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Factors associated with knowledge and awareness of HIV/AIDS among married women in Bangladesh: evidence from a nationally representative survey Women in Bangladesh share a greater risk of HumanImmunodeficiencyVirus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) infection compared to men. Levels of knowledge and awareness largely contribute to the prevalence of the HIV epidemic and its consequences. So, it is required to conduct studies based on most recent data to explore the determinants (...) of HIV awareness. Therefore, we aimed to find the awareness level and factors influencing HIV related awareness among the married women in Bangladesh. We used data from 2014 Bangladesh Demographic and Health Survey (BDHS). About two-third of total respondents who heard about the HIV/AIDS were selected and interviewed successfully (n = 12,593) about 11 basic questions related to individual's awareness. A score of the respondent's knowledge and awareness was determined based on these questions. We used
Integration of HIV and reproductive health services in public sector facilities: analysis of client flow data over time in Kenya Integration of HIV/AIDS with reproductive health (RH) services can increase the uptake and efficiency of services, but gaps in knowledge remain about the practice of integration, particularly how provision can be expanded and performance enhanced. We assessed the extent and nature of service integration in public sector facilities in four districts in Kenya.Between (...) 2009 and 2012, client flow assessments were conducted at six time points in 24 government facilities, purposively selected as intervention or comparison sites. A total of 25 539 visits were tracked: 15 270 in districts where 6 of 12 facilities received an intervention to strengthen HIV service integration with family planning (FP); and 10 266 visits in districts where half the facilities received an HIV-postnatal care intervention in 2009-2010. We tracked the proportion of all visits in which: (1
Validation of a Swahili version of the World Health Organization 5-item well-being index among adults living with HIV and epilepsy in rural coastal Kenya The purpose of this study was to evaluate the psychometric properties of the World Health Organization's five item well-being index (WHO-5) when administered to adults living with HIV or epilepsy in a rural setting at the coast of Kenya.A case control study design was conducted among 230 adults aged 18-50 years, who comprised 147 cases (63 (...) living with epilepsy and 84 living with HIV) and 83 healthy controls. The participants were administered to a face-to-face interview during which they completed the Swahili version of WHO-5 well-being index, the Major Depression Inventory (MDI) and responded to some items on their socio-demographic characteristics. Analysis to assess internal consistency, construct validity, discriminant validity, and convergent validity of the Swahili version of WHO-5 well-being index was conducted. A multivariate
Health-related quality of life and associated factors in adults living with HIV in Rwanda In Rwanda, as in other sub-Saharan African (SSA) countries, life expectancy of people living with HIV (PLWH) has increased dramatically as a result of combined antiretroviral therapy (cART). People living with HIV can now live longer but with increasing rates of non-communicable diseases (NCDs). Thus, prevention of NCD comorbidities in PWLHI is crucial to maintain and gain health-related benefits (...) and to maximise the health-related quality of life (HRQOL) in the long-term management of PLWH. This study determines the association between physical and mental health-related dimensions of quality of life (QOL) with behavioural and biological risk factors, after controlling socio-demographic and HIV-related factors in adults living with HIV in Rwanda. A cross-sectional study using the WHO STEPwise approach and Kinyarwanda version of the MOS-HIV Health Survey, risk factors for NCDs and HRQOL were analysed
Significant Association of Aldosterone and Liver Fat Among HIV-Infected Individuals With Metabolic Dysregulation Fatty liver disease is increased among individuals with HIV. We sought to explore how aldosterone, a key hormone linked to insulin resistance and inflammation, relates to liver fat in the large population of individuals with HIV and metabolic abnormalities.Forty-six individuals with HIV and increased waist circumference and dysglycemia were assessed for liver fat using proton (...) [8% (3%, 20%) vs 4% (2%, 10%); P = 0.02]. In the presence of metabolic syndrome, individuals with aldosterone levels above vs below the median had markedly elevated liver fat values [14% (9%, 23%) vs 5% (3%, 12%); P = 0.005] and increased presence of fatty liver disease (FLD; 92% vs 50%; P = 0.02). Controlling for metabolic syndrome, hepatitis C virus, and alcohol use, aldosterone was a significant and independent predictor of liver fat (β estimate: 0.6038, P = 0.01; overall model r2 = 0.41, P
Health care usersâ€™ knowledge, attitudes and perceptions of HIV self-testing at selected gateway clinics at eThekwini district, KwaZulu-Natal province, South Africa Progress in promoting knowledge of HIV status has been made globally, but half of all people living with HIV are still unaware of their HIV status. It is argued the new innovative HIV self-testing strategy could increase the uptake of HIV testing among the people. The aim of the study was to assess outpatients' health care user's (...) knowledge, attitudes and perceptions towards HIV self-testing (HIVST) at selected Gateway clinics at eThekwini District, KwaZulu-Natal Province, South Africa. The objectives of the study were to determine health care users' knowledge of HIVST, assess health care users' attitudes and perceptions towards HIVST and establish if there is any relationship between knowledge, attitudes and perceptions of health care users towards HIVST. A quantitative, non-experimental descriptive design was used to determine
A scalable, integrated intervention to engage people who inject drugs in HIV care and medication-assisted treatment (HPTN 074): a randomised, controlled phase 3 feasibility and efficacy study. People who inject drugs (PWID) have a high incidence of HIV, little access to antiretroviral therapy (ART) and medication-assisted treatment (MAT), and high mortality. We aimed to assess the feasibility of a future controlled trial based on the incidence of HIV, enrolment, retention, and uptake (...) of the intervention, and the efficacy of an integrated and flexible intervention on ART use, viral suppression, and MAT use.This randomised, controlled vanguard study was run in Kyiv, Ukraine (one community site), Thai Nguyen, Vietnam (two district health centre sites), and Jakarta, Indonesia (one hospital site). PWID who were HIV infected (index participants) and non-infected injection partners were recruited as PWID network units and were eligible for screening if they were aged 18-45 years (updated to 18-60
2018LancetControlled trial quality: predicted high
or undetectable viral loads, so there is a risk that their HIV infection may be misdiagnosed (9, 10). However, there are no testing algorithms specific to elite controllers (11, 12). While elite controllers are able to control their HIV infection, they continue to experience ongoing inflammation, decreases in CD4+ T cells, inflammation-associated cardiovascular disease and high rates of cancer, which suggest that their natural ability to control the virus over the long term may be coming at an immunologic (...) ). This review is focused specifically on elite controllers. It is important to understand the mechanisms underlying elite control of HIV — particularly in those individuals who have undetectable virus AND normal CD4 counts for at least 10 years — because it may represent a natural model for a “functional cure” (i.e. long term control of viral replication and remission from symptoms of HIV infection in the absence of antiretroviral therapy) (13, 17). The exact mechanisms of elite control remain unclear (18
Dolutegravir rilpivirine (Juluca) - For the treatment of humanimmunodeficiencyvirus type 1 (HIV-1) infection in adults who are virologically suppressed (HIV-1 RNA copies <50 copies/mL) on a stable antiretroviral regimen Published 10 September 2018 1 dolutegravir 50mg / rilpivirine 25mg film-coated tablets (Juluca ® ) SMC2091 ViiV Healthcare Ltd. 10 August 2018 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug (...) and Therapeutic Committees (ADTCs) on its use in NHS Scotland. The advice is summarised as follows: ADVICE: following a full submission dolutegravir / rilpivirine film-coated tablet (Juluca ® ) is accepted for use within NHSScotland. Indication under review: The treatment of humanimmunodeficiencyvirus type 1 (HIV-1) infection in adults who are virologically-suppressed (HIV-1 RNA 50 copies/mL in the 6-month period before screening and no more than one instance of viral load >50 copies/mL but <200 copies/mL
and Therapeutic Committees (ADTCs) on its use in NHS Scotland. The advice is summarised as follows: ADVICE: following a full submission bictegravir / emtricitabine / tenofovir alafenamide (Biktarvy ® ) is accepted for use within NHSScotland. Indication under review: Treatment of adults infected with humanimmunodeficiencyvirus 1 (HIV-1) without present or past evidence of viral resistance to the integrase inhibitor class, emtricitabine or tenofovir. Bictegravir / emtricitabine / tenofovir alafenamide was non (...) of the benefits of a Patient Access Scheme (PAS) that improves the cost-effectiveness of bictegravir / emtricitabine / tenofovir alafenamide. This advice is contingent upon the continuing availability of the PAS in NHSScotland or a list price that is equivalent or lower. Chairman Scottish Medicines Consortium 2 Indication Treatment of adults infected with humanimmunodeficiencyvirus 1 (HIV-1) without present or past evidence of viral resistance to the integrase inhibitor class, emtricitabine or tenofovir. 1
-OLE)  enrolled 1603 HIV-negative men and 339 (14%) trans women who have sex with men who were previously part of PrEP studies (iPrEx, ATN082/Project PrEPare and CDC MSM Safety Trial). Participants were offered daily TDF-FTC and were followed up for 72 weeks after enrolment. Uptake was high at 76%, and this was higher among those reporting condomless receptive anal intercourse and those who were herpes simplex-2 virus (HSV-2) seropositive, suggesting use during periods of risk. HIV incidence (...) - up there were no new HIV infections in the men enrolled in the programme . At the time of writing there have been three case reports of HIV transmissions in MSM taking PrEP despite apparent confirmed adherence. Two individuals were infected with resistant virus and, in one case, transmission occurred with wild-type virus sensitive to both tenofovir and emtricitabine . 4.1 Evidence for safety and efficacy in men who have sex with men (MSM): recommendations 1. We recommend that PrEP
studies The iPrEx Open-label Extension (iPrEx-OLE)  enrolled 1603 HIV-negative men and 339 (14%) trans women who have sex with men who were previously part of PrEP studies (iPrEx, ATN082/Project PrEPare and CDC MSM Safety Trial). Participants were offered daily TDF-FTC and were followed up for 72 weeks after enrolment. Uptake was high at 76%, and this was higher among those reporting condomless receptive anal intercourse and those who were herpes simplex-2 virus (HSV-2) seropositive, suggesting use (...) . After a maximum of 16 months’ follow- up there were no new HIV infections in the men enrolled in the programme . At the time of writing there have been three case reports of HIV transmissions in MSM taking PrEP despite apparent confirmed adherence. Two individuals were infected with resistant virus and, in one case, transmission occurred with wild-type virus sensitive to both tenofovir and emtricitabine . 4.1 Evidence for safety and efficacy in men who have sex with men (MSM): recommendations
Primary antifungal prophylaxis for cryptococcal disease in HIV-positive people. Cryptococcal disease remains one of the main causes of death in HIV-positive people who have low cluster of differentiation 4 (CD4) cell counts. Currently, the World Health Organization (WHO) recommends screening HIV-positive people with low CD4 counts for cryptococcal antigenaemia (CrAg), and treating those who are CrAg-positive. This Cochrane Review examined the effects of an approach where those with low CD4 (...) counts received regular prophylactic antifungals, such as fluconazole.To assess the efficacy and safety of antifungal drugs for the primary prevention of cryptococcal disease in adults and children who are HIV-positive.We searched the CENTRAL, MEDLINE PubMed, Embase OVID, CINAHL EBSCOHost, WHO International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, conference proceedings for the International AIDS Society (IAS) and Conference on Retroviruses and Opportunistic Infections (CROI
Role of a clinical pharmacist as part of a multidisciplinary care team in the treatment of HCV in patients living with HIV/HCV coinfection The objective of the study was to evaluate the role of a clinical pharmacist in hepatitis C virus (HCV) treatment of patients living with HIV/HCV coinfection.We conducted a descriptive study to quantify the functions of a clinical pharmacist in HCV treatment of patients living with HIV/HCV coinfection who were initiating HCV treatment at a publicly funded (...) clinic between March 18, 2015 and September 15, 2016. The clinical pharmacist's role was categorized into eight categories: 1) HCV prior authorization (PA) completion; 2) HCV medication adherence counseling; 3) HCV drug-drug interaction (DDI) counseling and screening; 4) HCV medication counseling regarding common adverse events (AEs); 5) HCV counseling regarding HCV treatment outcomes and risk of reinfection; 6) ordering laboratory tests and interpretation of HCV laboratory values; 7) HIV medication
Effect of a multicomponent behavioural PMTCT cluster randomised controlled trial on HIV stigma reduction among perinatal HIV positive women in Mpumalanga province, South Africa We evaluate the impact a multicomponent, behavioural, prevention of mother to child transmission (PMTCT), cluster randomised controlled trial on HIV stigma reduction among perinatal HIV infected women in rural South Africa.In a cluster randomised controlled trial, twelve community health centres (CHCs) in Mpumalanga (...) Province, South Africa, were randomised; pregnant women living with HIV enrolled received either: A Standard Care (SC) condition plus time-equivalent attention-control on disease prevention (SC; 6 CHCs; n =357), or an Enhanced Intervention (EI) condition of SC PMTCT plus the 'Protect Your Family' intervention (EI; 6 CHCs; n =342). HIV-infected pregnant women in the SC attended four antenatal and two postnatal video sessions; those in the EI, four antenatal and two postnatal group PMTCT sessions
HIV Viral Suppression Trends Over Time Among HIV-Infected Patients Receiving Care in the United States, 1997 to 2015: A Cohort Study. Because HIV viral suppression is essential for optimal outcomes and prevention efforts, understanding trends and predictors is imperative to inform public health policy.To evaluate viral suppression trends in people living with HIV (PLWH), including the relationship of associated factors, such as demographic characteristics and integrase strand transfer inhibitor (...) (ISTI) use.Longitudinal observational cohort study.8 HIV clinics across the United States.PLWH receiving clinical care.To understand trends in viral suppression (≤400 copies/mL), annual viral suppression rates from 1997 to 2015 were determined. Analyses were repeated with tests limited to 1 random test per person per year and using inverse probability of censoring weights to address loss to follow-up. Joint longitudinal and survival models and linear mixed models of PLWH receiving antiretroviral
Clearance of Type-Specific, Low-Risk, and High-Risk Cervical Human Papillomavirus Infections in HIV-Negative and HIV-Positive Women Purpose There is a dearth of data on clearance of cervical human papillomavirus (HPV) infection among women in West Africa. We examined the clearance of low-risk (lr) and high-risk (hr) cervical HPV infections, and the factors associated with these measures in HIV-negative and HIV-positive women. Methods We studied 630 Nigerian women involved in a study of HPV (...) infection using short polymerase chain reaction fragment-10 assay and line probe assay-25. Research nurses used a cervical brush to collect samples of exfoliated cervical cells from all the study participants. Cox proportional hazards models were used to estimate associations between HIV and HPV infections. Results The mean age of the study participants was 38 (standard deviation, ± 8) years; 51% were HIV positive. The rate of clearing any HPV infection was 2.0% per month among all women in the study
The effect of public health-oriented drug law reform on HIV incidence in people who inject drugs in Tijuana, Mexico: an epidemic modelling study As countries embark on public health-oriented drug law reform, health impact evaluations are needed. In 2012, Mexico mandated the narcomenudeo reform, which depenalised the possession of small amounts of drugs and instituted drug treatment instead of incarceration. We investigated the past and future effect of this drug law reform on HIV incidence (...) in people who inject drugs in Tijuana, Mexico.In this epidemic modelling study, we used data from the El Cuete IV cohort study to develop a deterministic model of injecting and sexual HIV transmission in people who inject drugs in Tijuana between 2012 and 2030. The population was stratified by sex, incarceration status, syringe confiscation by the police, HIV stage, and exposure to drug treatment or rehabilitation (either opioid agonist treatment or compulsory drug abstinence programmes). We modelled
Phase 3 Study of Ibalizumab for Multidrug-Resistant HIV-1. Ibalizumab, a humanized IgG4 monoclonal antibody, blocks the entry of humanimmunodeficiencyvirus type 1 (HIV-1) by noncompetitive binding to CD4.In this single-group, open-label, phase 3 study, we enrolled 40 adults with multidrug-resistant (MDR) HIV-1 infection in whom multiple antiretroviral therapies had failed. All the patients had a viral load of more than 1000 copies of HIV-1 RNA per milliliter. After a 7-day control period (...) of susceptibility to ibalizumab than at baseline. The most common adverse event was diarrhea (in 20% of patients). Four patients died from causes related to underlying illnesses; 1 had a serious adverse event (the immune reconstitution inflammatory syndrome) that was deemed to be related to ibalizumab therapy.In patients with MDR HIV-1 infection who had advanced disease and limited treatment options, ibalizumab had significant antiviral activity during a 25-week study. Evidence of the emergence of diminished