transcriptome in people with HIV (PWH) switching efavirenz (EFV) or a protease inhibitor to raltegravir and to compare the transcriptome of PWH to those of people without HIV (PWoH).</p><p><strong>Design: </strong>PWH ( n  = 36) on EFV ( n  = 22) or a protease inhibitor ( n  = 14) based ART regimen were randomized to switch to RAL ( n  = 15) or to continue unchanged medication ( n  = 17). PWoH ( n  = 10), comparable in age and BMI, were included for comparison.</p><p><strong>Methods: </strong>SAT gene expression was analyzed via RNA sequencing (Illumina Stranded mRNA library prep).</p><p><strong>Results: </strong>At baseline, only 51 out of 19 930 genes showed differential expression (FDR <0.05) between PWH and PWoH. Differentially expressed genes in PWH were identified as being HIV host factors or were associated with immune response, lipid metabolism, adipogenesis, apoptosis regulation, DNA/RNA metabolism, and cell structures. Mitochondria-encoded genes were consistently downregulated in PWH. Intergroup variations among PWH using different ART (EFV, protease inhibitor, RAL) were not significant, and switching EFV or a protease inhibitor to RAL did not induce substantial changes in the SAT transcriptome.</p><p><strong>Conclusion: </strong>While some specific genes linked to HIV are differentially expressed in PWH compared to PWoH, the overall SAT transcriptome remains relatively stable across various antiretroviral treatments and upon switching from EFV/protease inhibitor to RAL. These findings enhance our understanding of the molecular landscape on SAT in the context of HIV and ART.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"676-682"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057732","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":"Factors influencing antiretroviral therapy switching in people with virologically suppressed HIV-1: a cross-sectional multicenter study in France.","authors":"Valérie Pourcher, Olivier Robineau, Jean-Jacques Parienti, Paul Loubet, Christia Palacios, Christine Jacomet, Haydar Benachir, Philippe Mariot, Bruno Spire, Laurence Slama","doi":"10.1097/QAD.0000000000004118","DOIUrl":"10.1097/QAD.0000000000004118","url":null,"abstract":"<p><strong>Introduction: </strong>In France, over 90% of people with HIV-1 (PWH) achieve virological suppression with effective combination of antiretroviral therapies (ART), but limited data exist on the motivation for switching ART.</p><p><strong>Objective: </strong>To describe the reasons and determinants for switching ART, with a particular focus on doravirine-based regimens, in routine clinical practice in France.</p><p><strong>Design: </strong>This analysis of cross-sectional baseline data is part of the DoraVIH study, a French, multicenter (15 sites), two-step observational cohort study that includes prospective follow-up for a subset of participants.</p><p><strong>Methods: </strong>Eligible participants were PWH under ART regimen, virologically suppressed for at least 6 months, doravirine-naive and switching ART regimen. Sociodemographic and clinical data, ART history and reasons for switching ART were assessed at baseline.</p><p><strong>Results: </strong>Inclusions occurred between 13 December 2021 and 21 September 2022. Of the 291 PWH included, whose data were analyzed, 143 switched to doravirine-based regimen (DOR PWH) and 148 to another combined regimen (non-DOR PWH). Mean age was 51.6 years, and 206 participants (70.8%) were men. At baseline, 35 (25.0%) DOR PWH and 15 (10.6%) non-DOR PWH had BMI at least 30 kg/m 2 ( P  = 0.007). The most common reasons for switching were treatment simplification, tolerability and drug-drug interactions, accounting for 79.7% of all reasons. Among the 68 participants with prior tolerability issues, 47 (69.1%) switched to doravirine-based regimen.</p><p><strong>Conclusion: </strong>Primary reasons for switch were treatment simplification and tolerability. Participants with obesity were more likely to switch to doravirine, reflecting physicians' favorable perception of doravirine potential benefits, particularly in managing weight gain.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"695-700"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942569","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":"Outcomes and challenges in adolescents with HIV in France: a nationwide cohort study over 35 years.","authors":"Catherine Dollfus, Jérôme Le Chenadec, Véronique Reliquet, Fanny Alby-Laurent, Camille Brehin, Marion Caseris, Camille Runel-Belliard, Stéphane Blanche, Josiane Warszawski, Albert Faye, Pierre Frange","doi":"10.1097/QAD.0000000000004121","DOIUrl":"10.1097/QAD.0000000000004121","url":null,"abstract":"<p><strong>Objective: </strong>Most data published on adolescents with HIV (AWH) have been collected before the large diffusion of second-generation integrase strand transfer inhibitors (INSTI) among the pediatric population. We analyzed the nationwide ANRS-MIE CO10 Pediatric cohort to assess the changes over time in health and social outcomes of French AWH.</p><p><strong>Design: </strong>The cohort enrolled children born in France since 1985 and, from 2005, children diagnosed with HIV at ≤13 years, including those born abroad if antiretroviral-naive at first medical care in France.</p><p><strong>Methods: </strong>Adolescents aged ≥10 years at their last visit were included in this analysis. Their characteristics were compared between three periods of birth (1985-1993, 1994-1999, 2000-2010).</p><p><strong>Results: </strong>Overall, 529 AWH were included. Their median age at first HAART initiation decreased from 94 to 29 months ( P  < 0.0001). At the last evaluation, the proportions of AWH receiving HAART, receiving INSTI, having HIV-RNA < 50 copies/mL and having CD4 count ≥500/μl increased over time ( P  < 0.0001), reaching 98·7%, 53.3%, 81.3% and 85·0%, respectively, for those born in 2000-2010. The proportion of maternal and paternal orphans decreased until 14.4% and 11.0%, respectively, for AWH born recently. Compared to middle adolescents (15-17 years) born in 1994-1999, those born in 2000-2010 demonstrated higher academic success (69·2% versus 42·3%) and less frequent academic failure (4.6% versus 6.2%).</p><p><strong>Conclusions: </strong>Despite spectacular improvement in their health and immunovirological status, AWH remain vulnerable compared to other French adolescents, with a higher risk of being orphan and/or experiencing academic failure. Specific interventions are required to improve their global quality of life.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"667-675"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998638","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":"Efficacy, safety, and pharmacokinetics of lenacapavir oral bridging when subcutaneous lenacapavir cannot be administered.","authors":"Onyema E Ogbuagu, Anchalee Avihingsanon, Sorana Segal-Maurer, Hui Wang, Vamshi K Jogiraju, Renu Singh, Martin S Rhee, Hadas Dvory-Sobol, Peter A Sklar, Jean-Michel Molina","doi":"10.1097/QAD.0000000000004142","DOIUrl":"10.1097/QAD.0000000000004142","url":null,"abstract":"<p><strong>Objective: </strong>To assess efficacy, safety and pharmacokinetics (PK) of oral lenacapavir (LEN) when used as oral bridging (OB) between delayed subcutaneous (SC) LEN injections.</p><p><strong>Design: </strong>Post-hoc analysis of participants in two clinical trials of SC LEN for HIV-1 treatment who required OB when LEN SC dosing was interrupted.</p><p><strong>Methods: </strong>Oral LEN [300 mg once weekly (QW)] was initiated within 2 weeks of the next scheduled injection (dosing interval: 26 weeks). Efficacy, safety, and PK were assessed every 10-12 weeks.</p><p><strong>Results: </strong>Overall, 139 participants received ≥1 dose of oral 300 mg QW LEN plus other antiretrovirals. Median duration of OB was 19 weeks in both clinical trials. By missing = excluded analysis, over 95% of participants maintained virologic suppression (HIV-1 RNA <50 copies/mL) at Weeks 10, 20, and 30. Treatment-emergent AEs (TEAEs) were similar to those with SC LEN (excluding injection site reactions). No Grade ≥3 or serious TEAEs were considered related to oral LEN. Throughout OB, mean LEN plasma concentrations and lower bound of 90% confidence intervals (CIs) were consistently above inhibitory quotient 4 (4-fold in-vitro protein binding-adjusted 95% effective concentration). OB adherence (by pill count) was ≥95% in the majority of participants in both clinical trials.</p><p><strong>Conclusions: </strong>High rates of virological suppression were maintained during OB. Oral 300 mg QW LEN was well tolerated and provided adequate plasma concentrations to bridge SC LEN dosing. This analysis supports using 300 mg QW LEN for OB when SC LEN treatment is interrupted.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"639-648"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254012","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":"Provision of care for people with HIV migrating from Ukraine: preparing for a long-term response.","authors":"Miłosz Parczewski, Christoph Boesecke, Pavel Khaykin, David Jilich, Raluca Pătraşcu, Justyna Kowalska, Iurie Climasevschi, Teymur Noori","doi":"10.1097/QAD.0000000000004147","DOIUrl":"10.1097/QAD.0000000000004147","url":null,"abstract":"<p><p>Russia's invasion and war in Ukraine have caused a major humanitarian crisis among Ukrainian citizens, but also specifically affected diagnosis and provision of HIV care. As Ukraine remains the country with the second highest (after Russia) HIV incidence in Europe, the forced migration resulting from the war has required urgent and targeted responses to allow for uninterrupted access to medical care and antiretroviral drug supply in neighboring countries and beyond. Response and integration of people with HIV (PWH) has been swift across European countries, but several challenges remain. Key challenges relate to the expansion of unstigmatized HIV testing to tackle late diagnoses, development of legal frameworks allowing for access to medication not registered or under patent protection in other European countries, diagnosis and treatment of key comorbidities including tuberculosis (TB) and hepatitis C virus (HCV), vaccination programs, and continued surveillance for drug resistance and changes in molecular epidemiology.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 6","pages":"629-638"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770987","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":"Exploring the role of sex in hospitalizations among people with and without HIV in British Columbia, Canada.","authors":"Nicholas Naidu, Katherine W Kooij, Michael Budu, Monica Ye, Michelle Lu, Erin Ding, Alison McClean, Silvia Guillemi, Mark Hull, Rolando Barrios, Julio S G Montaner, Robert S Hogg","doi":"10.1097/QAD.0000000000004135","DOIUrl":"10.1097/QAD.0000000000004135","url":null,"abstract":"<p><strong>Objective: </strong>We assessed sex differences in hospitalization rates among people with HIV (PWH) and people without HIV (PWoH) in British Columbia (BC).</p><p><strong>Methods: </strong>PWH and a 10% random sample of PWoH in BC aged ≥19 were followed from 04/01/2002 to 03/31/2020, using linked administrative Comparative Outcomes and Service Utilization Trends (COAST) study data. Hospitalizations were categorized by discharge diagnosis, using broad International Classification of Diseases-classes. Using Poisson regression, we modelled the association between sex, HIV-status, their interaction, and hospitalization rates adjusting for confounders.</p><p><strong>Results: </strong>Among 12,635 PWH (17.81% females) and 548,992 PWoH (49.34% females), age-adjusted hospitalization rates per 100 person-years were highest among females with HIV [incidence rate (IR) 34.25], followed by males with HIV (IR 21.49), females (IR 7.10), and males (IR 7.06) without HIV. Hospitalization rates for all causes declined from 2002-2022 across all subgroups but remained consistently higher among females with HIV, except for circulatory diseases and neoplasms. Adjusted for socio-structural factors, being male [rate ratio (RR) 1.92] or female with HIV (RR 2.66) was significantly associated with a higher hospitalization rate compared to males without HIV. Among PWH, female sex remained significantly associated with a higher hospitalization rate, after adjusting for HIV- and disease-related factors.</p><p><strong>Conclusions: </strong>We found a higher hospitalization rate among PWH than PWoH in BC, with the highest rate among females with HIV. This could partially be explained by socio-structural factors. Addressing these disparities and improving our understanding of the underlying mechanisms is critical to enhance health outcomes for women with HIV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"737-745"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070862","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":"Central arterial stiffness in young adults with perinatal HIV exposure and infection.","authors":"Elaine M Urbina, Wendy Yu, Paige L Williams, George Sawyer, Russell Van Dyke, Steven Colan, Steven E Lipshultz","doi":"10.1097/QAD.0000000000004129","DOIUrl":"10.1097/QAD.0000000000004129","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare arterial stiffness between young adults with perinatally acquired HIV (YAPHIV) and young adults' perinatally HIV exposed but uninfected (YAPHEU).</p><p><strong>Design: </strong>A cross-sectional analysis of pulse wave velocity (PWV) measures among participants with echocardiography in the PHACS Cardiac Toxicity Substudy.</p><p><strong>Methods: </strong>A total of 150 participants (95 YAPHIV, 55 YAPHEU, mean 23.4 years, 60% female, 72% Black, 24% Hispanic) had echocardiography and PWV measured. We compared PWV between groups. Among YAPHIV, we fit linear regression models to evaluate the association of measures of HIV disease severity and antiretroviral treatment (ART) with PWV. We computed correlations between PWV and measures of left ventricular structure and function.</p><p><strong>Results: </strong>Mean PWV did not differ by group (YAPHIV 5.63 vs. YAPHEU 5.39 m/s; P  = 0.50). HIV control was good (82% with viral load <400 copies/ml); 91% used combination ART. Mean PWV was normal, but three of 95 YAPHIV (3%) had values above 11.8 m/s (level associated with cardiovascular events in adults). Weak correlations (<0.20) were observed between PWV and echocardiographic measures. Among YAPHIV, current and historical HIV severity measures were not associated with PWV. YAPHIV on protease inhibitor based ART had higher mean PWV than those on integrase strand inhibitors (1.68 m/s higher, 95% confidence interval -0.36, 3.72) or nonnucleoside transcriptase inhibitors (1.58 m/s higher, 95% confidence interval -0.94, 4.11).</p><p><strong>Conclusion: </strong>Our data show no difference in PWV between those perinatally exposed to and perinatally infected with HIV. Therefore, cardiovascular risk reduction guidelines should be followed to prevent cardiovascular disease in all young adults.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"701-707"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057736","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":"Effectiveness of levonorgestrel implant and depot medroxyprogesterone acetate injectable for women living with HIV on efavirenz: a prospective cohort study.","authors":"Katie R Mollan, Brian W Pence, Daniel Westreich, Agatha Bula, Clara Lemani, John Chapola, Jill M Hagey, Karen Diepstra, Jennifer Winston, Sam Phiri, Jane Chiwoko, Lameck Chinula, Mina C Hosseinipour, Michael G Hudgens, Mackenzie L Cottrell, Audrey Pettifor, Michele Jonsson-Funk, Jennifer H Tang","doi":"10.1097/QAD.0000000000004201","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004201","url":null,"abstract":"<p><strong>Objective: </strong>We compared the contraceptive effectiveness of typical-use LNG implant and depot medroxyprogesterone acetate (DMPA) injectable during efavirenz use.</p><p><strong>Design: </strong>We conducted a prospective cohort study of women living with HIV (WLHIV) on efavirenz-containing antiretroviral treatment in Lilongwe, Malawi. Eligible participants were 18-40 years of age and initiating LNG implant or DMPA injectable with desire to prevent pregnancy for 4+ years. Study visits and urine pregnancy testing occurred at enrollment, week 4, and every 24 weeks up to week 192. Malawi's efavirenz-to-dolutegravir transition shortened our duration of efavirenz follow-up.</p><p><strong>Methods: </strong>Pregnancy incidence rates/100 person-years (PY) and an incidence rate difference (IRD) were estimated using an inverse-probability-weighted Poisson model.</p><p><strong>Results: </strong>We enrolled 1,179 WLHIV on efavirenz: 592 and 587 chose to initiate the LNG implant and DMPA, respectively. Median follow-up during efavirenz use was 1.1 years (IQR: 0.5-1.7). Estimated pregnancy incidence rates were 6.6/100 PY (95%CI: 5.0, 8.7) in the LNG implant enrollment group (50 pregnancies) and 7.3/100 PY (95%CI: 5.5, 9.7) in the DMPA enrollment group (54 pregnancies), IRD -0.7/100 PY (95%CI: -3.5, 2.0). Results were similar in an analysis of first incident pregnancy during continued typical use of LNG implant (5.7/100 PY) versus continued typical use of DMPA (5.7/100 PY), IRD 0.0/100 PY (95%CI: -2.6, 2.7).</p><p><strong>Conclusions: </strong>In many settings, LNG implant has better contraceptive effectiveness than DMPA injectable. However, for WLHIV on efavirenz, we observed similar typical-use effectiveness for LNG implant versus provider-administrated DMPA injectable during the initial 1-2 years of use.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771048","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":"Food insecurity and mental health outcomes among people living with HIV in West Africa.","authors":"Noelle A Benzekri, Marie K Plaisy, Jean Jacques Koffi, Ephrem Mensah, Albert Minga, Didier K Ekouevi, Raoul Moh, Charlotte Bernard, Antoine Jaquet","doi":"10.1097/QAD.0000000000004200","DOIUrl":"10.1097/QAD.0000000000004200","url":null,"abstract":"<p><strong>Objectives: </strong>This study was conducted in order to determine whether food insecurity is associated with poor mental health outcomes among PLHIV in Togo and Côte d'Ivoire, West Africa.</p><p><strong>Design: </strong>Cross-sectional study among participants enrolled in the International epidemiological Databases to Evaluate AIDS West Africa cohort.</p><p><strong>Methods: </strong>The Household Food Insecurity Access Scale was used to measure food insecurity. The PHQ-9, GAD-7, PCL-5, and AUDIT-C instruments were used to assess depressive symptoms, anxiety symptoms, symptoms of post-traumatic stress disorder (PTSD), and harmful alcohol use, respectively. Logistic regression was used to identify factors associated with poor mental health outcomes.</p><p><strong>Results: </strong>Among 584 participants (68.8% female, median age 52 years), nearly half (48.1%) were food insecure; 7.0% were mildly food insecure, 26.7% were moderately food insecure, and 14.4% were severely food insecure. Severe food insecurity [OR 2.63 (1.30-5.34)] and being widowed [OR 2.15 (1.07-4.30)] were associated with moderate-to-severe depressive symptoms and formal education was protective [OR 0.30 (0.15-0.61)]; there was a trend towards an association between severe food insecurity and moderate-to-severe anxiety symptoms [OR 2.14 (0.98-4.70)] and formal education was protective [OR 0.35 (0.18-0.71)]; severe food insecurity [OR 6.87 (2.89-16.38)] and being widowed [OR 3.55 (1.46-8.59)] were associated with PTSD; mild food insecurity [OR 2.74 (1.20-6.26)] and male sex [OR 11.58 (5.44-24.68)] were associated with high risk alcohol use.</p><p><strong>Conclusions: </strong>Food insecurity is associated with poor mental health outcomes among PLHIV in Togo and Côte d'Ivoire, West Africa. Future studies to understand and address the causal links between food insecurity and mental health among PLHIV are warranted.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771051","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}