Journal of the International Association of Providers of AIDS Care最新文献

BackgroundIn Cameroon, Prevention of Mother-to-Child Transmission (PMTCT) program has been implemented for over two decades, yet persistent challenges hinder their effectiveness. This study evaluates the effectiveness of PMTCT program between 2021 and 2023 throughout the national territory.MethodsThis was a retrospective analysis of data from Cameroon's PMTCT program with data sourced from the national health records and analyzed using advance statistic technics.ResultsThe findings indicate a slight upward trend in transmission prevalence from 0.98% in 2021 to 1.06% in 2023. Maternal human immunodeficiency virus (HIV) status during pregnancy emerged as a major driver of transmission, highlighting gaps in repeated HIV testing. We note a national wide decline of first antenatal attendances and HIV testing coverage. Male partner involvement remained low and retention in care varied overtime inline to specific indicators.ConclusionWhile Cameroon's PMTCT program has made progress, challenges persist with mother-to-child transmission-related program indicators.

BackgroundThe co-infection of human immunodeficiency virus (HIV) and neurosyphilis presents a significant clinical challenge due to the increased risk of opportunistic infections, including progressive multifocal leukoencephalopathy (PML).Case PresentationA 23-year-old unmarried male with an unprotected sexual history presented with progressive right upper limb weakness and slurred speech for 10 days. He was diagnosed with HIV and neurosyphilis co-infection, and neuroimaging/cerebrospinal fluid studies confirmed PML.ConclusionsThis case highlights the importance of screening for HIV and neurosyphilis in young patients with neurological symptoms and the need for awareness of opportunistic infections such as PML in immunocompromised individuals.

BackgroundHIV self-tests (HIVSTs) have been promoted as one way to increase testing.MethodsWe extracted data from the GetaKit study for October 11, 2023 to June 30, 2025, focusing on participants to whom we co-offered an HIVST and serology.ResultsWe co-offered HIVST and serology to 3611 persons; 71.9% agreed to go to a lab and 19.4% opted for only the HIVST. Participants who were Black, Indigenous, or Persons of Color were less willing to attend a lab; participants who were men who have sex with men or reported injection drug use or sex work were more willing to attend a lab. First-time testers opted for the HIVST at a higher rate. HIVST did not yield new diagnoses.ConclusionsHIVSTs were an entry point to testing for some but were not the preferred modality for most. Promoting HIVSTs too broadly would not align with patient preference.

Despite progress in human immunodeficiency virus (HIV) prevention, global targets remain unmet, with over 1.3 million new infections annually-driven by adherence challenges, stigma, and daily pill fatigue linked to oral pre-exposure prophylaxis (PrEP). Lenacapavir, a long-acting injectable capsid inhibitor approved by the FDA in June 2025, offers transformative twice-yearly subcutaneous dosing with sustained efficacy and minimal drug interactions. PURPOSE 1 and 2 trials demonstrated near-complete protection across cisgender women, men who have sex with men, transgender individuals, and adolescents, highlighting its potential to overcome barriers to PrEP uptake. Its high acceptability, infrequent dosing, and pharmacologic durability make it ideal for individuals facing stigma, mobility constraints, or limited healthcare access. WHO's endorsement marks a pivotal milestone, but real-world implementation must address cold-chain logistics, cost, provider training, and systemic inequities. Integrating lenacapavir through decentralized delivery models, differentiated care, and inclusive national guidelines will be key to equitable access, decreasing gaps and advancing epidemic control.

BackgroundDue to high-risk sexual networks along their transit routes, Long-distance truckers' (LDTs) risk of HIV is known to be high, as evidenced by prevalence rates of 14.34% in the region. Besides, the spaces in which LDTs operate are often marred with a multitude of barriers to HIV/AIDS risk reduction. However, there is limited evidence on the barriers encountered by LDTs in Kenya, hence the need for the current study.Methods and MethodologyWe used nine key informants and 18 in-depth interviews from purposively sampled participants, such as nurses and LDT peer educators at Kenya's Busia and Namanga international border points. We used semi-structured interview guides to collect data through audio records. Interviews were transcribed, coded, and thematically analysed using the QDA-Miner software to generate themes and sub-themes around barriers to HIV/AIDS risk reduction among LDTs.FindingsOverall, three themes, namely, health system, individual-level, and trucking career-related barriers emerged. The sub-themes under health system barriers included the location of healthcare facilities far from transit routes, long durations of hospital waiting time, and lack of targeted health facilities for LDTs, among several others. Under trucking career-related barriers, the sub-themes comprised tight work schedules, unfavourable trucking career policies, and insecurity along transit routes. For individual barriers, some of the sub-themes were language barriers and lack of awareness of current HIV/AIDS risk reduction services.ConclusionAlongside health system factors, individual level and trucking career-related factors were highlighted as the barriers to HIV/AIDS risk reduction among LDTs in Kenya. The existence of these barriers may complicate the fight against the pandemic in this hard-to-reach population, given their already known vulnerability to HIV infections.

The manuscript outlines the establishment of a remote consultation service for clinicians in Mozambique, highlighting best practices and lessons learned. It discusses the transition to full management by the Ministry of Health and the challenges of sustaining the service post-transition within the MoH Telehealth Program. The program evaluation results focus on the national telephone consultation service for HIV/AIDS care and treatment, which, between 2013 and 2019, received calls from a wide range of health facilities and cadres, including nonmedical prescribers, doctors, clinical assistants, and nurses. A 2017 clinician satisfaction survey indicated high satisfaction rates. Key implementation lessons emphasized the necessity of staffing the consultation line with highly trained clinicians, leveraging training to enhance service awareness and trust, supporting the public health system, maintaining operational flexibility, and strengthening pre-service clinical training.

Purpose of the researchA major consequence of the COVID-19 pandemic was a disruption of medical care in the United States. Using cross-sectional data from an ongoing randomized clinical trial, we examined severity of COVID-related hardships and other factors that might have influenced newly diagnosed people with HIV's (PWH's) receipt of care during the initial years of the pandemic (2020-22).Major findingsIn a sample of 29 newly diagnosed PWH presenting for care at three geographically diverse medical clinics in the United States, results showed that most patients (72.4%) reported that obtaining an HIV medical appointment during the pandemic was "easy." Correlational analyses found that COVID-related hardships were significantly related to overall health and functioning, as well as experiences of discrimination.ConclusionsTaken together, these findings align with previous results to show that already vulnerable populations were particularly affected by service disruptions, but that many patients were able to access care despite the pandemic.

BackgroundHuman immunodeficiency virus (HIV) cases are rising in Central Asia and Kazakhstan. People living with HIV (PLWH) in Kazakhstan are at heightened risk of severe COVID-19. We conducted a study to evaluate determinants of COVID-19 vaccine uptake among PLWH in Kazakhstan.MethodsIn this cross-sectional study, 196 PLWH were recruited from the Almaty City AIDS Center (July 2022-January 2023). We used logistic regression to evaluate how multilevel factors are associated with COVID-19 vaccine uptake among PLWH in Kazakhstan.ResultsCOVID-19 vaccine non-uptake was associated with higher HIV stigma scores (AOR = 1.08, 95%CI:1.02,1.16, P = 0.017), a lower level of education (AOR = 2.53, 95%CI: 1.04,6.17, P = 0.0412), and never receiving the flu vaccine (AOR = 15.64, 95%CI:3.66,66.89, P = 0.0002). Participants with at least mild anxiety symptoms (AOR = 0.15, 95%CI:0.03,0.64, P = 0.0107) and a positive attitude towards vaccination (AOR = 0.79, 95%CI: 0.73,0.86, P < 0.0001) were less likely to remain unvaccinated against COVID-19.ConclusionsCOVID-19 vaccination campaigns should be tailored for PLWH and incorporate stigma reduction interventions within healthcare settings.