Community-Led Monitoring: When Community Data Drives Implementation Strategies
AbstractPurpose of ReviewCommunities occupy a central position in effective health systems, notably through monitoring of health service quality and by giving recipients of care a voice. Our review identifies community-led monitoring mechanisms and best practices.Recent FindingsImplementation of community-led monitoring mechanisms improved service delivery at facility-level, health system-wide infrastructure and health outcomes among recipients of care. Successful models were community-led, collaborative, continuous and systematic, and incorporated advocacy and community education.SummaryIdentifying and replicating success...
Source: Current HIV/AIDS Reports - July 31, 2020 Category: Infectious Diseases Source Type: research

Implementing a Status-Neutral Approach to HIV in the Asia-Pacific
AbstractPurpose of ReviewGlobally, “undetectable equals untransmittable (U=U)” and “pre-exposure prophylaxis (PrEP)” have become crucial elements in HIV treatment and prevention programs. We reviewed the implementation of U=U and PrEP among countries in the Asia-Pacific region.Recent FindingsU=U and PrEP uptakes were limited and slow in the Asia-Pacific. Inadequate knowledge among health care practitioners and pervasive stigma towards individuals living with HIV and their sexual lives are key barriers for the integration of U=U into clinical practice. Paternalistic and hierarchical health care syste...
Source: Current HIV/AIDS Reports - July 29, 2020 Category: Infectious Diseases Source Type: research

Social Network Interventions for HIV Transmission Elimination
AbstractPurpose of ReviewNetwork interventions for HIV prevention represent a potential area for growth in a globalizing world, where persons are more easily connected to one another through social media and networking applications. The basic tenets of network interventions such as (1) selection of a change agent, (2) segmentation, (3) induction, and (4) alteration represent myriad ways to structure network interventions for HIV prevention with the potential for large public health impact.Recent FindingsRecent studies have employed the use of social networking websites such as Facebook to identify key persons to recruit ot...
Source: Current HIV/AIDS Reports - July 28, 2020 Category: Infectious Diseases Source Type: research

Immunotherapeutics to Treat HIV in the Central Nervous System
AbstractPurpose of ReviewThe application of immunotherapies to HIV presents a new horizon of treatment options, but little is known about what impact they may have on the central nervous system (CNS). Here we review the most promising immunotherapeutic strategies that can be used to target HIV in the CNS and focus on identifying their potential benefits while exploring the challenges that remain in their application.Recent FindingsWe have identified five immunotherapeutic strategies that hold potential in managing CNS disease among HIV-infected patients. These include broadly neutralizing antibodies, multi-affinity antibod...
Source: Current HIV/AIDS Reports - July 16, 2020 Category: Infectious Diseases Source Type: research

Point-of-care and Near Real-time Testing for Antiretroviral Adherence Monitoring to HIV Treatment and Prevention
In this report, we review the need for point-of-care (POC) or near real-time testing for antiretrovirals, progress in the field, evidence for guiding implementation of these tests globally, and future directions in objective antiretroviral therapy (ART) or pre-exposure prophylaxis (PrEP) adherence monitoring.Recent FindingsTwo cornerstones to end the HIV/AIDS pandemic are ART, which provides individual clinical benefits and eliminates forward transmission, and PrEP, which prevents HIV acquisition with high effectiveness. Maximizing the individual and public health benefits of these powerful biomedical tools requires high a...
Source: Current HIV/AIDS Reports - July 6, 2020 Category: Infectious Diseases Source Type: research

Epidemiology, Natural History, and Treatment of Hepatitis Delta Virus Infection in HIV/Hepatitis B Virus Coinfection
AbstractPurpose of ReviewLimited data exist on the prevalence, determinants, and outcomes of hepatitis delta virus (HDV) infection among HIV/hepatitis B virus (HBV) –coinfected persons. This review provides current evidence on the epidemiology, natural history, and treatment of HDV infection in patients with HIV/HBV coinfection and highlights future research needs.Recent FindingsCross-sectional studies in Europe, Africa, South America, and Asia show that the prevalence of HDV among HIV/HBV-coinfected patients ranges from 1.2 to 25%. No studies have evaluated the prevalence of HDV infection among HIV/HBV-coinfected pa...
Source: Current HIV/AIDS Reports - July 1, 2020 Category: Infectious Diseases Source Type: research

Correction to: Integrating and Interpreting Findings from the Latest Treatment as Prevention Trials
The original version of this review article unfortunately contained a mistake in the category section. The Section Editor was inadvertently captured as “E Geng” instead of “SH Vermund”. (Source: Current HIV/AIDS Reports)
Source: Current HIV/AIDS Reports - June 30, 2020 Category: Infectious Diseases Source Type: research

A Systematic Review of Recent Methodological Approaches for Using Ecological Momentary Assessment to Examine Outcomes in U.S. Based HIV Research
AbstractPurpose of ReviewIn recent years, researchers have been adopting and using ecological momentary assessment (EMA) methods via technology devices for real-time measurement of exposures and outcomes in HIV research. To assess and critically evaluate how EMA methods are currently being used in HIV research, we systematically reviewed recent published literature (October 2017 –October 2019) and searched select conference databases for 2018 and 2019.Recent FindingsOur searches identified 8 published articles that used EMA via smartphone app, a handheld Personal Digital Assistant, and web-based survey programs for r...
Source: Current HIV/AIDS Reports - June 27, 2020 Category: Infectious Diseases Source Type: research

ART Adherence Among Men Who Have Sex with Men Living with HIV: Key Challenges and Opportunities
AbstractPurpose of ReviewIn the USA, gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. High levels of adherence to antiretroviral therapy (ART) can dramatically improve outcomes for persons living with HIV and reduce the risk of HIV transmission to others. Yet, there are numerous individual, social, and structural barriers to optimal ART adherence. Many of these factors disproportionately impact Black MSM and may contribute to their poorer rates of ART adherence. This review synthesizes the key challenges and intervention opportunities to improve ART adherence among MSM in the...
Source: Current HIV/AIDS Reports - June 18, 2020 Category: Infectious Diseases Source Type: research

Immunomodulatory and Anti-Inflammatory Strategies to Reduce Comorbidity Risk in People with HIV
AbstractPurpose of ReviewIn this review, we will discuss treatment interventions targeting drivers of immune activation and chronic inflammation in PWH.Recent FindingsPotential treatment strategies to prevent the progression of comorbidities in PWH have been identified. These studies include, among others, the use of statins to modulate lipid alterations and subsequent innate immune receptor activation, probiotics to restore healthy gut microbiota and reduce microbial translocation, hydroxychloroquine to reduce immune activation by altering Toll-like receptors function and expression, and canakinumab to block the action of...
Source: Current HIV/AIDS Reports - June 13, 2020 Category: Infectious Diseases Source Type: research

Sex Differences in the Treatment of HIV
AbstractPurpose of ReviewBiological and societal influences are different for men and women leading to different HIV outcomes and related infectious and non-infectious complications. This review evaluates sex differences in the epidemiology and immunological response to HIV and looks at major complications and coinfections, as well as care delivery systems focusing on low- and middle-income countries (LMICs) where most people with HIV live.Recent FindingsMore women than men access testing and treatment services in LMIC; women are more likely to be virologically suppressed in that environment. There is a growing recognition...
Source: Current HIV/AIDS Reports - June 11, 2020 Category: Infectious Diseases Source Type: research

The Evidence for HIV Self-Testing to Increase HIV Testing Rates and the Implementation Challenges that Remain
We describe the evidence regarding the impact of offering HIV self-testing (HIVST) and explore the gaps that need to be filled to design and implement HIVST programs.Recent FindingsNumerous randomized controlled trials found that offering HIVST increases HIV testing rates. However, these trials used an oral HIVST that was provided for free and there is no research examining the impact of offering blood-based (finger prick) kits or charging for HIVST kits. The trials also used various methods for distributing the HIVST kits, but there is little research comparing distribution methods. Study participants varied in the HIV te...
Source: Current HIV/AIDS Reports - June 10, 2020 Category: Infectious Diseases Source Type: research

From Berlin to London: HIV-1 Reservoir Reduction Following Stem Cell Transplantation
AbstractPurpose of ReviewFew interventional strategies lead to significant reductions in HIV-1 reservoir size or prolonged antiretroviral (ART)-free remission. Allogeneic stem cell transplantations (SCT) with or without donor cells harboring genetic mutations preventing functional expression of CCR5, an HIV coreceptor, lead to dramatic reductions in residual HIV burden. However, the mechanisms by which SCT reduces viral reservoirs and leads to a potential functional HIV cure are not well understood.Recent FindingsA growing number of studies involving allogeneic SCT in people with HIV are emerging, including those with and ...
Source: Current HIV/AIDS Reports - June 9, 2020 Category: Infectious Diseases Source Type: research

A Systematic Review of Technology-Assisted HIV Testing Interventions
AbstractPurpose of ReviewThe purpose of this review is to describe and assess the literature on mobile health (mHealth) and other technology-based HIV testing interventions published in the 5-year period from 2015 to 2020.Recent FindingsWe identified 18 published technology-based studies, 6 of which were efficacy trials and the remaining 12 were either pilot randomized controlled trials (RCTs) or quasi-experimental studies. Most (n = 10) interventions were conducted outside the USA, including countries in Sub-Saharan Africa (n = 4), China (n = 3), Latin America (n = 2...
Source: Current HIV/AIDS Reports - June 8, 2020 Category: Infectious Diseases Source Type: research

Universal HIV Testing and Treatment (UTT) Integrated with Chronic Disease Screening and Treatment: the SEARCH study
AbstractPurpose of ReviewThe growing burden of untreated chronic disease among persons with HIV (PWH) threatens to reverse heath gains from ART expansion. Universal test and treat (UTT) ’s population-based approach provides opportunity to jointly identify and treat HIV and other chronic diseases. This review’s purpose is to describe SEARCH UTT study’s integrated disease strategy and related approaches in Sub-Saharan Africa.Recent FindingsIn SEARCH, 97% of adults were HIV tested, 85% were screened for hypertension, and 79% for diabetes at health fairs after 2  years, for an additional $1.16/person. Af...
Source: Current HIV/AIDS Reports - June 8, 2020 Category: Infectious Diseases Source Type: research

Getting to 90 –90–90: Experiences from the MaxART Early Access to ART for All (EAAA) Trial in Eswatini
AbstractPurpose of ReviewThe MaxART Consortium —led by the Eswatini Ministry of Health—implemented multiple interventions between 2012 and 2017 to achieve UNAIDS 90–90–90 targets. We summarize key findings from community outreach strategies in support of the first 90 goal, and from the Early Access to ART for All (EAAA) trial on the impl ementation of a “Treat All” strategy to achieve the second and third 90 goals within a government-managed public health system.Recent FindingsThe MaxART Consortium demonstrated that “Fast Track,” a problem-solving approach, was effective at i...
Source: Current HIV/AIDS Reports - May 30, 2020 Category: Infectious Diseases Source Type: research

The CAN-DO-IT Model: a Process for Developing and Refining Online Recruitment in HIV/AIDS and Sexual Health Research
AbstractPurpose of ReviewHIV/AIDS and sexual health research has increasingly relied on online recruitment in recent years. However, as potential online recruitment avenues (e.g., dating and sexual networking applications, websites, social media) have proliferated, navigating this process has become increasingly complex. This paper presents a practical model to guide researchers through online recruitment irrespective of platform.Recent FindingsThe CAN-DO-IT model reflects 7 iterative steps based on work by the authors and other investigators: conceptualize scope of recruitment campaign, acquire necessary expertise, naviga...
Source: Current HIV/AIDS Reports - May 23, 2020 Category: Infectious Diseases Source Type: research

Approaches to Objectively Measure Antiretroviral Medication Adherence and Drive Adherence Interventions
AbstractPurpose of ReviewTraditional methods to assess antiretroviral adherence, such as self-report, pill counts, and pharmacy refill data, may be inaccurate in determining actual pill-taking to both antiretroviral therapy (ART) or pre-exposure prophylaxis (PrEP). HIV viral loads serve as surrogates of adherence on ART, but loss of virologic control may occur well after decreases in adherence and viral loads are not relevant to PrEP.Recent FindingsPharmacologic measures of adherence, electronic adherence monitors, and ingestible electronic pills all serve as more objective metrics of adherence, surpassing self-report in p...
Source: Current HIV/AIDS Reports - May 19, 2020 Category: Infectious Diseases Source Type: research

Frailty in People Living with HIV
AbstractPurpose of ReviewDifferent factors contribute to the decreased overall long-term survival in treated people living with HIV (PLWH). This paper will review the state of physical frailty which limits successful aging in PLWH.Recent FindingsIdentifiable events on the continuum from clinical normality to heightened risk of adverse health outcomes contribute to frailty. These center on chronic inflammation leading to destabilization of autoregulated physiologic systems challenged by environmental and biologic challenges. Frailty assessment can inform the profile of aging PLWH at increased risk of common age-related diso...
Source: Current HIV/AIDS Reports - May 12, 2020 Category: Infectious Diseases Source Type: research

A Review of Usability Evaluation Methods and Their Use for Testing eHealth HIV Interventions
AbstractPurpose of ReviewTo provide a comprehensive review of usability testing of eHealth interventions for HIV.Recent FindingsWe identified 28 articles that assessed the usability of eHealth interventions for HIV, most of which were published within the past 3  years. The majority of the eHealth interventions for HIV was developed on a mobile platform and focused on HIV prevention as the intended health outcome. Usability evaluation methods included eye-tracking, questionnaires, semi-structured interviews, contextual interviews, think-aloud protocols, co gnitive walkthroughs, heuristic evaluations and expert reviews...
Source: Current HIV/AIDS Reports - May 11, 2020 Category: Infectious Diseases Source Type: research

The Brain Retains: Nonhuman Primate Models for Pediatric HIV-1 in the CNS
AbstractPurpose of ReviewPerinatal HIV-1 infection is associated with an increased risk for neurologic impairments. With limited access to clinical specimens, animal models could advance our understanding of pediatric central nervous system (CNS) disease and viral persistence. Here, we summarize current findings on HIV-1 CNS infection from nonhuman primate (NHP) models and discuss their implications for improving pediatric clinical outcomes.Recent FindingsSIV/SHIV can be found in the CNS of infant macaques within 48  h of challenge. Recent studies show an impermeable BBB during SIV infection, suggesting neuroinvasion ...
Source: Current HIV/AIDS Reports - May 10, 2020 Category: Infectious Diseases Source Type: research

Improving Care Outcomes for PLWH Experiencing Homelessness and Unstable Housing: a Synthetic Review of Clinic-Based Strategies
AbstractPurpose of ReviewSingular interventions targeting vulnerable populations of people living with HIV (PLWH) are necessary for reducing new infections and optimizing individual-level outcomes, but extant literature for PLWH who experience homelessness and unstable housing (HUH) has not been compiled. To inform implementation of clinic-based programs that improve care outcomes in this population, we present a synthetic review of key studies examining clinic-based interventions, specifically case management, patient navigation, financial incentives, and the use of mobile technology.Recent FindingsResults from unimodal i...
Source: Current HIV/AIDS Reports - May 7, 2020 Category: Infectious Diseases Source Type: research

Ethical Considerations in HIV eHealth Intervention Research: Implications for Informational Risk in Recruitment, Data Maintenance, and Consent Procedures
This article draws on published works describing investigator experiences to contribute to the ongoing development of guidance in this area. (Source: Current HIV/AIDS Reports)
Source: Current HIV/AIDS Reports - May 2, 2020 Category: Infectious Diseases Source Type: research

Pediatric HIV: the Potential of Immune Therapeutics to Achieve Viral Remission and Functional Cure
AbstractPurpose of ReviewIn the absence of antiretroviral therapy (ART), more than 50% of perinatally HIV-infected children die by 2  years of age. Early ART from infancy is therefore a global recommendation and significantly improves immune health, child survival, and disease outcome. However, even early treatment does not prevent or eradicate the latent reservoir necessitating life-long ART. Adherence to life-long ART is chall enging for children and longstanding ART during chronic HIV infection led to higher risks of non-AIDS co-morbidities and virologic failure in infected children. Thus, HIV-infected children are...
Source: Current HIV/AIDS Reports - May 1, 2020 Category: Infectious Diseases Source Type: research

Senotherapeutics and HIV-1 Persistence
AbstractPurpose of ReviewTo review the potential use of senotherapeutics, pharmacologic agents that target senescent cells, in addressing HIV-1 persistence.Recent FindingsTreated HIV-1 infection results in a state of immune exhaustion, which may involve reprogramming of infected and bystander cells toward a state of cellular senescence. Aging research has recently uncovered pathways that make senescent cells uniquely susceptible to pharmacologic intervention. Specific compounds, known as senotherapeutics, have been identified that interrupt pathways senescent cells depend on for survival. Several of these pathways are impo...
Source: Current HIV/AIDS Reports - April 30, 2020 Category: Infectious Diseases Source Type: research

Artificial Intelligence and Machine Learning for HIV Prevention: Emerging Approaches to Ending the Epidemic
AbstractPurpose of ReviewWe review applications of artificial intelligence (AI), including machine learning (ML), in the field of HIV prevention.Recent FindingsML approaches have been used to identify potential candidates for preexposure prophylaxis (PrEP) in healthcare settings in the USA and Denmark and in a population-based research setting in Eastern Africa. Although still in the proof-of-concept stage, other applications include ML with smartphone-collected and social media data to promote real-time HIV risk reduction, virtual reality tools to facilitate HIV serodisclosure, and chatbots for HIV education. ML has also ...
Source: Current HIV/AIDS Reports - April 29, 2020 Category: Infectious Diseases Source Type: research

Contribution of Behavioral Health Factors to Non-AIDS-Related Comorbidities: an Updated Review
Discussion of recent randomized clinical trials and implementation research to curtail risk attributed to each behavioral health issue is provided.Recent FindingsSmoking, unhealthy alcohol use, opioid use, and depression are common among PWH and individually contribute to increased risk for non-AIDS-related comorbidities. The concurrence of these conditions is notable, yet understudied, and provides opportunity for linked-screening and potential treatment of more than one behavioral health factor. Current results from randomized clinical trials are inconsistent. Investigating interventions to reduce the impact of these beh...
Source: Current HIV/AIDS Reports - April 21, 2020 Category: Infectious Diseases Source Type: research

PrEP Product Acceptability and Dual Process Decision-Making Among Men Who Have Sex with Men
AbstractPurpose of ReviewAdvances in short- and long-acting pre-exposure prophylaxis (PrEP) technologies have incentivized the need to understand how individuals make trade-offs and competing decisions regarding PrEP modalities. The purpose of this review was to examine how researchers have conceptualized and measured attributes that are either intuitive and emotional (System 1) or deliberative and cognitive (System 2) in conjoint analysis or discrete choice experiments focused on diverse PrEP technologies among men who have sex with men (MSM).Recent FindingsAcross the 9 studies meeting inclusion criteria, 5 included oral ...
Source: Current HIV/AIDS Reports - April 16, 2020 Category: Infectious Diseases Source Type: research

Integrating and Interpreting Findings from the Latest Treatment as Prevention Trials
AbstractPurpose of ReviewIn 2018 –2019, studies were published assessing the effectiveness of reducing HIV incidence by expanding HIV testing, linkage to HIV treatment, and assistance to persons living with HIV to adhere to their medications (the “90-90-90” strategy). These tests of “treatment as prevention” (TasP) had co mplex results.Recent FindingsThe TasP/ANRS 12249 study in South Africa, the SEARCH study in Kenya and Uganda, and one comparison (arms A to C) of the HPTN 071 (PopART) study in South Africa and Zambia did not demonstrate a community impact on HIV incidence. In contrast, the B...
Source: Current HIV/AIDS Reports - April 16, 2020 Category: Infectious Diseases Source Type: research

Dysfunctional Immunometabolism in HIV Infection: Contributing Factors and Implications for Age-Related Comorbid Diseases
AbstractPurpose of ReviewAn increasing body of evidence indicates that persons living with HIV (PLWH) display dysfunctional immunometabolism. Here, we provide an updated review of this topic and its relationship to HIV-associated immune stimuli and age-related disease.Recent FindingsHIV infection alters immunometabolism by increasing reliance on aerobic glycolysis for energy and productive infection and repurposing oxidative phosphorylation machinery for immune cell proliferation and survival. Recent studies in PLWH with diabetes mellitus or cardiovascular disease have identified an association with elevated T cell and mon...
Source: Current HIV/AIDS Reports - March 5, 2020 Category: Infectious Diseases Source Type: research

The Impact of Treatment as Prevention on the HIV Epidemic in British Columbia, Canada
This study proposes to describe the impact of a publicly funded Treatment as Prevention (TasP) strategy in British Columbia (BC), Canada, in decreasing the individual and public health impact of the HIV/AIDS Epidemic.Recent FindingsIn BC, TasP has been associated with a steady decline in HIV-related morbidity and mortality. At the same time, a demographic transition was observed among people living with HIV (PLWH), with the majority of those on antiretroviral treatment (ART) now ≥ 50 years of age, living with at least one comorbidity, and dying from age-associated comorbidities. We also documented a progress...
Source: Current HIV/AIDS Reports - March 3, 2020 Category: Infectious Diseases Source Type: research

Assessing and Addressing Social Determinants of HIV among Female Sex Workers in the Dominican Republic and Tanzania through Community Empowerment-Based Responses
AbstractPurpose of ReviewThis review describes social determinants of HIV in two geographic and epidemic settings, the Dominican Republic (DR) and Tanzania, among female sex workers (FSW), their influence on HIV outcomes including 90-90-90 goals, and the development and impact of tailored, context driven, community empowerment-based responses in each setting.Recent FindingsOur review documents the significance of social determinants of HIV including sex work-related stigma, discrimination, and violence and the impact of community empowerment-based approaches on HIV incidence in Tanzania and other HIV prevention, treatment,...
Source: Current HIV/AIDS Reports - February 18, 2020 Category: Infectious Diseases Source Type: research

Opportunities and Challenges in HIV Treatment as Prevention Research: Results from the ANRS 12249 Cluster-Randomized Trial and Associated Population Cohort
AbstractPurpose of ReviewThe ANRS 12249 treatment as prevention (TasP) trial investigated the impact of a universal test and treat (UTT) approach on reducing HIV incidence in one of the regions of the world most severely affected by the HIV epidemic —KwaZulu-Natal, South Africa. We summarize key findings from this trial as well as recent findings from controlled studies conducted in the linked population cohort quantifying the long-term effects of expanding ART on directly measured HIV incidence (2004–2017).Recent FindingsThe ANRS TasP trial did not —and could not—demonstrate a reduction in HIV inci...
Source: Current HIV/AIDS Reports - February 18, 2020 Category: Infectious Diseases Source Type: research

Obesity and Weight Gain in Persons with HIV
AbstractPurpose of ReviewThe proportion of overweight and obese persons with HIV (PWH) has increased since the introduction of antiretroviral therapy (ART). We aim to summarize recent literature on risks of weight gain, discuss adipose tissue changes in HIV and obesity, and synthesize current understanding of how excess adiposity and HIV contribute to metabolic complications.Recent FindingsRecent studies have implicated contemporary ART regimens, including use of integrase strand transfer inhibitors and tenofovir alafenamide, as a contributor to weight gain, though the mechanisms are unclear. Metabolic dysregulation is lin...
Source: Current HIV/AIDS Reports - February 18, 2020 Category: Infectious Diseases Source Type: research

Defining T Cell Tissue Residency in Humans: Implications for HIV Pathogenesis and Vaccine Design
AbstractPurpose of ReviewThis review summarizes recent literature defining tissue-resident memory T cells (TRM) and discusses implications for HIV pathogenesis, vaccines, and eradication efforts.Recent FindingsInvestigations using animal models and human tissues have identified a TRM transcriptional profile and elucidated signals within the tissue microenvironment leading to TRM development and maintenance. TRM are major contributors to host response in infectious diseases and cancer; in addition, TRM contribute to pathogenic inflammation in a variety of settings. Although TRM are daunting to study in HIV infection, recent...
Source: Current HIV/AIDS Reports - February 12, 2020 Category: Infectious Diseases Source Type: research

Novel Antiretroviral Agents
AbstractPurpose of ReviewCombination antiretroviral therapy (cART) has had dramatic effects on morbidity and mortality for persons living with HIV (PLWH). Despite significant progress in treatment efficacy, tolerability, and reducing pill burden, new agents are needed to address issues of resistance, drug-drug interactions, end organ disease, and adherence. This review covers novel ART agents recently approved or in development.Recent FindingsCapsid inhibitors (CAI) demonstrate high potency and potential for extended-duration dosing in pre-clinical trials. While previous maturation inhibitors (MI) were hampered by issues o...
Source: Current HIV/AIDS Reports - February 12, 2020 Category: Infectious Diseases Source Type: research

HIV/AIDS Among Female Sex Workers in China: Epidemiology and Recent Prevention Strategies
AbstractPurpose of ReviewThis review aims to describe the epidemiology of HIV among female sex workers (FSWs) in China over the past decade, to summarize current gaps in knowledge regarding risk factors, and to identify new directions for HIV prevention strategies.Recent FindingsWe summarized national and regional levels of HIV prevalence among FSWs based on reported rates in the literature from 2008 to 2018. Studies identified cases of HIV infection among FSWs in all but one province during this time period, and demonstrated a sporadic pattern in most provinces, with a low overall national HIV prevalence below 1%. However...
Source: Current HIV/AIDS Reports - February 6, 2020 Category: Infectious Diseases Source Type: research

Recent Advances in the Development of Integrase Inhibitors for HIV Treatment
AbstractPurpose of the ReviewThe complex multistep life cycle of HIV allows it to proliferate within the host and integrate its genome in to the host chromosomal DNA. This provirus can remain dormant for an indefinite period. The process of integration, governed by integrase (IN), is highly conserved across theRetroviridae family. Hence, targeting integration is not only expected to block HIV replication but may also reveal new therapeutic strategies to treat HIV as well as other retrovirus infections.Recent FindingsHIV integrase (IN) has gained attention as the most promising therapeutic target as there are no equivalent ...
Source: Current HIV/AIDS Reports - January 21, 2020 Category: Infectious Diseases Source Type: research

Bone Update: Is It Still an Issue Without Tenofovir Disoproxil Fumarate?
AbstractPurpose of ReviewIn the era of modern bone-friendly antiretroviral therapy (ART) regimens for people living with HIV (PLWH), this review discusses the research gaps and management concerns that remain for individuals who have already been exposed to ART with negative effects on bone metabolism, especially children and adolescents who have not acquired peak bone mass, and older adults who have additional risk factors for fracture.Recent FindingsData now support the use of avoidance of TDF and use of bone-friendly regimens that include integrase strand transfer inhibitors in PLWH with increased risk of fracture for e...
Source: Current HIV/AIDS Reports - January 17, 2020 Category: Infectious Diseases Source Type: research

Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China
AbstractPurpose of ReviewMen who have sex with men (MSM) in China experience elevated risks of mental health issues in comparison to the general population in China, which contribute to vulnerability to HIV/STI risks and can comprise the effectiveness of HIV prevention efforts. A conceptual framework for understanding this mental health disparity is minority stress theory, which posits that experiences of external prejudice events (i.e., distal stressors) and internal stress processes such as internalized homophobia and concealment (i.e., proximal stressors) contribute to sexual minorities ’ elevated risk of psycholo...
Source: Current HIV/AIDS Reports - January 16, 2020 Category: Infectious Diseases Source Type: research

Optimizing Treatment for Adults with HIV/AIDS in China: Successes over Two Decades and Remaining Challenges
AbstractPurpose of ReviewThe introduction of the National Free Antiretroviral Therapy Program (NFATP) in 2003 by the China National Center for AIDS/STD Control and Prevention has led to dramatic increases in antiretroviral therapy (ART) coverage among HIV-infected Chinese patients. Despite limitations in the number of available free antiretroviral drugs, the overall mortality associated with HIV/AIDS has dropped from 39.3 per 100 person-years in 2002 to 3.1 in 2014. In this review, we summarize the challenges, responses, and achievements of antiretroviral therapy (ART) in China over the past 20  years.Recent FindingsC...
Source: Current HIV/AIDS Reports - January 14, 2020 Category: Infectious Diseases Source Type: research

Screening for Hepatocellular Carcinoma in HIV-Infected Patients: Current Evidence and Controversies
AbstractPurpose of ReviewThis review aims to summarize evidence regarding hepatocellular carcinoma (HCC) screening in the specific context of HIV infection and discuss areas of uncertainty.Recent FindingsIt has not been definitely established if HCC incidence in HIV/HCV-coinfected patients with cirrhosis is above the 1.5%/year threshold that makes screening cost-effective. Outside cirrhosis or HBV infection, available data do not support surveillance. The performance of currently recommended ultrasound (US) screening strategy is poor in HIV-infected patients, as rates of early-stage HCC detection are low. Magnetic resonanc...
Source: Current HIV/AIDS Reports - January 13, 2020 Category: Infectious Diseases Source Type: research

Addressing Hepatitis C in the American Incarcerated Population: Strategies for Nationwide Elimination
AbstractPurpose of ReviewThe prevalence of Hepatitis C virus (HCV) in the US incarcerated population is disproportionately high, and when inmates with infection are released back into the general population, they play a substantial role in the spread of disease. This review provides support for targeting the jail/prison population to eliminate HCV in the general population. It will also summarize various screening/treatment models to curtail the burden of disease behind and beyond bars.Recent FindingsTransitioning from risk-based testing to opt-out testing in prisons/jails would be cost-effective through greater identifica...
Source: Current HIV/AIDS Reports - January 13, 2020 Category: Infectious Diseases Source Type: research

Aging with HIV
AbstractPurpose of ReviewThis review points out unmet medical needs and open research questions of older adults living with HIV. Starting from the definition of aging in HIV, it explores the mosaic of this condition at epidemiological, pathophysiological, and clinical level. Antiretroviral management and diverse models of care are critically discussed.Recent FindingsAging cohorts suggest HIV as a paradigm of chronic inflammation and immune activation with specific aging trajectory patterns in which antiretroviral therapy may play a role. In the absence of randomized clinical trials, observational cohorts show that therapy ...
Source: Current HIV/AIDS Reports - December 10, 2019 Category: Infectious Diseases Source Type: research

“Getting to Zero” Among Men Who Have Sex with Men in China: a Review of the HIV Care Continuum
AbstractPurpose of ReviewTo review the literature on progress towards UNAIDS 90-90-90 targets for HIV prevention and treatment among men who have sex with men (MSM) in China.Recent FindingsChina has made progress towards UNAIDS 90-90-90 targets among MSM. However, socio-structural barriers, including HIV-related stigma and homophobia, persist at each stage of the HIV care continuum, leading to substantial levels of attrition and high risk of forward HIV transmission. Moreover, access to key prevention tools, such as pre-exposure prophylaxis, is still limited. Multilevel interventions, many using digital intervention, have ...
Source: Current HIV/AIDS Reports - December 2, 2019 Category: Infectious Diseases Source Type: research

Peer Support for Adolescents and Young People Living with HIV in sub-Saharan Africa: Emerging Insights and a Methodological Agenda
AbstractPurposeDespite clear need and disproportionate risk, adolescents, and young people living with HIV (AYPLHIV) are underserved within the HIV response. “Peer support” increasingly forms part of adolescent and youth-responsive service packages as a class of implementation strategies that can support adolescents to access, engage, and sustain treatment. This paper examines examples of peer support for AYPLHIV within sub-saharan Africa to explore the determinants of successful implementation, outcomes and scale-up, as well as policy and programmatic implications.Recent FindingsAlthough adolescent peer suppor...
Source: Current HIV/AIDS Reports - November 27, 2019 Category: Infectious Diseases Source Type: research

Contemporary Lifestyle Modification Interventions to Improve Metabolic Comorbidities in HIV
AbstractPurpose of ReviewMetabolic comorbidities including diabetes, obesity, dyslipidemia, and hypertension, all of which are traditional cardiovascular disease risk factors that are highly prevalent in people with HIV (PWH). Bone disease including osteopenia, osteoporosis, and fragility fractures is also prevalent in PWH. These comorbidities may be prevented and treated in part with lifestyle modification, including changes to dietary and physical habits. The purpose of this review is to highlight recent literature that characterizes current lifestyle habits in PWH as well as the effectiveness of lifestyle strategies to ...
Source: Current HIV/AIDS Reports - November 27, 2019 Category: Infectious Diseases Source Type: research

Interventions to improve the HIV continuum of care in China
AbstractPurpose of ReviewTo describe HIV epidemic and interventions for improving HIV continuum of care in China.Recent FindingsThe reported HIV epidemic has been continuously increasing, partially due to the expansion of active HIV testing campaign. Public health intervention programs have been effective in containing HIV spread among former plasma donors and people who inject drugs (PWID), but more infections occur among heterosexual men and women and young men who have sex with men. Of 1.25 million Chinese people are living with HIV, one-third do not know their status. About two-thirds of diagnosed individuals have used...
Source: Current HIV/AIDS Reports - November 27, 2019 Category: Infectious Diseases Source Type: research

HIV and Aging in Mainland China: Implications for Control and Prevention Research
AbstractPurpose of ReviewThe last 15  years have witnessed a dramatic change in HIV-related epidemiology amidst improvements in treatment and care in China. With proper treatment, HIV is now considered a chronic disease. As a consequence, many people living with HIV (PLWH) now present age-related comorbidities. We reviewed 13 topical issues concerning the epidemiology of aging with HIV in mainland China.ResultsMany of aging-related issues associated with the biological and physical aspects of living with HIV addressed in mainland China are consistent with the global literature. Greater prevalence of age-related comorb...
Source: Current HIV/AIDS Reports - November 26, 2019 Category: Infectious Diseases Source Type: research

Evolving HIV Epidemiology in Mainland China: 2009 –2018
AbstractPurpose of ReviewThis review is intended to provide an overview of the evolution of HIV epidemiology over the past decade in China.Recent FindingsWe provided a succinct overall view of the epidemic, followed by surveillance data, profiles of key populations, HIV molecular epidemiology, and drug resistance, as well as survival in the age of antiretroviral therapy usage. For each topical issue, we first reviewed the latest empirical evidence, followed by a brief summary assessment. We briefly addressed the challenges and opportunities of the next generation of HIV control and prevention efforts in China.SummaryNotabl...
Source: Current HIV/AIDS Reports - November 26, 2019 Category: Infectious Diseases Source Type: research