AIDS Research and Therapy最新文献

Postpartum adiposity is associated with long-term risk of cardiovascular disease (CVD), which may be influenced by HIV infection. We investigated cross-sectional correlations between postpartum adiposity measures, and circulating proteins linked to CVD in women living with and without HIV. Irrespective of HIV status, adiposity was positively correlated with fatty acid binding protein 4, leptin and galectin 9; and negatively correlated with insulin-like growth factor binding protein 2 and V-set immunoglobulin domain containing 2. The link between adiposity and CVD-linked circulating proteins underscores the role of protein markers in understanding the cardiometabolic health of postpartum women living with and without HIV. Clinical trial number: Not applicable.

Background: The introduction of HIV self-testing (HIVST) kits has revolutionized HIV prevention by offering a confidential and accessible option, particularly for vulnerable groups. Despite this, uptake varies widely due to multiple influencing factors. In Tanzania, where HIV prevalence among women remains high, the determinants of HIVST use are not well understood. This study addresses this gap by analyzing the 2022 Tanzania Demographic and Health Survey (TDHS), aiming to identify key predictors of HIVST uptake among women of reproductive age.

Methods: This study conducted a cross-sectional analysis using 2022 TDHS data. Data management and analysis were performed using Stata 18. Given the survey's complex design, a multilevel mixed-effect logistic regression model was used to identify predictors of HIVST kit use, with results presented as adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Statistical significance was set at p < 0.05.

Results: The prevalence of HIVST kit usage among women of reproductive age in Tanzania was 3.2% (95% CI: 2.8-3.7%). Individual-level factors associated with a higher likelihood of HIVST kit use included age, 25-34 (AOR = 1.93, 95%CI: 1.43-2.60) and 35-49 (AOR = 1.60, 95%CI:1.43-2.26), secondary/higher education (AOR = 2.77, 95%CI: 1.57-4.85), belonging to the rich wealth quintile (AOR = 2.69, 95%CI: 1.52-4.77), internet use (AOR = 3.04, 95%CI: 2.04-4.52), awareness of sexually transmitted infections (STIs) (AOR = 2.03, 95%CI: 1.21-3.42), and one or higher number of sexual partners. At the community level, geographical zone was associated with increased odds of use, while living in a high poverty level community (AOR = 0.52, 95%CI: 0.30-0.89) was associated with a lower likelihood of HIVST kit use.

Conclusion: This study highlights a low uptake of HIVST kits among reproductive-aged women in Tanzania, driven by both individual and community factors. Higher education and STI awareness significantly increase HIVST use, indicating the need for education and targeted health communication. Additionally, community poverty underscores the importance of economic empowerment and resource support to improve access. Addressing these factors can help tailor interventions to boost HIVST uptake and reduce HIV transmission in Tanzania.

HIV drug resistance (HIVDR) was retrospectively characterized among 20 children and adolescents with HIV with virologic failure on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy, and virologic response in those switched to dolutegravir (DTG)-based therapy described. All participants had at least one NNRTI resistance mutation, most commonly K103N (N = 12) and 15 (75%) had nucleoside reverse transcriptase inhibitor (NRTI) resistance mutations, most commonly M184I/V (N = 15). Five (45%) of 11 participants who were switched to DTG-based regimens for a median of 50 months had HIV suppression. Further studies to understand the role of pre-existing HIVDR in the failure of DTG-based regimens are needed.

Malawi is among the countries with the highest HIV prevalence worldwide. Adolescents living with HIV (ALHIV) face diverse challenges, which influence their emotional wellbeing and long-term health, in addition to impacting HIV onward transmission. HIV education, especially the use of fear-based animation, but also the figurative language used for HIV, contribute to how ALHIV perceive and respond to their HIV status. The aim of the study was to explore how ALHIV in Malawi describe, perceive, and represent HIV, with a particular focus on the role of language in shaping these perceptions and its impact on their experiences and emotional wellbeing. This study employed hermeneutic phenomenology and reflexive thematic analysis; data were collected through semi-structured in-depth interviews, focus group discussions and drawings. Participants were sampled purposively and included 16 ALHIV and five service providers. The adolescents imagined HIV as personified, harmful creature in their body with functional senses and gender identity. Those negative perceptions originated mainly from the local term used for HIV, HIV-related stigma and discrimination and HIV representations in hospital HIV books. HIV peer support groups were identified as safe environments for learning about HIV and for debating HIV-related topics, especially in view of the usually required silence and secrecy to prevent stigma. The findings enhance the understanding of participants' lived experiences and perceptions of HIV, and thus may contribute to new methods of holistic health education, tailored for adolescents to improve their emotional wellbeing and attitudes towards HIV through context-specific programmes.

Introduction: HIV/AIDS remain a major health crisis globally, and it is disproportionately higher among young women. Expanding HIV testing coverage is very critical to help reduce the spread of the disease and speed up HIV epidemic control and elimination. Though there are several studies on HIV care and prevention in Ghana, few of such studies focus on HIV self-testing (HIVST). This study examined the prevalence and factors associated with the awareness and use of HIVST kits among young women aged 15-24 in Ghana.

Methods: This study used the 2022 Ghana Demographic and Health Survey data conducted in 2022/2023. The sample was restricted to young women aged 15-24 who have ever had sex, yielding a sample size of 3312. The dependent variables were awareness and use of HIVST kits. Binary logistic regression models were used to examine the factors associated with awareness and use of HIVST kit.

Results: Out of the 3,312 respondents, 17.8% were aware of HIVST kits, and 9.9% have ever used the HIVST kit to check their HIV status. Women with HIV testing history were more likely to be aware and use HIVST kits, while those with no formal, primary and secondary educations were less likely to be aware and use HIVST kits. Also, significant factors associated with only awareness of HIVST kits were age, ecological zones, marital status, religion, and heard of antiretrovirals (ARVs). Specifically, women aged 20-24 and those who have ever heard of ARVs were more likely to be aware of HIVST kits. Moreover, women who used condom during last sex in the past year were more likely to use the HIVST kits.

Conclusion: Awareness and use of HIVST kits were generally low among young women in Ghana. Policymakers should strengthen HIV/AIDS education interventions by targeting vulnerable women (those with no, primary and secondary education, those not using condom during last sex in the past year, and those without HIV testing history) to promote the uptake of HIVST kits.

Background: Despite advancements in antiretroviral therapy (ART) for people with HIV, barriers to adherence remain, potentially leading to long-term gaps in adherence known as treatment interruptions. These treatment interruptions are associated with viral rebound and can impact the effectiveness of the subsequent regimen and the long-term health of the individual. We aimed to characterize unplanned ART treatment interruptions in the OPERA^® cohort and investigate virologic outcomes among individuals who resumed treatment with bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF).

Methods: We identified adults with HIV-1 who were active in care and on an oral ART regimen with ≥ 2 antiretrovirals, including ≥ 1 anchor agent, between 30JUN2021 and 31AUG2023. Individuals with ≥ 1 period of ≥ 45 days without any ART, based on supply from last prescription, were considered to have experienced a treatment interruption. Individuals who resumed treatment by 31AUG2023 were defined as having experienced a treatment interruption with resumption. Each interruption observed during the study period was described, allowing for multiple interruptions per person. Treatment interruptions, pre-interruption regimens, and post-interruption regimens were described. Among individuals who resumed treatment with B/F/TAF, virologic outcomes were investigated through 29FEB2024 using Kaplan-Meier methods. All analyses were repeated with treatment interruption definitions of ≥ 60 and ≥ 90 days.

Results: Of 76,883 people for whom a treatment interruption could be observed, 8,550 (11%) experienced ≥ 1 period of ≥ 45 days without any ART. By 31AUG2023, 4,163 (49%) individuals resumed treatment (mean: 1.25 per person) and were included in the study population. The median age was 44 years, 81% were male, 52% Black, 41% White, and 18% Hispanic. Median time since HIV diagnosis was 118 months. B/F/TAF was the most common pre- and post-interruption regimen (49% and 51%, respectively). The cumulative probability of achieving virologic suppression on B/F/TAF was 68% (95% CI: 57, 78) when the viral load measurement was ≥ 200 copies/mL at resumption.

Conclusions: Treatment interruptions occurred in 11% of ART users in routine clinical care during the 26-month study period. Despite treatment interruption increasing the risk for viral rebound, most individuals who resumed treatment with B/F/TAF were able to achieve virologic suppression or avoid virologic failure.

Background: Despite advancements in HIV prevention strategies, including pre-exposure prophylaxis (PrEP), uptake remains suboptimal in high-burden regions like Africa. Healthcare workers (HCWs) play a pivotal role in PrEP implementation. This study systematically reviews the scientific literature to evaluate the knowledge, attitudes, and willingness of healthcare workers in offering pre-exposure prophylaxis (PrEP) in Africa.

Methods: This systematic review and meta-analysis followed PRISMA guidelines, synthesizing qualitative and quantitative studies from PubMed, Cochrane CENTRAL, and Google Scholar (2010-2024). We included studies that assessed HCWs' PrEP-related knowledge, attitudes, and willingness in African settings. Pooled proportions for key outcomes were calculated using random-effects models, and barriers/facilitators were thematically analyzed.

Results: Of 293 screened records, 34 studies conducted in 12 countries were included. Meta-analysis revealed high PrEP awareness (85%, 95% CI: 75-91%) but poor knowledge (18%, 95% CI: 4-55%). Attitudes were moderately positive (46%, 95% CI: 25-68%), and willingness to prescribe PrEP was 58% (95% CI: 43-72%). Key barriers included stigma, inadequate training, workload, concerns about risk compensation, and health system constraints. Facilitators included provider training, experience, and integrated service delivery.

Conclusion: While PrEP awareness is high among African HCWs, knowledge gaps and attitudinal barriers hinder optimal implementation. Targeted interventions-such as structured training, stigma reduction, and health system strengthening-are critical to enhancing PrEP adoption. Future research should explore context-specific strategies to improve HCW engagement in PrEP programs.

Background: In recent years, owing to the implementation of highly active antiretroviral therapy (HAART), human immunodeficiency virus (HIV) has become a manageable chronic disease. Consequently, the quality of life (QOL) of people living with HIV (PLWH) has warranted increasing attention. Although a substantial number of articles on QOL among PLWH have been published, statistical analysis of the data presented in these publications remains lacking. This study aimed to identify and analyze emerging trends and collaborative networks in research on the QOL of PLWH.

Methods: Research publications on the QOL of PLWH from 1992 to 2025 were collected from the Web of Science Core Collection. After screening and deduplication, the following bibliometric data were extracted from each article: title, abstract, keywords, authors, affiliations, geographic origin (countries/regions), publication year, journal name, and references. Various scientometric mapping tools-including Microsoft Office Spreadsheet, VOSviewer, and the Bibliometrix R-package-were used to analyze basic bibliometric parameters, leading contributors, high-impact keywords, and research trends.

Results: A total of 6,163 publications met the inclusion criteria. Over the past 33 years, the annual number of publications has shown an overall upward trend. The United States had the highest number of publications (n = 2,432) and the highest total link strength (TLS = 1,798) in collaborative research. The University of California, San Francisco, served as the core institution, and PLOS ONE was the most prolific journal. Wu AW was identified as a core member of the industry collaboration network. By combining keyword co-occurrence and co-citation analyses, this study found that clinical concerns (e.g., antiretroviral therapy adherence, depression, anxiety) remained prominent, while stigma, healthcare access, and age-related impairments emerged as the latest hotspots with strong burst strength.

Conclusions: This bibliometric analysis highlights the growing importance of QOL research in the field of PLWH, which can inform clinicians, researchers, and policymakers to prioritize areas for future investigation in order to develop comprehensive, patient-centered strategies. The findings advocate for appropriate resources for interventions that benefit HIV populations and a better understanding of the psychosocial needs of PLWH to improve their QOL.

Background: Long-acting cabotegravir/rilpivirine (LA-CAB/RPV) is the only available approved injectable antiretroviral therapy (ART) for youth living with HIV (YLHIV). However, it is not yet available through the Thai National AIDS Program (NAP). This study assessed Thai YLHIV attitudes toward LA-CAB/RPV and identified the proportion of medically eligible YLHIV within the NAP.

Methods: Two cross-sectional studies were conducted, the first study conducted in an HIV clinic in Bangkok involving YLHIV aged 13-24 years, assessing attitudes via questionnaires. The second study analyzed medical eligibility among 14,670 youth aged 12-24 years in the NAP, defined by current HIV RNA < 50 copies/ml, no prior treatment failure (HIV RNA < 1,000 copies/ml) and no suspected archived resistance to CAB/RPV. Logistic regression was performed to identify factors associated with willingness and eligibility.

Results: From April to June 2024, 100 YLHIV (median age 20 years; IQR 19.0-21.7) were enrolled, 71% had non-perinatally acquired HIV (non-PHIV). Overall, 85% expressed willingness to use LA-CAB/RPV. Non-PHIV youth showed significantly higher interest (93.0% vs. 65.5%); OR 6.9 [95% CI: 2.1-22.8], despite a shorter median treatment duration (2.7 vs. 14.3 years). LA-CAB/RPV was considered more convenient than pills by 76%, although 42% anticipated injection-site reactions. Among YLHIV in the NAP (median age 22 years; IQR 20-23), 64% were medically eligible, non-PHIV youth also had a higher eligibility proportion (70% vs. 32%) with an aOR 2.0 [95% CI: 1.7-2.4].

Conclusion: The majority of Thai YLHIV showed positive attitudes towards LA-CAB/RPV, with two-thirds meeting medical eligibility criteria. Enhancing access to generic formulations of this regimen could significantly impact lifelong HIV management.