AIDS Research and Therapy最新文献

Introduction: Limited knowledge about preventing mother-to-child transmission of HIV contributes to the high prevalence of pediatric HIV caused by vertical transmission. Given the lack of sufficient information, this study aimed to identify hotspot and cold spot areas as well as the factors influencing reproductive-age women's knowledge about preventing mother-to-child transmission of HIV in Ethiopia.

Method: The study utilized data from the 2016 Ethiopian Demographic and Health Survey, comprising a weighted sample of 15,683 reproductive-age women. Spatial analysis was conducted to identify significant clusters, and determinants were assessed using adjusted odds ratios with 95% confidence intervals.

Result: Significant hotspot regions were identified in Somali, Gambela, Afar, Benishangul Gumuz, the northern part of SNNP, and certain areas of Oromia. Key determinants included education level (primary: AOR = 1.19, 95% CI = 1.02-1.40; secondary: AOR = 1.41, 95% CI = 1.08-1.85; higher: AOR = 2.22, 95% CI = 1.52-3.25), religious affiliation (Muslim: AOR = 0.57, 95% CI = 0.47-0.68; Protestant: AOR = 0.76, 95% CI = 0.61-0.93; Other: AOR = 0.54, 95% CI = 0.33-0.86), having an employed partner (AOR = 1.36, 95% CI = 1.08-1.71), higher wealth index (rich: AOR = 1.35, 95% CI = 1.11-1.63), media exposure (AOR = 1.32, 95% CI = 1.12-1.57), antenatal care attendance (AOR = 1.46, 95% CI = 1.25-1.70), institutional childbirth (AOR = 1.18, 95% CI = 1.01-1.37), urban living (AOR = 1.36, 95% CI = 1.01-1.83), residence in larger central regions (AOR = 1.38, 95% CI = 1.12-1.70), and living in communities with high media exposure (AOR = 1.41, 95% CI = 1.13-1.75).

Conclusion: In Ethiopia, knowledge about preventing mother-to-child transmission of HIV among women of reproductive age varies significantly across regions. Therefore, implementing targeted interventions in the identified hotspot areas is essential to support the WHO's goal of eliminating new pediatric HIV infections by 2030.

Background: Anaemia and thrombocytopenia adversely affect adolescent HIV outcomes, yet adolescent-specific data from the tenofovir/lamivudine/dolutegravir (TLD) era remain scarce, and access to full blood count (FBC) testing is limited in Cameroon. We evaluated the prevalence, severity, and factors associated with these cytopenias among adolescents living with HIV (ADLHIV) in the TLD era.

Methods: Multicentre cross-sectional study was conducted among ADLHIV (10-19 years) receiving TLD in the CIPHER-ADOLA cohort in Cameroon. Full blood count, viral load (VL) and CD4-count were performed. Factors associated with anaemia and thrombocytopenia were ascertained.

Results: A total of 252 ADLHIV was enrolled (50.8% male, 83.3% were vertically infected, and 7.2% were underweighted). ART-duration and TLD-exposure were 10 [6-13] years and 26 [12-33] months, respectively. Concerning virological response, 71.4%, 13.1%, and 15.5% had a VL < 50, 50-999, and ≥ 1000, respectively. Overall, 102 (40.5%) were anaemic, with only 2.9% severe. Anaemia rate was twice higher in females (55.6%, p < 0.001); 64.1% with VL ≥ 1000 against 35.0% with VL < 50 (p = 0.003); 60.0% with CD4 < 200 against 35.4% with CD4 > 500 (p = 0.046). Regarding thrombocytopenia, the burden was low (6.7%), but higher among VL ≥ 1000 (p = 0.003). Multivariate analyses showed a threefold higher anaemia prevalence in females (aOR [95% CI: 3.406 [1.8952-5.940]), fivefold without formal education (0.191 [0.047-0.776]), threefold in VL ≥ 1000 copies/ml (0.338 [0.156-0.733]). Thrombocytopenia was fourfold more likely in males (aOR: 0.236 [0.072-0.774]) and sevenfold more likely in individuals with VL ≥ 1000 copies/mL (aOR: 0.140 [0.038-0.510]).

Conclusion: In the TLD era, anaemia remains common but generally mild, and thrombocytopenia is uncommon. Cytopenias were associated with unsuppressed viral load, with a stronger association for anaemia in females. These findings support programmatic targeted haemovigilance prioritising adolescents with unsuppressed viral load, particularly females, in settings where access to FBC testing is limited.

Background: HIV-related stigma harms people living with HIV (PWH), contributing to psychological distress, isolation, poor adherence, and reduced quality of life, especially in healthcare settings. The aim of the study was to assess the prevalence and characteristics of HIV-related stigma experienced by PWH in both the Infectious Diseases Unit (IDU) and other hospital departments of a tertiary-care university hospital.

Methods: A cross-sectional survey was conducted at a single center between December 2024 and February 2025 among PWH. Participants completed a self-administered 10-item questionnaire assessing perceived stigma in areas such as access to care, quality of care, and inclusion. Descriptive statistics and multivariable logistic regression were used to identify factors associated with HIV-related stigma.

Results: Six-hundred-thirty-four PWH participated in the study: 466 (73.5%) were male; median age was 56 years (IQR:45-62). Most were Caucasian (570, 89.9%) and 233 (36.8%) heterosexuals. Out of 634 individuals, 253 (39.9%) reported experiencing stigma in healthcare settings at least once. Perceived stigma was significantly lower in the IDU compared to other wards (59 versus 194 cases, p < 0.001). Multivariable analysis revealed that people who inject drugs were associated with an increased risk of stigma perception within the IDU (p = 0.037). Outside the IDU, a shorter duration of HIV infection (< 5 years) was protective against stigma perception (p < 0.001).

Conclusion: HIV-related stigma remains highly prevalent in hospital settings, particularly outside specialized care. A multifaceted strategy including staff education, anti-stigma training, and institutional policies is urgently needed to promote equitable and respectful care for PWH. Further research should incorporate measures of mental health (e.g., anxiety and depression), as perceived stigma may impact the psychological well-being of people with HIV.

Background: In India, despite significant advancements in Antiretroviral Therapy (ART), stigma and discrimination remain major barriers for people living with HIV (PLHIV), often hindering ART adherence and compromising treatment outcomes. This study aimed to assess the determinants and contributing factors of HIV-related stigma among PLHIV in Mizoram, a northeastern state with one of the highest HIV prevalence rates in the country.

Methods: A cross-sectional study was conducted among 300 PLHIV attending the ART Center, in Aizawl, Mizoram. Descriptive statistics, Chi-square tests, and binary logistic regression were used to assess factors associated with stigma and treatment adherence.

Results: A total of 300 PLHIV were enrolled in the study, comprising 176 (58.7%) males and 124 (41.3%) females. In the internalized stigma domain, males experienced significantly higher stigma compared to females (aOR = 2.394, CI = 1.294-4.426, p = 0.005). In the felt-normative stigma domain, participants aged 41-50 years reported higher stigma levels compared to aged 51 years and above (aOR = 0.329, CI = 0.110-0.985, p = 0.047). Regarding medication adherence, 208 (69.3%) participants demonstrated optimal adherence to ART, while 92 (30.7%) had sub-optimal adherence.

Conclusion: Most PLHIV in our study reported low to moderate stigma across domains. To reduce HIV related stigma among PLHIV, one should prioritize patient centric counselling, educational interventions in the form of mass communication, printed media etc., to ensure their psychological well-being and to create educational awareness involving the community and healthcare professionals to promote more positive thoughts on HIV which will reduce HIV related stigma in the society.

Background: HIV testing services are crucial in preventing the spread of the virus and providing care for those infected. Despite the decline in the number of newly infected people, HIV/AIDS remains a major public health problem in Africa. Being aware of one's HIV status is linked to reduced risk and changes in behavior. Individuals who are newly diagnosed with HIV can quickly be linked to antiretroviral therapy (ART), as well as care and support service.

Methods: Data from the recent Demographic and Health Surveys were used for analysis. The study used a total of 82,361 young women. The determinants of non-testing were examined using a multilevel mixed-effects logistic regression model. Significant factors associated with HIV non-testing were declared significant at p-values < 0.05. The adjusted odds ratio and confidence interval were used to interpret the results. A model with the lowest deviance and highest logliklihood ratio was selected as the best-fit model.

Results: HIV non-testing prevalence among women in 12 Sub-Saharan Africa was 53.96% (95% CI: 53.61%, 54.30%). Women age (AOR = 1.88, 95% CI: 1.02, 1.38), educational level (AOR = 0.711, 95% CI: 0.673,0.751), marital status (AOR = 1.61, 95% CI: 1.5,1.74), media exposure (AOR = 1.08, 95% CI: 1.04,1.12), wealth index (AOR = 0.86, 95% CI: 0.82, 0.899), visited health facility (AOR = 0.41, 95% CI: 0.396, 0.424), Age at first sexual intercourse (AOR = 1.12, 95% CI: 1.001,1.25), risky sexual behavior (AOR = 1.34, 95% CI: 1.26,1.42), knowledge (AOR = 0.71, 95% CI: 0.684, 0.731), residence (AOR = 0.567, 95% CI: 0.542,0.592), distance from the health facility (AOR = 0.927, 95% CI: 0.893, 0.962), had higher odds of HIV non testing prevalence.

Conclusion: According to this study, the prevalence of HIV non-testing among young women in Sub-Saharan Africa is alarmingly high at 53.96%. This prevalence is determined by risky sexual activities, age, marital status and other factors. Targeted awareness campaigns, especially for those in disadvantaged circumstances, should be put into place to address this problem. Testing is promoted by stepping up community outreach and using media campaigns. Furthermore, expanding access to medical facilities and offering counseling services will motivate more young women to be checked, which will ultimately improve the region's health results. To achieve this, interventions such as mobile testing units, youth-friendly clinics, and school-based awareness campaigns should be prioritized to ensure effective engagement and support for young women.

Introduction: Viral load suppression is essential for reducing human immunodeficiency virus (HIV) related morbidity and mortality. To eliminate the HIV epidemic and enhance adherence to antiretroviral therapy (ART) globally, the Joint United Nations Program on HIV/AIDS and the World Health Organization (WHO) recommend enhanced adherence counseling (EAC) for individuals with a viral load above 1000 copies/ml. EAC helps identify and address adherence barriers, assisting patients in recognizing challenges and developing an effective plan to achieve viral load suppression. It also enables early detection of ART failure, ensuring a timely and appropriate switch to second-line medications.

Method: We conducted a systematic review and meta-analysis by performing comprehensive literature search in PubMed, Google Scholar, Hinari-Research4life, and Since Direct to identify relevant articles. Data were extracted via an Excel spreadsheet (version 5.1) and then imported into STATA (version 17.1) for analysis. A random-effects model was applied to the pooled effect of the outcomes, with a 95% confidence interval, which was visualized using a forest plot. Heterogeneity was assessed via I² statistics, and publication bias was examined through a funnel plot and Egger's test (p < 0.05) to determine statistical significance.

Results: This systematic review and meta-analysis included eleven primary studies with a total of 4488 participants. The pooled rate of viral load suppression after enhance adherence counseling among HIV patients on ART was 63% [95%CI: ( 55-71)], with significant heterogeneity (I²-100, p = 0.00). The funnel plot showed asymmetry, and Egger's test result of 0.8104 indicated no publication bias. A leave-one-out analysis revealed that all studies fell within the 95% CI of the pooled rate, suggesting that no single study significantly influenced the overall estimate. In the subgroup analysis the viral load suppression rate was 61% [95% CI: (55-66)] in Ethiopia, and 69% [95%CI: ( 49-90)] in Uganda and it ranged from 63% across all age groups to70% in adult HIV patients.

Conclusion: The rate of viral load suppression following enhanced adherence counseling among HIV patients on antiretroviral therapy(ART) in East Africa was 63%.This value is significantly below the 95% target set by the WHO and UNAIDS under the 95-95-95 framework, emphasizing a substantial gap in achieving the desired outcome of viral load suppression in this region.

Background: This study aimed to assess the PrEP utilization and associated factors among sexually active adolescents and young adults in Soroti city.

Method: A cross-sectional design was employed. Descriptive analysis assessed the level of PrEP utilization while multivariate logistic regression assessed associated factors.

Results: Of the 421 participants, 61(14%) reported having used PrEP. Factors associated with PrEP utilization included: gender (P-value=0.03), HIV risk awareness (P-value=0.002), stigma (P-value<0.001), and social support (P-value<0.001).

Conclusion: PrEP utilization among adolescents and young adults in Soroti City is limited. There is need to address the gender and social inequities in accessing and utilizing PrEP for HIV prevention.

Background: Antiretroviral therapy (ART) has dramatically reduced HIV-related morbidity and mortality worldwide, but adherence remains a critical challenge, particularly in Sub-Saharan Africa. In Somalia, where HIV prevalence is low but health systems are fragile, little is known about the lived experiences of people living with HIV (PLHIV) regarding ART adherence.

Methods: A qualitative study was conducted at ART clinic In Mogadishu Somalia between March-August 2024. A total of 22 adult PLHIV and 12 healthcare providers (8 ART nurses and 4 case managers) participated. Purposive sampling was used to recruit participants; Data were collected through 30 in-depth interviews and 4 focus group discussions using semi-structured guides. Interviews were audio-recorded, transcribed, translated, and thematically analyzed using NVivo software, with emerging themes classified into barriers and facilitators of adherence.

Results: Barriers to adherence included stigma and discrimination, religious and cultural beliefs (such as reliance on prayer or holy water), economic hardship (transport costs, food insecurity), health system challenges (stock-outs, long waiting times, confidentiality concerns), and psychological factors (depression, denial). Facilitators included strong family and social support, religious coping that motivated adherence, positive patient-provider relationships, peer support networks, and personal motivation and resilience, particularly among patients committed to living for their children. Illustrative quotes highlighted the daily struggles and strategies patients employed to remain in care.

Conclusion: ART adherence in Somalia is shaped by complex interactions between socio-cultural, economic, psychological, and health system factors. Interventions that reduce stigma, integrate mental health services, strengthen health systems, provide economic and food support, and leverage religious and peer networks are essential. Collaborating with traditional and religious leaders may further improve acceptance and sustainability of ART programs.

Background: In Ethiopia, where vertical transmission (VT) of HIV remains high, this study investigates the impact of maternal virological failure (VF) on VT outcomes.

Methods: A retrospective cohort of 541 HIV-positive pregnant women from three high-prevalence hospitals was analyzed using bivariable and multivariable logistic regression.

Results: Multivariable logistic regression revealed that maternal VF was strongly associated with VT of HIV. Mothers with VF were nearly ten times more likely to transmit HIV to their infants compared to those with viral suppression (AOR = 9.96; 95% CI 3.19-31.11; p < 0.001). Additional independent predictors of VT included ART initiation during pregnancy (AOR = 3.54; 95% CI 1.48-8.48; p = 0.005), baseline CD4 count ≤ 350 cells/mm3 (AOR = 5.66; 95% CI 2.67-12.00; p < 0.001), poor ART adherence (AOR = 8.09; 95% CI 3.09-21.24; p < 0.001), and absence of infant nevirapine prophylaxis (AOR = 6.54; 95% CI 2.42-17.69; p < 0.001).

Conclusion: Maternal VF was strongly associated with increased risk of VT. These findings highlight the importance of early initiation of ART, consistent viral suppression, adherence support, and routine viral load monitoring as key strategies to reduce VT, particularly in high-burden settings. Strengthening these interventions may help target the small subset of mothers at highest risk and improve overall prevention outcomes.

Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is indicated for people with HIV who are virologically suppressed, including those with M184V/I. Data on B/F/TAF effectiveness during viremia with M184V/I are limited. This observational study retrospectively collected clinical/demographic data from adults with viremia and M184V/I receiving B/F/TAF or alternate antiretroviral therapy (ART). Virologic suppression at 3 and ≥ 6 months was evaluated. For participants with data, 5/5 (100%) and 7/8 (88%) on B/F/TAF and 4/6 (67%) and 7/10 (70%) on alternate ART achieved virologic suppression at 3 and ≥ 6 months, respectively. Virologic suppression was achieved in most people with HIV who were viremic with M184V/I on B/F/TAF, as with alternate ART.