Risultati per: Linee guida su HIV, epatite e malattie sessualmente trasmissibili.

Report Iss, in salita quelle di tipo A, B ed E. In calo la C

Aiutando genitori si riduce rischio di nuovi accessi in ospedale

People with HIV-1 who received a long-acting antiretroviral treatment combining 2 drugs, cabotegravir and rilpivirine, were better able to maintain low levels of the virus compared with those who received daily oral medication, according to interim data, the National Institutes of Health (NIH) announced. The US Food and Drug Administration approved the combination of cabotegravir and rilpivirine, marketed as Cabenuva, as a once-monthly injectable for adults in 2021.

This randomized trial assesses whether a linkage case management intervention reduces 12-month mortality compared with enhanced standard care among people with HIV not taking antiretroviral therapy (ART) who were hospitalized for any reason.

Identifying effective strategies to reach the Joint United Nations Programme on HIV/AIDS 2030 targets for 95% of all people with HIV knowing their status, 95% of these receiving uninterrupted effective antiretroviral therapy (ART), and 95% of these achieving viral suppression remains critical. Global estimates track dramatic improvements in all parts of the continuum of HIV care during the past 2 decades, but marked disparities in progress have been noted between and within regions among key populations. Moreover, even with substantial improvements, current estimates highlight the ongoing gaps in linkage to care, receipt of ART, and, ultimately, viral suppression. Strategies to improve the experience of engaging or reengaging in HIV care remain a high priority throughout the world.

To the Editor Long-acting injectable cabotegravir and rilpivirine (CAB-RPV) is approved for people with HIV who have viral suppression with oral antiretroviral therapy (ART), no known or suspected resistance to either drug, and no chronic hepatitis B. In clinical trials, switching to this injectable therapy demonstrated noninferiority to continued oral ART in maintaining viral suppression. The most recent International Antiviral Society–USA (IAS-USA) treatment guidelines cited a study of successful treatment with CAB-RPV in 15 people with HIV viremia who were not taking oral ART due to adherence challenges. Because of the small size and preliminary nature of this report, CAB-RPV was not recommended in the setting of viremia.

Comunicato del 25/03/2024 n°20

Objective
To explore the syndemic interaction between social, environmental, and structural contexts and HIV infection in peri-mining areas in South Africa.

Design
Mixed qualitative methods consisting of in-depth interviews (IDIs) and focus group discussions (FGDs) exploring the interaction between HIV infection and the social, environmental and structural factors affecting people living in the peri-mining areas of South Africa. Themes were analysed following the syndemic theoretical framework.

Setting
Participants were recruited from three mining companies and locations in the peri-mining communities surrounding the mining companies in Limpopo, Mpumalanga, and Northern Cape provinces.

Participants
Inclusion criteria included mineworkers, healthcare workers, female sex workers (FSWs), injection drug users (IDUs), and other community members, ≥18 years, living in the peri-mining area at the time of participation. Three FGDs were conducted (n=30): 13 men and 17 women aged 18–55 years. IDIs were conducted with 45 participants: mineworkers (n=10), healthcare workers (n=11), FSWs (n=15), truck drivers (n=4) and IDUs (n=5).

Results
The findings from this study indicate that a syndemic of four socio-behavioural factors is associated with HIV acquisition in peri-mining areas. These are migrancy, accessibility to alcohol and substance use, commercial and transactional sex, and uptake of HIV prevention services.

Conclusions
Our findings have implications for HIV prevention programmes in mining companies, which rely on male condom usage promotion. More emphasis on better education about HIV prevalence, transmission and up-to-date prevention alternatives, such as pre-exposure prophylaxis for mineworkers is recommended. Furthermore, collaboration with community-based organisations is recommended to wholly address the syndemic factors influencing HIV transmission in peri-mining communities.

Introduction
Sub-Saharan Africa continues to experience a syndemic of HIV and non-communicable diseases (NCDs). Vertical (stand-alone) HIV programming has provided high-quality care in the region, with almost 80% of people living with HIV in regular care and 90% virally suppressed. While integrated health education and concurrent management of HIV, hypertension and diabetes are being scaled up in clinics, innovative, more efficient and cost-effective interventions that include decentralisation into the community are required to respond to the increased burden of comorbid HIV/NCD disease.

Methods and analysis
This protocol describes procedures for a process evaluation running concurrently with a pragmatic cluster-randomised trial (INTE-COMM) in Tanzania and Uganda that will compare community-based integrated care (HIV, diabetes and hypertension) with standard facility-based integrated care. The INTE-COMM intervention will manage multiple conditions (HIV, hypertension and diabetes) in the community via health monitoring and adherence/lifestyle advice (medicine, diet and exercise) provided by community nurses and trained lay workers, as well as the devolvement of NCD drug dispensing to the community level. Based on Bronfenbrenner’s ecological systems theory, the process evaluation will use qualitative methods to investigate sociostructural factors shaping care delivery and outcomes in up to 10 standard care facilities and/or intervention community sites with linked healthcare facilities. Multistakeholder interviews (patients, community health workers and volunteers, healthcare providers, policymakers, clinical researchers and international and non-governmental organisations), focus group discussions (community leaders and members) and non-participant observations (community meetings and drug dispensing) will explore implementation from diverse perspectives at three timepoints in the trial implementation. Iterative sampling and analysis, moving between data collection points and data analysis to test emerging theories, will continue until saturation is reached. This process of analytic reflexivity and triangulation across methods and sources will provide findings to explain the main trial findings and offer clear directions for future efforts to sustain and scale up community-integrated care for HIV, diabetes and hypertension.

Ethics and dissemination
The protocol has been approved by the University College of London (UK), the London School of Hygiene and Tropical Medicine Ethics Committee (UK), the Uganda National Council for Science and Technology and the Uganda Virus Research Institute Research and Ethics Committee (Uganda) and the Medical Research Coordinating Committee of the National Institute for Medical Research (Tanzania). The University College of London is the trial sponsor. Dissemination of findings will be done through journal publications and stakeholder meetings (with study participants, healthcare providers, policymakers and other stakeholders), local and international conferences, policy briefs, peer-reviewed journal articles and publications.

Trial registration number
ISRCTN15319595.

Progetto Pascnet contro la nuova emergenza di sanità pubblica

Introduction
Young people aged 18–24 years old are a key demographic target for eliminating HIV transmission globally. Pre-exposure prophylaxis (PrEP), a prevention medication, reduces HIV transmission. Despite good uptake by gay and bisexual men who have sex with men, hesitancy to use PrEP has been observed in other groups, such as young people and people from ethnic minority backgrounds. The aim of this study was to explore young people’s perceptions and attitudes to using PrEP.

Design
A qualitative transcendental phenomenological design was used.

Participants and setting
A convenience sample of 24 young people aged between 18 and 24 years was recruited from England.

Methods
Semistructured interviews and graphical elicitation were used to collect data including questions about current experiences of HIV care, awareness of using PrEP and decision-making about accessing PrEP. Thematic and visual analyses were used to identify findings.

Results
Young people had good levels of knowledge about HIV but poor understanding of using PrEP. In this information vacuum, negative stigma and stereotypes about HIV and homosexuality were transferred to using PrEP, which were reinforced by cultural norms portrayed on social media, television and film—such as an association between using PrEP and being a promiscuous, white, gay male. In addition, young people from ethnic minority communities appeared to have negative attitudes to PrEP use, compared with ethnic majority counterparts. This meant these young people in our study were unable to make decisions about when and how to use PrEP.

Conclusion
Findings indicate an information vacuum for young people regarding PrEP. A strength of the study is that theoretical data saturation was reached. A limitation of the study is participants were largely from Northern England, which has low prevalence of HIV. Further work is required to explore the information needs of young people in relation to PrEP.

This pooled analysis of postapproval studies examines the association between baseline demographics and other characteristics and PrEP adherence trajectories with HIV incidence in women.

Iniziativa presentata per la festa del papà

Sono la prima causa di malattia e disabilità