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Key population perceptions and opinions about long-acting antiretrovirals for prevention and treatment: a scoping review. 主要人群对长效抗逆转录病毒药物预防和治疗的看法和意见:范围审查。
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-05-01 Epub Date: 2022-04-18 DOI: 10.1097/COH.0000000000000734
Omar Sued, Norma Nardi, Luciana Spadaccini

Purpose of review: Key populations are disproportionately affected by human immunodeficiency virus (HIV). Access, retention, and adherence are important barriers for the efficacy of preexposure prophylaxis (PrEP) and HIV treatment among these populations. Long-acting (LA) antiretrovirals hold the promise to solve some of these backdrops. The objective of the current review is to update the perceptions of key populations and PLWH about LA, based on their opinion, acceptability, and willingness to use it.

Recent findings: According to the review preferences for LA vary with the population studied. Regarding people living with HIV (PLWH), male having sex with men are interested in having different options, adolescents are interested in LA (strong preference for implants), yet also perceive substantial obstacles to using biomedical prevention; transgender women aimed to nonvisible small implants, with long-lasting effects or LA injections that can be applied in other areas than buttocks, and women who experienced history of medical injections might increase preference for LA (except for history of people who inject drugs [IDU]). Female sex workers and IDU both showed interest in LA-PrEP. Regarding antiretroviral therapy, LA increased treatment satisfaction and acceptance, mainly among those receiving injections every 2 months. LA helped overcome pill fatigue, stigma, and adherence issues.

Summary: Knowing preferences for biomedical interventions will contribute to better understanding and developing effective strategies for these populations.

审查目的:重点人群受到人类免疫缺陷病毒(HIV)的不成比例的影响。在这些人群中,获取、保留和坚持是暴露前预防(PrEP)和艾滋病毒治疗效果的重要障碍。长效(LA)抗逆转录病毒药物有望解决其中一些问题。当前审查的目的是更新关键人群和PLWH对LA的看法,基于他们的意见,可接受性和使用它的意愿。最近的研究发现:根据综述,对LA的偏好因研究人群而异。关于艾滋病毒感染者(PLWH),与男性发生性关系的男性对拥有不同的选择感兴趣,青少年对LA(植入物的强烈偏好)感兴趣,但也认为使用生物医学预防存在重大障碍;跨性别女性的目标是不可见的小型植入物,具有持久的效果,或者LA注射可以应用于臀部以外的其他部位,而有过医疗注射史的女性可能会增加对LA的偏好(注射吸毒者的历史除外[IDU])。女性性工作者和IDU都对LA-PrEP感兴趣。在抗逆转录病毒治疗方面,LA提高了治疗满意度和接受度,主要是在每2个月接受一次注射的患者中。洛杉矶帮助克服了药物疲劳、耻辱和依从性问题。摘要:了解对生物医学干预措施的偏好将有助于更好地了解和制定针对这些人群的有效策略。
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引用次数: 0
Editorial: Is it time to implement injectable antiretroviral treatments globally? 社论:现在是在全球实施可注射抗逆转录病毒治疗的时候了吗?
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-05-01 DOI: 10.1097/COH.0000000000000736
M. Boffito, Kimberley K. Scarsi, C. Orkin
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引用次数: 0
Clinical implementation of long-acting antiretroviral treatment in high-income countries: challenges and advantages 高收入国家长效抗逆转录病毒治疗的临床实施:挑战与优势
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-04-18 DOI: 10.1097/COH.0000000000000730
L. Waters, Alex Sparrowhawk
Purpose of review Long-acting antiretroviral therapy (LA-ART) brings a paradigm shift to HIV care with injectable cabotegravir/rilpivirine (IM-CAB/RPV) in current or imminent use in several countries. This brings the usual opportunities and challenges of a new therapy, plus requirements to adapt services to reliably deliver injections and ensure patients understand advantages and limitations. We summarise key considerations for implementation in high-income countries. Recent findings Monthly IM-CAB/RPV is noninferior to oral ART and monthly IM-CAB/RPV to 1-monthly in carefully selected virally suppressed people. The numerically higher virological failure rate on two-monthly IM-CAB/RPV warrants close attention and careful monitoring. Implementation projects report positive experiences for patients and staff, but also barriers. Data is needed in younger people, pregnancy/breastfeeding, and in those with detectable viraemia secondary to suboptimal adherence. Summary We highlight a paucity of real-world data and key unanswered questions. Existing data on injection techniques may have implications for training; monitoring of outcomes is crucial to ensure clinical trial results are replicated in real-life. Better understanding of treatment failure, and individualised therapy, is crucial, and it is important to repeat patient preference surveys as new data emerges to ensure decisions are based on the most recent evidence of benefit vs risk.
长效抗逆转录病毒疗法(LA-ART)在一些国家目前或即将使用的可注射卡波特韦/利比韦林(IM-CAB/RPV)带来了艾滋病毒治疗的范式转变。这给新疗法带来了通常的机遇和挑战,此外还需要调整服务,以可靠地提供注射,并确保患者了解优势和局限性。我们总结了在高收入国家实施的关键考虑因素。在精心挑选的病毒抑制人群中,每月IM-CAB/RPV不低于口服ART,每月IM-CAB/RPV低于1个月。两个月的IM-CAB/RPV的病毒学失败率较高,值得密切关注和仔细监测。实施项目报告了患者和工作人员的积极经验,但也存在障碍。需要在年轻人、怀孕/母乳喂养者以及继发于次优依从性的可检测到的病毒血症患者中提供数据。我们强调缺乏真实世界的数据和关键的未解问题。关于注射技术的现有数据可能对培训有影响;监测结果对于确保临床试验结果在现实生活中得到复制至关重要。更好地了解治疗失败和个性化治疗是至关重要的,随着新数据的出现,重复患者偏好调查以确保决策基于最新的获益与风险证据是很重要的。
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引用次数: 2
Editorial introductions. 编辑介绍。
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-03-01 DOI: 10.1097/COH.0000000000000719
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引用次数: 0
Adapting digital health interventions for the evolving HIV landscape: examples to support prevention and treatment research. 适应不断变化的艾滋病毒形势的数字卫生干预措施:支持预防和治疗研究的实例。
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-03-01 DOI: 10.1097/COH.0000000000000721
Henna Budhwani, B Matthew Kiszla, Lisa B Hightow-Weidman
Purpose of review Although many HIV prevention and/or treatment digital health interventions (DHIs) have shown feasibility and acceptability, fewer have indicated efficacy, and only a subset have been adapted for new contexts. Adaptation is a key element of pragmatic implementation science research. Adaptation is cost effective and time efficient compared with new development. Leveraging adaptation can lead to accelerated scale-up and enhanced public health impact. Considering the value of adaptation, the purpose of this piece is to present examples of DHI to DHI adaptation sequences to inform future HIV prevention and/or treatment research. Recent findings From an examination of recent academic articles (01 November 2016 to 31 October 2021), we identified adaptation sequences that included an original DHI with at least two adaptations. Four models are presented herein; examples consist of adapted DHIs for new population, health outcome, geography, or a combination thereof. Summary Adaptation is a promising scientific approach to expeditiously respond to the evolving HIV landscape. We present examples of DHI adaptations alongside considerations for each type of adaptation; we also present adaptation challenges with responsive strategies. We suggest when conducted with attention to rigor (leveraging adaptation frameworks, community engagement, and tailoring content), adaptation is a powerful tool to pragmatically address the HIV epidemic.
审查目的:尽管许多艾滋病毒预防和/或治疗数字健康干预措施(DHIs)已显示出可行性和可接受性,但显示出有效性的较少,并且只有一小部分已适应新的情况。适应是语用实施科学研究的重要内容。与新开发相比,适应具有成本效益和时间效率。利用适应能力可以加速扩大规模并增强公共卫生影响。考虑到适应的价值,这篇文章的目的是提出DHI到DHI适应序列的例子,为未来的艾滋病毒预防和/或治疗研究提供信息。最近的发现:从最近的学术文章(2016年11月1日至2021年10月31日)的检查中,我们确定了适应序列,其中包括具有至少两个适应的原始DHI。本文提出了四种模型;例子包括针对新人群、健康结果、地理位置或其组合而调整的DHIs。摘要:适应是一种有前途的科学方法,可以迅速应对不断变化的艾滋病毒形势。我们提出了DHI适应的例子以及对每种适应类型的考虑;我们还提出了相应的适应战略。我们建议,在严格执行(利用适应框架、社区参与和定制内容)的情况下,适应是务实应对艾滋病毒流行的有力工具。
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引用次数: 11
Context, COVID-19 and comorbidities: exploring emergent directions in syndemics and HIV research. 背景、COVID-19 和合并症:探索综合症和艾滋病研究的新方向。
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-03-01 DOI: 10.1097/COH.0000000000000722
Carmen H Logie, Madelaine Coelho, Brandon Kohrt, Alexander C Tsai, Emily Mendenhall

Purpose of review: The purpose of this review is to identify themes across articles that aimed to explore HIV-related syndemics in 2020 and 2021 and to discuss their implications for research on syndemics.

Recent findings: We identified 189 articles on syndemics between 2020 and 2021. Key themes across studies included COVID-19; mental health and psychosocial challenges; substance use; socio-structural factors; protective factors; and methodological approaches. COVID-19's implications for HIV syndemic research were discussed. Mental health and substance use research largely examined linkages with sexual practices or reduced HIV care retention. Researchers examined associations between socio-structural variables (e.g. poverty) and elevated HIV exposure, reduced HIV testing and poorer health. Concepts of water insecurity and 'ecosyndemics' were also raised, as was the importance of attending to noncommunicable diseases and comorbidities. Most studies did not assess interactions between health conditions, signalling the need for methodological grounding in the foundational concepts of syndemic theory.

Summary: Most studies recommended that HIV prevention and care research attend to the interplay between poor mental health, substance use and multidimensional violence. Increased attention to structural factors, particularly exacerbated poverty in the COVID-19 pandemic, is required. Research can identify protective factors to harness to advance HIV prevention and care.

综述的目的:本综述旨在确定 2020 年和 2021 年旨在探讨艾滋病毒相关综合征的文章的主题,并讨论其对综合征研究的影响:我们确定了 2020 年至 2021 年间有关综合征的 189 篇文章。各项研究的关键主题包括 COVID-19、心理健康和社会心理挑战、药物使用、社会结构因素、保护因素和方法学方法。讨论了 COVID-19 对艾滋病毒综合征研究的影响。心理健康和药物使用方面的研究主要探讨了与性行为的联系或艾滋病毒护理保留率降低的问题。研究人员审查了社会结构变量(如贫困)与艾滋病毒接触率升高、艾滋病毒检测减少和健康状况不佳之间的联系。还提出了水不安全和 "生态疾病 "的概念,以及关注非传染性疾病和合并症的重要性。小结:大多数研究建议,艾滋病毒预防和护理研究应关注不良心理健康、药物使用和多层面暴 力之间的相互作用。需要更多地关注结构性因素,尤其是在 COVID-19 大流行中加剧的贫困问题。研究可以确定保护性因素,利用这些因素推进艾滋病毒预防和护理工作。
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引用次数: 0
Behavioral and social interventions to promote optimal HIV prevention and care continua outcomes in the United States. 在美国采取行为和社会干预措施,促进实现最佳的艾滋病毒预防和护理效果。
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-03-01 DOI: 10.1097/COH.0000000000000717
Kristi E Gamarel, Wesley M King, Don Operario

Purpose of review: This review reports on trends in behavioral and social intervention research in the United States published over the past year (2020-2021) investigating HIV prevention and care outcomes, organized by the level of intervention focus - individual, dyadic, and organizational.

Recent findings: Researchers have continued to develop and evaluate behavioral and social interventions to reduce HIV acquisition risk and disease progression. With few exceptions, social and behavioral interventions have primarily focused on individuals as the unit of behavior change. Interventions operating at the individual-, dyadic-, and organizational-level have made strides to reduce HIV transmission risk and disease progressing by addressing mental health, substance use, stigma, peer and romantic relationships, and, to some extent, structural vulnerabilities.

Summary: Social and behavioral interventions continue to be critical in addressing HIV inequities in the United States. An important gap in the literature is the need for multilevel interventions designed and implemented within existing community-based organizations and local healthcare settings. We call on researchers to continue to attend to the structural, environmental, and economic vulnerabilities that shape HIV inequities in the development of multilevel approaches necessary to realize the full potential of existing and emerging HIV prevention and care strategies.

综述目的:本综述报告了美国在过去一年(2020-2021 年)中发表的调查艾滋病预防和护理结果的行为和社会干预研究的趋势,并按照干预重点的层次--个人、二元体和组织--进行了分类:研究人员不断开发和评估行为和社会干预措施,以降低艾滋病感染风险和疾病进展。除少数例外,社会和行为干预措施主要以个人为行为改变的单位。通过解决心理健康、药物使用、污名化、同伴关系和恋爱关系,以及在一定程度上解决结构性弱点,在个人、伴侣和组织层面的干预措施在降低 HIV 传播风险和疾病进展方面取得了长足进步。文献中的一个重要空白是需要在现有的社区组织和当地医疗机构中设计和实施多层次的干预措施。我们呼吁研究人员在制定必要的多层次方法以充分发挥现有和新出现的 HIV 预防和护理策略的潜力时,继续关注造成 HIV 不平等的结构、环境和经济脆弱性。
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引用次数: 0
From surviving to thriving: the current status of the behavioral, social, and psychological issues of aging with HIV. 从生存到繁荣:老年艾滋病患者的行为、社会和心理问题的现状。
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-03-01 DOI: 10.1097/COH.0000000000000725
Erik L Ruiz, Karah Y Greene, Jerome T Galea, Brandon Brown

Purpose of review: Despite significant advances in knowledge regarding the biological and clinical issues related to aging with HIV, significantly less research has centered on related psychological, behavioral, and social issues, which are increasingly recognized as important for successfully aging with HIV.

Recent findings: Barriers to successful aging include physical challenges from a sociobehavioral perspective, psychosocial challenges, and system-level challenges. In contrast, several resiliencies and interventions that help facilitate healthy aging with HIV are also emerging. Comprehensive interventions to address the physical, mental, and psychosocial needs of older people living with HIV (OPLWH) are necessary.

Conclusion: To promote healthy aging with HIV, we must utilize both clinical and biopsychosocial interventions. The lack of data on the needs of OPLWH is an important barrier to healthy aging in this population.

综述目的:尽管在与HIV伴发衰老相关的生物学和临床问题方面的知识取得了重大进展,但在相关的心理、行为和社会问题上的研究却显著减少,而这些问题越来越被认为是HIV伴发衰老的重要因素。最近的研究发现:成功老龄化的障碍包括社会行为角度的身体挑战、社会心理挑战和系统层面的挑战。相比之下,一些有助于促进感染艾滋病毒的健康老龄化的复原力和干预措施也正在出现。有必要采取综合干预措施,解决老年艾滋病毒感染者(OPLWH)的身体、精神和社会心理需求。结论:为促进艾滋病毒感染者健康老龄化,应采取临床和生物心理社会干预相结合的措施。缺乏OPLWH需求的数据是这一人群健康老龄化的一个重要障碍。
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引用次数: 6
Beyond criminalization: reconsidering HIV criminalization in an era of reform. 超越刑事化:改革时代对艾滋病刑事化的重新思考。
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-03-01 DOI: 10.1097/COH.0000000000000715
Trevor Hoppe, Alexander McClelland, Kenneth Pass

Purpose of review: This paper reviews recent studies examining the application of human immunodeficiency virus (HIV)-specific criminal laws in North America (particularly the United States and Canada). In the wake of the development of new biomedical prevention strategies, many states in the United States (US) have recently begun to reform or repeal their HIV-specific laws. These findings can help inform efforts to 'modernize' HIV laws (or, to revise in ways that reflect recent scientific advances in HIV treatment and prevention).

Recent findings: Recent studies suggest that HIV-specific laws disproportionately impact Black men, white women, and Black women. The media sensationally covers criminal trials under these laws, especially when they involve Black defendants who they often describe in racialized terms as predators. Activists contest these laws and raise concerns about new phylogenetic HIV surveillance techniques that have the potential to be harnessed for law enforcement purposes.

Summary: These findings collectively raise urgent concerns for the continued use of HIV-specific criminal laws. These policies disproportionately impact marginalized groups - particularly Black men. Media coverage of these cases often helps to spread misinformation and stigmatizing rhetoric about people living with HIV and promulgate racist stereotypes. Although well-intentioned, new phylogenetic HIV surveillance technologies have the potential to exacerbate these issues if law enforcement is able to gain access to these public health tools.

审查目的:本文审查了最近在北美(特别是美国和加拿大)审查适用针对人类免疫缺陷病毒(HIV)的刑法的研究。随着新的生物医学预防战略的发展,美国许多州最近开始改革或废除其针对艾滋病毒的法律。这些发现有助于为使艾滋病毒法律“现代化”的努力提供信息(或者以反映艾滋病毒治疗和预防方面的最新科学进展的方式进行修订)。最近的发现:最近的研究表明,针对艾滋病毒的法律对黑人男性、白人女性和黑人女性的影响不成比例。媒体耸人听闻地报道根据这些法律进行的刑事审判,特别是当涉及黑人被告时,他们经常用种族化的术语将他们描述为掠夺者。活动人士对这些法律提出质疑,并对新的系统发育艾滋病监测技术表示担忧,这些技术有可能被用于执法目的。总结:这些发现共同提出了继续使用针对艾滋病毒的刑法的紧迫关切。这些政策不成比例地影响了边缘化群体——尤其是黑人男性。媒体对这些案件的报道往往有助于传播关于艾滋病毒感染者的错误信息和污名化言论,并传播种族主义陈规定型观念。尽管出发点是好的,但如果执法部门能够获得这些公共卫生工具,新的系统发育艾滋病毒监测技术有可能加剧这些问题。
{"title":"Beyond criminalization: reconsidering HIV criminalization in an era of reform.","authors":"Trevor Hoppe,&nbsp;Alexander McClelland,&nbsp;Kenneth Pass","doi":"10.1097/COH.0000000000000715","DOIUrl":"https://doi.org/10.1097/COH.0000000000000715","url":null,"abstract":"<p><strong>Purpose of review: </strong>This paper reviews recent studies examining the application of human immunodeficiency virus (HIV)-specific criminal laws in North America (particularly the United States and Canada). In the wake of the development of new biomedical prevention strategies, many states in the United States (US) have recently begun to reform or repeal their HIV-specific laws. These findings can help inform efforts to 'modernize' HIV laws (or, to revise in ways that reflect recent scientific advances in HIV treatment and prevention).</p><p><strong>Recent findings: </strong>Recent studies suggest that HIV-specific laws disproportionately impact Black men, white women, and Black women. The media sensationally covers criminal trials under these laws, especially when they involve Black defendants who they often describe in racialized terms as predators. Activists contest these laws and raise concerns about new phylogenetic HIV surveillance techniques that have the potential to be harnessed for law enforcement purposes.</p><p><strong>Summary: </strong>These findings collectively raise urgent concerns for the continued use of HIV-specific criminal laws. These policies disproportionately impact marginalized groups - particularly Black men. Media coverage of these cases often helps to spread misinformation and stigmatizing rhetoric about people living with HIV and promulgate racist stereotypes. Although well-intentioned, new phylogenetic HIV surveillance technologies have the potential to exacerbate these issues if law enforcement is able to gain access to these public health tools.</p>","PeriodicalId":10949,"journal":{"name":"Current Opinion in HIV and AIDS","volume":"17 2","pages":"100-105"},"PeriodicalIF":4.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Moving toward equity: fostering transdisciplinary research between the social and behavioral sciences and implementation science to end the HIV epidemic. 迈向公平:促进社会和行为科学与执行科学之间的跨学科研究,以结束艾滋病毒的流行。
IF 4.1 3区 医学 Q2 IMMUNOLOGY Pub Date : 2022-03-01 DOI: 10.1097/COH.0000000000000726
Maria Pyra, Darnell Motley, Alida Bouris

Purpose of review: Since the beginning of the HIV epidemic, social and behavioral scientists have developed interventions to stem the spread of the virus. The dissemination of these interventions has traditionally been a lengthy process; however, implementation science (IS) offers a route toward hastening delivery of effective interventions. A transdisciplinary approach, wherein IS informs and is informed by social and behavioral sciences (SBS) as well as community participation, offers a strategy for more efficiently moving toward health equity and ending the HIV epidemic.

Recent findings: There has been considerable growth in HIV research utilizing IS theories, methods and frameworks. Many of these studies have been multi or interdisciplinary in nature, demonstrating the ways that IS and SBS can strengthen one another. We also find areas for continued progress toward transdisciplinarity.

Summary: We review literature from 2020 to 2021, exploring the ways IS and SBS have been used in tandem to develop, evaluate and disseminate HIV interventions. We highlight the interplay between disciplines and make a case for moving toward transdisciplinarity, which would yield new, integrated frameworks that can improve prevention and treatment efforts, moving us closer to achieving health equity.

审查目的:自艾滋病毒开始流行以来,社会和行为科学家已经制定了阻止该病毒传播的干预措施。这些干预措施的传播传统上是一个漫长的过程;然而,实施科学(IS)为加速提供有效干预措施提供了一条途径。一种跨学科的方法,其中信息系统向社会和行为科学以及社区参与提供信息并受其影响,为更有效地实现卫生公平和结束艾滋病毒流行提供了一种战略。最近的发现:利用IS理论、方法和框架的HIV研究有了相当大的增长。这些研究中有许多是多学科或跨学科的,证明了IS和SBS可以相互加强的方式。我们也发现了继续向跨学科发展的领域。摘要:我们回顾了2020年至2021年的文献,探讨了IS和SBS在开发、评估和传播艾滋病毒干预措施中的协同应用方式。我们强调学科之间的相互作用,并提出向跨学科方向发展的理由,这将产生新的综合框架,可以改善预防和治疗工作,使我们更接近实现卫生公平。
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引用次数: 3
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Current Opinion in HIV and AIDS
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