Providing an antiretroviral regimen of dolutegravir, tenofovir and lamivudine to all adults living with HIV in sub-Saharan Africa, regardless of viral suppression or plans to have children, would prevent more ill health than policies which restricted use of the regimen in women of childbearing potential or people with suppressed viral load, a modelling study published in The Lancet HIV shows. Moreover, it would be cost saving.
Managing sexual and survival risks: the impact of inequity and stigma on Jamaican MSM and trans women
Two recent qualitative studies highlight Jamaican men who have sex with men (MSM) and transgender (trans) women’s heightened vulnerability to HIV. These groups are at higher risk of infection as a result of various socioeconomic inequalities – homelessness, lack of employment, the criminalisation of same-sex practices and high levels of stigma and violence.
Women living with HIV have a significantly higher risk of the menstrual disorder amenorrhea (missing three of more consecutive periods), according to a meta-analysis published in the online edition of AIDS. Infection with HIV was associated with a 70% increase in the risk of amenorrhea, and low body mass index (BMI) emerged as a possible risk factor.
The latest annual surveillance report by the European Centre for Disease Prevention and Control (ECDC) shows that Europe maintains its distinction as the World Health Organization region with the largest increase in HIV cases in a year, and one of only two of the six global regions (the other being the Middle East and north Africa) that has not seen cases decline. Two-thirds of all cases were in a single country: Russia, which had 65.5% of new diagnoses in the European region, even though it only has 16% of its population.
Patient-provider relationships are strained by poor working conditions and rigid application of one-size-fits-all models of care, according to an in-depth investigation of why people with HIV drop out of HIV treatment services in Zambia, recently published in BMJ Global Health. But patients rate antiretroviral services more highly than traditional healers, who are perceived to have problems of their own.
Treatment with tenofovir disoproxil fumarate (TDF) does not increase the risk of fractures, according to French research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes. Findings of the case-controlled study showed there was no association between TDF and fractures in any of the statistical models designed by the authors.
The bacterium that causes the common sexually transmitted infection (STI) gonorrhoea develops resistance to antibiotics easily, and some cases of multidrug-resistant gonorrhoea, originating from abroad, were reported from the UK this year, raising concerns that gonorrhoea could become untreatable.
New British HIV Association (BHIVA) guidelines on the management of HIV in pregnancy have been issued this month, emphasising the continuing scientific uncertainty over HIV transmission through breastfeeding despite undetectable viral load, and the importance of financial assistance for women on lower incomes who need to use formula feed.
A digital health system combining online services with text messages is highly effective in early infant diagnosis of HIV according to findings from a cluster-randomised controlled trial in Kenya published in The Lancet HIV.