Pub Date : 2025-10-01Epub Date: 2025-07-22DOI: 10.1016/S2352-3018(25)00193-6
Remko van Leeuwen, Françoise Barré-Sinoussi, Michaela Müller-Trutwin, Asier Sáez-Cirión, Monique Nijhuis, Sharon R Lewin, Thumbi Ndung'u, Florence Riako-Anam, Mitchell Warren, Izukanji Sikazwe, Birgit Poniatowski, Beatriz Grinsztejn, Cissy Kityo, Masen Davis, Ole S Søgaard, Marcus Altfeld, Javier Martinez-Picado, Linos Vandekerckhove, Andrea Gramatica, Devin Sok, Simon Collins, Yazdan Yazdanpanah
{"title":"The imperative for increased investment for an HIV cure.","authors":"Remko van Leeuwen, Françoise Barré-Sinoussi, Michaela Müller-Trutwin, Asier Sáez-Cirión, Monique Nijhuis, Sharon R Lewin, Thumbi Ndung'u, Florence Riako-Anam, Mitchell Warren, Izukanji Sikazwe, Birgit Poniatowski, Beatriz Grinsztejn, Cissy Kityo, Masen Davis, Ole S Søgaard, Marcus Altfeld, Javier Martinez-Picado, Linos Vandekerckhove, Andrea Gramatica, Devin Sok, Simon Collins, Yazdan Yazdanpanah","doi":"10.1016/S2352-3018(25)00193-6","DOIUrl":"10.1016/S2352-3018(25)00193-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e671-e673"},"PeriodicalIF":13.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/s2352-3018(25)00192-4
Jack Stone,Kennedy Kipkoech Mutai,Adelina Artenie,Romain Silhol,Marie-Claude Boily,Jirair Ratevosian,Chris Beyrer,Peter Vickerman
BACKGROUNDIn January, 2025, the US Government issued a directive, pausing all foreign aid programmes. This directive included a 90-day pausing of all US President's Emergency Plan for AIDS Relief (PEPFAR) funding for HIV oral pre-exposure prophylaxis (PrEP) except for pregnant and breastfeeding women, with a return to funding for PrEP looking increasingly unlikely. We aimed to estimate the impact of a funding pause for PrEP on HIV infections in sub-Saharan Africa.METHODSIn this mathematical modelling study, we developed a static HIV transmission model incorporating PrEP, parameterised with estimates of population size, HIV prevalence and incidence, and PrEP effectiveness for different subpopulations (including key populations) in each PEPFAR-funded sub-Saharan African country. Key populations were men who have sex with men, female sex workers, transgender women, and people who inject drugs. We used PEPFAR reporting on numbers of people in different subpopulations returning for oral PrEP for each country in July to September, 2024, as the estimated number using oral PrEP provided by PEPFAR. For each country and subpopulation, we modelled the relative and absolute increase in new primary HIV infections resulting from removing this funded PrEP for a year and the number of secondary infections that could result from these primary infections during the next 5 years.FINDINGSTowards the end of 2024, 719 384 individuals who were not breastfeeding or pregnant, including 205 868 people from key populations, received PEPFAR-funded PrEP across 28 sub-Saharan African countries. The estimated proportion of HIV-negative key population individuals receiving PEPFAR-funded PrEP (ie, the coverage) ranged from 2·6% (95% uncertainty interval 2·0-3·4) in people who inject drugs to 5·0% (4·5-5·9) in female sex workers. Estimated coverage among non-key population men was less than 0·1% (<0·1 to <0·1) and in women was 0·1% (0·1 to 0·1). Stopping PEPFAR's provision of PrEP for a year could lead to 6671 (5032-8192) additional new primary HIV infections, including 5663 (4146-7074) in key populations. Within key populations, this absolute increase corresponds to relative increases in new HIV infections of 0·8% (0·3-1·5) in people who inject drugs, 1·4% (0·8-2·3) in transgender women, 2·2% (1·3-3·0) in men who have sex with men, and 2·9% (1·8-4·4) in female sex workers. In Zambia, the country with the highest PEPFAR coverage across all key populations, this increase ranges from 7·8% (2·5-17·1) in people who inject drugs to 18·1% (9·7-33·2) in men who have sex with men. When considering secondary transmissions, we estimated that a 1-year pause could lead to 10 313 (7796-12 921) additional infections during the next 5 years.INTERPRETATIONOur projections show the substantial detrimental impacts that cuts to PEPFAR funding could have. Mitigation measures, including funding through alternative international donors or domestic government budgets, are needed to maintain and increase
{"title":"The impact of cuts in the US President's Emergency Plan for AIDS Relief funding for HIV pre-exposure prophylaxis in sub-Saharan Africa: a modelling study.","authors":"Jack Stone,Kennedy Kipkoech Mutai,Adelina Artenie,Romain Silhol,Marie-Claude Boily,Jirair Ratevosian,Chris Beyrer,Peter Vickerman","doi":"10.1016/s2352-3018(25)00192-4","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00192-4","url":null,"abstract":"BACKGROUNDIn January, 2025, the US Government issued a directive, pausing all foreign aid programmes. This directive included a 90-day pausing of all US President's Emergency Plan for AIDS Relief (PEPFAR) funding for HIV oral pre-exposure prophylaxis (PrEP) except for pregnant and breastfeeding women, with a return to funding for PrEP looking increasingly unlikely. We aimed to estimate the impact of a funding pause for PrEP on HIV infections in sub-Saharan Africa.METHODSIn this mathematical modelling study, we developed a static HIV transmission model incorporating PrEP, parameterised with estimates of population size, HIV prevalence and incidence, and PrEP effectiveness for different subpopulations (including key populations) in each PEPFAR-funded sub-Saharan African country. Key populations were men who have sex with men, female sex workers, transgender women, and people who inject drugs. We used PEPFAR reporting on numbers of people in different subpopulations returning for oral PrEP for each country in July to September, 2024, as the estimated number using oral PrEP provided by PEPFAR. For each country and subpopulation, we modelled the relative and absolute increase in new primary HIV infections resulting from removing this funded PrEP for a year and the number of secondary infections that could result from these primary infections during the next 5 years.FINDINGSTowards the end of 2024, 719 384 individuals who were not breastfeeding or pregnant, including 205 868 people from key populations, received PEPFAR-funded PrEP across 28 sub-Saharan African countries. The estimated proportion of HIV-negative key population individuals receiving PEPFAR-funded PrEP (ie, the coverage) ranged from 2·6% (95% uncertainty interval 2·0-3·4) in people who inject drugs to 5·0% (4·5-5·9) in female sex workers. Estimated coverage among non-key population men was less than 0·1% (<0·1 to <0·1) and in women was 0·1% (0·1 to 0·1). Stopping PEPFAR's provision of PrEP for a year could lead to 6671 (5032-8192) additional new primary HIV infections, including 5663 (4146-7074) in key populations. Within key populations, this absolute increase corresponds to relative increases in new HIV infections of 0·8% (0·3-1·5) in people who inject drugs, 1·4% (0·8-2·3) in transgender women, 2·2% (1·3-3·0) in men who have sex with men, and 2·9% (1·8-4·4) in female sex workers. In Zambia, the country with the highest PEPFAR coverage across all key populations, this increase ranges from 7·8% (2·5-17·1) in people who inject drugs to 18·1% (9·7-33·2) in men who have sex with men. When considering secondary transmissions, we estimated that a 1-year pause could lead to 10 313 (7796-12 921) additional infections during the next 5 years.INTERPRETATIONOur projections show the substantial detrimental impacts that cuts to PEPFAR funding could have. Mitigation measures, including funding through alternative international donors or domestic government budgets, are needed to maintain and increase","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"26 1","pages":"e712-e721"},"PeriodicalIF":16.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/s2352-3018(25)00263-2
Victor Abiola Adepoju,Abdulrakib Abdulrahim,Shankar Biswas
{"title":"The promise and paradox of HIV self-testing in the era of twice-yearly PrEP.","authors":"Victor Abiola Adepoju,Abdulrakib Abdulrahim,Shankar Biswas","doi":"10.1016/s2352-3018(25)00263-2","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00263-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"5 1","pages":"e674"},"PeriodicalIF":16.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/s2352-3018(25)00272-3
The Lancet Hiv
{"title":"Russia spiralling into an HIV crisis.","authors":" The Lancet Hiv","doi":"10.1016/s2352-3018(25)00272-3","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00272-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"78 1","pages":"e669"},"PeriodicalIF":16.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-05-30DOI: 10.1016/S2352-3018(25)00133-X
Joe Parkin Daniels
{"title":"Bridging the gap in Ecuador's health system.","authors":"Joe Parkin Daniels","doi":"10.1016/S2352-3018(25)00133-X","DOIUrl":"10.1016/S2352-3018(25)00133-X","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e677"},"PeriodicalIF":13.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-06-24DOI: 10.1016/S2352-3018(25)00187-0
Vijay Shankar Balakrishnan
{"title":"Community and care in MENA's HIV crisis.","authors":"Vijay Shankar Balakrishnan","doi":"10.1016/S2352-3018(25)00187-0","DOIUrl":"10.1016/S2352-3018(25)00187-0","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e675-e676"},"PeriodicalIF":13.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-26DOI: 10.1016/s2352-3018(25)00238-3
Fio Trethewey
{"title":"Love, resilience, and community in the Chilean desert.","authors":"Fio Trethewey","doi":"10.1016/s2352-3018(25)00238-3","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00238-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"70 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-26DOI: 10.1016/s2352-3018(25)00237-1
Peter Ranscombe
{"title":"Nostalgic throwbacks in Sad Gay AIDS Play parody.","authors":"Peter Ranscombe","doi":"10.1016/s2352-3018(25)00237-1","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00237-1","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"327 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-26DOI: 10.1016/s2352-3018(25)00267-x
Roger Pebody
{"title":"Creating a space where young people with HIV can be free.","authors":"Roger Pebody","doi":"10.1016/s2352-3018(25)00267-x","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00267-x","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"65 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：