Current opinion in HIV and AIDS最新文献

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Reaching 90-90-90 in rural communities in East Africa: lessons from the Sustainable East Africa Research in Community Health Trial. 东非农村社区达到90-90-90岁：东非社区健康试验可持续研究的经验教训。

Current opinion in HIV and AIDS Pub Date : 2019-11-01 DOI: 10.1097/COH.0000000000000585

Gabriel Chamie, Moses R Kamya, Maya L Petersen, Diane V Havlir

{"title":"Reaching 90-90-90 in rural communities in East Africa: lessons from the Sustainable East Africa Research in Community Health Trial.","authors":"Gabriel Chamie, Moses R Kamya, Maya L Petersen, Diane V Havlir","doi":"10.1097/COH.0000000000000585","DOIUrl":"https://doi.org/10.1097/COH.0000000000000585","url":null,"abstract":"Purpose of review: There is an urgent need to understand new population-level approaches that achieve high levels of treatment and viral suppression for persons living with HIV.Recent findings: The SEARCH Universal test and treat (UTT) trial conducted in Kenya and Uganda aimed to reduce HIV incidence and improve community health. SEARCH offered HIV and multidisease testing at health fairs followed by home testing for nonparticipants in 32 communities, each with approximately 10 000 persons. In the 16 intervention communities, UNAIDS 90-90-90 targets were achieved within 3 years, reaching '92-95-90' and 79% population-level viral suppression. HIV incidence declined by 32% between year 1 and 3 of follow-up. Key principles of SEARCH's approach included community engagement, integration of HIV with multidisease services, rapid ART start upon HIV diagnosis, and patient-centered, streamlined care. SEARCH's community health approach also reduced HIV mortality, annual TB incidence, and uncontrolled hypertension compared with a country standard of care. Population-level viral suppression increased beyond the UNAIDS 73% target in women and men and reached levels well above recent country estimates across much of sub-Saharan Africa.Summary: SEARCH provides one example of how to rapidly surpass UNAIDS 90-90-90 targets while addressing community health on the path to HIV epidemic control.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"14 6","pages":"449-454"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/COH.0000000000000585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Future technologies for monitoring HIV drug resistance and cure. 监测艾滋病毒耐药性和治疗的未来技术。

Current opinion in HIV and AIDS Pub Date : 2017-03-01 DOI: 10.1097/COH.0000000000000344

Urvi M Parikh, Kevin McCormick, Gert van Zyl, John W Mellors

{"title":"Future technologies for monitoring HIV drug resistance and cure.","authors":"Urvi M Parikh, Kevin McCormick, Gert van Zyl, John W Mellors","doi":"10.1097/COH.0000000000000344","DOIUrl":"10.1097/COH.0000000000000344","url":null,"abstract":"Purpose of review: Sensitive, scalable and affordable assays are critically needed for monitoring the success of interventions for preventing, treating and attempting to cure HIV infection. This review evaluates current and emerging technologies that are applicable for both surveillance of HIV drug resistance (HIVDR) and characterization of HIV reservoirs that persist despite antiretroviral therapy and are obstacles to curing HIV infection.Recent findings: Next-generation sequencing (NGS) has the potential to be adapted into high-throughput, cost-efficient approaches for HIVDR surveillance and monitoring during continued scale-up of antiretroviral therapy and rollout of preexposure prophylaxis. Similarly, improvements in PCR and NGS are resulting in higher throughput single genome sequencing to detect intact proviruses and to characterize HIV integration sites and clonal expansions of infected cells.Summary: Current population genotyping methods for resistance monitoring are high cost and low throughput. NGS, combined with simpler sample collection and storage matrices (e.g. dried blood spots), has considerable potential to broaden global surveillance and patient monitoring for HIVDR. Recent adaptions of NGS to identify integration sites of HIV in the human genome and to characterize the integrated HIV proviruses are likely to facilitate investigations of the impact of experimental 'curative' interventions on HIV reservoirs.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"12 2","pages":"182-189"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738332/pdf/nihms-1048382.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What people want from sex and preexposure prophylaxis. 人们想要从性行为和预存预防中得到什么。

Current opinion in HIV and AIDS Pub Date : 2016-01-01 DOI: 10.1097/COH.0000000000000216

Robert M Grant, Kimberly A Koester

{"title":"What people want from sex and preexposure prophylaxis.","authors":"Robert M Grant, Kimberly A Koester","doi":"10.1097/COH.0000000000000216","DOIUrl":"10.1097/COH.0000000000000216","url":null,"abstract":"Purpose of review: As demand for preexposure prophylaxis (PrEP) increases, we are learning more about what people want from sex and PrEP.Recent findings: PrEP demand has reached a tipping point in the USA and is increasing rapidly. Although the primary benefit of PrEP use is biological, to reduce risk of HIV infection, PrEP users often express an alternative set of social and emotional benefits that are provided by PrEP. These collateral benefits of PrEP have salience, affect, and are experienced in the present, which are compelling drivers of human behavior. PrEP use has been associated with feeling safe during sex, usually in contrast to ruminations related to fear of HIV or intimate partner violence or control. PrEP can create empowerment, or agency, defined as the capacity and autonomy to act on one's own behalf, because it provides control over one's vulnerability to HIV and relief to women and men who may otherwise worry about whether their partners will use a condom, take antiretroviral therapy, or disclose their HIV status accurately. Planning for sexual and social goals in calm moments is also empowering. These highly desired collateral benefits of PrEP could be undermined, or eliminated, if PrEP is implemented in ways that are coercive or that foment fear of sexual risk compensation, drug resistance, toxicity, or moral judgment.Summary: Current PrEP implementation provides direct and indirect benefits that are highly desired.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"11 1","pages":"3-9"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446930/pdf/nihms-734443.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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