AIDS最新文献

Objective: To analyze correlates of recent HIV infection among people who inject drugs (PWID) in Ukraine to inform public health interventions.

Design: Secondary data analysis of bio-behavioral surveillance (BBS) studies using respondent-driven sampling (RDS) conducted over multiple years.

Methods: We analyzed data from four rounds of RDS-based BBS conducted among PWID in Ukraine during 2013, 2015, 2017, and 2020. Analysis included 27,852 PWID who participated in 100 RDS studies in 33 cities. Only participants classified as having recent HIV infection and those who tested HIV negative were included. Recent HIV infection was identified using rapid or laboratory recency test, followed by viral load confirmation. We used univariate and multivariable mixed-effect logistic regression models to estimate crude and adjusted odds ratios (aOR) for correlates of recent HIV infection.

Results: The odds of testing recent were greater in 2017 that the other years. Reported use of sterile needles/syringes during the last injection was associated with lower odds (aOR 0.34, 95% CI 0.16-0.73). Having a sex partner living with HIV had the strongest association (aOR 5.58, 95% CI 2.02-15.38) with a recent-positive test result. Recent infections were positively associated with history of incarceration more than one year ago among males (aOR 1.83, 95% CI 1.10-3.06) and among females who were never incarcerated (aOR 2.81 95% CI (1.65-4.77).

Conclusions: This study underscores the importance of sex-specific interventions for PWID. The lower odds of recent HIV in connection to safe injection practices highlights the importance of maintaining sustainable harm reduction programs.

We found that risk of SARS-CoV-2 breakthrough infection did not meaningfully differ between a population-based cohort of vaccinated people with HIV and a matched cohort of people without HIV after accounting for sociodemographic factors, previous SARS-CoV-2 infection, SARS-CoV-2 testing patterns and COVID-19 vaccine doses (14 December 2020 to 5 May 2024). However, rates of breakthrough infection were higher among men with HIV compared to without HIV during the pre-Omicron era.

Background: Administrative claims provide rich data for HIV-related program implementation or research. However, identifying people with HIV in these data remains challenging. We examined the validity of competing case identification algorithms to identify adults with HIV in claims data.

Methods: Claims with diagnosis, procedure, and prescription drug codes, as well as enrollment and demographic information, came from Virginia Medicaid, 2012-2023. Surveillance data came from the Virginia Department of Health's Care Markers database, 2012-2023. We created 12 case identification algorithms based on combinations of diagnosis, procedure, and prescription drug codes. After matching the claims to gold-standard surveillance data, for each algorithm, we calculated diagnostic accuracy measures to assess discriminative (sensitivity, specificity, and receiver operating characteristics-area under the curve [ROC-AUC]) and predictive (positive predictive value [PPV] and negative predictive value [NPV]) ability.

Results: For algorithms with a single HIV-related code, algorithm sensitivity was 73-75%, 87% for ROC-AUC, and 47-70% for PPV. As frequency and type of HIV-related codes increased, the sensitivity of algorithms decreased to 58-67% (≥2 HIV-related codes) and 51-63% (≥3 HIV-related codes), whereas ROC-AUC decreased to 79-83% and 75-81%, respectively. PPV increased to 83-88% (≥2 HIV-related codes) and 88-90% (≥3 HIV-related codes). Specificity and NPV exceeded 99% for all case identification algorithms.

Conclusion: Case identification algorithms have good performance when applied in a population-based sample of claims data with low HIV prevalence and using multiple code types. Trade-offs between discriminative and predictive ability suggest algorithms should be tailored to use.

Objectives: In Los Angeles, cisgender men who have sex with men (MSM) - particularly Black/African American and Latinx individuals - are a high-priority population for new HIV prevention interventions. Incentive programs that pay people for engaging in healthy behaviors, also known as "conditional cash transfers" (CCTs), are a promising strategy, but there is little evidence about their use in Black/African American and Latinx cisgender MSM.

Design and methods: We surveyed 133 cisgender MSM who identified as Black/African American or Latinx and included a discrete choice experiment to elicit their preferences for CCTs to incentivize preexposure prophylaxis (PrEP) use and, separately, HIV testing.

Results: Our findings suggest that respondents preferred more frequent payments of higher monetary value (e.g., a 35.2 percentage point increased probability of choosing a PrEP use CCT with $1200 versus $300 payment, and a 49.7 percentage point increased probability of choosing an HIV testing CCT with $1200 versus $300 payment). Additionally, respondents showed a preference for receiving CCT payments in cash over gift card payments (a 9.4 percentage point increased preference in the PrEP use CCT, and an 11 percentage point increased preference in the HIV testing CCT), particularly among those who were unemployed. Younger respondents had a stronger preference for more frequent payments. Higher monetary amounts were more strongly preferred by those with greater educational attainment and those who were employed.

Conclusions: This preimplementation research highlights important, and heterogeneous, preferences in the design details of a HIV prevention CCT for Black/African American and Latinx cisgender MSM in Los Angeles.

Objective: This study aimed to report a novel HIV-1 circulating recombinant form (CRF) identified among men who have sex with men (MSM) in China.

Design: Viral sequences were isolated from MSM patients, and the recombination and evolutionary histories of this CRF were elucidated through phylogenetic and Bayesian analyses.

Methods: Near full-length genomes (NFLGs) and partial genome sequences were amplified from RNA extracted from plasma samples of three HIV-1 seropositive MSM in Heilongjiang Province, China. Phylogenetic analysis was conducted using FastTree v2.1.9, and recombination analysis was performed using Simplot v3.5.1. The emergence time of the novel CRF was estimated by Bayesian evolutionary analysis using BEAST v1.10.4.

Results: Two NFLGs and two partial genome segments were successfully obtained from three MSM participants. This novel CRF was characterized by 12 mosaic gene segments, comprising 6 segments from the CRF01_AE cluster 4 and 6 segments from the CRF07_BC cluster N, and thus was designated as CRF183_0107. The estimated time of origin for the CRF01_AE and CRF07_BC components within CRF183_0107 were approximately 2009.2 and 2012.5, respectively.

Conclusion: A novel second-generation HIV-1 recombinant, named CRF183_0107, was identified within the MSM population in China. This CRF exemplified the recombination events occurring between the CRF01_AE cluster 4 and the CRF07_BC cluster N during 2009-2012.