The Impact of Cannabis Use on Cognition in People with HIV: Evidence of Function-Dependent Effects and Mechanisms from Clinical and Preclinical Studies
AbstractPurpose of ReviewCannabis may have beneficial anti-inflammatory effects in people with HIV (PWH); however, given this population ’s high burden of persisting neurocognitive impairment (NCI), clinicians are concerned they may be particularly vulnerable to the deleterious effects of cannabis on cognition. Here, we present a systematic scoping review of clinical and preclinical studies evaluating the effects of cannabinoid exp osure on cognition in HIV.Recent FindingsResults revealed little evidence to support a harmful impact of cannabis use on cognition in HIV, with few eligible preclinical data existing. Furtherm...
Source: Current HIV/AIDS Reports - April 11, 2024 Category: Infectious Diseases Source Type: research
A 5-Year Review of the Impact of Lottery Incentives on HIV-Related Services
AbstractPurpose of reviewLottery incentives are an innovative approach to encouraging HIV prevention, treatment initiation, and adherence behaviours. This paper reviews the latest research on lottery incentives ’ impact on HIV-related services, and their effectiveness for motivating behaviours to improve HIV service engagement and HIV health outcomes.Recent findingsOur review of ten articles, related to lottery incentives, published between 2018 and 2023 (inclusive) shows that lottery incentives have promise for promoting HIV-related target behaviours. The review highlights that lottery incentives may be better for affec...
Source: Current HIV/AIDS Reports - April 4, 2024 Category: Infectious Diseases Source Type: research
Leveling Up PrEP: Implementation Strategies at System and Structural Levels to Expand PrEP Use in the United States
AbstractPurpose of ReviewDespite highly effective biomedical HIV pre-exposure prophylaxis (PrEP) options, suboptimal PrEP uptake impedes progress towards ending the epidemic in the United States of America (USA). Implementation science bridges what we know works in controlled clinical trial settings to the context and environment in which efficacious tools are intended to be deployed. In this review, we focus on strategies that target PrEP use barriers at the system or structural level, exploring the implications and opportunities in the context of the fragmented USA healthcare system.Recent FindingsTask shifting could inc...
Source: Current HIV/AIDS Reports - March 22, 2024 Category: Infectious Diseases Source Type: research
Getting HIV Pre-exposure Prophylaxis (PrEP) into Private Pharmacies: Global Delivery Models and Research Directions
AbstractPurpose of ReviewTo provide an overview of the current state of HIV pre-exposure prophylaxis (PrEP) delivery via private sector pharmacies globally, to discuss the context-specific factors that have influenced the design and implementation of different pharmacy-based PrEP delivery models in three example settings, and to identify future research directions.Recent FindingsMultiple high- and low-income countries are implementing or pilot testing PrEP delivery via private pharmacies using a variety of delivery models, tailored to the context. Current evidence indicates that pharmacy-based PrEP services are in demand a...
Source: Current HIV/AIDS Reports - March 22, 2024 Category: Infectious Diseases Source Type: research
“Your Package Could Not Be Delivered”: The State of Digital HIV Intervention Implementation in the US
This article reviews what is known about U.S. implementation of digital HIV interventions and presents a strategy to cross the research-to-practice chasm for these types of interventions.Recent FindingsWe conducted a narrative review of U.S.-based original research on implementation of digital HIV interventions and identified few studies reporting on implementation determinants, strategies, processes, or outcomes, particularly outside the context of effectiveness trials. To supplement the literature, in 2023, we surveyed 47 investigators representing 64 unique interventions about their experiences with implementation after...
Source: Current HIV/AIDS Reports - March 19, 2024 Category: Infectious Diseases Source Type: research
Synthetic Controls for Implementation Science: Opportunities for HIV Program Evaluation Using Routinely Collected Data
AbstractPurpose of ReviewHIV service delivery programs are some of the largest funded public health programs in the world. Timely, efficient evaluation of these programs can be enhanced with methodologies designed to estimate the effects of policy. We propose using the synthetic control method (SCM) as an implementation science tool to evaluate these HIV programs.Recent FindingsSCM, introduced in econometrics, shows increasing utility across fields. Key benefits of this methodology over traditional design-based approaches for evaluation stem from directly approximating pre-intervention trends by weighting of candidate non-...
Source: Current HIV/AIDS Reports - March 13, 2024 Category: Infectious Diseases Source Type: research
HIV-1 Myeloid Reservoirs — Contributors to Viral Persistence and Pathogenesis
AbstractPurpose of ReviewHIV reservoirs are the main barrier to cure. CD4+ T cells have been extensively studied as the primary HIV-1 reservoir. However, there is substantial evidence that HIV-1-infected myeloid cells (monocytes/macrophages) also contribute to viral persistence and pathogenesis.Recent FindingsRecent studies in animal models and people with HIV-1 demonstrate that myeloid cells are cellular reservoirs of HIV-1. HIV-1 genomes and viral RNA have been reported in circulating monocytes and tissue-resident macrophages from the brain, urethra, gut, liver, and spleen. Importantly, viral outgrowth assays have quanti...
Source: Current HIV/AIDS Reports - February 27, 2024 Category: Infectious Diseases Source Type: research
Complex Decisions in HIV-Related Cryptococcosis: Addressing Second Episodes of Cryptococcal Meningitis
AbstractPurpose of ReviewThis review highlights the difficulties in diagnosing and treating persons with a prior history of cryptococcal meningitis who improve but suffer from a recurrence of symptoms. This scenario is well known to those who frequently care for patients with cryptococcal meningitis but is not well understood. We highlight major gaps in knowledge.Recent FindingsWe recently summarized our experience with 28 persons with paradoxical immune reconstitution inflammatory syndrome (IRIS) and 81 persons with microbiological relapse. CD4 count and cerebrospinal fluid white blood cell count were higher in IRIS than ...
Source: Current HIV/AIDS Reports - February 24, 2024 Category: Infectious Diseases Source Type: research
Antiretroviral Therapy in Pregnancy: A 2023 Review of the Literature
The objective of this review is to summarize the underlying data that informs the current clinical perinatal guidelines in the USA.Recent FindingsData now supports the use of dolutegravir at all stages of pregnancy with no significant increase in neural tube defects. Safety and pharmacokinetic data on newer antiretroviral medications in pregnancy continue to lag behind the general population.SummaryWhile there are multiple safety and tolerability concerns with older regimens, there are now multiple options of regimens that are highly efficacious and have good safety data in pregnancy. Most pregnant patients who are virally...
Source: Current HIV/AIDS Reports - January 26, 2024 Category: Infectious Diseases Source Type: research
Central Nervous System Complications of HIV in Children
(Source: Current HIV/AIDS Reports)
Source: Current HIV/AIDS Reports - January 22, 2024 Category: Infectious Diseases Source Type: research
Major Drug Resistance Mutations on Reverse Transcriptase Gene in Human Immunodeficiency Virus Type-1 in Indonesia: A Systematic Review
AbstractPurpose of ReviewThe prevalence of HIV-1 in Indonesia is on a concerning upward trajectory, with a concurrent rise in the development of drug-resistant strains, challenging the efficacy of antiretroviral therapy (ART). Many mutations have been found in the pol gene that makes HIV resistant to ART. We aim to review the major drug resistance mutations (DRMs) of reverse transcriptase (RT) of pol gene in HIV-1 cases in Indonesia.Recent FindingsA total of eleven articles reporting DRMs in HIV-1 subjects from various regions between 2015 –2020 in Indonesia are included. The prevalence of major DRMs on the RT gene in st...
Source: Current HIV/AIDS Reports - January 20, 2024 Category: Infectious Diseases Source Type: research
More than the Infinite Monkey Theorem: NHP Models in the Development of a Pediatric HIV Cure
AbstractPurpose of ReviewAn HIV cure that eliminates the viral reservoir or provides viral control without antiretroviral therapy (ART) is an urgent need in children as they face unique challenges, including lifelong ART adherence and the deleterious effects of chronic immune activation. This review highlights the importance of nonhuman primate (NHP) models in developing an HIV cure for children as these models recapitulate the viral pathogenesis and persistence.Recent FindingsSeveral cure approaches have been explored in infant NHPs, although knowledge gaps remain. Broadly neutralizing antibodies (bNAbs) show promise for ...
Source: Current HIV/AIDS Reports - January 16, 2024 Category: Infectious Diseases Source Type: research
Digital Interventions to Enhance PrEP Uptake and Adherence Through Stigma Reduction
AbstractPurpose of ReviewAlthough pre-exposure prophylaxis (PrEP) is effective for reducing risk of HIV transmission, stigma persists as a barrier to HIV prevention. Digital technologies present opportunities to access hard-to-reach populations and increase the efficiency of established interventions. This review examines current digital interventions addressing stigma to improve PrEP-related outcomes.Recent FindingsDigital technologies are increasingly used for HIV prevention and include a wide range of formats. Recent interventions focused on stigma and PrEP tend to engage mobile phone-related technology and focus on you...
Source: Current HIV/AIDS Reports - December 7, 2023 Category: Infectious Diseases Source Type: research
Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa
AbstractPurpose of ReviewEast and Southern Africa are the epicenter of the HIV epidemic. High HIV incidence rates among adolescent girls and young women (AGYW) remain stable over the last decade despite access to daily oral PrEP. Some settings have experienced high PrEP uptake among AGYW; however, discontinuation has been high. This review sought to understand drivers of PrEP discontinuation in this population in order to identify potential mechanisms to facilitate PrEP restart and optimize PrEP use.Recent FindingsDrivers of PrEP discontinuation included low perceived HIV acquisition risk, PrEP-associated side effects, pil...
Source: Current HIV/AIDS Reports - December 5, 2023 Category: Infectious Diseases Source Type: research
The Role of p53 in HIV Infection
AbstractPurpose of ReviewThis review aims to elucidate the multifaceted role of the tumor suppressor protein p53 in the context of HIV infection. We explore how p53, a pivotal regulator of cellular processes, interacts with various facets of the HIV life cycle. Understanding these interactions could provide valuable insights into potential therapeutic interventions and the broader implications of p53 in viral infections.Recent FindingsRecent research has unveiled a complex interplay between p53 and HIV. Several reports have highlighted the involvement of p53 in restricting the replication of HIV within both immune and noni...
Source: Current HIV/AIDS Reports - November 27, 2023 Category: Infectious Diseases Source Type: research
