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

Undergraduate, underrepresented minority (URM) scholars must be comprehensively supported by the current HIV workforce to lead the future of HIV research. This commentary elaborates on the lived experience and outcomes of alumni from an undergraduate HIV research program and is written by alumni themselves. Undergraduate research enrichment programs for URM scholars are consistently deprioritized, underfunded, underresourced, and scrutinized. We seek to remind our audience of the outstanding contributions made to HIV and public health by URM scholars from these programs, such as the Student Opportunities for AIDS/HIV Research (SOAR) program. SOAR students and alumni report 95% placement in Masters, Doctoral, and Professional graduate programs, 100 conference presentations, and 34 publications within 3 years of the program's onset. Ultimately, this commentary speaks to the necessity of not only supporting URM researchers but also having a sustainable succession plan for advancing HIV research and programming. We recommend incorporating (a) critical health equity curriculum, (b) multidirectional mentorship, and (c) paid labor, which are crucial to tailor to URM scholars for their success and retention in research. Waiting to support the next generation of HIV researchers denies the urgency to respond to this intersectional public health issue-inaction is not an option.

Introduction: Dolutegravir (DTG)-based antiretroviral therapy (ART) use has been associated with excessive weight gain, increasing the risk of dyslipidemias such as hypercholesterolemia. We assessed the prevalence of, and associated factors with dyslipidemia among adults on DTG-based ART.Materials and methodsWe conducted a cross-sectional study among 281 systematically sampled adults on DTG-based ART for ≥ 6 months at Kira Health Centre IV, Wakiso District, Central Uganda. Data were collected through structured questionnaires, medical record reviews, anthropometric measurements, and laboratory biomarker analysis. Logistic regression was used to determine associated factors, and the predictive performance of obesity indices was evaluated using receiver operating characteristic (ROC) curve analysis.ResultsThe prevalence of dyslipidemia was 44.1% 95% CI: 38.4%-50.0%. Low high-density lipoprotein (HDL) cholesterol was the most common abnormality, affecting 39.9% of participants, followed by elevated total cholesterol at 5.7% [95% CI: 3.51-9.11] and elevated low-density lipoprotein (LDL) cholesterol at 5.0%. High waist circumference (WC) was significantly associated with dyslipidemia; (aPR: 1.93, 95% CI: 1.15-3.24, p = .013), and demonstrated a significant ability to predict dyslipidemia with area under the curve (AUC) of 0.577 [95% CI: 0.511-0.644]. The AUC for WC in predicting hypercholesterolemia, elevated LDL-C, and low HDL-C were 0.702 (95% CI: 0.547-0.857), 0.729(95% CI: 0.590-0.867), and 0.548 (95% CI: 0.481-0.616) respectively.ConclusionDyslipidemia is prevalent among adults on DTG-based ART, and is potentially associated with high WC.

ObjectiveYoung people with perinatally acquired HIV (YPHIV) in Thailand face psychosocial, developmental, and structural challenges. Intrinsic motivation strongly shapes health behaviors, including treatment adherence and Human immunodeficiency virus (HIV) self-care.MethodsA qualitative study was conducted in March 2025 at the Chiang Mai University in Thailand enrolling 32 YPHIV aged 16-30 years (median age 22.9). Using photovoice and focus group discussions, participants shared their experiences and motivations for self-care.ResultsThematic analysis revealed key sources of motivation: supportive family ties, self-value, ambitious life goals, and inspiration from nature. While medication adherence and HIV self-care were seen as manageable, disclosure of HIV status remained highly stressful.ConclusionFindings suggest YPHIV demonstrates resilience and intrinsic motivation despite ongoing challenges. Strengthening intrinsic motivation may enhance adherence, self-care, and long-term health outcomes through timely interventions and social support.

We evaluated Klick, a nurse-led, digitally enabled model of HIV outpatient care, launched in 2020. Klick's smartphone app offers online booking, remote nurse-led consultations, and results. An audit of Klick nurse-led consultations was conducted against BHIVA monitoring guidelines, and nurses were interviewed about their experience. Of 40 Klick patients audited, 4 of 5 BHIVA standards were met: 100% had documented co-medications, smoking history, blood pressure, and viral load data, and 89% received a cardiovascular risk calculation (Targets 97%-90%-90%-90%-90%). Compared to national BHIVA audit findings, Klick performed better across 22 of 24 comparable measures. Nurses safely managed a cohort comprising some complexity (eg, co-morbidities, polypharmacy); no cases were escalated off the pathway, and all were virologically suppressed. Using a digitally supported model, nurses effectively provided safe care to HIV-positive patients with predominantly stable health, enabling consultants to focus on more complex caseloads. Care was comprehensive and person-centered and obtained better outcomes compared to previous national audits.

Background: Identifying patterns in the distribution of new HIV infections in the population is critical for HIV programmatic interventions. This study aimed to determine the distribution of New HIV infection by applying the incidence patterns mathematical model to data from Lagos state.

Methods: The incidence patterns model (IPM) software is a mathematical model developed by UNAIDS to estimate the demographic and epidemic patterns of HIV infections. This model was adapted in Lagos state to predict the distribution of new HIV infections among specified risk groups in the next 12 months.

Results: The IPM predicted a total HIV incidence of 37 cases per 100 000 individuals (3979 new infections) will occur among the 15 to 49 subpopulations. The results also showed that sero-concordant HIV-negative couples with external partners (29%), female sex workers (26%), men-having-sex-with-men (18%), and previously married females (6%) accounted for the majority of the estimated new HIV infections. Overall, key populations constitute almost half (48%) of the estimated number of new HIV infections.

Conclusion: The study helped to identify the population groups contributing significantly to new HIV infections. Therefore, priority interventions should be focused on these groups.

Background: Frailty may affect people living with HIV (PLHIV) prematurely. Fried's frailty phenotype, composed of 5 criteria, is one of the most used instruments for its assessment. This study aimed to determine the prevalence of these criteria among PLHIV classified as prefrail and frail in Brazil.

Methods: A cross-sectional study analyzed the prevalence of the Frailty Phenotype in Brazil with 670 individuals aged ≥ 50 years and undetectable viral load.

Results: The prevalence of prefrail and frail individuals was 50.7% and 13.6%, respectively. A low level of physical activity was the most prevalent criterion (50.9%). Except for unintentional weight loss, all other criteria were more prevalent among individuals with lower education levels. All criteria were more prevalent among individuals of lower socioeconomic status than among those of moderate or high status (P < .05).

Conclusions: A low level of physical activity was the component that most contributed to PLHIV being considered prefrail or frail.

Background: This study determined the trends of transfusion-transmissible infections (TTIs) among blood donors in a regional hospital in Ghana from 2017 to 2022.

Methods: A retrospective analysis was conducted on 6339 blood donor records. Data were analyzed using STATA version 17.0 at the 0.05 significance level.

Results: The prevalence of TTIs was 31.4% in 2017, 13.8% in 2018, 20.4% in 2019, 9.5% in 2020, 9.6% in 2021, and 11.7% in 2022. There were significant associations between hepatitis C virus (HCV), Syphilis, and sex (OR = 2.06; 95% CI [1.29-3.30]; P = .003) and (OR = 2.28; 95% CI [1.48-3.54]; P < .001), respectively. Blood donors aged 20-29 were more likely to be infected with hepatitis B virus (OR = 1.96; 95% CI [1.28-2.99]; P = .002). Blood donors aged 40-49 had higher odds of infection with HCV (OR = 3.36; 95% CI [2.02-5.57]; P < .001) and Syphilis (OR = 3.79; 95% CI [2.45-5.87]; P < .001).

Conclusion: The study highlights the need to implement targeted prevention strategies for donors with a higher TTI prevalence.

Polygamy is the practice of marriage to multiple partners. Approximately 6-11% of households in Uganda and 4-11% of households in Kenya are polygamous. The complex families produced by polygamous marriage customs give rise to additional considerations for healthcare providers and public health messaging around HIV care. Using 27 in-depth, semi-structured qualitative interviews with participants in two studies in rural Kenya and Uganda, we analysed challenges and opportunities that polygamous families presented in the diagnosis, treatment and prevention of HIV, and provider roles in improving HIV outcomes in these families. Overall, prevention methods seemed more justifiable to families where co-wives live far apart than when all members live in the same household. In treatment, diagnosis of one member did not always lead to disclosure to other members, creating an adverse home environment; but sometimes diagnosis of one wife led not only to diagnosis of the other, but also to greater household support.

Introduction: CARISEL is an implementation-effectiveness "hybrid" study examining the perspectives of people living with HIV-1 (patient study participants [PSPs]) on cabotegravir (CAB) plus rilpivirine (RPV) long-acting (LA) dosed every 2 months (Q2M) across 5 European countries.

Methods: PSPs completed questionnaires on acceptability (Acceptability of Intervention Measure), appropriateness (Intervention Appropriateness Measure), and feasibility (Feasibility of Intervention Measure) at their first (Month [M] 1), third (M4), and seventh (M12) injection visits. Semistructured qualitative interviews were also conducted.

Results: Overall, 437 PSPs were enrolled, of whom 430 received treatment. Median (interquartile range) age was 44 (37-51) years, 25.3% (n = 109/430) were female (sex at birth), and 21.9% (n = 94/430) were persons of color. Across time points, PSPs found CAB + RPV LA highly acceptable, appropriate, and feasible (mean scores ≥4.47/5). Qualitative data supported these observations.

Conclusions: PSPs found CAB + RPV LA Q2M to be an acceptable, appropriate, and feasible treatment option.