Voluntary Medical Male Circumcision for HIV Prevention: a Global Overview
AbstractPurpose of ReviewWith the promise of HIV prevention, there has been a scale-up of voluntary medical male circumcision (VMMC) in high HIV incidence/low circumcision prevalence nations worldwide. Nonetheless, debates over the implementation and the effectiveness and safety of the VMMC in real-world settings persist. We revisit the role of VMMC in HIV prevention to inform health professionals, policymakers, and advocates or opponents in this new era.Recent FindingsThere has been substantial progress on VMMC scale-up to date, but this has varied considerably by region. The evidence of solid and direct protection of VMM...
Source: Current HIV/AIDS Reports - November 8, 2022 Category: Infectious Diseases Source Type: research
Consolidated Overview of Notifiable Adverse Events in the U.S. President ’s Emergency Plan for AIDS Relief’s Voluntary Medical Male Circumcision Program Through 2020
AbstractPurpose of ReviewThrough December 2020, the U.S. President ’s Emergency Plan for AIDS Relief (PEPFAR) supported more than 25 million voluntary medical male circumcisions (VMMC) as part of the combined HIV prevention strategy in 15 African countries. PEPFAR monitors defined adverse events (AEs) occurring within 30 days of VMMC through its notifiable adver se event reporting system (NAERS). All NAERS reports through December 2020 were reviewed to quantify AE type, severity, and relation to the VMMC procedure. Interventions to improve client safety based on NAERS findings are described.Recent FindingsFourteen count...
Source: Current HIV/AIDS Reports - November 8, 2022 Category: Infectious Diseases Source Type: research
Voluntary Medical Male Circumcision for HIV Prevention: a Global Overview
AbstractPurpose of ReviewWith the promise of HIV prevention, there has been a scale-up of voluntary medical male circumcision (VMMC) in high HIV incidence/low circumcision prevalence nations worldwide. Nonetheless, debates over the implementation and the effectiveness and safety of the VMMC in real-world settings persist. We revisit the role of VMMC in HIV prevention to inform health professionals, policymakers, and advocates or opponents in this new era.Recent FindingsThere has been substantial progress on VMMC scale-up to date, but this has varied considerably by region. The evidence of solid and direct protection of VMM...
Source: Current HIV/AIDS Reports - November 8, 2022 Category: Infectious Diseases Source Type: research
Consolidated Overview of Notifiable Adverse Events in the U.S. President ’s Emergency Plan for AIDS Relief’s Voluntary Medical Male Circumcision Program Through 2020
AbstractPurpose of ReviewThrough December 2020, the U.S. President ’s Emergency Plan for AIDS Relief (PEPFAR) supported more than 25 million voluntary medical male circumcisions (VMMC) as part of the combined HIV prevention strategy in 15 African countries. PEPFAR monitors defined adverse events (AEs) occurring within 30 days of VMMC through its notifiable adver se event reporting system (NAERS). All NAERS reports through December 2020 were reviewed to quantify AE type, severity, and relation to the VMMC procedure. Interventions to improve client safety based on NAERS findings are described.Recent FindingsFourteen count...
Source: Current HIV/AIDS Reports - November 8, 2022 Category: Infectious Diseases Source Type: research
Evidence for Implementation: Management of TB in HIV and Pregnancy
AbstractPurpose of
ReviewPregnant people living with HIV (PLWH) are at especially high risk for progression from latent tuberculosis infection (LTBI) to active tuberculosis (TB) disease. Among pregnant PLWH, concurrent TB increases the risk of complications such as preeclampsia, intrauterine fetal-growth restriction, low birth weight, preterm-delivery, perinatal transmission of HIV, and admission to the neonatal intensive care unit. The grave impact of superimposed TB disease on maternal morbidity and mortality among PLWH necessitates clear guidelines for concomitant therapy and an understanding of the pharmacokinetics...
Source: Current HIV/AIDS Reports - October 29, 2022 Category: Infectious Diseases Source Type: research
How Does Voluntary Medical Male Circumcision Reduce HIV Risk?
AbstractPurpose of ReviewVoluntary medical male circumcision (VMMC) is a surgical procedure that reduces HIV acquisition risk by almost two-thirds. However, global implementation is lagging, in part due to VMMC hesitancy. A better understanding of the mechanism(s) by which this procedure protects against HIV may increase acceptance of VMMC as an HIV risk reduction approach among health care providers and their clients.Recent FindingsHIV acquisition in the uncircumcised penis occurs preferentially across the inner foreskin tissues, due to increased susceptibility that is linked to elevated inflammatory cytokine levels in th...
Source: Current HIV/AIDS Reports - October 29, 2022 Category: Infectious Diseases Source Type: research
Evidence for Implementation: Management of TB in HIV and Pregnancy
AbstractPurpose of
ReviewPregnant people living with HIV (PLWH) are at especially high risk for progression from latent tuberculosis infection (LTBI) to active tuberculosis (TB) disease. Among pregnant PLWH, concurrent TB increases the risk of complications such as preeclampsia, intrauterine fetal-growth restriction, low birth weight, preterm-delivery, perinatal transmission of HIV, and admission to the neonatal intensive care unit. The grave impact of superimposed TB disease on maternal morbidity and mortality among PLWH necessitates clear guidelines for concomitant therapy and an understanding of the pharmacokinetics...
Source: Current HIV/AIDS Reports - October 29, 2022 Category: Infectious Diseases Source Type: research
How Does Voluntary Medical Male Circumcision Reduce HIV Risk?
AbstractPurpose of ReviewVoluntary medical male circumcision (VMMC) is a surgical procedure that reduces HIV acquisition risk by almost two-thirds. However, global implementation is lagging, in part due to VMMC hesitancy. A better understanding of the mechanism(s) by which this procedure protects against HIV may increase acceptance of VMMC as an HIV risk reduction approach among health care providers and their clients.Recent FindingsHIV acquisition in the uncircumcised penis occurs preferentially across the inner foreskin tissues, due to increased susceptibility that is linked to elevated inflammatory cytokine levels in th...
Source: Current HIV/AIDS Reports - October 29, 2022 Category: Infectious Diseases Source Type: research
Trends and Clinical Characteristics of HIV and Cerebrovascular Disease in Low- and Middle-Income Countries (LMICs) Between 1990 and 2021
AbstractPurpose of the ReviewTo describe trends and clinical characteristics of HIV and cerebrovascular disease between 1990 and 2021 in LMICs and identify the gaps in our understanding.Recent FindingsIn the era of antiretroviral therapy (ART), people living with HIV (PLWH) live longer and risk excess cerebrovascular events due to ageing and HIV-driven factors. Despite the highest burden of HIV infection in low-to-middle income countries, there is underreporting in the literature of cerebrovascular events in this population. We systematically reviewed published literature for primary clinical studies in adult PLWH and cere...
Source: Current HIV/AIDS Reports - October 20, 2022 Category: Infectious Diseases Source Type: research
Lessons for Understanding Central Nervous System HIV Reservoirs from the Last Gift Program
AbstractPurpose of ReviewDeep tissue HIV reservoirs, especially within the central nervous system (CNS), are understudied due to the challenges of sampling brain, spinal cord, and other tissues. Understanding the cellular characteristics and viral dynamics in CNS reservoirs is critical so that HIV cure trials can address them and monitor the direct and indirect effects of interventions. The Last Gift program was developed to address these needs by enrolling altruistic people with HIV (PWH) at the end of life who agree to rapid research autopsy.Recent FindingsRecent findings from the Last Gift emphasize significant heteroge...
Source: Current HIV/AIDS Reports - October 19, 2022 Category: Infectious Diseases Source Type: research
Long-Acting Injectable Cabotegravir for HIV Prevention: What Do We Know and Need to Know about the Risks and Consequences of Cabotegravir Resistance?
AbstractPurpose of ReviewCabotegravir is a potent integrase strand transfer inhibitor (INSTI) recently approved as a long-acting injectable formulation for HIV prevention (CAB-LA). We summarize what is known about cabotegravir pharmacokinetics, activity, and emergence of resistance from in vitro, macaque and clinical studies, and we evaluate the risk of resistance from CAB-LA with on-time injections and after CAB-LA discontinuation.Recent FindingsThe accumulation of multiple INSTI mutations is required for high-level cabotegravir resistance, and the same mutation combinations may cause cross-resistance to dolutegravir, whi...
Source: Current HIV/AIDS Reports - October 1, 2022 Category: Infectious Diseases Source Type: research
Ingestible Electronic Sensors for Monitoring Real-time Adherence to HIV Pre-exposure Prophylaxis and Antiretroviral Therapy
AbstractPurpose of ReviewThis review summarizes the recent advancements and future directions of digital pill systems (DPS) — which utilize ingestible sensors to directly measure medication ingestion events in real-time — in the context of HIV prevention and treatment.Recent FindingsTwo DPS are cleared by the US Food and Drug Administration. The bioequivalence and stability of digitized pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) have been established, and pilot studies have demonstrated the feasibility and acceptability of using DPS for PrEP and ART adherence measurement. Important bioethical and ...
Source: Current HIV/AIDS Reports - October 1, 2022 Category: Infectious Diseases Source Type: research
