Cross-sectional study measuring the level and relationship of awareness, attitude and willingness to use HIV pre-exposure prophylaxis in Davao City, Philippines

Objectives
To improve on the implementation and uses of HIV pre-exposure prophylaxis (PrEP) programmes, factors affecting HIV PrEP willingness must be investigated. This study aims to determine not only the willingness to use HIV PrEP but also to establish whether awareness and attitude affect this.

Design
This study used a cross-sectional survey research design to examine the awareness, attitude and willingness to use HIV PrEP in Davao City. The survey was adapted from multiple studies and was validated and pilot tested. Statistical analysis included descriptive and inferential statistics like correlation, linear regression and structural modelling.

Settings
This research was conducted in Davao City, Philippines. This is one of the regions in the country with a high HIV incidence. The survey was conducted from March to June 2024.

Participants
Participants were at least 18 years of age, currently living in Davao City and a permanent resident of the city.

Results
A total of 258 respondents were gathered in this study, of which 53.10% of all respondents were fully aware of HIV PrEP, while 27.13% were partially aware. The study found the mean attitude and willingness to be 4.21±0.686 and 4.08±0.685, respectively. There was a significant difference in the awareness when grouped according to identity category (X2=24.428; p value=0.002) and highest education attained (X2=15.919; p value=0.044). Being fully aware positively affected willingness to use HIV PrEP by indirectly contributing positively to attitude towards HIV PrEP (β=0.180; p value=0.012).

Conclusion
Generally, the awareness, attitude and willingness to use HIV PrEP is high. However, some respondents are hesitant to use HIV PrEP if it is not a hundred percent effective and unable to adhere to it. The results imply a need for action programmes involving various multidisciplinary stakeholders to ensure that the community possesses full awareness, positive attitudes and increased willingness to use HIV PrEP.

Leggi
Gennaio 2025

PrEP15-19 Choices: an implementation study protocol of HIV prevention with oral and long-acting injectable cabotegravir PrEP in real-word settings among sexual and gender minority adolescents in Brazil

Introduction
Long-acting injectable (LAI) cabotegravir is a promising new method for preventing HIV. Safe and effective long-acting agents for pre-exposure prophylaxis (PrEP) for HIV infection are needed to increase preventive options among sexual and gender minority adolescents.

Methods and analysis
This is a multisite, prospective implementation study of three PrEP modalities (LAI-PrEP, event-driven (ED) and daily oral), using a mixed-method design with quantitative and qualitative approaches. The study will include a sample of 550 HIV-negative adolescent men who have sex with men, non-binary individuals assigned male at birth, transgender men and women, aged 15–19 years, in three Brazilian capital cities. Participants will be allocated into two arms, according to their choice of PrEP modalities, and followed up to 36 months. Switching between oral and LAI-PrEP will be allowed, according to the participants’ needs and preferences. The qualitative studies will focus on investigating the processes involved in linkage and retention in care, switching between PrEP modalities and strategies of the implementation process of LAI-PrEP in the current PrEP programming and acceptability from health providers, policymakers and stakeholders’ perspectives.

Ethics and dissemination
The adolescent’s autonomy for consenting to their participation and understanding of PrEP will be assessed by the project team before any care is given and will be recorded in their medical record. Adolescents aged 15–17 years will sign an informed assent form, waiving the need for the approval of a legal guardian, except in cases where the adolescent is found not to have the necessary autonomy. The study was approved by the WHO Ethics Review Committee and by the local IRBs from the universities coordinating the study, the University of São Paulo, the Federal University of Bahia and the Federal University of Minas Gerais. This project is part of an effort to expedite the inclusion of new modalities in the Brazilian PrEP Programme, based on the development of studies to evaluate the implementation of LAI-PrEP and ED-PrEP as a choice. The results will be published in peer-reviewed journals and presented to the study participants and communities.

Trial registration number
https://ensaiosclinicos.gov.br/rg/RBR-104736f4. The trial registration number: RBR-104736f4

Leggi
Gennaio 2025

Magnitude of opportunistic infections and associated factors among HIV-infected individuals attending care and treatment clinics in Dar es Salaam, Tanzania: a hospital-based cross-sectional study

Objectives
This study aims to assess the magnitude of opportunistic infection (OI) and to identify factors associated with OIs among people living with HIV (PLHIV) on antiretroviral treatment (ART), attending HIV care and treatment clinics.

Design
A hospital-based cross-sectional study.

Setting
The study was conducted at Muhimbili National Hospital, Mwananyamala and Temeke Regional Referral Hospitals, in Dar es Salaam, Tanzania.

Participants
We enrolled 382 PLHIV on ART who were attending HIV care and treatment clinics in Dar es Salaam. Structured questionnaires were used to collect socio-demographic information, and a checklist was used to extract clinical characteristics from the client’s HIV care and treatment clinic cards. Information was subjected to descriptive and regression analysis using Stata V.13. All factors were considered significant at p

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Gennaio 2025

Development of a core patient-reported outcome set for use in HIV care at the individual patient level in Montreal: protocol for a two-phased multimethod project

Introduction
There is international interest in using patient-reported outcome measures in HIV care to improve the well-being of people with HIV, but the prioritisation of specific outcomes and measures remains unclear. This project’s objective is to engage both people with HIV and healthcare, social and community service providers to develop a French and English-language core set of patient-reported outcomes and measures for use in HIV care at the patient level in Montreal (Canada).

Methods and analysis
This multimethod project will follow guidance from the Core Outcome Measures in Effectiveness Trials Initiative and involve two phases. Phase 1 will see the selection of the core set of outcomes (ie, the health concepts to target) and include a rapid scoping review to inform a Delphi study with a panel of 50 people with HIV and providers in Montreal. It will end with a multidisciplinary consensus meeting to make final decisions on the outcomes. Phase 2 will be devoted to choosing the measures to assess the selected outcomes. It will include a systematic search for instruments, an appraisal of the quality and feasibility of the identified instruments and a consensus meeting for the final selection.

Ethics and dissemination
Research ethics board (REB) approval was obtained on 9 December 2024, from the institutional REB of the Research Institute of the McGill University Health Centre (reference number: 2024-9695). Findings will primarily be disseminated to (1) healthcare and social service providers through academic rounds and a provincial continuing education programme for HIV clinicians; (2) to people with HIV through partner community organisations and (3) a range of stakeholders at local, national and international conferences and through peer-reviewed publications.

Leggi
Gennaio 2025

Association between poor drug adherence and undernutrition among adult HIV patients in southern Ethiopia: an institution based cross sectional study

Objective
Undernutrition is a common issue for HIV and other immune suppressed patients. Approximately 462 million people worldwide living with HIV are experiencing undernutrition, with sub-Saharan Africa having the highest prevalence. Good adherence to antiretroviral therapy (ART) indirectly helps prevent undernutrition by suppressing viral load, increasing CD4 count, preventing viral resistance, enhancing immune reconstitution and delaying disease progression in HIV patients. This study aims to assess the association between poor drug adherence and undernutrition among adult HIV patients in southern Ethiopia.

Study design
An institution based cross sectional study design was used.

Setting and participants
The study was conducted in 406 randomly selected adult HIV patients from Gamo zone public health facilities.

Primary and secondary outcomes
The data were collected by a trained data collector using a structured interviewer administered questionnaire, patient record review and physical measurements. Binary logistic regression was run to select candidate variables, and a multivariable logistic regression model was used to assess the association between undernutrition and poor drug adherence, as well as other variables. A p value

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Gennaio 2025

Review protocol for a systematic review and meta-analysis on HIV inequities in transgender and non-binary populations

Introduction
Global disparities in HIV prevalence among transgender women are well documented. However, current epidemiological literature on HIV disparities demonstrates gaps in research that include the diversity within transgender populations—for example, transgender men and non-binary trans people across global regions. This systematic review and meta-analysis protocol aims to summarise global HIV inequities among all transgender and non-binary (trans) populations. The objectives of this review are to estimate pooled HIV prevalence and prevention outcomes (pre-exposure prophylaxis and antiretroviral therapy) and differences by gender identity, global regions and self-report versus lab-confirmed findings among trans adults worldwide.

Methods and analysis
We will conduct a systematic review of all studies on HIV outcomes among trans youth and adults (aged 15+ years) published between 2000 and 2024, following the Preferred Reporting Items for Systematic Review and Meta-Analysis Prereporting guidelines. We will use Covidence software for the title and abstract screening, full-text review and data abstraction processes. We will summarise the study’s descriptive statistics and conduct meta-analyses of extracted data points to calculate and synthesise pooled findings and effect size. Specifically, we will use the Mantel–Haenszel method with random effects to model our meta-analyses and the DerSimonian and Laird Q test for heterogeneity testing. We will conduct a narrative synthesis on the areas of research that have been conducted to improve HIV prevention and treatment among trans populations and summarise their findings. Subgroup analyses by gender identity, global regions and self-report versus lab-confirmed findings will be conducted.

Ethics and dissemination
Ethics approval is not applicable for this review since we will not be collecting primary data. The results will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO registration number
The protocol is registered in the International Prospective Register of Systematic Reviews database (PROSPERO ID: CRD42022357285).

Leggi
Gennaio 2025