New HIV diagnoses in the UK have fallen again, with the greatest reduction seen in gay and bisexual men. Previously diagnoses in this group increased year on year, reaching 3390 in 2015. Since then they have fallen to 2820 diagnoses in 2016 and 2330 diagnoses in 2017 – this amounts to a 31% fall between 2015 and 2017.
Funders, health providers and advocates should take lessons from the rollout of voluntary medical male circumcision (VMMC) as an HIV prevention measure in Africa if they wish to hasten access to programmes providing pre-exposure prophylaxis (PrEP), researchers argue in the International Journal of STD and AIDS.
Older people living with HIV describe a range of strategies to maintain or improve their mental health and emotional wellbeing, according to an English study published in AIDS Care. Many people said they shifted the focus of their attention away from HIV to other aspects of their lives. Getting support from external agencies and from other people living with HIV was also extremely important for many.
Social support from peers living with HIV is of a different nature to the support received from people who do not have that direct, lived experience of the challenges of growing older with HIV, according to a qualitative study published in Ageing & Society. Participants stated that they needed to be in contact with people who are ‘in the same boat’ and who really ‘know what it’s like to live with HIV’.
Unstable housing associated with low CD4 cell count and detectable viral load for HIV-positive women in US
Unstable housing is associated with an increased risk of a detectable viral load and low CD4 cell count among HIV-positive women, according to US research published in Social Science & Medicine. Women with unstable housing were around 50% more likely to have adverse HIV treatment outcomes than women living in more secure accommodation. Reasons for the poorer outcomes observed in women with unstable housing included poorer continuity of health care.
Modest improvements in HIV knowledge and disclosure beliefs after summer camp for adolescents living with HIV in the UK
An evaluation of the summer camp organised by the Children’s HIV Association (CHIVA) for 12-16 year olds living with HIV in the UK showed modest but statistically significant improvements in some psychological measures, six months after camp. Findings are reported in AIDS Care and Children and Youth Services Review.
Work to improve the HIV care continuum for black transgender women should concentrate on HIV diagnosis
Less than half of black transgender women living with HIV in the United States are aware of their HIV status, but most of those who have been diagnosed report that they engage with care and take HIV treatment. Rates of viral suppression, however, are sub-optimal, according to an analysis published in the Journal of Acquired Immune Deficiency Syndromes.
HIV testing and treatment programmes in sub-Saharan Africa need to prioritise older individuals, according to research published in PLOS ONE. Investigators in Uganda found that after starting antiretroviral therapy (ART) people aged 50 years and older had higher mortality and poorer immune reconstitution compared to younger people.
A prospective study that recruited a significant proportion of people newly diagnosed with HIV in four locations in Indonesia and offered them immediate antiretroviral therapy (ART) found that only 35% of them were still on ART and virally suppressed at the end of the year.
Exposure to protease inhibitor (PI)-based regimens and non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens may each be linked to low birth weight and pre-term births in infants of mothers living with HIV in lower-income countries, but the choice of nucleoside reverse transcriptase inhibitor (NRTI) backbone also appears to influence this risk, according to a systematic review of studies published in the Journal of Acquired Immune Deficiency Syndromes.
A survey conducted by Planned Parenthood in the US state of Connecticut has found that although less than a quarter of women attending their clinics were aware of pre-exposure prophylaxis (PrEP), they generally expressed positive views about it. Only about a third of respondents endorsed the view that people would assume they were promiscuous or were in fact HIV positive if they took PrEP; two-thirds said that they would expect their sexual partners or family members to approve of their taking PrEP and three-quarters said their friends would be supportive.
Chronic pain was reported by a quarter of people living with HIV in an American study published in the Journal of Acquired Immune Deficiency Syndromes. Among people reporting ongoing pain of moderate intensity or worse, individuals who did not receive long-term opioid therapy (LTOT) were at increased risk of missing follow-up appointments and having a detectable viral load. Receiving LTOT was associated with lower rates of virologic failure.
The work of a couple: how gay men in relationships come to trust that “Undetectable = Untransmittable”
Having a relationship based on trust, commitment and familiarity helps Australian gay men rely on undetectable viral load as a means of HIV prevention, according to interviews with HIV-positive and HIV-negative members of serodifferent couples. Confidence in the protective power of an undetectable viral load is also strengthened by receiving consistent test results after repeated condomless sex, according to a qualitative study recently published in AIDS and Behavior.