JAIDS Journal of Acquired Immune Deficiency Syndromes

HIV treatment can suppress viral load and prevent transmission between sex partners, a strategy known as treatment as prevention (TasP). TasP is key for ending the HIV epidemic, and it is important to understand its adoption among priority populations. We examined the TasP adoption cascade using cross-sectional survey data from 1443 U.S. men and transgender, gender-nonconforming, and nonbinary individuals who reported having sex with men. Most participants (82.4%; n = 1189/1443) reported prior a...

ObjectiveTo quantify trends in annual mean healthcare costs per person living with HIV from 2003 to 2018 from a publicly funded healthcare system perspective. DesignWe conducted a retrospective population-based study using administrative health data in Ontario, Canada, including 25,842 people living with HIV diagnosed and entering care between 1992 and 2018. A nested cohort from the Ontario HIV Treatment Network Cohort Study (n=3,516) provided additional HIV-related characteristics. MethodsAnn...

BackgroundRecipients of HIV pre-exposure prophylaxis (PrEP) experience higher rates of gonorrhea and chlamydia diagnoses than non-recipients. However, it is unclear if these observations reflect a causal relationship between PrEP initiation and acquisition of sexually transmitted infections (i.e., behavioral "risk compensation"), or alternatively a diagnostic bias related to PrEP recipients screening more frequently than non-recipients. MethodsWe conducted a self-controlled case series study co...

ImportanceAs the population living with HIV in the US ages, state-level projections of the aging dynamics among people with diagnosed HIV (PWDH) will be needed to inform local planning and intervention efforts. ObjectiveWe sought to explore how aging dynamics of the population with HIV in the US are expected to differ at the state level between 2025 and 2040. Design, Setting, and ParticipantsWe projected epidemic trajectories from 2025 to 2040 in 24 US states comprising 86% of PWDH in the US u...

ImportanceAs the population of older people with HIV (PWH) in the US is growing, costs to Medicare are expected to rise substantially. ObjectivesTo project the number of Medicare beneficiaries with HIV aged 65y+ on ART in the US from 2026-2035 and the budget impact on Medicare. Design, Setting, and ParticipantsWe developed the novel CHARMED simulation model and projected the number of Medicare beneficiaries with HIV aged 65y+ on ART and associated costs from 2026 to 2035; we populated the mode...

BackgroundFemale sex workers (FSW) are a key population for HIV prevention and care. Increasing evidence suggests that social and structural barriers are key drivers of HIV transmission. This global systematic review assesses whether experiencing violence is associated with worse HIV outcomes among FSW. Methods and FindingsWe searched MEDLINE, Embase, and PsycINFO databases for studies published from January 1st, 2010 to February 10th, 2025 assessing the impact of violence on HIV outcomes among...

The advent of antiretroviral therapy (ART) has led to substantial increases in life expectancy among persons with diagnosed HIV (PWDH), and in turn, an increasingly older population. This represents a public health challenge, as older PWDH are more susceptible to age-related health morbidities compared to the general population. In this study, we triangulate diverse data sources to reconstruct the Italian PWDH age structure over the past decade to better-understand recent trends, and provide dem...

ObjectiveTo evaluate risk of dementia after cancer diagnosis among Medicaid beneficiaries with HIV. DesignLongitudinal observational study of Medicaid enrollment, inpatient, and outpatient claims data from 14 states, 2001-2015. MethodsBeneficiaries aged 18-64 with HIV and [≥]6 months of enrollment were matched 1:1 on cancer status by age, sex, race, year, and state. We estimated the weighted cumulative incidence functions (CIFs) of dementia at 1, 2, and 5 years after cancer diagnosis using ...

ObjectivesEstimate the HIV testing, diagnoses, and test positivity rates among Medicaid beneficiaries in 2016-2021 and assess the impact of the COVID-19 pandemic on these outcomes. DesignProspective observational study of Medicaid enrollment, inpatient, and outpatient claims data from 27 states, 2016-2021. MethodsWe assessed Medicaid claims from adult beneficiaries with full benefits whose first continuous enrollment was [≥]6 months without dual enrollment in other insurance, and without pr...

BackgroundPeople with HIV (PWH) experience an increased burden of cardiovascular disease (CVD), partly driven by chronic immune activation despite antiretroviral therapy (ART). Tuberculosis (TB), a frequent co-infection, may leave persistent inflammatory sequelae even after cure, potentially accelerating hypertension and cardiovascular risk. Evidence on long-term cardiometabolic consequences of prior TB in virally suppressed PWH, particularly sex-specific effects, remains limited. MethodsIn a p...

BackgroundLoss to follow-up (LTFU) undermines the success of antiretroviral therapy (ART) programs, especially in high HIV prevalence regions like Njombe, Tanzania. Understanding factors influencing LTFU is critical to enhance patient retention. AimTo assess the prevalence and predictors of LTFU among people living with HIV (PLHIV) receiving ART in Njombe, Tanzania, from 2017 to 2021 MethodsWe conducted a retrospective cohort study using the National Care and Treatment Clinic (CTC2) database, ...

HIV testing remains the primary entry point to HIV prevention, treatment, and care. Although Zambia has made substantial progress in its HIV response, men remain less consistently reached by HIV testing services. This study assessed trends and determinants of HIV testing uptake among men aged 15-59 years in Zambia using repeated nationally representative survey data. We pooled mens data from the Zambia Demographic and Health Surveys (ZDHS) conducted in 2007, 2013/14, 2018, and 2024. The outcome...

BackgroundInterleukin-17A (IL-17A) is a key cytokine in inflammation and autoimmunity. However, its systemic correlates, particularly in a high HIV burden population, are not fully elucidated. This study aimed to identify the sociodemographic, clinical, inflammatory, metabolic, and renal factors independently associated with plasma IL-17A levels. MethodsThis cross-sectional analysis enrolled a cohort of adults from Livingstone Teaching Hospital in Zambia. Sociodemographic and clinical variables...

Because of its recent regulatory approval in southern and eastern Africa, CAB PrEP represents a scientific advancement with unknown implementation costs in most African countries. To our knowledge, this paper is the first study comparing PrEP costs in health facilities where clients had a choice between three PrEP methods. We collected and analyzed the direct service delivery costs for each method using the same costing approach and assumptions at three facilities in Lesotho and six facilities i...

BackgroundAchieving optimal adherence and retention in HIV care is essential for sustaining viral suppression. Pharmacy refill records offer an objective approach to assessing adherence in settings where routine viral load testing is limited. This study evaluated pharmacy refill adherence, loss to follow-up (LTFU), and their predictors among people living with HIV (PLHIV) in the Manyara region of Tanzania. MethodsWe conducted a retrospective cohort analysis of 22,650 PLHIV across five districts...

CD4+ T-cell enumeration remains critical for management of people with HIV (PWH). In resource-limited settings, point-of-care CD4 testing can increase accessibility and decrease turnaround time compared to flow cytometry. This study evaluated the performance of VITA point-of-care CD4 (Accesso Biotech; VITA CD4) compared to AQUIOS (Beckman Coulter; AQUIOS) flow cytometry. Remnant venous blood samples from PWH with known CD4 counts on FDA-cleared AQUIOS flow cytometry were tested twice with VITA ...

There is no readily accessible, scalable cure for HIV infection. Trials of HIV-specific broadly neutralising antibodies (bNAbs) demonstrate inhibition of viral replication and reduction of the reservoir of latently-infected cells, potentially offering new strategies for HIV eradication. Animal and human studies suggest bNAbs have multiple activities, including a direct antiviral action and a secondary induction of T cell responses, the vaccinal effect. The RIO trial assessed HIV-specific cell-m...

BackgroundHIV-specific broadly neutralising antibodies (bNAbs) can maintain viral control after interrupting antiretroviral therapy (ART). We investigated the duration and efficacy of Fc-engineered long-acting bNAbs (LS-bNAbs) in maintaining ART-free HIV control compared with placebo. MethodsRIO is a 1:1 randomised double-blind placebo-controlled trial of two LS-bNAbs (3BNC117-LS & 10-1074-LS) in individuals virally suppressed on ART initiated since early-stage HIV. Eligible participants interr...

BackgroundAngiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are established antihypertensive treatments that reduce cardiovascular disease (CVD) risk. However, their comparative effectiveness in people with HIV (PWH) is not well examined. This study evaluated the comparative effectiveness of ACEIs and ARBs head-to-head and versus no antihypertensive treatment in preventing primary CVD. MethodsUsing a target trial emulation framework and data from the Nort...

COVID-19 disrupted global health service delivery, particularly among children and adolescents living with HIV (CALHIV), increasing the risk of poor treatment adherence. This study assessed the impact of the COVID-19 pandemic on WHO-recommended early warning indicators (EWIs) of HIV drug resistance (HIVDR) among CALHIV. We conducted a descriptive, longitudinal, retrospective study among children (0-9 years) and adolescents (10-19 years) receiving antiretroviral therapy (ART) in five health facil...