HIV Research & Clinical Practice

Strengthening person-centered care through quality improvement: a mixed-methods study examining implementation of the Person-Centered Care Assessment Tool in Zambian health facilities
Casella A, Paxon Ndhlovu A, Posner JE, Kawanga L, Chan P, Duffy M, Madevu-Matson C and Musangulule JM
Person-centered care (PCC) is considered a fundamental approach to address clients' needs. There is a dearth of data on specific actions that HIV treatment providers identify as priorities to strengthen PCC.
The prevalence of vertical transmission of human immunodeficiency virus and associated factors among exposed infants in Eastern Lake zone and Southern Highland of Tanzania: a cross-sectional study
Torokaa PR, Urio L, Mwakalobo A, Eriyo G, Magesa AS, Julius R, Kyalo A, Allan JN, Osima DJ, Shao FM, Mziray J, Mtui L, Mbago TP, Robert M, Nyamhagatta MA, Msangi M, Chacha M, Charles H, Mtui GD, Majigo M and Joachim A
Globally, the rate of antiretroviral therapy coverage for pregnant women living with human immunodeficiency virus (HIV) increased by 38% between 2010 and 2015 but only by 2% between 2016 and 2020.
Kaposi sarcoma and vertebral involvement in people with HIV: a case report and systematic literature review
Mazzitelli M, Leoni D, Maraolo A, Marinello S, Calandrino L, Panese A, Calabrò ML, Marino D, Scaglione V and Cattelan A
Kaposi Sarcoma (KS) has been historically associated with HIV, especially in people with advanced immunosuppression. Its prevalence decreased over time, but management remains difficult especially when the diagnosis is late and there is a visceral involvement. Bone localization, and particularly the vertebral one, is rare. We herein present a case of vertebral localizations of KS and performed a review literature to assess demographic, clinical characteristics and treatment outcomes in people with HIV.
Factors driving decisions in the use of HIV pre-exposure prophylaxis: a real-world study in the United States
Whiteside Y, McMillan A, Hennessy F, Salmon P, Holbrook T and Tadese BK
Uptake of pre-exposure prophylaxis (PrEP) in the United States (US) remains below target, despite reported high efficacy in prevention of HIV infection and being considered as a strategy for ending new HIV transmissions. Here, we sought to investigate drivers for PrEP use and barriers to increased uptake using real-world data. Data were drawn from the Adelphi PrEP Disease Specific Programme, a cross-sectional survey of PrEP users and PrEP non-users at risk for HIV and their physicians in the US between August 2021 and March 2022. Physicians reported demographic data, clinical characteristics, and motivations for prescribing PrEP. PrEP users and non-users reported reasons for or against PrEP use, respectively. Bivariate analyses were performed to compare characteris tics of users and non-users. In total, 61 physicians reported data on 480 PrEP users and 121 non-users. Mean ± standard deviation of age of users and non-users was 35.3 ± 10.8 and 32.5 ± 10.8 years, respectively. Majority were male and men who have sex with men. Overall, 90.0% of users were taking PrEP daily and reported fear of contracting HIV (79.0%) and having at-risk behaviors as the main drivers of PrEP usage. About half of non-users (49.0%) were reported by physicians as choosing not to start PrEP due to not wanting long-term medication. PrEP stigma was a concern for both users (50.0%) and non-users (65.0%). More than half felt that remembering to take PrEP (57.0%) and the required level of monitoring (63.0%) were burdensome. Almost half of people at risk for HIV were not taking PrEP due to not wanting long-term daily medication and about half of current PrEP users were not completely adherent. The most common reason for suboptimal adherence was forgetting to take medication. This study highlighted drivers for PrEP uptake from physician, PrEP user, and non-user perspectives as well as the attributes needed in PrEP products to aid increased PrEP uptake.
Comorbidity and polypharmacy among people with HIV stratified by age, sex, and race
Paudel M, Prajapati G, Buysman EK, Goswami S, McNiff K, Kumar P and Tadese BK
With an increase in life expectancy of people with HIV, there is a corresponding rise in comorbidities and consequent increases in comedications. This study compared comorbidity and polypharmacy among people with HIV and people without HIV stratified by age, sex, and race. This retrospective study utilised administrative claims data to identify adult people with HIV with antiretroviral therapy (ART) claims and HIV diagnosis codes from 01 January 2018 to 31 December 2018. Index date was the earliest ART claim or HIV diagnosis in the absence of ART claims. Inclusion required continuous enrolment for ≥12-month pre-index and ≥30-day post-index, along with ≥1 HIV diagnosis during baseline or follow-up. People with HIV were matched 1:2 with people without HIV on sociodemographic. Results were compared using z-tests with robust standard errors in an ordinary least squares regression or Rao-Scott tests. Study sample comprised 20,256 people with HIV and 40,512 people without HIV. Mean age was 52.3 years, 80.0% males, 45.9% Caucasian, and 28.5% African American. Comorbidities were significantly higher in younger age people with HIV than people without HIV. Female had higher comorbidity across all comorbidities especially younger age people with HIV. Polypharmacy was also significantly greater for people with HIV versus people without HIV across all age categories, and higher in females. Across races, multimorbidity and polypharmacy were significantly greater for people with HIV versus people without HIV. Comorbidities and polypharmacy may increase the risk for adverse drug-drug interactions and individualised HIV management for people with HIV across all demographics is warranted.
Healthcare worker perspectives on HIV status sharing intervention components for partnered, Black sexual minority men in South Africa
Barry MP, Peters RPH, Portle S, Bongo C, Nel D, Struthers HE and Daniels J
Globally, there is suboptimal coverage of antiretroviral treatment to treat and prevent HIV. It is crucial for individuals to know their partner's HIV status so they may use all appropriate and available prevention tools. For sexual minority men in South Africa, a population known to face intersecting forms of marginalization including a disparate burden of HIV incidence, there are challenges to status sharing.
Induced abortion incidence and associated factors in a cohort of women living with HIV in Rio De Janeiro, Brazil, 1996-2016
Domingues RMSM, Quintana MSB, Coelho LE, Friedman RK, Jalil EM, Rabello ACVA, Rocha V and Grinsztejn B
Abortion is a public health problem in Latin America and is more common among women living with HIV.
Psychosocial and socioeconomic changes among low-income people with HIV during the COVID-19 pandemic in Miami-Dade County, Florida: racial/ethnic and gender differences
Fernandez SB, Dawit R, Nawfal ES, Ward MK, Ramírez-Ortiz D, Sheehan DM and Trepka MJ
COVID-19 profoundly and uniquely impacted people with HIV. People with HIV experienced significant psychosocial and socioeconomic impacts, yet a limited amount of research has explored potential differences across gender and racial/ethnic groups of people with HIV.
Assessment of the HIV Enhanced Access Testing in the Emergency Department (HEATED) program in Nairobi, Kenya: a quasi-experimental prospective study
Aluisio AR, Smith-Sreen J, Offorjebe A, Maina W, Pirirei S, Kinuthia J, Bukusi D, Waweru H, Bosire R, Ojuka DK, Eastment MC, Katz DA, Mello MJ and Farquhar C
Persons seeking emergency injury care are often from higher-risk and underserved key populations (KPs) and priority populations (PPs) for HIV programming. While facility-based HIV Testing Services (HTS) in Kenya are effective, emergency department (ED) delivery is limited, despite the potential to reach underserved persons.
Unity is strength: creation and future actions for a consortium for HIV cure research in Latin America and the Caribbean 'Lac-Cura'
Turk G, Devisich G, Valiente-Echeverria F, Figueroa MI, Cassetti I, Cahn P, Cortes CP, Crabtree-Ramírez B, Sued O and Laufer N
The development of effective HIV cure strategies is crucial. However, most research in this area has been concentrated in high-income countries, underscoring the need to expand efforts to regions like Latin America and the Caribbean (LAC), which face distinct biomedical, social, political, and economic challenges. Data on LAC's participation in HIV cure research, along with stakeholder perceptions, reveal that the work being done in the region is scarce, fragmented, scattered, and characterized by limited resources and infrastructure. Establishing a regional consortium of basic researchers, clinicians, social scientists, and community members in LAC could be a key step in integrating the region into the global HIV cure landscape. We have already begun laying the groundwork for its creation and propose to name it 'LAC-Cura'-short for 'Latin America and the Caribbean HIV Cure Consortium'.
Barriers to HIV rapid start among New Jersey providers
Mohammed DY, Brewer R, Leider J, Martin E and Choe S
Rapid Start ensures that persons with HIV initiate antiretroviral therapy in less than seven days after diagnosis. Benefits of Rapid Start include timely linkage to medical care, viral suppression in a shorter time and improved retention to medical care. Despite these benefits, there is a slow uptake of Rapid Start, in New Jersey.
A cascade of care for diabetes in people living with HIV in a tertiary care center in Mexico City
Espejo-Ortiz CE, Sierra-Barajas N, Silva-Casarrubias A, Guerrero-Torres L, Caro-Vega Y, Serrano-Pinto YG, Lopez-Iñiguez A, Sierra-Madero JG and Crabtree-Ramírez BE
Diabetes affects 4.5% of people living with HIV in Mexico. This study aims to describe the diabetes cascade of care (DMC) in people with HIV in a tertiary center in Mexico City.
Developing the IDCaRe team: an integrated and culturally-affirming approach to improving health engagement for HIV-positive veterans
Brennan JM, Bailey MB and Hua W
Veterans Health Administration (VHA) has been at the forefront of offering integrated and patient-centered care to address the complex needs of more than 30,000 Veterans with HIV in the United States of America. These Veterans present with diverse cultural identities, personal values, and goals pertinent to their care, and they are often managing multiple comorbid chronic conditions, mental health diagnoses, and psychosocial stressors alongside HIV. The quality of their care has often been affected by stigma, minority stress, and the quality of the patient-provider relationship and associated collaborations over treatment approaches and goals, which has a direct effect on outcomes.
Evaluating knowledge, practice, and attitude of Syrian population on sexually transmitted infections and human immunodeficiency virus
Swed S, Alibrahim H, Albakri K, Rais MA, Al-Rassas S, Hafez W, Sawaf B, Almoshantaf MB, Elsayed M, Albazee E, Cheema HA, Hraiz W, Taieb F, Ameen VH, Rakab A, Emran TB, AbdElrahim E, Osman H, Khan Pathan R and Khandaker MU
Human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) can cause severe and fatal complications; knowledge about these diseases is essential for promoting safe sex practices and modifying behaviours that are harmful to one's health. This study investigates Syrian people's understanding, attitudes, and behaviors towards HIV/AIDS and STIs, aiming to identify factors promoting safe sex practices and modifying harmful behaviors.
A randomised control trial of BIC/F/TAF vs DRV/c/F/TAF in context of HIV test-and-treat, BicTnT
Whitlock G, Fidler S, Clarke A, Kang S, Xhikola A, Milinkovic A, Soler-Carracedo A, Henderson M, Adams T, Jahan I, Khawaja A, Taylor G and Boffito M
Head-to-head data for bictegravir/emtricitabine/tenofovir alafenamide (BIC/F/TAF; B) and darunavir/cobicistat/emtricitabine/tenofovir alafenamide (DRV/c/F/TAF; D) are lacking in the context of rapid antiretroviral therapy (ART) initiation. This study, BIC-T&T, evaluates the efficacy and tolerability of B vs D in a UK test-and-treat setting.
'The tablets make a certain noise': uncovering barriers and enablers related to providing PMTCT services to adolescents and young women living with HIV in Zimbabwe
Sharer M, Haruzivishe C, Ndaimani A and Duffy M
Zimbabwe antenatal HIV prevalence rate is 16.1%. HIV-positive pregnant adolescent girls and young women (AYW) are at high risk to experience perinatal mental health challenges, attributed to a combination of factors including HIV status, stigma and perinatal depression. Perinatal depression and stigma among AYW is understudied in Zimbabwe and may affect short- and long-term health of HIV positive mothers and their children, and can impact treatment adherence.
Prevalence of human immunodeficiency virus drug resistance and factors associated with high viral load among adolescents on antiretroviral therapy in Dar Es Salaam, Tanzania
Maseke I, Joachim A, Kamori D, Abade A, Moremi N and Majigo M
Resistance to antiretrovirals against human immunodeficiency virus (HIV) poses a threat to zero transmission of HIV by 2030. Few studies have been conducted on HIV drug resistance (HIVDR) mutations targeting adolescents. We determined the prevalence, pattern of HIVDR mutations, and factors associated with unsuppressed HIV viral load among adolescents on antiretroviral therapy (ART).
General and healthcare-related HIV stigma among cisgender Brazilian women: the role of socioeconomic vulnerability
Brandelli Costa A, Martins da Silva M, Wiehe Chaves L, Gelain M, Graeff Bins-Ely I, Alckmin-Carvalho F and Wendt GW
HIV-related stigma is associated with worse health outcomes and lower adherence to antiretroviral therapy. There is limited data on the stigma faced by Latin American cisgender women, although they are among the populations most affected by HIV. This study aims to provide insight into the Stigma Index Brazil, with the objective of estimating the prevalence of HIV-related stigma among cisgender women in Brazil and to investigate the role of low socioeconomic status in stigma experience.
Opportunities and challenges for the integration of managing non-communicable diseases within HIV care and treatment services in Tanzania
Rugakingira AA, Yondu E, Thobias JM, Dionis I, Kamata CC, Kilonzi M, Metta E and Sirili N
People living with HIV and non-communicable diseases (NCDs) are reported to experience challenges in accessing affordable and high-quality NCD care services. Consequently, the World Health Organization (WHO) recommends care integration of NCDs within the HIV services in resource-limited regions. The available opportunities and challenges need to be understood and addressed for an effective integration process. This study explored opportunities and challenges for integrating NCDs within HIV care and treatment services in Tanzania.
Parenting with HIV: a patient's view on updated infant feeding guidelines in the US
Covin C
Prevalence of human papilloma virus infection and anal dysplasia among men with HIV in Lebanon: a cross-sectional study
Abi Aad Y, Ballouz T, Faysal H, Mahfouz R, Shabb N, Sader G, El-Helou R, Doughan S and Rizk NA
Oncogenic human papillomavirus (HPV) types are linked to anal cancer, with elevated risk among men who have sex with men (MSM), especially men with HIV. Data on HPV-related malignancies in the Middle East and North Africa (MENA) region is scarce. This study aims to assess anal HPV strains, dysplasia, and sexually transmitted infections (STIs) among asymptomatic MSM with HIV in Lebanon.