United Nations Programme On HIV/AIDS Research Articles

Pretreatment and acquired HIV drug resistance in Belize—results of nationally representative surveys, 2021–22

Abstract Background The rising prevalence of pretreatment drug resistance (PDR) to non-nucleoside reverse-transcriptase inhibitors threatens the effectiveness of ART. In response, the WHO recommends dolutegravir-based ART regimens due to their high genetic barrier to resistance and better treatment outcomes. This is expected to contribute to achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) target of 95% viral suppression in people on ART. Objectives To estimate the prevalence of PDR among adults initiating ART and assess viral suppression and acquired HIV drug resistance (ADR) among individuals receiving ART in Belize. Patients and methods Nationally representative cross-sectional PDR and ADR surveys were conducted between 2021 and 2022. Sixty-seven adults were included in the PDR survey, and 43 children and adolescents and 331 adults were included in the ADR survey. Demographic and clinic data and blood specimens were collected. HIV drug resistance (HIVDR) was predicted using the Stanford HIVdb tool. Results The prevalence of PDR to efavirenz or nevirapine in adults was 49.3% (95% CI 42.2%–56.4%) and was significantly higher in those with previous antiretroviral exposure (OR: 7.16; 95% CI 2.71–18.95; P = 0.002). Among children and adolescents receiving ART, 50.0% had viral suppression, with better rates for those receiving dolutegravir-based ART (OR: 5.31; 95% CI 3.02–9.34; P < 0.001). In adults, 79.6% achieved viral suppression. No resistance to integrase inhibitors was observed in those on dolutegravir-based ART. Conclusions Prioritizing dolutegravir-based ART is critical for achieving HIV epidemic control in Belize. Efforts should focus on retention in care and adherence support to prevent HIVDR.

Missed opportunities for guidance on sexually transmitted infection services: a global review of national HIV PrEP guidance

ObjectivesPeople who use or would benefit from pre-exposure prophylaxis (PrEP) for HIV infection are disproportionately affected by sexually transmitted infections (STIs). Integrating STI services when offering PrEP fosters synergies and...

HIV outbreak in Pakistan - a wakeup call?

Human immune-deficiency virus (HIV) is a global threat with an estimated 38.6 million people being previously infected while 25 million of them have succumbed to the disease. In Pakistan, since 2004, there has been a 50-fold increase from 2700 to 130,000 in the number of people infected with HIV, while Sub- Saharan Africa alone bears the heaviest burden of HIV having 25 million infected individuals. Considering these devastating numbers, it was alarming to find that in June 2019, 751 new cases of HIV were diagnosed in Larkana, in the province of Sindh, Pakistan. Therefore, to make sure that the efforts of international institutions like The Joint United Nations Programme on HIV/AIDS (UNAIDS) which are trying to effectively reduce the spread of HIV are such regions is streamlined it is extremely important to highlight some of the underlying causes which are endemic to such regions such as re-using of blades by barbers and the practice of re-using needles by un-licensed medical practitioners offering miraculous cures. It is also equally important to suggest and re-iterate possible ways in which this situation, which is rapidly worsening, can be improved.

Community contexts and knowledge: accountability, leadership and meaningful involvement of communities in Programme Science.

A Programme Science approach that prioritizes populations who will benefit most and ensuring resources are allocated to programmes that meet the needs of those populations will bring an equity focus to research. Gay men and other men who have sex with men, people who use drugs, sex workers of all genders, and trans and gender-diverse people, defined by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) as key populations, have been disproportionately impacted since the start of the HIV pandemic. Through documenting community experiences from global key population-led networks, the authors explore the potential value and impact of community-led organizations and service delivery as critical components in effective HIV and Sexually Transmitted infections (STI) programmes. Through advocacy and research interventions, global key population networks have identified barriers against scaling up interventions for criminalized and marginalized communities, as well as highlighted solutions. The authors examine some of the current barriers to meaningful involvement of communities and the scaling up of community-led programmes that need to be addressed if Programme Science is to maintain an equity lens and the needs of key populations are to be met and highlight the need to make visible community engagement and participation in embedded research and Programme Science. The Programme Science approach provides an important opportunity to understand practical issues that will increase effective coverage in the implementation of public health and other interventions, which will require the prioritizing of key populations and their priorities in HIV and STI programmes. It will require extensive time and work to build relationships, increase capacity and share power. Where this has already happened, it has resulted in positive outcomes, including better health outcomes, reduced stigma, increased agency for key populations, and built community-led organizations and responses.

The HepHIV 2023 Madrid conference: A call to action for political leadership in reaching the sustainable development goals on earlier testing and linkage to care for HIV, viral hepatitis, and sexually transmitted infections.

The HepHIV 2023 Conference, held in Madrid in November 2023, highlighted how Europe is not on track to meet the United Nations (UN) sustainable development goals and Joint UN Programme on HIV/AIDS (UNAIDS) targets. This article presents the outcomes of the conference, which focus on ways to improve testing and linkage to care for HIV, viral hepatitis, and other sexually transmitted infections. HIV-related stigma and discrimination, a major barrier to progress, was a key concept of the conference and on the agenda of the Spanish Presidency of the European Union. The HepHIV 2023 organizing committee, alongside the Spanish Ministry of Health, oversaw the conference organization and prepared the scientific programme based on abstract rankings. Key outcomes are derived from conference presentations and discussions. Conference presentations covered the obstacles that HIV-related stigma and discrimination continue to pose to access to services, models for data collection to better monitor progress in the future, and examples of legislative action that can be taken at national levels. Diversification of testing approaches was also highlighted, to reach key populations, (e.g. migrant populations), to increase testing offered in healthcare settings (e.g. emergency departments), and to account for different stages of epidemics across the region. With a strong call for intensified action to address the impact of HIV-related stigma and discrimination on testing uptake, the conference concluded that strengthened collaboration is required between governments and implementers around testing and linkage to care. There is also an ongoing need to ensure sustainable political commitment and appropriate resource allocation to address gaps and inequalities in access for key populations and to focus on the implementation of integrated responses to HIV, viral hepatitis, and sexually transmitted infections.

Spatiotemporal Analysis of HIV/AIDS Incidence in China From 2009 to 2019 and Its Association With Socioeconomic Factors: Geospatial Study.

The Joint United Nations Program on HIV/AIDS (UNAIDS) has set the "95-95-95" targets to ensure that 95% of all people living with HIV will know their HIV status, 95% of all people living with HIV will receive sustained antiretroviral therapy (ART), and 95% of all people receiving ART will achieve viral suppression (<1000 copies/mL). However, few countries have currently achieved these targets, posing challenges to the realization of the UNAIDS goal to eliminate the global HIV/AIDS epidemic by 2030. The Chinese government has implemented corresponding policies for HIV/AIDS prevention and control; however, it still faces the challenge of a large number of HIV/AIDS cases. Existing research predominantly focuses on the study of a particular region or population in China, and there is relatively limited research on the macro-level analysis of the spatiotemporal distribution of HIV/AIDS across China and its association with socioeconomic factors. This study seeks to identify the impact of these factors on the spatiotemporal distribution of HIV/AIDS incidence in China, aiming to provide scientific recommendations for future policy development. This study employed ArcGIS 10.2 (Esri) for spatial analysis, encompassing measures such as the imbalance index, geographical concentration index, spatial autocorrelation analysis (Moran I), and hot spot analysis (Getis-Ord Gi*). These methods were used to unveil the spatiotemporal distribution characteristics of HIV/AIDS incidence in 31 provinces of China from 2009 to 2019. Geographical Detector was used for ecological detection, risk area detection, factor detection, and interaction detection. The analysis focused on 9 selected socioeconomic indicators to further investigate the influence of socioeconomic factors on HIV/AIDS incidence in China. The spatiotemporal distribution analysis of HIV/AIDS incidence in China from 2009 to 2019 revealed distinct patterns. The spatial distribution type of HIV/AIDS incidence in China was random in 2009-2010. However, from 2011 to 2019, the distribution pattern evolved toward a clustered arrangement, with the degree of clustering increasing each year. Notably, from 2012 onwards, there was a significant and rapid growth in the aggregation of cold and hot spot clusters of HIV/AIDS incidence in China, stabilizing only by the year 2016. An analysis of the impact of socioeconomic factors on HIV/AIDS incidence in China highlighted the "urbanization rate" and "urban basic medical insurance fund expenditure" as the primary factors influencing the spatial distribution of HIV/AIDS incidence. Additionally, among social factors, indicators related to medical resources exerted a crucial influence on HIV/AIDS incidence. From 2009 to 2019, HIV/AIDS incidence in China was influenced by various socioeconomic factors. In the future, it is imperative to optimize the combination of different socioeconomic indicators based on regional incidence patterns. This optimization will facilitate the formulation of corresponding policies to address the challenges posed by the HIV/AIDS epidemic.

Lower Prevalence Countries Outside of South-Eastern Africa Now Have the Fastest Growing HIV Epidemic.

The United Nations Program on HIV/AIDS (UNAIDS) targets aim to reduce new HIV infections below 370 000 annually by 2025. However, there were 1.3 million new HIV infections worldwide in 2022. We collected and analyzed data for key variables of the HIV epidemic from UNAIDS and supplemented by PUBMED/EMBASE searches and national reports. A total of 53% of the HIV infections worldwide were in 14 high-prevalence countries in Southern/East Africa-where most of the funding for treatment and prevention is allocated-versus 47% in 54 low-prevalence countries. In 2022, there were more new HIV infections (770 000 vs 468 000), more HIV-related deaths (383 000 vs 225 000), higher rates of mother-to-child transmissions (16% vs 9%) and lower antiretroviral therapy coverage (67% vs 83%) in low-prevalence countries versus high-prevalence countries. To achieve UNAIDS annual new infections target for 2025, ART coverage needs to be optimized worldwide, and preexposure prophylaxis coverage expanded to 74 million people, versus 2.5 million currently treated.

HIV self-testing strategy: implementation in Latin America and Mexico. Where are we going

HIV/AIDS emerged in the 1980s and created an urgent need for detection tests. Laboratory tests to detect HIV antibodies in blood samples were developed, followed by rapid tests in the 1990s. In the 2000s, HIV self-testing kits were introduced, improving accuracy and ease of use. Self-testing has become crucial in the fight against HIV. By 2030, the United Nations Programme on HIV/AIDS (UNAIDS) sets goals for detection and treatment. Despite progress, challenges such as stigma and education persist. In Latin America, national self-testing programs are being implemented, such as in Chile, Brazil, and Colombia. In Mexico, the approval of self-tests in 2024 represents a significant advancement. Self-tests are expected to be widely used to detect the disease early, ensuring privacy and reducing stigma and discrimination. They will also be used for research in vulnerable groups and to refer patients to pre-exposure prophylaxis (PrEP) services. With these actions, the aim is to achieve the goals set by UNAIDS and improve public health in the fight against HIV.

Effectiveness of human immunodeficiency virus prevention strategies by mapping the geographic dispersion pattern of human immunodeficiency virus prevalence in Nanning, China

BackgroundThe Guangxi government initiated two rounds of the Guangxi AIDS Conquering Project (GACP) in 2010 (Phase I) and 2015 (Phase II) to control human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemics. However, the effectiveness of GACP in HIV prevention and treatment has rarely been reported. This study aimed to assess the effectiveness of the GACP implemented in Guangxi, China and provide data for strategy and praxis improvements to achieve Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95 targets.MethodsWe used spatial approaches to trace the spatiotemporal distribution properties, epidemic trends, and correlation between macroscopic factors and HIV incidence using data from the Chinese HIV/AIDS case reporting system to explore the effects of the GACP.ResultsDuring the GACP era, the HIV epidemic stabilized in urban centers, showing a downward trend in the Hengzhou and Binyang Counties in the eastern region, whereas it continued to increase in rural areas of the northwest region, such as the Long’an, Mashan, Shanglin, and Wuming Districts. The linear directional mean (LDM) of HIV infection reported cases displayed a southeast–northwest direction, with an LDM value of 12.52°. Compared with that in Phase I, Hengzhou withdrew from the high-high clustering area, and the west–north suburban counties pulled out the low-low clustering area during Phase II. Significant HIV clusters were identified in the eastern region during Phase I, whereas these clusters emerged in the northwestern areas during Phase II. Regarding HIV, socioeconomic status, population mobility, and medical care levels were the key social drivers of heterogeneous spatial distribution.ConclusionsThe GACP assisted in effectively managing the HIV epidemic in urban and eastern areas of Nanning City. However, prevention and control efforts in rural regions, particularly those located in the northwest, may not have yielded comparable outcomes. To address this disparity, allocating additional resources and implementing tailored intervention measures for these rural areas are imperative.

Optimizing health resource allocation for improving timely HIV diagnosis in China.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) updated the 95-95-95 targets for the HIV endgame in 2030. To achieve the first target in a timely manner, we investigate the optimized strategy of resource allocation to maximize timely HIV diagnosis in 14 populations in China. We developed a mathematical model by integrating epidemiological, demographical and behavioural data from 12 high-risk and two general populations to evaluate the impact of various resource allocation strategies of HIV testing on HIV incidence in China. We identified the optimized allocation strategy that maximizes the number of HIV diagnoses at an estimated total spending on HIV tests in China and calculated the per-capita cost of new HIV case detection. We estimated that 144,795 new HIV cases may occur annually in 14 populations in China, with a total annual spending of US$2.8 billion on HIV testing. The largest proportion of spending was allocated to general males (44.0%), followed by general females (42.6%) and pregnant women (5.1%). Despite this allocation strategy, only 45.5% (65,867/144,795, timely diagnosis rate) of annual new infections were diagnosed within a year of acquisition, with a cost of $42,852 required for each new HIV case detection. By optimizing the allocation of HIV testing resources within the same spending amount, we found that general females received the highest proportion of spending allocation (45.1%), followed by low-risk men who have sex with men (13.9%) and pregnant women (8.4%). In contrast, the proportion of spending allocation for the general males decreased to 0.2%. With this optimized strategy, we estimated that 120,755 (83.4%) of annual new infections would be diagnosed within a year of acquisition, with the cost required for one HIV case detection reduced to $23,364/case. Further spending increases could allow for significant increases in HIV testing among lower-risk populations. Optimizing resource allocation for HIV testing in high-risk populations would improve HIV timely diagnosis rate of new infections and reduce cost per HIV case detection.

How Reliable is ChatGPT as a Novel Consultant in Infectious Diseases and Clinical Microbiology?

The study aimed to investigate the reliability of ChatGPT's answers to medical questions, including those sourced from patients and guide recommendations. The focus was on evaluating ChatGPT's accuracy in responding to various types of infectious disease questions. The study was conducted using 200 questions sourced from social media, experts, and guidelines related to various infectious diseases like urinary tract infection, pneumonia, HIV, various types of hepatitis, COVID-19, skin infections, and tuberculosis. The questions were arranged for clarity and consistency by excluding repetitive or unclear ones. The answers were based on guidelines from reputable sources like the Infectious Diseases Society of America (IDSA), Centers for Disease Control and Prevention (CDC), European Association for the Study of Liver Disease (EASL) and Joint United Nations Programme on HIV/AIDS (UNAIDS) AIDSinfo. According to the scoring system, completely correct answers were given 1-point, and completely incorrect ones were given 4-points. To assess reproducibility, each question was posed twice on separate computers. Repeatability was determined by the consistency of the answers' scores. In the study, ChatGPT was posed with 200 questions: 107 from social media platforms and 93 from guidelines. The questions covered a range of topics: urinary tract infections (n=18 questions), pneumonia (n=22), HIV (n=39), hepatitis B and C (n=53), COVID-19 (n=11), skin and soft tissue infections (n=38), and tuberculosis (n=19). The lowest accuracy was 72% for urinary tract infections. ChatGPT answered 92% of social media platform questions correctly (scored 1-point) versus 69% of guideline questions (p=0.001; OR=5.48, 95% CI=2.29-13.11). Artificial intelligence is widely used in the medical field by both healthcare professionals and patients. Although ChatGPT answers questions from social media platforms quite properly, we recommend that healthcare professionals be conscientious when using it.

Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review.

Targeted interventions for key populations remain critical for realisation of epidemic control for human immunodeficiency virus (HIV) infection because of the causal relationship between HIV infection in the general population and among key population groups. To consolidate evidence on the fast-track interventions towards achieving HIV epidemic control among key populations. A rapid scoping review was conducted using the methodological framework by Arksey and O' Malley. The Population, Intervention, Context and Outcome (PICO) framework was used to identify relevant studies using key words with Boolean operators in electronic data bases, namely CINHAL, Web of Science, Psych Info and Sabinet. Studies were extracted using a modified data extraction tool, and results were presented narratively. A total of 19 articles were included in this review. Most articles were primary studies (n = 17), while another involved the review of existing literature and policies (n = 2) and routinely collected data (n = 1). Most studies were conducted in the United States of America (n = 6), while another were conducted in China, Kenya, Botswana, South Africa and Mozambique. All studies revealed findings on tested interventions to achieve HIV epidemic control among key populations. Effective interventions for HIV epidemic control were stand-alone behavioural preventive interventions, stand-alone biomedical preventive strategies and combination prevention approaches. Furthermore, the findings suggest that effective activities to achieve HIV epidemic control among key populations should be centred around prevention.Contribution: The findings of this study have policy and practice implications for high HIV burden settings such as South Africa in terms of interventions to facilitate realisation of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets, thereby contributing to HIV epidemic control.

Unravelling the experiences of incarcerated individuals living with HIV on ART: a qualitative study in Ghanaian prisons

PurposeThe Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy.Design/methodology/approachThe study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software.FindingsThree themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother’s keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality.Originality/valueThrough first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.

Comparison of Empirically Derived and Model-Based Estimates of Key Population HIV Incidence and the Distribution of New Infections by Population Group in Sub-Saharan Africa.

The distribution of new HIV infections among key populations, including female sex workers (FSWs), gay men and other men who have sex with men (MSM), and people who inject drugs (PWID) are essential information to guide an HIV response, but data are limited in sub-Saharan Africa (SSA). We analyzed empirically derived and mathematical model-based estimates of HIV incidence among key populations and compared with the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates. We estimated HIV incidence among FSW and MSM in SSA by combining meta-analyses of empirical key population HIV incidence relative to the total population incidence with key population size estimates (KPSE) and HIV prevalence. Dynamic HIV transmission model estimates of HIV incidence and percentage of new infections among key populations were extracted from 94 country applications of 9 mathematical models. We compared these with UNAIDS-reported distribution of new infections, implied key population HIV incidence and incidence-to-prevalence ratios. Across SSA, empirical FSW HIV incidence was 8.6-fold (95% confidence interval: 5.7 to 12.9) higher than total population female 15-39 year incidence, and MSM HIV incidence was 41.8-fold (95% confidence interval: 21.9 to 79.6) male 15-29 year incidence. Combined with KPSE, these implied 12% of new HIV infections in 2021 were among FSW and MSM (5% and 7% respectively). In sensitivity analysis varying KPSE proportions within 95% uncertainty range, the proportion of new infections among FSW and MSM was between 9% and 19%. Insufficient data were available to estimate PWID incidence rate ratios. Across 94 models, median proportion of new infections among FSW, MSM, and PWID was 6.4% (interquartile range 3.2%-11.7%), both much lower than the 25% reported by UNAIDS. Empirically derived and model-based estimates of HIV incidence confirm dramatically higher HIV risk among key populations in SSA. Estimated proportions of new infections among key populations in 2021 were sensitive to population size assumptions and were substantially lower than estimates reported by UNAIDS.

Updated Data and Methods for the 2023 UNAIDS HIV Estimates.

Each year, supported by the Joint United Nations Programme on HIV/AIDS (UNAIDS), country teams across the globe produce estimates that chart the state of their HIV epidemics. In 2023, HIV estimates were available for 174 countries, accounting for 99% of the global population, of which teams from 150 countries actively engaged in this process. The methods used to derive these estimates are developed under the guidance of the UNAIDS Reference Group on Estimates, Modeling, and Projections (www.epidem.org). Updates to these methods and epidemiological analyses that inform parameters and assumptions are documented in this supplement.

Piloting the Impact of an e-Learning on Knowledge About HIV Prevention and Prophylaxis Among General Practitioners in Belgium.

The Joint United Nations Program on HIV/AIDS (UNAIDS) has set a goal to eliminate AIDS as a public health threat by 2030 and the World Health Organization emphasized pre-exposure prophylaxis (PrEP) as a crucial element. Despite the lack of a specific role for general practitioners (GPs) in PrEP care, GPs could play a crucial role in the follow-up but this is still uncommon. Above, GPs estimate their knowledge about PrEP as low. This study seeks to understand the knowledge of GPs regarding PrEP care. Through online e-learning, we aimed to enhance our knowledge of PrEP care. Firstly, we assessed general knowledge about the PrEP of GPs. Secondly, we investigated the impact of e-learning on knowledge of PrEP care among GPs. We developed a multiple-choice questionnaire to evaluate self-assessed knowledge and knowledge about PrEP. One group of participants completed an e-learning module and took a pre- and post-test to assess changes in knowledge. Another group completed the questionnaire without e-learning. Seventy-two participants completed the survey. Finally, 18 participants successfully completed the e-learning module. Nineteen percent (n = 14) of all GPs considered their general knowledge of PrEP to be "good," while 68% (n = 49) of the GPs felt confident in identifying patients at risk, rating their ability as "good." Participants achieved an average score of 4.7 (test group) and 4.6 (e-learning group) out of 10 on the knowledge test. After completion of the e-learning, the overall average score of the e-learning group significantly increased by 33% (p-value < .03). GP generally scored low on knowledge covering different aspects of PrEP. However, after completing an e-learning module, there was a significant increase in the average test scores. These findings highlight the potential efficacy of targeted educational interventions in enhancing the understanding of PrEP among GPs.

HIV prevalence and associated factors among married women, Mozambique, 2015: analysis of the 2015 National AIDS Indicator Survey (IMASIDA).

epidemiological estimates from the 2021 Joint United Nations Program on HIV/AIDS (UNAIDS) emphasize the existing gender disparities, where women face a higher risk of HIV/AIDS exposure. In Mozambique, as of 2021, the HIV prevalence rate among the adult population stood at 12.5%, with an even more concerning rate of 15.4% among women of reproductive age. a cross-sectional study was carried out with secondary data from the Survey on National Indicators of Vaccination, Malaria, and HIV/AIDS (IMASIDA 2015), where we included married women, both civil marriage and common law marriage of reproductive age 15-49 years. Statistical analyses, including chi-squared tests and logistic regression models, accounting for survey design, were employed to assess associations. the study findings showed that HIV prevalence was higher among married women aged 35-49 years (aOR=2.5; 95% CI: 1.3-4.6; p=0.005), those without formal education (aOR=7.7; 95% CI: 1.1-52.9; p=0.038) and those with primary education (aOR=9.8; 95% CI: 1.6-60.1; p=0.014), those who experienced domestic violence (aOR=1.8; 95% CI: 1.0-3.2; p=0.04), had an uncircumcised partner (aOR=1.9; 95% CI: 1.2-3.1; p=0.008), and had three or more lifetime sex partners (aOR=3.6; 95% CI: 2.9-7.3; p<0.001). Women who were in one lifelong union had a lower risk of HIV positivity (aOR=0.5; 96%CI: 0.3-0.8, p=0.005). the findings of this study highlight sociodemographic, behavioral, and violent factors associated with HIV prevalence among women. These findings underscore the importance of targeted interventions and education programs aimed at reducing HIV transmission among females and promoting safer sexual practices.

Assessment of Routine Viral Load Monitoring Services and Performance of HIV Projects. A Case of Health Facilities in Nairobi County, Kenya

Antiretroviral therapy (ART) is a cornerstone of HIV management, and viral load testing serves as the gold standard for assessing drug effectiveness and confirming treatment adherence. The objectives set by The Joint United Nations Programme on HIV/AIDS (UNAIDS) for HIV care and treatment still encounter challenges, particularly in achieving improved access to ART and associated services, including essential laboratory viral load monitoring. This study investigated gaps in routine viral load monitoring within the 95-95-95 cascade, with particular emphasis on the final 95%, which remains unattained across individual, programmatic, and population levels. The research adopted a cross-sectional survey design with a pragmatic approach, focusing on healthcare professionals providing HIV services in clinics in Nairobi. A proportional sample of 226 respondents was collected from a population of 550 to gather qualitative and quantitative data. The study yielded a 90% response rate, with 96% agreement among respondents. The findings revealed a moderately low but statistically significant positive correlation (r=0.479&lt;0.05). The R2 value of 0.230 explained 23.3% of project performance and displayed statistical significance (p-value=0.000&lt;0.05). Consequently, the null hypothesis was rejected, indicating a substantial relationship between routine viral load monitoring services and the performance of HIV projects. In light of these results, the study recommends the implementation of a combination of feasible strategies, tailored to differentiated care models, to address challenges in low-resource settings across various population groups. These strategies aim to enhance adherence and improve viral load suppression rates, thus promoting the objectives of HIV care and treatment.

Providing anti-retroviral treatment did not achieve the ambition of 'Joint united nations program on HIV/AIDS (UNAIDS) among HIV positive patient in Ethiopia': a systematic review and meta-analysis.

Antiretroviral Treatment (ART) has great importance in reducing viral load. Though a global effort was made to suppress viral load, the level of viral load suppression among ART patients is still high in Ethiopia. This study aims to assess the magnitude and contributing factors for viral load suppression among patients attending ART clinics in Ethiopia. The articles were searched using different databases using the guideline of reporting systematic review and meta-analysis (PRISMA). A random effect model was used to ascertain the pooled prevalence of viral load suppression in Ethiopia using STATA 14 software. The pooled prevalence of suppressed viral load was 75.25% (95% CI: 68.61-81.89). Having good adherence (OR: 2.71, 95% CI 2.27, 3.15), baseline CD4 count (OR: 1.74, 95% CI 1.53, 1.96), and being female (OR: 1.41, 95% CI 1.04, 1.79) were determinants of pooled estimates of suppressed viral load. The pooled prevalence of suppressed viral load was 75% which is lower than the targeted level by the sustainable development goal (SDG) 2020, which was 90%. Therefore, the stakeholders should be focused on the existing strategies to decrease viral load among ART patients. They should work to adhere to patients for ART treatment.

Estimates of the global burden of non-Hodgkin lymphoma attributable to HIV: a population attributable modeling study

Human immunodeficiency virus (HIV) significantly increases the risk of non-Hodgkin lymphoma (NHL) development, yet the population-level impact on NHL burden is unquantified. We aim to quantify this association and estimate the global burden of HIV-associated NHL. In this meta-analysis, we searched five databases (PubMed, EMBASE, Cochrane Library, Web of Science, Scopus) from database inception up to September 13, 2023, identifying cohort, case-control, or cross-sectional studies with an effective control group to assess NHL risk among individuals with HIV infection, with two authors extracting summary data from reports. Global and regional HIV-associated population attributable fraction (PAF) and NHL disease burden were calculated based on the pooled risk ratio (RR). HIV prevalence and NHL incidence were obtained from the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Trends in NHL incidence due to HIV were assessed using age-standardised incidence rate (ASIR) and estimated annual percentage change (EAPC). This study was registered with PROSPERO (CRD42023404150). Out of 14,929 literature sources, 39 articles met our inclusion criteria. The risk of NHL was significantly increased in the population living with HIV (pooled RR 23.51, 95% CI 17.62-31.37; I2=100%, p<0.0001), without publication bias. Globally, 6.92% (95% CI 2.18%-11.57%) of NHL new cases in 2019 were attributable to HIV infection (30,503, 95% CI 9585-52,209), which marked a more than three-fold increase from 1990 (8340, 95% CI 3346-13,799). The UNAIDS region of Eastern and Southern Africa was the highest affected region, with 44.46% (95% CI 19.62%-58.57%) of NHL new cases attributed to HIV infection. The Eastern Europe and Central Asia region experienced the highest increase in ASIR of NHL due to HIV in the past thirty years, wherein the EAPC was 8.74% (95% CI 7.66%-9.84%), from 2010 to2019. People with HIV infection face a significantly increased risk of NHL. Targeted prevention and control policies are especially crucial for countries in Eastern and Southern Africa, Eastern Europe and Central Asia, to achieve the UNAIDS's '90-90-90' Fast-Track targets. Limited studies across diverse regions and heterogeneity between research have hindered precise estimations for specific periods and regions. Sichuan Provincial People's Hospital, Chengdu, China; Health Care for Cadres of Sichuan Province, Chengdu, China; Science and Technology Department of Sichuan Province, Chengdu, China.