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HIV Exposure

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101. Breastfeeding, HIV exposure, childhood obesity, and prehypertension: A South African cohort study. (PubMed)

Breastfeeding, HIV exposure, childhood obesity, and prehypertension: A South African cohort study. Evidence on the association between breastfeeding and later childhood obesity and blood pressure (BP) is inconsistent, especially in HIV-prevalent areas where, until recently, HIV-infected women were discouraged from breastfeeding, but obesity is increasingly prevalent.The Siyakhula cohort (2012-2014), a population-based prospective cohort study, collected data over 3 visits on HIV-negative (...) children ages 7 to 11 years in rural South Africa. We used weight (body mass index [BMI]), fat, and BP as outcome variables and incorporated early life (including mother's age at delivery and HIV status) and current life factors (including maternal education and current BMI). Our primary exposure was breastfeeding duration. We dichotomized 3 outcome measures using pre-established thresholds for clinical interpretability: (1) overfat: ≥85th percentile of body fat; (2) overweight: >1 SD BMI z score

2019 PLoS medicine

102. Association between lipodystrophy and length of exposure to ARTs in adult HIV-1 infected patients in Montreal. (PubMed)

Association between lipodystrophy and length of exposure to ARTs in adult HIV-1 infected patients in Montreal. The aim of this study was to establish the prevalence of lipodystrophy and its association to cumulative exposure to antiretroviral drugs.We conducted a cross sectional study in all HIV- infected patients attending the HIV clinic in the Centre hospitalier universitaire de Montréal (CHUM) with DEXA scan. Lipodystrophy was defined as a trunk/limb fat ratio ≥ 1.5. Association between (...) cumulative exposure to antiretroviral (measured in years of use) with trunk/limb fat ratio (coded as a continuous variable) was assessed using univariate and multivariate linear regression for each antiretroviral drug with at least 40 exposed patients.One hundred sixty-six patients were included. Seventy-five percent were male, median age was 56 years, 67% were Caucasian. Overall, prevalence of lipodystrophy was 47%, with a mean trunk/limb fat ratio of 1.87, SD = 1.03, min = 0.6 and max = 5.87. Each 10

2019 BMC Infectious Diseases

103. HIV Pre-Exposure Prophylaxis and Increased Incidence of Sexually Transmitted Infections in the United States. (PubMed)

HIV Pre-Exposure Prophylaxis and Increased Incidence of Sexually Transmitted Infections in the United States. HIV pre-exposure prophylaxis (HIV PrEP) decreases HIV transmission. Some studies have raised concerns about a potential association between the implementation of HIV PrEP and the growing incidence rates of sexually transmitted infections (STIs) in the United States (U.S.).We conducted a quasi-experimental (interrupted time series) analysis of STIs (syphilis, gonorrhea and chlamydia (...) ) rates before (2000-2012) and after (2013-2017) the implementation of HIV PrEP. We also performed correlations between HIV PrEP utilization and STI cases at the national (2012-2017) and state (2017) levels. We defined HIV PrEP utilization as the number of people taking tenofovir disoproxil fumarate/emtricitabine for HIV prevention.HIV PrEP implementation was associated with 25% (RR: 1.254, 95% confidence interval: 1.245-1.263, P < 0.001) and 26% (RR: 1.260, 95% confidence interval: 1.257-1.264, P

2019 Clinical Infectious Diseases

104. Doravirine exposure and HIV-1 suppression after switching from an efavirenz-based regimen to doravirine/lamivudine/tenofovir disoproxil fumarate. (PubMed)

Doravirine exposure and HIV-1 suppression after switching from an efavirenz-based regimen to doravirine/lamivudine/tenofovir disoproxil fumarate. Doravirine is a non-nucleoside reverse transcriptase inhibitor approved for the treatment of HIV-1. In a phase 1 trial, doravirine exposure was transiently decreased when treatment was started immediately after stopping efavirenz. In a post-hoc subgroup analysis of participants who switched from an efavirenz-based regimen to doravirine/lamivudine (...) /tenofovir disoproxil fumarate in the phase 3 DRIVE-SHIFT trial, doravirine plasma levels at week 4 were similar to non-induced levels, and HIV-1 suppression was maintained at weeks 24 and 48.Copyright © 2019 Greaves et al.

2019 Antimicrobial Agents and Chemotherapy

105. A cross-jurisdictional review of HIV testing intervals for population groups at high risk of HIV infection

and why it’s important HIV screening and testing are extremely important tools within the HIV prevention, engagement and care cascade. In Ontario, individuals are urged to test in the aftermath of a potential high-risk exposure to HIV at intervals of three weeks, six weeks and three months, however many individuals do not come forward following such exposures. Accordingly, this review was requested to investigate what routine guidelines have been established in other jurisdictions to promote frequent (...) about testing frequencies among those population groups at high risk of HIV infection, stating that there is “insufficient evidence to provide recommendations for the exact frequency of HIV testing for each scenario due to the number of variables involved with each individual’s potential for exposure” (12). Nevertheless, the Public Health Agency of Canada states that people “with a negative test result who continue to engage in at-risk behaviours will benefit from more frequent retesting than

2019 Ontario HIV Treatment Network

106. Strategies to link people with undiagnosed HIV infection to HIV testing, care, and prevention services

testing and treatment clinic in Ottawa, demonstrated the utility of targeted HIV rapid testing (11). For three hours per week, free HIV testing (anonymous or nominal) was offered to patients based on sexual history and symptoms. Referral to local HIV care physicians, pre-exposure prophylaxis (PrEP), and HIV prevention counselling was also provided. A total of 28 individuals were diagnosed with HIV (HIV positivity rate ranging between 0.7% to 1.8% from 2011-2013). This rate reached 3.6% for anonymous (...) are not virologically suppressed are at high risk of acquiring HIV infection (55). Partner notification (also called disclosure or contact tracing) involves a voluntary process whereby individuals diagnosed with HIV are interviewed to identify their sexual or drug-injecting partners, partners are notified of their risk of HIV exposure and offered HIV testing, and HIV-positive partners are linked to HIV care (56). Partner notification can be provided using passive or assisted approaches (56). Through passive

2019 Ontario HIV Treatment Network

107. Awareness and willingness towards pre-exposure prophylaxis against HIV infection among individuals seeking voluntary counselling and testing for HIV in Taiwan: a cross-sectional questionnaire survey. (Full text)

Awareness and willingness towards pre-exposure prophylaxis against HIV infection among individuals seeking voluntary counselling and testing for HIV in Taiwan: a cross-sectional questionnaire survey. We aimed to investigate the awareness and willingness towards pre-exposure prophylaxis (PrEP) among individuals seeking voluntary counselling and testing (VCT) for HIV in Taiwan, where PrEP is currently not reimbursed by the insurance.Between April and October 2016, a questionnaire interview (...) was conducted among VCT clients to inquire about the attitudes towards PrEP against HIV infection. Multivariate logistic regression analysis was performed to identify the associated factors with willingness to initiate PrEP.During the 6-month period, 1173 VCT clients (99.8%) completed the interviews, with 67.4% being homosexual or bisexual male. While 67.2% of the clients knew of postexposure prophylaxis, 40.2% heard of PrEP. Overall, 546 clients (46.5%) were willing to initiate PrEP and 89.5% of them would

2017 BMJ open PubMed

108. Alignment of adherence and risk for HIV acquisition in a demonstration project of pre-exposure prophylaxis among HIV serodiscordant couples in Kenya and Uganda: a prospective analysis of prevention-effective adherence. (Full text)

Alignment of adherence and risk for HIV acquisition in a demonstration project of pre-exposure prophylaxis among HIV serodiscordant couples in Kenya and Uganda: a prospective analysis of prevention-effective adherence. Adherence is essential for pre-exposure prophylaxis (PrEP) to protect against HIV acquisition, but PrEP use need not be life-long. PrEP is most efficient when its use is aligned with periods of risk - a concept termed prevention-effective adherence. The objective of this paper (...) is to describe prevention-effective adherence and predictors of adherence within an open-label delivery project of integrated PrEP and antiretroviral therapy (ART) among HIV serodiscordant couples in Kenya and Uganda (the Partners Demonstration Project).We offered PrEP to HIV-uninfected participants until the partner living with HIV had taken ART for ≥6 months (a strategy known as "PrEP as a bridge to ART"). The level of adherence sufficient to protect against HIV was estimated in two ways: ≥4 and ≥6 doses

2017 Journal of the International AIDS Society PubMed

109. Evaluation of a multi-drug assay for monitoring adherence to a regimen for HIV pre-exposure prophylaxis in a clinical study (HIV Prevention Trials Network 073). (Full text)

Evaluation of a multi-drug assay for monitoring adherence to a regimen for HIV pre-exposure prophylaxis in a clinical study (HIV Prevention Trials Network 073). Daily oral tenofovir disoproxil fumarate (TDF)-emtricitabine (FTC) is a safe and effective intervention for HIV preexposure prophylaxis (PrEP). We evaluated the performance of a qualitative assay that detects 20 antiretroviral (ARV) drugs (multidrug assay) in assessing recent PrEP exposure (detection limit, 2 to 20 ng/ml). Samples were (...) obtained from 216 Black men who have sex with men (208 HIV-uninfected men and 8 seroconverters) who were enrolled in a study in the United States evaluating the acceptability of TDF-FTC PrEP (165 of the uninfected men and 5 of the seroconverters accepted PrEP). Samples from 163 of the 165 HIV-uninfected men who accepted PrEP and samples from all 8 seroconverters were also tested for tenofovir (TFV) and FTC using a quantitative assay (detection limit for both drugs, 0.31 ng/ml). HIV drug resistance

2017 Antimicrobial Agents and Chemotherapy PubMed

110. Association of HIV diagnosis rates and laws criminalizing HIV exposure in the United States. (PubMed)

Association of HIV diagnosis rates and laws criminalizing HIV exposure in the United States. To assess whether state criminal exposure laws are associated with HIV and stage 3 (AIDS) diagnosis rates in the United States.We assessed the relationship between HIV and stage 3 (AIDS) diagnosis data from the National HIV Surveillance System and the presence of a state criminal exposure law as identified through WestlawNext by using generalized estimating equations.We limited analysis to persons aged (...) at least 13 years with diagnosed HIV infection or AIDS reported to the National HIV Surveillance System of the Centers for Disease Control and Prevention. The primary outcome measures were rates of diagnosis of HIV (2001-2010 in 33 states) and AIDS (1994-2010 in 50 states) per 100 000 individuals per year. In addition to criminal exposure laws, state-level factors evaluated for inclusion in models included income, unemployment, poverty, education, urbanicity, and race/ethnicity.At the end of the study

2017 AIDS

111. Addressing the dual health epidemics of HIV and sexual abuse among children and adolescents in Kenya: uptake of HIV counseling and post-exposure prophylaxis (Full text)

Addressing the dual health epidemics of HIV and sexual abuse among children and adolescents in Kenya: uptake of HIV counseling and post-exposure prophylaxis Child sexual abuse and HIV are key health challenges in Kenya. In 2015, LVCT Health conducted a study aimed at assessing the quality of HIV-related services offered to child survivors of sexual violence in public health facilities.A qualitative data collection approach was utilized. Qualitative data were collected through in-depth (...) of postexposure prophylaxis (PEP). Providers did not conduct HIV pre- and posttest counseling for the survivors. There were no longitudinal follow-up mechanisms to ensure child survivors initiated on PEP adhered to the treatment plan. Less than 30% of survivors returned to the facility for PEP adherence counseling and follow-up HIV testing. Twenty providers cited capacity gaps in undertaking HIV risk assessment for child survivors. Limited availability of PEP is a barrier to HIV prevention, as most

2017 Adolescent health, medicine and therapeutics PubMed

112. HIV Diagnosis and Treatment at Birth for Newborn With High Risk HIV Exposure

HIV Diagnosis and Treatment at Birth for Newborn With High Risk HIV Exposure HIV Diagnosis and Treatment at Birth for Newborn With High Risk HIV Exposure - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. HIV (...) Diagnosis and Treatment at Birth for Newborn With High Risk HIV Exposure (DIAVINA) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03642704 Recruitment Status : Recruiting First Posted : August 22, 2018 Last Update Posted

2017 Clinical Trials

113. Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa (Full text)

Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa Introduction: Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV.  Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate (...) practical examples of how PrEP can be delivered.  Methods: We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa.  The delivery model integrated PrEP into HIV treatment services, prioritizing PrEP for HIV-negative partners within serodiscordant couples prior to and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART).  We measured adherence to PrEP through

2017 Gates Open Research PubMed

114. Medication Sharing is Rare among African HIV-1 Serodiscordant Couples Enrolled in an Efficacy Trial of Oral Pre-exposure Prophylaxis (PrEP) for HIV-1 Prevention (Full text)

Medication Sharing is Rare among African HIV-1 Serodiscordant Couples Enrolled in an Efficacy Trial of Oral Pre-exposure Prophylaxis (PrEP) for HIV-1 Prevention Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed (...) the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at <0.01% of visits, and 0%-1.6% of randomly selected and 0% of purposively selected specimens from HIV-1 infected participants had detectable tenofovir concentrations (median: 66.5 ng/mL, range: 1.3-292 ng/mL). PrEP sharing within HIV-1 serodiscordant couples was extremely rare.

2017 Journal of acquired immune deficiency syndromes (1999) PubMed

115. Safety of oral tenofovir disoproxil fumarate-based HIV pre-exposure prophylaxis use in lactating HIV-uninfected women (Full text)

Safety of oral tenofovir disoproxil fumarate-based HIV pre-exposure prophylaxis use in lactating HIV-uninfected women In settings where HIV is prevalent in heterosexual populations, pregnancy and postpartum breastfeeding periods can be associated with substantial HIV acquisition risk. Pre-exposure prophylaxis (PrEP) with daily oral tenofovir disoproxil fumarate (TDF)/emtricitabine is an attractive HIV prevention option for women who are lactating but data are limited on its safety during (...) the lactation period. Areas covered: We provide a concise synthesis and summary of current evidence on the safety of TDF-based PrEP during breastfeeding. We conducted a review, searching Pubmed database and major PrEP conferences for primary studies with TDF-based PrEP exposure during postpartum breastfeeding. Expert opinion: TDF-based oral PrEP is an effective female-controlled HIV prevention option. There is evidence supporting the safety of TDF use for infant outcomes during breastfeeding

2017 Expert opinion on drug safety PubMed

116. Prescribing of Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis by HIV Medical Providers in the United States, 2013–2014 (Full text)

Prescribing of Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis by HIV Medical Providers in the United States, 2013–2014 Clinical trials have demonstrated the effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) for reducing HIV acquisition. Understanding how HIV care providers are prescribing PrEP is necessary to ensure success of this prevention strategy.During 2013-2014, we surveyed US HIV care providers who also provided care to HIV-negative (...) patients. We estimated percentages who had prescribed PrEP and assessed associations between provider characteristics and PrEP prescribing.An estimated 26% (95% confidence interval [CI], 20-31) had ever prescribed PrEP. Of these, 74% (95% CI, 61-87) prescribed for men who have sex with men (MSM), 30% (95% CI, 21-39) for women who have sex with men, 23% (95% CI, 9-37) for men who have sex with women, 23% (95% CI, 15-30) for uninfected partners in HIV-discordant couples trying to conceive, and 1% (95% CI

2017 Open forum infectious diseases PubMed

117. HIV/AIDS Conspiracy Beliefs and Intention to Adopt HIV Pre-Exposure Prophylaxis among Black men who have sex with men in Los Angeles (Full text)

HIV/AIDS Conspiracy Beliefs and Intention to Adopt HIV Pre-Exposure Prophylaxis among Black men who have sex with men in Los Angeles In the United States, black men who have sex with men (MSM) are the group most affected by the HIV/AIDS epidemic. Pre-exposure prophylaxis (PrEP) is an important new HIV prevention strategy that may help reduce new HIV infections among black MSM. This analysis examined the association between HIV/AIDS conspiracy beliefs and intentions to adopt PrEP among 224 black (...) MSM. The likelihood of adopting PrEP was assessed and more than half (60%) of the study population indicated a high intention to adopt PrEP. HIV/AIDS genocidal and treatment-related conspiracies were assessed using scales previously validated with black MSM. Almost two-thirds (63%) endorsed at least one of eight HIV/AIDS conspiracy beliefs presented. In multivariable analyses, black MSM who agreed with the genocidal or treatment-related conspiracy beliefs scales had a lower intention to adopt PrEP

2017 International journal of STD & AIDS PubMed

118. Short Communication: Manα1-2Man-Binding Anti-HIV Lectins Enhance the Exposure of V2i and V3 Crown Neutralization Epitopes on the V1/V2 and V3 Hypervariable Loops of HIV-1 Envelope (Full text)

Short Communication: Manα1-2Man-Binding Anti-HIV Lectins Enhance the Exposure of V2i and V3 Crown Neutralization Epitopes on the V1/V2 and V3 Hypervariable Loops of HIV-1 Envelope This study aimed to explore the contribution of high-mannose glycans in the masking of conserved V3 crown (GPG) and V2i epitopes on the hypervariable loops of most exposed distal surface of HIV-1 Env. Using lectins specific to Manα1-2Man residue containing Man6-9GlcNAc2 glycans extensively decorating HIV-1 Env, we (...) found that Manα1-2Man-binding lectins enhance the exposure of these partially and transiently exposed epitopes and consequentially increase the neutralization strength of antibodies against these epitopes.

2017 AIDS research and human retroviruses PubMed

119. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines (Full text)

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines Daily use of coformulated tenofovir and emtricitabine for HIV pre-exposure prophylaxis (PrEP) by populations at high risk of HIV infection is now recommended in guidelines from the United States, Europe and Australia and globally through the 2015 WHO guidelines. These 2017 Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine's (ASHM) PrEP Guidelines (...) clinicians in commencing and monitoring patients on PrEP including PrEP dosing schedules, management of side-effects and toxicity, use of PrEP in pregnancy and in chronic hepatitis B infection and how to cease PrEP Daily PrEP with co-formulated tenofovir and emtricitabine, used continuously or for shorter periods of time, is recommended in these guidelines as a key HIV-prevention option for men who have sex with men (MSM), transgender men and women, heterosexual men and women, and people who inject drugs

2017 Journal of virus eradication PubMed

120. HIV serodisclosure among men who have sex with men and transgender women on HIV pre-exposure prophylaxis (Full text)

HIV serodisclosure among men who have sex with men and transgender women on HIV pre-exposure prophylaxis HIV pre-exposure prophyalxis (PrEP) might lead individuals to view serodisclosure as unnecessary. We examined the prevalence of non-disclosure and lack of knowledge of partner status in a global cohort of men who have sex with men (MSM) and transgender women (TW) enrolled in the iPrEx Open Label Extension (OLE). We calculated prevalence ratios by fitting a logistic model and estimating (...) (adjusted prevalence ratio [aPR] 1.54, [95% confidence interval 1.24-1.84]) and transactional sex partners (aPR 2.03, [1.44-2.62]), and among partners whom participants have known only minutes or hours before their first sexual encounter (aPR 1.62, [1.33-1.92]). Similarly, participants were less likely to know the HIV status of casual partners (aPR 1.50, [1.30-1.71]), transactional sex partners (aPR 1.62, [1.30-1.95]), and those they have known for only days or weeks (aPR 1.13, [0.99-1.27]) or minutes

2017 AIDS care PubMed

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