The Value of Assessing Self-Reported and Biological Indicators of Outcomes in Evaluating HIV Programs
AbstractPurpose of ReviewIn this manuscript, we present recent findings concerning concordance and discrepancy between biological measures and self-reports of these three outcomes of HIV programs: HIV status, adherence to antiretroviral medications (ARVs) and use of and adherence to pre-exposure prophylaxis medication (PrEP), and condom use/unprotected sex.Recent FindingsRecent studies suggest that three successive rapid HIV tests (for those whose first test in positive) might be reasonably inexpensive and valid biological data to collect to combine with self-reports of HIV status, dried blood spots sufficiently affordable...
Source: Current HIV/AIDS Reports - May 16, 2021 Category: Infectious Diseases Source Type: research
Approaches to Promoting Linkage to and Retention in HIV Care in the United States: a Scoping Review
AbstractPurpose of ReviewLinkage to and retention in HIV care, as conceptualized in the HIV care continuum, remain critical steps towards achieving and maintaining viral suppression. We evaluated recently published (Jan 2018 –Nov 2020) peer-reviewed clinical trials of linkage to and retention in care outcomes in the United States.Recent FindingsWe identified 12 trials evaluating linkage to and retention in care outcomes in the United States. Most trials did not adhere to standardized definitions or metrics for linkage to or retention in HIV care, hindering comparisons between studies. Four interventions indicated improve...
Source: Current HIV/AIDS Reports - May 6, 2021 Category: Infectious Diseases Source Type: research
Novel Longitudinal Methods for Assessing Retention in Care: a Synthetic Review
AbstractPurpose of ReviewRetention in care is both dynamic and longitudinal in nature, but current approaches to retention often reduce these complex histories into cross-sectional metrics that obscure the nuanced experiences of patients receiving HIV care. In this review, we discuss contemporary approaches to assessing retention in care that captures its dynamic nature and the methodological and data considerations to do so.Recent FindingsEnhancing retention measurements either through patient tracing or “big data” approaches (including probabilistic matching) to link databases from different sources can be used to as...
Source: Current HIV/AIDS Reports - May 4, 2021 Category: Infectious Diseases Source Type: research
The Past, Present, and Future of PrEP implementation Among People Who Use Drugs
AbstractPurpose of reviewRecent HIV outbreaks among people who use drugs (PWUD) necessitate additional HIV prevention tools. Pre-exposure prophylaxis (PrEP) is highly efficacious yet uptake among PWUD remains exceedingly low. To address multilevel, complex barriers to PrEP use among PWUD, a range of intervention strategies are needed.Recent findingsThe literature on interventions to optimize PrEP use among PWUD is nascent, comprising small pilots and demonstration projects in early phases of intervention development. Initial studies suggest that structural, healthcare, interpersonal, and individual-level interventions can ...
Source: Current HIV/AIDS Reports - April 27, 2021 Category: Infectious Diseases Source Type: research
Application of the Consolidated Framework for Implementation Research to Facilitate Violence Screening in HIV Care Settings: a Review of the Literature
We describe several potential implementation strategies to overcome the most salient barriers identified across this limited body of summarized research. (Source: Current HIV/AIDS Reports)
Source: Current HIV/AIDS Reports - April 18, 2021 Category: Infectious Diseases Source Type: research
Frailty and HIV: Moving from Characterization to Intervention
AbstractPurpose of ReviewWhile the characteristics associated with frailty in people with HIV (PWH) have been well described, little is known regarding interventions to slow or reverse frailty. Here we review interventions to prevent or treat frailty in the general population and in people with HIV (PWH).Recent FindingsFrailty interventions have primarily relied on nonpharmacologic interventions (e.g., exercise and nutrition). Although few have addressed frailty, many of these therapies have shown benefit on components of frailty including gait speed, strength, and low activity among PWH. When nonpharmacologic intervention...
Source: Current HIV/AIDS Reports - April 5, 2021 Category: Infectious Diseases Source Type: research
Use of eHealth for HIV Medical Education: a Narrative Review
AbstractPurpose of ReviewThe complexity of HIV care and its expanding clinical workforce has created a need for new distance learning models to deliver medical education. We conducted a narrative review to assess the acceptability and effectiveness of recent eHealth HIV education interventions supporting HIV healthcare providers.Recent FindingsEvidence from 24 articles revealed that synchronous (real time), asynchronous (any time), and hybrid (combination) models of eHealth education are feasible and acceptable. Only two interventions (one asynchronous, one hybrid) of 19 included in the review utilized a randomized control...
Source: Current HIV/AIDS Reports - April 5, 2021 Category: Infectious Diseases Source Type: research
Ethical Implications of eHealth Tools for Delivering STI/HIV Laboratory Results and Partner Notifications
We describe ethical implications for such technologies.Recent FindingsOur review found that despite widespread research on the use of eHealth tools in delivering laboratory results and partner notifications, these studies rarely measured or reported on the ethical implications. Such implications can be organized according to the four major principles in bioethics: beneficence, patient autonomy, non-maleficence, and justice. The beneficence of eHealth typically measures efficacy in comparison to existing standards of care. Patient autonomy includes the ability to opt in or out of eHealth tools, right-based principles of con...
Source: Current HIV/AIDS Reports - March 26, 2021 Category: Infectious Diseases Source Type: research
Cost-Effectiveness Analysis in Implementation Science: a Research Agenda and Call for Wider Application
We describe examples of how model-based CEA can integrate implementation scientific concepts and evidence to help tailor evaluations to local context. We also propose six distinct domains for methodological advancement in order to enhance the uptake and impact of model-based cost-effectiveness analysis in implementation scientific research. (Source: Current HIV/AIDS Reports)
Source: Current HIV/AIDS Reports - March 20, 2021 Category: Infectious Diseases Source Type: research
HIV Pathogenesis in the Human Female Reproductive Tract
We describe recent findings on innate immune protection and HIV target cell distribution in the FRT. We also review multiple factors that modify susceptibility to infection, including sex hormones, microbiome, trauma, and how HIV risk changes during women ’s life cycle. Finally, we review current strategies for HIV prevention and identify barriers for research in HIV infection and pathogenesis in women.SummaryA complex network of interrelated biological and sociocultural factors contributes to HIV risk in women and impairs prevention and cure strategies. Understanding how HIV establishes infection in the FRT can provide ...
Source: Current HIV/AIDS Reports - March 15, 2021 Category: Infectious Diseases Source Type: research
Immunologic Control of HIV-1: What Have We Learned and Can We Induce It?
AbstractPurpose of ReviewA large amount of data now exists on the virus-specific immune response associated with spontaneous or induced immunologic control of lentiviruses. This review focuses on how the current understanding of HIV-specific immunity might be leveraged into induction of immunologic control and what further research is needed to accomplish this goal.Recent FindingsDuring chronic infection, the function most robustly associated with immunologic control of HIV-1 is CD8+ T cell cytotoxic capacity. This function has proven difficult to restore in HIV-specific CD8+ T cells of chronically infected progressors in ...
Source: Current HIV/AIDS Reports - March 11, 2021 Category: Infectious Diseases Source Type: research
Probing the Interface of HIV and Inflammaging
AbstractPurpose of ReviewSystemic inflammation increases as a consequence of aging (inflammaging) and contributes to age-related morbidities. Inflammation in people living with HIV is elevated compared with the general population even after prolonged suppression of viremia with anti-retroviral therapy. Mechanisms that contribute to inflammation during aging and in treated HIV disease are potentially interactive, leading to an exaggerated inflammatory phenotype in people with HIV.Recent FindingsRecent studies highlight roles for anti-retroviral therapy, co-infections, immune system alterations, and microbiome perturbations ...
Source: Current HIV/AIDS Reports - March 11, 2021 Category: Infectious Diseases Source Type: research
Implementing Implementation Research: Teaching Implementation Research to HIV Researchers
AbstractPurpose of ReviewGiven the growth in HIV-related implementation research, there is a need to expand the workforce and rigor through implementation science (IS) training and mentorship. Our objective is to review IS training opportunities for HIV-focused researchers and describe the approach and lessons learned from a recent HIV-related implementation research training initiative.Recent FindingsIS training opportunities range from degree programs to short- and longer-term professional development institutes and community-focused institutional trainings. Until recently, there have not been extensive dedicated opportu...
Source: Current HIV/AIDS Reports - March 11, 2021 Category: Infectious Diseases Source Type: research
Gut Innate Immunity and HIV Pathogenesis
AbstractPurpose of ReviewIn the gastro-intestinal tract, the complex network of multiple innate cell populations play critical roles not only as a first line of defense against invading pathogens and in driving adaptive immune responses but also in maintaining intestinal homeostasis. Here, we describe the roles of various innate immune cell populations in gut immunity and detail studies investigating the impact of acute and chronic HIV infection on these cell populations.Recent FindingsAlterations in frequencies, phenotype and/or function of innate lymphoid cells, dendritic cells, macrophages, neutrophils, and innate-like ...
Source: Current HIV/AIDS Reports - March 9, 2021 Category: Infectious Diseases Source Type: research
Machine Learning and Clinical Informatics for Improving HIV Care Continuum Outcomes
AbstractPurpose of ReviewThis manuscript reviews the use of electronic medical record (EMR) data for HIV care and research along the HIV care continuum with a specific focus on machine learning methods and clinical informatics interventions.Recent FindingsEMR-based clinical decision support tools and electronic alerts have been effectively utilized to improve HIV care continuum outcomes. Accurate EMR-based machine learning models have been developed to predict HIV diagnosis, retention in care, and viral suppression. Natural language processing (NLP) of clinical notes and data sharing between healthcare systems and public h...
Source: Current HIV/AIDS Reports - March 4, 2021 Category: Infectious Diseases Source Type: research
