AIDS reviews最新文献

The aim of this umbrella review of systematic reviews and meta-analyses was to systematically consolidate and evaluate the existing evidence on interventions aimed at preventing vertical transmission of HIV, with a specific focus on assessing their efficacy and clinical applicability. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Cochrane Library, and Embase were searched for systematic reviews and meta-analyses (up to Feb 2025). Two reviewers independently screened studies and extracted data, including intervention outcomes. Twenty-three systematic reviews and meta-analyses were synthesized, categorizing interventions into seven types: antiretroviral therapy (ART) (n = 7), cesarean delivery (n = 1), vitamins (n = 2), vaginal disinfection (n = 2), partner engagement (n = 3), telemedicine (n = 1), and integrated approaches (n = 7). Based on this, we conclude that ART demonstrated the strongest efficacy to suppress vertical transmission of HIV. Cesarean delivery reduced transmission risk but increased postpartum morbidity. Vitamins and vaginal disinfection had minimal impact. Telemedicine may improve adherence to prevention protocols. Integrated strategies combining ART showed enhanced effectiveness in low-resource settings. In conclusion, the evidence reported in this umbrella review suggests that ART therapy supplemented by other preventive measures is an effective way to reduce the rate of mother to child transmission of HIV. Vitamin supplement and vaginal disinfection had no clear association with the risk of vertical transmission of HIV.

The persistence of HIV-related stigma within workplace environments presents significant challenges to public health goals and organizational well-being. This review systematically examines the integration of business management strategies aimed at reducing stigma and enhancing support for employees affected by HIV across diverse workplace settings. Drawing from multidisciplinary perspectives, including public health, organizational behavior, and human resource management, this work identifies key intervention models, such as policy development, educational programs, leadership training, and Employee Assistance Programs. Specific attention is given to the critical role of leadership commitment, the creation of psychologically safe environments, and the implementation of multi-component, culturally sensitive interventions that address both visible and invisible dimensions of diversity. The review highlights how workplace dynamics surrounding disclosure dilemmas, confidentiality breaches, and enacted discrimination can negatively impact employee well-being and organizational productivity. Furthermore, it explores the intersectionality of HIV stigma with other marginalized identities, underscoring the necessity for targeted strategies that consider complex social identities and systemic inequities. Despite promising intervention outcomes, methodological weaknesses in existing studies - such as limited long-term evaluations and a lack of standardized measurement tools - remain pressing challenges. This review concludes by recommending evidence-based, participatory approaches that prioritize inclusive policies, robust employee support mechanisms, and stronger cross-sector collaborations to create healthier and more equitable workplaces for all employees, including those affected by HIV.

This review elucidates the complex interplay between HIV infection and male infertility, underscoring the multifaceted mechanisms through which HIV undermines male reproductive health. These mechanisms encompass diminished semen quality, orchitis, hypogonadism, and leukocytospermia. Concurrently, while antiretroviral therapy (ART) is salvific, it may pose additional fertility challenges. The introduction of highly suppressive ART has revolutionized the reproductive landscape for HIVserodiscordant couples, enabling them to plan for children with minimal risk of HIV transmission, thereby justifying the Undetectable = Untransmissible (U = U) paradigm. Despite these impediments, sperm washing in conjunction with sophisticated assisted reproductive technologies (ARTs), such as in vitro fertilization and intracytoplasmic sperm injection, offers efficacious fertility solutions for HIV-positive males, substantially mitigating the risk of HIV transmission. Psychological and ethical considerations further shape fertility treatment decisions and outcomes within this demographic. Future research should focus on elucidating the long-term effects of ART on male fertility and devising targeted interventions to enhance reproductive health in HIV-positive men.

Southern Africa is characterized by exceptionally high rates of HIV prevalence and incidence of cervical cancer, exceeding those observed in other regions of the continent. This situation highlights the urgent need for targeted and coordinated public health action. In this context, this review aims to clarify the links between these two diseases, to understand their interaction better, and to guide prevention and treatment strategies adapted to this high-risk region. This study, conducted according to the PRISMA 2020 guidelines, explored the impact of HIV on the risk of cervical cancer and the prevalence of HIV among cervical cancer patients in southern Africa. Eighteen original studies, covering six countries in the Southern Africa region and published between 2003 and 2022, were included. The prevalence of HIV in patients with cervical cancer was 5.30% (95% confidence interval [CI]: 4.21-6.67; and p = 0.001). In addition, the analysis revealed a significant association between HIV infection and an increased risk of cervical cancer, with an overall odds ratio of 2.29 (95% CI: 1.62-3.23; p = 0.001). Tests for publication bias showed no significant bias, and trim-and-fill analysis did not reveal any missing studies. In conclusion, this study highlights a high prevalence of HIV among cervical cancer patients in southern Africa, with a strong association between HIV infection and an increased risk of this form of cancer. These findings underline the importance of integrated prevention strategies, including human papillomavirus vaccination, cervical cancer screening, and improved access to antiretrovirals, to reduce the combined burden of HIV and cervical cancer in this high-risk region.

Human immunodeficiency virus (HIV) was first reported in Pakistan in 1987. Initially believed to have a low HIV prevalence mainly confined to high-risk groups such as injection drug users (IDUs) and commercial sex workers. However, HIV prevalence has steadily increased, with Punjab and Sindh provinces reporting the highest rates. Heterosexual transmission is the most frequent transmission route. High-risk populations include IDUs, men having sex with men, commercial sex workers, as well as truck drivers and miners. Furthermore, HIV has spread from urban centers to rural areas. The World Health Organization has reported over 200,000 HIV cases in Pakistan, making it the second-largest HIV-positive nation in Asia after India. The proportion of undiagnosed individuals is high and antiretroviral coverage is suboptimal. Fear of societal discrimination often leads individuals with HIV to hide their status, further spreading the virus. Mother-to-child transmission is another significant concern. Challenges in patient adherence to antiretroviral therapy (ART) exist, with many patients missing follow-up appointments. ART access due to shortages is frequent stemming from the reliance on imports. To mitigate the growing burden of HIV in Pakistan, it is essential to prioritize prevention through awareness campaigns and robust screening and antiretroviral programs targeting high-risk populations.

Combined antiretroviral therapies have revolutionized HIV management. Triple-drug regimens (3DR) have been the cornerstone of HIV treatment, which provide durable virologic suppression, reduce HIV-related morbidity and mortality, and improve immune reconstitution. However, 3DR are associated to long-term toxicities. In certain settings, two-drug regimens (2DR) present non-inferior virological efficacy compared to 3DR and may improve tolerability and adherence. In this review, we examine the efficacy, safety, and patient-centered outcomes of 3DR and 2DR, and the potential benefits of transitioning from triple to dual therapy regimens in people with HIV. We conducted a literature search on PubMed, EMBASE, and the Cochrane Library databases for studies published between January 2010 and June 2024. Overall data support the non-inferior efficacy of 2DR to 3DR in the management of HIV, with no evidence of an increased risk of subclinical failure with dual therapy. Switching from 3DR to 2DR may reduce the risk of drug interactions and toxicity. Within the 2DR, the long-acting therapies represent the most innovative dual therapy since they simplify the treatment by reducing from triple to dual therapy along shifting from daily pills to bi-monthly injections. Long-acting 2DR are effective, provide high levels of satisfaction, and improve adherence and quality of life.

The universal and disparaging nature of HIV stigma fuels discrimination, discourage HIV testing and treatment, and perpetuate cycles of marginalization in key populations, such as injecting drug users living with HIV/AIDS. Therefore, the objective of this research is to explore the correlation among HIV stigma, HIV-related communication, treatment adherence, and mental health in HIV positive injecting drug users in Pakistan. A cross-sectional survey research design was employed to recruit 200 consecutive participants purposively from the Mayo HIV Clinic, Lahore, Pakistan. HIV-positive injecting drugs users (IDU's) who were on follow-up treatment taking antiretroviral therapy (ART) were only recruited in this study. The study employed four established self-report measures: the HIV stigma scale, HIV-related communication scale, ART adherence measure, and an 18-item mental health inventory. Findings indicated that there is a significant negative association in HIV stigma and factors, such as HIV communication, treatment adherence, and mental health. Hierarchical regression analysis revealed that HIV-related communication and treatment adherence are significant positive predictors of mental well-being. Moreover, the parallel mediation model indicated that HIV communication and treatment adherence mediate in the association between HIV stigma and mental health. Addiction specialists and HIV clinicians must address issues, such as HIV related stigma and poor treatment adherence, as they are essential to enhance the overall well-being of HIV positive-IDUs. Furthermore, HIV clinicians must incorporate non-judgmental communication about HIV and simplified ART regimens to reduce the psychological toll of HIV stigma and treatment challenges.