AIDS and Behavior最新文献

{"title":"Intentions to Use PrEP Among a National Sample of Transgender and Gender-Expansive Youth and Emerging Adults: Examining Gender Minority Stress, Substance Use, and Gender Affirmation.","authors":"Sabrina R Cluesman, Marya Gwadz, Charles M Cleland","doi":"10.1007/s10461-025-04613-1","DOIUrl":"https://doi.org/10.1007/s10461-025-04613-1","url":null,"abstract":"<p><p>Transgender and gender-expansive young people, ages 13-24 years, experience disproportionate HIV risk yet are among those with the lowest US PrEP uptake rates (< 10%). Factors influencing PrEP outcomes for this population are poorly understood. This study examines the effects of gender minority stressors, gender affirmation, and heavy substance use on their PrEP outcomes using data from the CDC's 2018 START study (N = 972). A conceptual model integrating the gender minority stress and gender affirmation models was developed, mapping relevant START items onto it. Structural equation modeling (Mplus-8.9) was used to examine factors related to their PrEP intentions. Most participants were 18-24 (68%), trans-female (46%), white (45%), and reported heavy substance use (40%). Medical discrimination increased internalized transphobia (b = 0.097, SE = 0.034, p = 0.005) and perceived stigma (b = 0.087, SE = 0.034, p = 0.010). Family rejection increased perceived stigma (b = 0.181, SE = 0.032, p < 0.001) and heavy substance use (b = 0.260, SE = 0.053, p < 0.001). Perceived stigma also increased heavy substance use (b = 0.106, SE = 0.037, p = 0.004). Perceived stigma (b=-0.085, SE = 0.027, p = 0.002) and heavy substance use (b=-0.161, SE = 0.031, p < 0.001) decreased PrEP intentions, while gender affirmation increased them (b = 0.045, SE = 0.019, p = 0.020). A 1-point increase in gender affirmation reduced heavy substance use risk by -0.179 (SE = 0.030, p < 0.001) in the presence of family rejection and by -0.074 (SE = 0.041, p = 0.074) when perceived stigma was present. This study underscores heavy substance use as a potential barrier to PrEP uptake for transgender/gender-expansive youth. Future research could explore how gender affirmation acts as a protective factor against the negative impact of family rejection and perceived stigma on heavy substance behaviors among these populations.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998533","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":"\"You're in an Image of a Man but Not a Man\": A Qualitative Analysis of Intersectional Stigma Among Men with HIV Experiencing Subfertility in Rural Southwestern Uganda.","authors":"Madeline C Pratt, Moran M Owembabazi, Alex T Menninger, Eunice Kanini, B Rosemary Kansiime, Patricia M Smith, Janet M Turan, Lynn T Matthews, Esther C Atukunda","doi":"10.1007/s10461-025-04611-3","DOIUrl":"https://doi.org/10.1007/s10461-025-04611-3","url":null,"abstract":"<p><p>Many men with HIV (MWH) want to have children and may encounter HIV- and infertility-related stigma experiences. Integration of reproductive health and HIV care for men is rare. When available, safer conception care focuses on HIV prevention but lacks fertility support. We conducted qualitative in-depth interviews in Uganda with 30 MWH who desired more children and self-reported no partner pregnancy after 12 or more months of conception attempts. We separately interviewed 10 female partners. Interviews explored stigma experiences and factors impacting engagement in HIV and reproductive care. We used vignettes to elicit responses to stories of couples experiencing challenges of HIV and subfertility. The study team discussed, coded, and analyzed data from individual participant interview transcripts, inductively identifying emergent themes. The following overarching themes emerged: (1) Reproductive goals often take priority over HIV prevention among HIV-affected couples in this context, influenced by multi-level subfertility stigma in society. (2) MWH may pursue behaviors that increase risk of HIV transmission to meet their reproductive goals. (3) Men and women are eager to maintain their primary partnerships, prevent HIV transmission, and meet their reproductive goals with guidance from healthcare providers. Further research is needed on the causes of subfertility and infertility among HIV-affected couples in East Africa to better support their conception goals. Additionally, studies on the intersection of HIV and infertility stigma in high-fertility, high-HIV prevalence areas are essential for designing interventions that meet couples' social, emotional, and medical needs.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998471","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":"Infection and Persistent Infection of Human Papillomavirus Among HIV-Negative Men Who Have Sex with Men in Xinjiang, China: A Prospective Cohort Study.","authors":"Guozhen Zhang, Heng Yang, Juyuan Bian, Shulipan Asilibieke, Tian Tian, Henry S Lynn, Jianghong Dai","doi":"10.1007/s10461-024-04569-8","DOIUrl":"https://doi.org/10.1007/s10461-024-04569-8","url":null,"abstract":"<p><p>Anal HPV infection is particularly prevalent among men who have sex with men (MSM). The purpose of this study was to understand the status and influencing factors of HPV infection in MSM in Urumqi, Xinjiang, in order to provide suggestions for policy formulation. A prospective cohort study was conducted among HIV-negative MSM in Urumqi Xinjiang between April 2016 and June 2023. 824 MSM were recruited. Data were collected anal swab results from self-administered questionnaires and laboratory tests. A Cox regression model was employed to analyze factors associated with HPV infection. The prevalence rates of high-risk HPV and low-risk HPV were 37.99% and 25.97%. Receptive anal intercourse is a well-established risk factor for both incident and persistent HPV infections among MSM. For new high-risk HPV infections, the adjusted hazard ratio is 1.55 (95% CI: 1.28-1.89), and for persistent high-risk HPV infections, the aHR is 1.95 (95% CI: 1.48-2.57). Similarly, for low-risk HPV, receptive anal intercourse increases the risk of incidence (aHR = 1.34, 95% CI: 1.07-1.67) and persistent infection (aHR = 1.64, 95% CI: 1.18-2.29). Seeking sexual partners in bathhouses raised the risk of low-risk HPV infections (aHR = 1.36, 95% CI: 1.05-1.76). Young MSM may face a higher risk of HPV infection. Implementing targeted HPV vaccination catch-up programs for the MSM population in Urumqi could offer significant societal benefits.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982493","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":"Sexual Networks and Behavioral Characteristics of HIV-Positive Male Military Members, Female Sex Workers, and Male Civilians.","authors":"Michael P Grillo, Karen Saylors, Bonnie R Tran, Nichelle Brown, Osika Tripathi, Jordan Killion, Carol Macera, Babacar Faye, Ernest C Chisoko, Mapoma Kabengele, Anthony M Mutombe, Cyrille F Djoko, Davey Smith, Antoine Chaillon","doi":"10.1007/s10461-024-04580-z","DOIUrl":"https://doi.org/10.1007/s10461-024-04580-z","url":null,"abstract":"<p><p>Military members and female sex workers (FSWs) may be more likely to acquire or transmit HIV. Mapping HIV transmission across these high-risk populations and identifying behaviors associated with sexual network clustering are needed for effective HIV prevention approaches. A cross-sectional study recruited participants newly diagnosed with HIV among militaries, civilians, and FSWs in Zambia, Senegal, and Democratic Republic of the Congo (DRC). Participants were interviewed on behaviors and provided blood samples for HIV-1 partial pol sequencing. Genetic-distance based network analyses inferred putative relationships between HIV-1 partial pol sequences. Bivariate logistic regression models identified variables associated with clustering in a sexual network. 908 participants were included (n = 313 FSWs, n = 297 military, n = 298 civilians). 311 blood samples were sequenced and had survey data, of which 93 (29.9%) were genetically linked, forming 36 transmission clusters. All but one cluster were comprised of participants from the same country, including one large cluster (n = 12; 9 FSWs and 3 civilians) from DRC. A large mixed-country cluster (n = 9) including 7 men (4 civilians, 3 military) and 2 FSWs was observed. The odds of clustering in a sexual network were elevated for DRC participants, FSWs, and those cohabitating with a sexual partner. Findings underscore the importance of identifying linkages in high-risk populations to develop tailored HIV prevention strategies. Linkages across risk groups and countries illustrate the potential role of mobile populations in HIV transmission and acquisition. Larger studies including HIV recency testing may better elucidate biological and behavioral interactions between military, civilians, and FSWs.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977166","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":"Assessing the Risk of Sexually Transmitted Infections among Men who have Sex with Men in San Francisco during COVID-19: A Socio-ecological Analysis.","authors":"Christopher Justin Hernandez, Dillon Trujillo, Moranda Tate, Glenda Baguso, Jerry Quintana, Katherine C McNaughten, Jennifer P Jain, Glenn-Milo Santos, Sean Arayasirikul, Willi McFarland, Erin C Wilson","doi":"10.1007/s10461-024-04608-4","DOIUrl":"https://doi.org/10.1007/s10461-024-04608-4","url":null,"abstract":"<p><strong>Background: </strong>Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections, a disparity that has only worsened in recent years. During the COVID-19 pandemic, an overall increasing trend remained.</p><p><strong>Methods: </strong>We utilized data from the MSM cycle of the National HIV Behavioral Surveillance (NHBS) study in San Francisco, California, conducted from June 2021 through December 2021, to identify socio-ecological disruptions during the COVID-19 pandemic that were associated with sexually transmitted infections.</p><p><strong>Results: </strong>In total, 505 participants were surveyed, and approximately 24% of the participants reported having been diagnosed with an STI infection within the past 12 months. In the adjusted Poisson regression models, socio-ecologic factors that were independently associated with STI infection included barriers to STI testing due to COVID-19 (aRR 1.62, 95% CI 1.18-2.23), sex with partners part of small social circles/pods (aRR 2.41, 95% CI 1.41-4.12), sex with partners whose risk for COVID-19 was not known (aRR 3.53, 95% CI 2.05-6.06), and an increase or relapse in recreational substance use (aRR 2.01, 95% CI 1.49-2.72).</p><p><strong>Conclusions: </strong>These findings indicate the importance of enacting comprehensive policies that not only address an ongoing global pandemic but also consider its potential effects on other public health epidemics, such as sexually transmitted infections among men who have sex with men.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963306","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":"Impact of COVID-19 Public Health Measures on Antiretroviral Therapy Use Among Ugandans Living with HIV in Sero-Different Couples.","authors":"Timothy R Muwonge, Erika Feutz, Rogers Nsubuga, Jane M Simoni, Florence Nambi, Lylianne Nakabugo, Sylvia Namanda, Joseph Kibuuka, Dorothy Thomas, Ingrid T Katz, Katherine K Thomas, Norma C Ware, Monique A Wyatt, Herbert Kadama, Andrew Mujugira, Renee Heffron","doi":"10.1007/s10461-025-04612-2","DOIUrl":"https://doi.org/10.1007/s10461-025-04612-2","url":null,"abstract":"<p><p>Antiretroviral therapy (ART) use and HIV suppression among people living with HIV (PLHIV) are critical for HIV control and prevention. Extreme restrictions on movement early during the COVID-19 pandemic in Uganda may have impeded the ability to initiate and sustain access to and use of ART. From our stepped-wedge cluster-randomized trial of an integrated PrEP and ART intervention for HIV-serodifferent couples at 12 ART clinics in Uganda, we identified participants who enrolled and had a 6-month post-ART initiation viral load measured before the beginning of the first COVID-19 lockdown (Period 1), participants whose enrollment and 6-month viral load measurement straddled pre-COVID and COVID lockdown times (Period 2), and participants whose enrollment and 6-month viral load were quantified entirely during COVID-19 (Period 3). ART and viral load data were abstracted from standard-of-care HIV clinic records. We used adjusted generalized estimating equation models to compare viral suppression between the different periods. We enrolled 1,381 PLHIV, including 896 (64.9%) in Period 1, 260 (18.8%) in Period 2, and 225 (16.3%) in Period 3. Almost all (1371, 99.3%) initiated ART within 90 days of enrollment and 59.2% had baseline CD4 > 350 cells/mm³. Among those enrolled, 88.8% of participants in Period 1 were virally suppressed (< 1000 copies/mL) within six months of ART initiation, 80.5% in Period 2, and 88.2% in Period 3. All pairwise comparisons demonstrated statistically similar levels of viral suppression. Despite COVID-19 lockdown measures, PLHIV in serodifferent partnerships successfully initiated ART and attained and maintained viral suppression.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942550","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":"Experiences with Oral Pre-Exposure Prophylaxis (PrEP) Service Delivery and Use Among Adolescent Girls and Young Women (AGYW) in Routine Primary Care Settings, South Africa.","authors":"Catherine E Martin, Lorrein S Muhwava, Siphokazi Dada, Fiona Scorgie, Saiqa Mullick","doi":"10.1007/s10461-024-04596-5","DOIUrl":"https://doi.org/10.1007/s10461-024-04596-5","url":null,"abstract":"<p><p>In South Africa, oral PrEP was included in national guidelines as part of a combination HIV prevention package for adolescent girls and young women (AGYW) in 2017. Understanding their experiences of accessing and using PrEP is necessary to evaluate and improve PrEP service delivery approaches. This descriptive study explored AGYW's knowledge and understanding of PrEP, their experiences and influences on PrEP access and use in real world settings in South Africa. We conducted 44 in-depth interviews with female PrEP users (15-24 years) enrolled in Project PrEP. Interviews were audio recorded and transcribed for analysis using thematic analysis procedures. Participants reported positive experiences and overall satisfaction with accessing health services (i.e., youth-friendly clinic spaces, friendly and non-judgemental staff, privacy during consultations). Distance from the clinic, long queues, negative provider attitudes, and occasional stock-outs were key health service barriers to accessing PrEP. Individual motivating factors to continued PrEP use included creating daily pilltaking routines and the goal to remain HIV negative, while barriers included pill fatigue, frequent clinic visits, and side-effects. Positive relationships with partners and family facilitated disclosure of PrEP use, while stigma was identified as a community barrier to accessing PrEP services. Our study highlights AGYWs' experiences with PrEP access and use in a real-world setting. Facilitators and barriers identified in this study can be leveraged to strengthen efforts to support young women and ensure effective PrEP use. The findings also contribute to the development of appropriate service delivery.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942547","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":"Marriage and Steady Relationships with Women in Men Who Have Sex with Men in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-analyses.","authors":"Marion Fiorentino, Robinson Gravier-Dumonceau Mazelier, Nathan Yanwou, August Eubanks, Perrine Roux, Christian Laurent, Bruno Spire","doi":"10.1007/s10461-024-04517-6","DOIUrl":"https://doi.org/10.1007/s10461-024-04517-6","url":null,"abstract":"<p><p>High HIV prevalence in Sub-Saharan African (SSA) in men who have sex with men (MSM) leads to greater risk for their wives and other steady female partners because of prolonged exposure. To provide insights into the context possibly contributing to the risk of HIV transmission from MSM to women, our mixed-method synthesis about MSM' marriage and steady relationships with cisgender women aimed to: (i) assess the extent of engagement in steady relationships with women and in risky behaviors with these women across SSA's four regions; (ii) explore the underlying dynamics within these relationships by gathering qualitative information. We used quantitative and qualitative data specifically pertaining to related to marriage or other steady relationships with women from a systematic review on men who have sex with both men and women (MSMW) in SSA (PROSPERO-CRD42021237836). Meta-analyses were performed on quantitative data for each region. Pooled proportions were calculated using random-effects models. Qualitative data were analyzed using thematic synthesis. Data were selected from 125 studies. For Southern, East and West Africa, the estimated pooled proportions of married MSM were 4% (95% CI 2-8%; n = 10 studies; 4183 MSM), 8% (6-11%; 19; 7070), and 7% (6-9%; 13; 4705). In Southern Africa, 29% (11-56%; 5; 1667) of MSM had steady female partners. In East Africa, 34% (14-61%; 5; 2003) were currently or previously married to women. Motives to marry women included a desire to have children, and to conform to heteronormative social norms and family pressure. Marriage was seen as a means to discontinue homosexual behaviors or, conversely, a way to secretly continue same-sex behaviors more freely. Procreative intentions and a desire for secrecy often deterred MSM from using HIV prevention methods with their wives. For some MSM, steady relationships with women provided them with mutual support. However, these relationships could also lead to stressful and conflict-ridden situations, potentially resulting in psychosocial and HIV-related risks for the MSM as well as their male and steady female partners. Steady relationships with women are common in MSM in SSA. Sexuality concealment strategies with steady female partners depend on the circumstances that lead MSM to enter into these relationships, and have various implications on sexual behaviors with both male and female partners. Community-based support, HIV research, prevention, and care programs should be adapted to MSM's different life situations to reduce direct HIV transmission risk to steady female partners.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942553","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":"Understanding Awareness, Utilization, and the Awareness-Utilization Gap of HIV PrEP and nPEP Among Young MSM in China.","authors":"Jingtao Zhou, Yutong Xu, Qingyu Li, Yuhang Zhang, Siwen Huang, Jiaruo Sun, Jiayin Zheng, Yan Li, Yongkang Xiao, Wei Ma, Lin He, Xianlong Ren, Zhen Dai, Hui Xue, Feng Cheng, Wannian Liang, Sitong Luo","doi":"10.1007/s10461-024-04606-6","DOIUrl":"https://doi.org/10.1007/s10461-024-04606-6","url":null,"abstract":"<p><p>HIV/AIDS remains a significant public health challenge in China, particularly among men who have sex with men (MSM). Pre-Exposure Prophylaxis (PrEP) and non-occupational post-exposure Prophylaxis (nPEP) are effective interventions to reduce HIV transmission in high-risk populations. This study assessed awareness and utilization levels of PrEP and nPEP among young MSM (YMSM) aged 18-29 in China and examined associated factors. A cross-sectional survey of 2,493 YMSM was conducted across six Chinese provinces in September 2022. Participants, recruited via facility-based sampling, completed self-administered online questionnaires distributed by MSM-oriented community-based organizations. Of all the participants, 2,278 (91.4%) were aware of PrEP, and 220 (8.8%) had ever used PrEP; 2,321 (93.1%) were aware of nPEP, and 209 (8.4%) had ever used nPEP. Education level and having recent male sexual partners were positively associated with awareness of PrEP and nPEP, while self-stigma was negatively associated with awareness for both. Among those who had head of PrEP or nPEP, age, having more than 2 male sex partners, and having a history of sexually transmitted diseases (STD) infection were positively associated with the utilization of PrEP and nPEP; inconsistent condom use was associated with less PrEP utilization; monthly income was positively associated with nPEP utilization. Despite high awareness levels, the low utilization of PrEP and nPEP highlights missed opportunities for HIV prevention. Strengthening education on their importance, promoting condom use alongside PrEP/nPEP, reducing stigma, and addressing financial barriers are critical steps toward improving HIV prevention strategies and empowering YMSM to engage with these life-saving interventions.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942476","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":"Real World Data from an Italian Outpatient Clinical Setting and from Home Care Assistance of Treatment-Experienced PWH Switching to CAB + RPV Regimen: A Prospective Observational Study.","authors":"V Iannone, F Lombardi, A Ciccullo, F Lamanna, P F Salvo, A Sanfilippo, G Baldin, A Borghetti, C Torti, S Di Giambenedetto","doi":"10.1007/s10461-024-04597-4","DOIUrl":"https://doi.org/10.1007/s10461-024-04597-4","url":null,"abstract":"<p><p>The new Cabotegravir + Rilpivirine long acting (CAB + RPV) is the injectable regimen for treatment-experienced people with HIV (PWH). Little data from real-world settings are available, particularly in more complex PWH. We aimed to investigate the effectiveness of CAB + RPV in our real-life cohort of experienced PWH. We conducted a prospective observational longitudinal study by enrolling PWH who switched to CAB + RPV. We recruited participants from our outpatient clinic and a lower percentage of complex PWH followed by our home-care assistance (HCA). We evaluated time to virological failure (VF) and time to treatment discontinuation (TD) for any cause using Cox regression analyses. In the subgroup followed by HCA we also analyzed the total HIV-DNA trend during the study period. We enrolled 62 participants: 52 were outpatients (83.9%) and 10 followed by HCA (16.1%). Mostly were males (66.1%), with a median age of 51 years (IQR 31-60). During a 31.5 person-years follow-up (PYFU), all participants maintained virological suppression (< 30cps/mL). We observed 9 discontinuations during follow-up, with a rate of discontinuation of 28.6 per 100 PYFU. The estimated probabilities of maintaining CAB + RPV at 24 and 48 weeks were 84.9% (SD: 0.5) and 79.2% (SD: 0.7), respectively. No significant predictors of discontinuations were found. In the subgroup, we found no significant changes in the HIV-DNA levels over time (p = 0.332). Our results confirm the efficacy of CAB + RPV as a switch strategy in virologically suppressed PWH and even in more complex individuals, encouraging its use in PWH in need, coupled with HCA home administration support.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942558","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}