AIDS最新文献

{"title":"Willingness to switch to long-acting regimens among people with HIV: a systematic review and meta-analysis.","authors":"Kyra F Mendes de Leon, Roos D Klungers, Pythia T Nieuwkerk, Marc Van Der Valk","doi":"10.1097/QAD.0000000000004556","DOIUrl":"10.1097/QAD.0000000000004556","url":null,"abstract":"<p><strong>Objectives: </strong>Long-acting regimens (LARs) offer promising alternatives for people with HIV, enhancing autonomy and convenience. Understanding preferences for LAR is essential to guide policy and implementation.</p><p><strong>Design: </strong>This systematic review and meta-analysis examined willingness among adults with HIV to switch from daily oral antiretroviral therapy (ART) to LAR.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we included studies of adults with HIV using daily oral ART reporting willingness to switch to existing or hypothetical LAR. The primary outcome was the proportion willing to switch. Articles were searched in PubMed and Embase up to October 2024. Risk of bias was assessed using the RoB-PrevMH tool. A random-effects meta-analysis with a generalized linear mixed model synthesized willingness for LAR. Subgroup analyses explored heterogeneity. Alternative LAR were summarized descriptively.</p><p><strong>Results: </strong>Searches identified 2038 records, of which 22 studies were included. Most studies were conducted in Europe or North America (96%). Willingness to switch to any LAR was 70% [95% confidence interval (95% CI): 59-79; I2  = 97.9%]. Furthermore, two-monthly intramuscular injections were the most frequently investigated LAR, with a pooled willingness of 60% (95%CI: 42-76; I2  = 97.5%). No study-level characteristics explained heterogeneity. Limited studies investigated willingness for alternative LAR.</p><p><strong>Conclusion: </strong>The majority of people with HIV expressed willingness to switch to LAR, with two-monthly intramuscular injections being the most commonly investigated formulation. Substantial heterogeneity persisted, suggesting that LAR preferences are highly context dependent. Evidence on alternative LAR, including tablets, implants and intravenous infusions, is limited. Low and middle-income countries were underrepresented, highlighting the need for geographically diverse research to better understand context-specific preferences and thereby inform treatment policy.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1435-1445"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148154865","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":"A systematic review of qualitative research on HIV and food insecurity in high-income countries.","authors":"Emily Jay Nicholls, P Bicarregui, Anna Brewster, Indrajit Ghosh, Stuart Flanagan, Shema Tariq","doi":"10.1097/QAD.0000000000004552","DOIUrl":"10.1097/QAD.0000000000004552","url":null,"abstract":"<p><strong>Objectives: </strong>Food insecurity leads to adverse health outcomes in people living with HIV, including obesity, poor mental health and viral non-suppression. Qualitative studies in low- and middle-income countries have described the impact of food insecurity on medication adherence. However, limited qualitative research exists on the lived experiences of food insecurity among people living with HIV in high-income countries (HICs). We aimed to synthesize qualitative literature on food insecurity among people living with HIV in HICs.</p><p><strong>Design: </strong>Systematic review and textual narrative synthesis.</p><p><strong>Methods: </strong>We searched MEDLINE, CINAHL, Scopus, Embase, and PsycINFO, extracting data from included articles on a standardized form in Covidence. We synthesized literature using a textual narrative approach. We conducted quality appraisal (Critical Appraisal Skills Programme Qualitative Studies Checklist) and graded certainty of findings (GRADE-CERQual).</p><p><strong>Results: </strong>We reviewed 2772 articles, reduced to 940 after deduplication, with 12 articles included after full text screening. Included articles reported on studies conducted in the United States ( n  = 7), and Canada ( n  = 5). We identified three key themes, each with their own sub-themes: the role of structural inequalities in shaping and navigating food insecurity; the impacts of food insecurity on health and wellbeing; and the labour of acquiring of food.</p><p><strong>Conclusions: </strong>Our review highlights the syndemic nature of food insecurity and HIV; intersecting experiences of multiple structural hardships constellate and interact synergistically to amplify poor health outcomes. Interventions should address the multiple and reinforcing social and structural conditions that shape food insecurity among people living with HIV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1539-1551"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013052","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":"Comparing carbon emissions from oral tenofovir disoproxil fumarate/emtricitabine for preexposure prophylaxis and long-acting injectables for HIV prevention.","authors":"Kiran Rodrigues, Ramine Bahrambegi, Michael Reid","doi":"10.1097/QAD.0000000000004537","DOIUrl":"10.1097/QAD.0000000000004537","url":null,"abstract":"<p><p>Estimated greenhouse gas emissions from active pharmaceutical ingredient (API) production were compared for oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) and long-acting injectable preexposure prophylaxis (PrEP) agents, cabotegravir (CAB-LA) and lenacapavir (LEN). For 2 million person-years of PrEP, TDF/FTC generated approximately 108 million kg CO2e, compared with 4.1 million kg for CAB-LA and less than 0.1 million kg for LEN. These findings suggest substantially lower emissions with long-acting agents, supporting consideration of environmental sustainability in HIV prevention strategies.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"40 10","pages":"1585-1587"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823863","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":"Exposure to size-specific particulate matter accelerates DNA methylation aging in people with HIV.","authors":"Wei Liang, Lanting Zhang, Boxiang Wang, Huimin Ben, Zhengbo Ji, Zhihao Xie, Dong Hou","doi":"10.1097/QAD.0000000000004554","DOIUrl":"10.1097/QAD.0000000000004554","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) face accelerated aging and increased health risks, with DNA methylation age (DNAmAge) as a critical senescence biomarker. Particulate matter is linked to DNAmAge acceleration (DNAmAA) in general population, but its impact in PWH remains unstudied.</p><p><strong>Methods: </strong>Thirty-two PWH from Wuhan, China, were enrolled in a prospective panel study with follow-up, and each participant underwent at least two repeated measurements during the study period. Portable air quality monitor measured PM 1 , PM 2.5 , and PM 10 exposures 72 h preblood sampling. We analyzed genome-wide DNA methylation in peripheral blood and calculated six AA metrics. Linear mixed-effects and weighted quantile sum regression models evaluated associations between particulate matter exposure and DNAmAA.</p><p><strong>Results: </strong>Significant associations between particulate matter exposure and DNAmAA were observed at various lag windows. For every 10 μg/m 3 increase in 24-h average PM 2.5 , Hannum DNAmAA, Pheno DNAmAA, Grim DNAmAA, SkinBlood DNAmAA, and Elastic DNAmAA increased by 0.266 years [95% confidence interval (CI): 0.035-0.480], 0.421 years (95% CI: 0.032-0.701), 0.336 years (95% CI: 0.073-0.546), 0.295 years (95% CI: 0.021-0.495), and 0.254 years (95% CI: 0.034-0.445), respectively. PM 10 contributed most substantially to the cumulative PM effect on epigenetic AA in the lag0-24 h window.</p><p><strong>Conclusion: </strong>Short-term particulate matter exposure, particularly PM 10 , significantly accelerates epigenetic aging in PWH, highlighting the need to integrate air quality management into healthy aging strategies for this vulnerable population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1571-1576"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013113","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":"Characterization of HIV acquisitions during a large oral preexposure prophylaxis implementation study.","authors":"Brenda Hoagland, Thiago Silva Torres, Carolina Coutinho, Mayara Secco Torres Silva, Ronaldo Ismério Moreira, Kelika A Konda, Hamid Vega-Ramirez, Iuri C Leite, Pedro Leite, Marcelo Cunha, Sandra Wagner Cardoso, Emilia M Jalil, Marcos Benedetti, Cristina Pimenta, Carlos F Caceres, Juan Vicente Guanira, Valdilea Gonçalves Veloso, Beatriz Grinsztejn","doi":"10.1097/QAD.0000000000004562","DOIUrl":"10.1097/QAD.0000000000004562","url":null,"abstract":"<p><strong>Objective: </strong>Characterization of HIV acquisitions during ImPrEP study.</p><p><strong>Design: </strong>Implementation study among MSM and transgender women in Brazil, Mexico, and Peru (February 2018 to December 2020).</p><p><strong>Methods: </strong>Participants used HIV rapid tests at enrollment and follow-up visits. HIV viral load on enrollment blood samples was used to identify acute HIV infections retrospectively. Participants with an HIV-negative rapid test at enrollment initiated oral PrEP. Adjusted logistic regression model assessed factors associated with acute HIV infections. We described characteristics of participants who acquired HIV during follow-up according to country, PrEP adherence measures, and virological outcomes.</p><p><strong>Results: </strong>Acute HIV prevalence at enrollment was 0.5% ( n  = 43/9552). Factors associated included younger age and having any STI. Among 8714 participants (12 185.25 person-years of follow-up; median age 29  years; MSM: 94.8%; transgender women: 5.2%), 104 (1.2%) were diagnosed with HIV during follow-up. Among these, median HIV viral load was 12 257 copies/ml [interquartile range (IQR) 851-114 118]. One (1.8%) participant had K65R mutation and six (10.5%) M184V/I mutations. Median time from first PrEP dispensation to HIV diagnosis was 360  days, varying by country ( P  = 0.012). Only five participants (8.6%) had tenofovir intracellular levels consistent with at least four doses per week at HIV diagnosis visit.</p><p><strong>Conclusion: </strong>Our findings highlight low detection of acute HIV infection among those starting oral PrEP. Significant challenges in PrEP adherence were verified among young MSM and transgender women who acquired HIV during PrEP follow-up. Innovative approaches, such as long-acting PrEP formulations and tailored adherence support strategies, could play a crucial role in reducing HIV incidence among people using PrEP in Latin America.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1446-1458"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203711","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":"Cancer incidence and risk factors among people with HIV in REPRIEVE.","authors":"Sophia Zhao, Sara McCallum, Aya Awwad, Philip E Castle, Marissa R Diggs, Markella V Zanni, Sarah M Chu, Alex B Lu, Judith S Currier, Judith A Aberg, Carl J Fichtenbaum, Gerald S Bloomfield, Carlos D Malvestutto, Pamela S Douglas, Heather J Ribaudo, Steven K Grinspoon","doi":"10.1097/QAD.0000000000004625","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004625","url":null,"abstract":"<p><strong>Objective: </strong>Cancer is a leading cause of morbidity and mortality among people with HIV (PWH), who face a greater risk than the general population. An enhanced understanding of cancer incidence and associated risk factors among PWH receiving effective antiretroviral therapy (ART) may guide targeted preventive interventions.</p><p><strong>Design and methods: </strong>Analyses included REPRIEVE participants without cancer at baseline, followed until first cancer incidence or trial end. Incidence rates were computed for all cancers, AIDS-defining cancers (ADCs), non-AIDS-defining cancers (NADCs), both infection-related and noninfection-related, by Global Burden of Disease (GBD) region and sex. Cause-specific Cox models assessed associations with traditional [age, sex, region, body mass index (BMI), smoking] and HIV-related (nadir CD4, baseline CD4, CD4/CD8 ratio) factors.</p><p><strong>Results: </strong>Among 7507 participants (31.5% women) with median follow-up of 5.6 (Q1-Q3: 4.6-6.3) years, 219 incident cancers occurred [incidence rate (IR): 5.6 per 1000 person-years, 95% confidence interval (CI): 4.9-6.4]. Noninfection-related NADCs were most common (3.4 [2.8-4.0]), followed by infection-related NADCs (1.5 [1.1-1.9]) and ADCs (0.6 [0.4-0.9]). Incidence was higher in males and participants from high-income countries. Leading cancers included prostate, breast, lung, and anal. Older age, high-income country residence, and current smoking were independently associated with higher cancer risk, whereas sex, BMI, and HIV-related factors were not.</p><p><strong>Conclusions: </strong>In a global cohort of PWH on effective ART, cancer remains an important comorbidity, with risk varying by demographic and behavioral factors. Targeted prevention strategies, particularly smoking cessation and age- and region-specific cancer screening approaches, may help reduce cancer burden in this population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001078","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: is it still a clinically useful indicator for monitoring long-term engagement in HIV care in the treat-all era?","authors":"Sita Lujintanon, Peter F Rebeiro, Keri N Althoff, Joyce L Jones, Lauren C Zalla, Nel Jason L Haw, Brenna C Hogan, Amber J Hackstadt, Elisa Yazdani, Michael A Horberg, Richard D Moore, Jessie K Edwards, Sonia Napravnik, Jonathan A Colasanti, Vincent C Marconi, Jennifer O Lam, Lesley S Park, Kelly A Gebo, Catherine R Lesko","doi":"10.1097/QAD.0000000000004623","DOIUrl":"10.1097/QAD.0000000000004623","url":null,"abstract":"<p><strong>Objectives: </strong>Describe changes in visit frequency by viral suppression (VS) vs. non-VS among people with HIV (PWH) in the US treat-all era.</p><p><strong>Design: </strong>Observational cohort study.</p><p><strong>Methods: </strong>We defined six period-cohorts of PWH in U.S. clinical cohorts of the NA-ACCORD who had initiated antiretroviral therapy and were retained in clinic (attended ≥1 visit in 9 months [mo]) prior to January 1, 2012, 2014, 2016, 2018, 2020, and 2022 (n = 42 389-54 655). We estimated the proportions of PWH retained in clinic, having gaps in visits of >9-15mo or >15mo, and returned to clinic after gaps by time-updated VS status (< vs. ≥200 copies/ml) over 2 years of follow-up using multi-state models, standardized to the 2012 cohort.</p><p><strong>Results: </strong>PWH in 2012 cohort had a median age of 51 years (IQR: 43-58); 85% were cismen; 43% were non-Hispanic Black; 15% were Hispanic; 84% had VS at baseline. The proportions of PWH having >9-15mo gaps with prior VS increased from 2012 (3.8%; 95% CI: 3.6%, 3.9%) to 2022 (6.9%; 95% CI: 6.5%, 7.3%). The proportions of PWH having >15mo gaps with prior VS increased from 2012 (6.6%; 95% CI: 6.4%, 6.8%) to 2022 (10.7%; 95% CI: 10.2%, 11.2%). The proportions of PWH with >9-15mo and >15mo gaps with non-VS remained low from 2012 to 2022. The majority of PWH returned to clinic after gaps.</p><p><strong>Conclusions: </strong>Over the past 12 years, PWH with prior VS had more gaps in visits that did not meet a minimum of 6-mo visit frequency consistent with standard retention indicators. Better indicators are needed to optimally direct resources for care engagement and VS.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001022","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":"Effects of semaglutide on subclinical cardiovascular health in people with HIV.","authors":"Joviane Daher, Ziad Koberssy, Nicolas Moussallem, Qian Wu, Abdus Sattar, Aaron A Fletcher, Christian M McComsey, Nicholas T Funderburg, Kate Ailstock, Alisson Ross Eckard","doi":"10.1097/QAD.0000000000004624","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004624","url":null,"abstract":"<p><strong>Design and objective: </strong>Lipohypertrophy, characterized by central adipose tissue accumulation, is common in people with HIV (PWH) and contributes to cardiometabolic risk. In a recent randomized, double-blind, placebo-controlled phase 2b trial, semaglutide significantly improved weight, total fat, visceral adiposity, blood pressure, glucose metabolism, and lipids over 32 weeks in PWH with lipohypertrophy. This prespecified secondary analysis evaluated semaglutide's effects on subclinical cardiovascular health.</p><p><strong>Methods: </strong>Virologically suppressed adults with HIV without known diabetes, receiving stable antiretroviral therapy, with body mass index >25 kg/m2 and increased waist circumference/waist-to-hip ratio were enrolled. Participants were randomized 1 : 1 to semaglutide or placebo for 32 weeks. Pulse wave velocity (PWV) and endothelial peripheral arterial tonometry (endoPAT) assessed arterial stiffness and endothelial function, and coronary artery calcium (CAC) score assessed calcified coronary atherosclerosis. Indirect calorimetry measured resting energy expenditure (REE) and oxygen consumption (VO2). 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores were calculated. Analyses followed intention-to-treat principles using sex-adjusted multiplicative regression.</p><p><strong>Results: </strong>One hundred eight participants (n = 54 semaglutide) were enrolled (median age 53 years; 60% male; 65% non-White; 35% smokers). Semaglutide had no significant effect on PWV, CAC score, reactive hyperemia index, augmentation index, or REE. VO2 showed a downward trend (β -43 ml/min; P = 0.087). At week 32, significant reductions were observed in 10-year ASCVD risk (-32.6%; P = 0.026) and hsCRP (-23.4%; P = 0.02) in the semaglutide group relative to placebo.</p><p><strong>Conclusion: </strong>Semaglutide did not improve subclinical vascular markers over 32 weeks but significantly improved overall cardiometabolic health and cardiovascular disease risk. Longer and larger studies of GLP-1 RAs are indicated in HIV to further assess their effects on long-term cardiovascular disease outcomes.</p><p><strong>Trial registration: </strong>NCT04019197.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987566","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":"Antiretroviral therapy regimens initiated during pregnancy and risks of adverse perinatal outcomes.","authors":"Basma N Dib, Rebecca Zash, Sean Brummel, Modiegi Diseko, Judith Mabuta, Shahin Lockman, Gaerolwe Masheto, Joseph Makhema, Roger Shapiro, Lisa M Bodnar, Maria M Brooks, Sharon Riddler, Ellen Caniglia, Sonja A Swanson","doi":"10.1097/QAD.0000000000004620","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004620","url":null,"abstract":"<p><strong>Objective: </strong>Antiretroviral therapy prevents mother-to-child HIV transmission during pregnancy. We estimated risks of adverse perinatal outcomes following postconception initiation of DTG/FTC/TAF, EFV/FTC/TDF, DTG/FTC/TDF, and DTG/3TC/TDF.</p><p><strong>Design: </strong>Observational emulation of a target trial using population-based birth outcomes surveillance data from Botswana.</p><p><strong>Methods: </strong>We emulated the IMPAACT 2010/VESTED trial protocol in Botswana's surveillance data and compared the risk of a composite outcome - stillbirth, preterm birth, or small-for-gestational-age birth - among individuals initiating DTG/FTC/TAF, EFV/FTC/TDF, or DTG/FTC/TDF at 14-28 weeks' gestation. After benchmarking results against the trial, we added DTG/3TC/TDF and evaluated individual outcomes (stillbirth, preterm birth, small-for-gestational-age birth, very preterm birth, very-small-for-gestational-age birth, low birthweight, high birthweight, neonatal death).</p><p><strong>Results: </strong>Adjusted risk of the composite outcome was 30.3% (unadjusted n = 83/278) for DTG/FTC/TAF, compared with 34.3% for EFV/FTC/TDF (1378/4042; risk difference -4.1% [95% confidence interval (CI) -10.6 to 2.4] and 34% for DTG/FTC/TDF [741/2,173; -3.7% (-10.3 to 2.9)]. All three risks were slightly higher than estimated in the trial. DTG/3TC/TDF showed a similar adjusted risk [34.7%; 1,008/2,883; -4.8% (-11.1 to 1.6)]. Risks of individual outcomes were generally comparable across regimens.</p><p><strong>Conclusion: </strong>Our observational study findings for the composite outcome were comparable to the IMPAACT 2010/VESTED trial in a real-world programmatic setting and enabled evaluation of additional regimen and broader set of outcomes. In settings where randomized trial data are limited, well designed observational emulations of trials using nonrandomized data can provide informative evidence. As Botswana expands use of TAF in pregnancy, these results provide reassuring evidence supporting its safety.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944042","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":"Does where you live matter? Rurality and 30-day hospital readmission among people with HIV.","authors":"Michael O Budu, Katherine W Kooij, Ravnit Dhinsa, Taylor McLinden, Jenny Li, Clara Wang, Scott D Emerson, Julio S G Montaner, Robert S Hogg","doi":"10.1097/QAD.0000000000004619","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004619","url":null,"abstract":"<p><strong>Objective: </strong>We examined whether rural residence would compound existing challenges in continuity of HIV care and post discharge follow-up among people with HIV (PWH), leading to higher odds of 30-day hospital readmission compared to urban residence.</p><p><strong>Methods: </strong>We used data from the Comparative Outcomes and Service Utilization Trends (COAST) study to identify hospitalizations between April 2001 and March 2020. COAST includes virtually all known PWH in British Columbia. Readmissions were defined as hospitalizations occurring within 30 days of discharge. Rural, small urban, and large urban areas were defined using census-derived statistical area classification groups. We used logistic regression models with generalized estimating equations to examine the association between rurality and readmission.</p><p><strong>Results: </strong>Among 7159 PWH included in our analyses, 82.3% (n = 5893) resided in large urban areas,11.8% (n = 848) in small urban areas and 5.9% (n = 418) in rural areas. Living in a small urban area was associated with lower odds of readmission compared with large urban areas [adjusted odds ratio (aOR) = 0.83; 95% confidence interval (CI): 0.72-0.95]. No significant difference in the odds of readmission was observed between large urban and rural areas (aOR = 1.02; 95% CI: 0.86-1.22).</p><p><strong>Conclusion: </strong>Small urban residence was associated with lower odds of 30-day hospital readmission among PWH compared with large urban residence, whereas rural residence was not. Further research is needed to identify the healthcare and social factors underlying these geographic differences.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910593","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}