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Unity is strength: creation and future actions for a consortium for HIV cure research in Latin America and the Caribbean 'Lac-Cura'. 团结就是力量:拉丁美洲和加勒比地区 "Lac-Cura "艾滋病毒治愈研究联合会的创建和未来行动。
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-09-18 DOI: 10.1080/25787489.2024.2403955
Gabriela Turk,Gastón Devisich,Fernando Valiente-Echeverria,María Inés Figueroa,Isabel Cassetti,Pedro Cahn,Claudia P Cortes,Brenda Crabtree-Ramírez,Omar Sued,Natalia Laufer
The development of effective HIV cure strategies is crucial. However, most research in this area has been concentrated in high-income countries, underscoring the need to expand efforts to regions like Latin America and the Caribbean (LAC), which face distinct biomedical, social, political, and economic challenges. Data on LAC's participation in HIV cure research, along with stakeholder perceptions, reveal that the work being done in the region is scarce, fragmented, scattered, and characterized by limited resources and infrastructure. Establishing a regional consortium of basic researchers, clinicians, social scientists, and community members in LAC could be a key step in integrating the region into the global HIV cure landscape. We have already begun laying the groundwork for its creation and propose to name it 'LAC-Cura'-short for 'Latin America and the Caribbean HIV Cure Consortium'.
制定有效的艾滋病毒治愈策略至关重要。然而,这一领域的大部分研究都集中在高收入国家,这突出表明有必要将研究工作扩展到拉丁美洲和加勒比地区(LAC)等地区,因为这些地区面临着独特的生物医学、社会、政治和经济挑战。有关拉丁美洲和加勒比地区参与艾滋病毒治愈研究的数据以及利益相关者的看法表明,该地区正在开展的工作稀少、零碎、分散,而且资源和基础设施有限。在拉丁美洲和加勒比地区建立一个由基础研究人员、临床医生、社会科学家和社区成员组成的地区联盟,是将该地区纳入全球艾滋病治愈格局的关键一步。我们已经开始为建立该联盟奠定基础,并建议将其命名为 "LAC-Cura"--"拉丁美洲和加勒比地区艾滋病治愈联盟 "的简称。
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引用次数: 0
Assessment of the HIV Enhanced Access Testing in the Emergency Department (HEATED) program in Nairobi, Kenya: a quasi-experimental prospective study. 肯尼亚内罗毕急诊科艾滋病病毒强化检测(HEATED)项目评估:一项准实验性前瞻性研究。
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-09-18 DOI: 10.1080/25787489.2024.2403958
Adam R Aluisio,Joshua Smith-Sreen,Agatha Offorjebe,Wamutitu Maina,Sankei Pirirei,John Kinuthia,David Bukusi,Harriet Waweru,Rose Bosire,Daniel K Ojuka,McKenna C Eastment,David A Katz,Michael J Mello,Carey Farquhar
BACKGROUNDPersons seeking emergency injury care are often from higher-risk and underserved key populations (KPs) and priority populations (PPs) for HIV programming. While facility-based HIV Testing Services (HTS) in Kenya are effective, emergency department (ED) delivery is limited, despite the potential to reach underserved persons.METHODSThis quasi-experimental prospective study evaluated implementation of the HIV Enhanced Access Testing in Emergency Departments (HEATED) at Kenyatta National Hospital ED in Nairobi, Kenya. The HEATED program was designed as a multi-component intervention employing setting appropriate strategies for HIV care sensitization and integration, task shifting, resource reorganization, linkage advocacy, skills development and education to promote ED-HTS with a focus on higher-risk persons. KPs included sex workers, gay men, men who have sex with men, transgender persons and persons who inject drugs. PPs included young persons (18-24 years), victims of interpersonal violence, persons with hazardous alcohol use and persons never HIV tested. Data were obtained from systems-level records, enrolled injured patient participants and healthcare providers. Systems and patient-level data were collected during a pre-implementation period (6 March - 16 April 2023) and post-implementation (period 1, 1 May - 26 June 2023). Additional, systems-level data were collected during a second post-implementation (period 2, 27 June - 20 August 2023). HTS data were evaluated as facility-based HIV testing (completed in the ED) and distribution of HIV self-tests independently, and aggregated as ED-HTS. Evaluation analyses were completed across reach, effectiveness, adoption, implementation and maintenance framework domains.RESULTSAll 151 clinical staff were reached through trainings and sensitizations on the HEATED program. Systems-level ED-HTS among all presenting patients increased from 16.7% pre-implementation to 23.0% post-implementation periods 1 and 2 (RR = 1.31, 95% CI: 1.21-1.43; p < 0.001). Among 605 enrolled patient participants, facilities-based HTS increased from 5.7% pre-implementation to 62.3% post-implementation period 1 (RR = 11.2, 95%CI: 6.9-18.1; p < 0.001). There were 440 (72.7%) patient participants identified as KPs (5.6%) and/or PPs (65.3%). For enrolled KPs/PPs, facilities-based HTS increased from 4.6% pre-implementation to 72.3% post-implementation period 1 (RR = 13.8, 95%CI: 5.5-28.7, p < 0.001). Systems and participant level data demonstrated successful adoption and implementation of the HEATED program. Through 16 wk post-implementation a significant increase in ED-HTS delivery was maintained as compared to pre-implementation.CONCLUSIONSThe HEATED program increased overall ED-HTS and augmented delivery to KPs/PPs, suggesting that broader implementation could improve HIV services for underserved persons already in contact with health systems.
背景寻求紧急伤害护理的人通常来自高风险和服务不足的重点人群(KPs)和艾滋病计划的优先人群(PPs)。尽管肯尼亚基于设施的 HIV 检测服务(HTS)非常有效,但急诊科(ED)提供的服务却很有限,尽管它有可能惠及服务不足的人群。方法这项准实验性前瞻性研究评估了肯尼亚内罗毕肯雅塔国立医院急诊科(ED)实施 HIV 加强急诊科检测(HEATED)的情况。HEATED项目是一项由多部分组成的干预措施,采用了艾滋病护理宣传和整合、任务转移、资源重组、联系宣传、技能开发和教育等适合当地环境的策略,以促进急诊科艾滋病检测,重点关注高危人群。高危人群包括性工作者、男同性恋者、男男性行为者、变性人和注射毒品者。感染者包括年轻人(18-24 岁)、人际暴力受害者、酗酒者和从未接受过艾滋病毒检测者。数据来自系统级记录、登记的受伤患者参与者和医疗服务提供者。在实施前(2023 年 3 月 6 日至 4 月 16 日)和实施后(第一阶段,2023 年 5 月 1 日至 6 月 26 日)收集了系统和患者层面的数据。在实施后的第二阶段(阶段 2,2023 年 6 月 27 日至 8 月 20 日)收集了更多系统级数据。半边天数据作为独立的设施艾滋病毒检测(在急诊室完成)和艾滋病毒自我检测分发进行评估,并作为急诊室半边天数据进行汇总。结果通过 HEATED 项目的培训和宣传,所有 151 名临床工作人员都接受了培训。在所有就诊患者中,系统级 ED-HTS 从实施前的 16.7% 增加到实施后第一和第二阶段的 23.0%(RR = 1.31,95% CI:1.21-1.43;p < 0.001)。在 605 名登记的患者参与者中,基于设施的半边天从实施前的 5.7% 增加到实施后第 1 期的 62.3%(RR = 11.2,95%CI:6.9-18.1;p <0.001)。有 440 名(72.7%)患者参与者被确认为 KPs(5.6%)和/或 PPs(65.3%)。对于注册的 KPs/PPs,基于设施的半边天计划从实施前的 4.6% 增加到实施后第一阶段的 72.3%(RR = 13.8,95%CI:5.5-28.7,p < 0.001)。系统和参与者层面的数据表明,HEATED 计划的采用和实施取得了成功。结论HEATED项目提高了ED-HTS的总体水平,并增加了向KPs/PPs提供的服务,这表明更广泛地实施该项目可以改善已与医疗系统接触的服务不足人群的艾滋病服务。
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引用次数: 0
Induced abortion incidence and associated factors in a cohort of women living with HIV in Rio De Janeiro, Brazil, 1996-2016. 1996-2016 年巴西里约热内卢感染艾滋病毒妇女队列中的人工流产发生率及相关因素。
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-09-10 DOI: 10.1080/25787489.2024.2401268
Rosa Maria Soares Madeira Domingues,Marcel de Souza Borges Quintana,Lara Esteves Coelho,Ruth Khalili Friedman,Emilia M Jalil,Angela Cristina Vasconcelos de Andrade Rabello,Vania Rocha,Beatriz Grinsztejn
BACKGROUNDAbortion is a public health problem in Latin America and is more common among women living with HIV.OBJECTIVEto verify the incidence and factors associated with induced abortion in a cohort of women living with HIV assisted in a reference service for care for individuals with HIV/AIDS in Rio de Janeiro/Brazil.METHODSProspective cohort during the period 1996-2016. We estimated the incidence of induced abortions during follow-up in the cohort by calculating person-time incidence rates [per 100 persons-years (PY)] and investigated the factors associated with the outcome "induced abortion" using a generalized linear mixed model.RESULTS753 women and 210 pregnancies were included in the present analysis. We estimated an induced abortion incidence rate of 0.68/100 persons-years (95% confidence interval [CI]: 0.47; 0.94) in the study period, with a significant reduction after 2006. The main factors associated with an induced abortion were currently living with a partner (adjusted OR [AdjOR] 0.32 95% CI: 0.10-0.98), number of children (2 children AdjOR 0.12, 95% CI: 0.02-0.95) and the type of antiretroviral treatment used (regimen without Efavirenz: AdjOR: 0.11, 95% CI 0.02-0.70).CONCLUSIONSWe showed a significant reduction in the incidence of induced abortions in a cohort of women living with HIV in Rio de Janeiro, Brazil, probably due to a decrease in the incidence of pregnancies observed in the same period. The factors associated with a lower occurrence of induced abortion suggest a good integration between the clinical and reproductive assistance offered to those women.
背景堕胎是拉丁美洲的一个公共卫生问题,在感染艾滋病毒的妇女中更为常见。目的核实巴西里约热内卢艾滋病毒/艾滋病患者护理参考服务机构协助的艾滋病毒感染妇女队列中人工流产的发生率和相关因素。我们通过计算人时发生率[每 100 人-年 (PY)]来估计队列随访期间的人工流产发生率,并使用广义线性混合模型研究了与 "人工流产 "结果相关的因素。据估计,研究期间的人工流产发生率为 0.68/100人-年(95% 置信区间 [CI]:0.47; 0.94),2006 年后显著下降。与人工流产相关的主要因素有:目前与伴侣同居(调整后 OR [AdjOR] 0.32 95% CI:0.10-0.98)、子女数量(2 个子女 AdjOR 0.12,95% CI:0.02-0.95)和所使用的抗逆转录病毒治疗类型(不含依非韦伦的治疗方案:AdjOR:0.11, 95% CI 0.02-0.70)。结论我们发现,在巴西里约热内卢的一组女性艾滋病感染者中,人工流产的发生率显著下降,这可能是由于同期观察到的怀孕发生率下降所致。与人工流产发生率降低相关的因素表明,为这些妇女提供的临床和生殖援助得到了很好的整合。
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引用次数: 0
Parenting with HIV: a patient’s view on updated infant feeding guidelines in the US 带着艾滋病毒养育子女:一位病人对美国最新婴儿喂养指南的看法
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-04 DOI: 10.1080/25787489.2024.2357871
Ciarra Covin
Published in HIV Research & Clinical Practice (Vol. 25, No. 1, 2024)
发表于《艾滋病研究与临床实践》(第 25 卷第 1 期,2024 年)
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引用次数: 0
Weight change with antiretroviral switch from integrase inhibitor or tenofovir alafenamide-based to Doravirine-Based regimens in people with HIV 艾滋病毒感染者从基于整合酶抑制剂或替诺福韦-阿拉非那胺的抗逆转录病毒疗法转为基于多拉韦林的抗逆转录病毒疗法后的体重变化
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-03 DOI: 10.1080/25787489.2024.2339576
Arianna E. Kousari, Melissa P. Wilson, Kellie L. Hawkins, Mohamed Mehdi Bandali, Andrés F. Henao-Martínez, Edward M. Gardner, Kristine M. Erlandson
Weight gain has been well-described with integrase strand transfer inhibitors (INSTIs) and tenofovir alafenamide (TAF). Doravirine (DOR) has been identified as a relatively “weight-neutral” drug; h...
关于整合酶链转移抑制剂(INSTIs)和替诺福韦阿烯酰胺(TAF)体重增加的描述很多。多拉韦林(DOR)已被确定为一种相对 "体重中性 "的药物;它是一种 "中性 "药物。
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引用次数: 0
Understanding the lived experience research priorities for improving health-related quality of life in people living with HIV with cognitive impairment 了解认知障碍艾滋病毒感染者的生活经历 改善与健康相关的生活质量的研究重点
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-03 DOI: 10.1080/25787489.2024.2358724
Kate Alford, Jaime H. Vera, John Hammond, Stephanie Daley
People living with HIV experience higher rates of cognitive impairment (CI), and at younger ages, than the general population. These individuals report poor health-related quality of life (HRQL), h...
与普通人群相比,艾滋病病毒感染者的认知障碍(CI)发生率更高,而且年龄更小。这些人的健康相关生活质量(HRQL)较差,他们的认知能力也较差。
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引用次数: 0
Clinical characteristics and outcomes of people living with HIV and ocular syphilis during the COVID-19 health emergency COVID-19 卫生紧急事件期间艾滋病毒感染者和眼梅毒患者的临床特征和结果
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-03 DOI: 10.1080/25787489.2024.2359791
Edgar Pérez-Barragán, Juan Carlos Rodríguez-Aldama, Paulina Rodríguez-Badillo, Karyme Guadalupe Villegas-Moreno, Gabriel Ezequiel Galindo-Magaña, Berenice González-Flores, Andrea González-Rodríguez, Raul Adrián Cruz-Flores
The global shift in healthcare during the COVID-19 pandemic led to challenges in the care of people living with HIV.We conducted a retrospective study that aimed to delineate sociodemographic, clin...
在COVID-19大流行期间,全球医疗保健发生了转变,这给艾滋病毒感染者的护理工作带来了挑战。
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引用次数: 0
The impact of COVID-19 on HIV treatment and care delivery in South and Southeast Asia: a qualitative study COVID-19 对南亚和东南亚艾滋病毒治疗和护理服务的影响:定性研究
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-05-20 DOI: 10.1080/25787489.2024.2355763
Sophie Ahmad, Shannon Fuller, Annette H. Sohn
The COVID-19 pandemic has significantly impacted HIV treatment worldwide, but its effects on South and Southeast Asia, particularly in India, Indonesia, and Thailand, have been less evident. Our ai...
COVID-19 大流行对全世界的艾滋病治疗产生了重大影响,但它对南亚和东南亚,尤其是印度、印度尼西亚和泰国的影响却不那么明显。我们的建议是...
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引用次数: 0
The impact of COVID-19 on HIV treatment and care delivery in South and Southeast Asia: a qualitative study. COVID-19 对南亚和东南亚艾滋病毒治疗和护理服务的影响:定性研究。
IF 1.7 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-05-14 Epub Date: 2024-05-20
Sophie Ahmad, Shannon Fuller, Annette H Sohn

The COVID-19 pandemic has significantly impacted HIV treatment worldwide, but its effects on South and Southeast Asia, particularly in India, Indonesia, and Thailand, have been less evident. Our aim was to study the perceptions of providers and policymakers to understand how interventions were implemented as part of pandemic responses and how their effectiveness was viewed. We conducted a qualitative study with semi-structured interviews focusing on the shifts in HIV care in response to the pandemic. Between June and July 2021, 40 individuals were invited for interviews; 33 (83%) agreed. Participants included 25 (76%) providers and 8 (24%) policymakers, who were from India (10; 30%), Indonesia (10; 30%), and Thailand (10; 30%), along with 3 (9.1%) regional policymakers. Sixteen (48%) were female. Our findings revealed four major themes: (1) limitations in accessing HIV care due to movement restrictions and shutdowns, such as transportation issues; (2) diversion of healthcare resources away from HIV care to COVID-19 responses, leading to reallocation of providers and hospital space; (3) setbacks in HIV-related policy implementation as COVID-19 emergency responses took priority; (4) the expansion of HIV differentiated service delivery interventions, allowing longer gaps between visits and larger-volume prescription refills to delay returns to healthcare facilities. These changes have raised concerns about the long-term consequences on HIV epidemic control and future pandemic responses. However, they have also presented opportunities for innovative care delivery, which should be sustained to address these challenges effectively.

COVID-19 大流行对全球艾滋病治疗产生了重大影响,但其对南亚和东南亚,尤其是印度、印度尼西亚和泰国的影响却不那么明显。我们的目的是研究提供者和决策者的看法,以了解作为大流行应对措施的一部分,干预措施是如何实施的,以及如何看待其有效性。我们通过半结构式访谈开展了一项定性研究,重点关注艾滋病护理在应对大流行方面的转变。2021 年 6 月至 7 月间,我们邀请了 40 人参加访谈;33 人(83%)同意参加。参与者包括 25 名(76%)医疗服务提供者和 8 名(24%)政策制定者,他们分别来自印度(10 人;30%)、印度尼西亚(10 人;30%)和泰国(10 人;30%),以及 3 名(9.1%)地区政策制定者。其中 16 人(48%)为女性。我们的研究结果揭示了四大主题:(1)由于行动限制和关闭(如交通问题),获得 HIV 护理受到限制;(2)医疗资源从 HIV 护理转向 COVID-19 应对措施,导致医疗服务提供者和医院空间的重新分配;(3)由于 COVID-19 紧急应对措施占据优先地位,HIV 相关政策的实施受到挫折;(4)HIV 差异化服务提供干预措施的扩大,使得就诊间隔时间更长,处方补充量更大,从而推迟了返回医疗机构的时间。这些变化引起了人们对艾滋病毒疫情控制和未来大流行病应对措施长期后果的担忧。然而,这些变化也为创新性地提供护理服务提供了机遇,应继续保持以有效应对这些挑战。
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引用次数: 0
Impact of switching to injectables cabotegravir and rilpivirine on sleep disturbances in a cohort of people living with HIV 转用注射用卡博替拉韦和利匹韦林对一组艾滋病毒感染者睡眠障碍的影响
IF 1.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-05-10 DOI: 10.1080/25787489.2024.2351258
Maria Mazzitelli, Elena Agostini, Eleonora Vania, Nicolò Presa, Lolita Sasset, Davide Leoni, Samuele Gardin, Vincenzo Scaglione, Annamaria Cattelan
Recently, injectable cabotegravir/rilpivirine (ICAB/RPV) became available for HIV treatment. However, there are no real-life data on the impact of switching to ICAB/RPV on sleep disturbances (SD). ...
最近,注射用卡博替拉韦/利匹韦林(ICAB/RPV)开始用于艾滋病治疗。然而,目前还没有关于改用 ICAB/RPV 对睡眠障碍(SD)影响的真实数据。
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引用次数: 0
期刊
HIV Research & Clinical Practice
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