News from aidsmap

Nicotine metabolised at a faster rate among HIV-positive smokers – implications for quitting smoking

HIV-positive smokers metabolise nicotine at a significantly higher rate than HIV-negative individuals, investigators from the United States report in the online edition of AIDS. The finding could explain why people with HIV have more difficulty quitting smoking than their HIV-negative peers. A second study involving the same HIV-positive smokers and published in the Journal of Acquired Immune Deficiency Syndromes showed that a higher nicotine metabolism ratio (NMR) was associated with symptoms of anxiety and treatment with efavirenz.

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Cocaine use associated with poor adherence to PrEP and dropping out of care

Cocaine users have poorer adherence to HIV pre-exposure prophylaxis (PrEP) and engagement with care, according to research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes. Even light cocaine use doubled the odds of having blood levels of tenofovir, a key PrEP drug, that were insufficient to protect against infection with HIV. Individuals with moderate/heavy cocaine use were three times more likely to drop out of PrEP care than individuals who did not use cocaine.

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In the USA, only two in five PrEP users keep taking it over two years

Real-world data from a large American chain of retail pharmacies show that only two in five people keep on taking pre-exposure prophylaxis (PrEP) for two years after starting, researchers report in the Journal of the International AIDS Society.

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Shifting social norms around what “safer” sex is: perspectives of HIV-negative men in Canada

HIV-negative men who have sex with men (MSM) living in Vancouver, Canada are redefining ways to negotiate sexual safety and risk, according to qualitative research recently published by Dr Benjamin Klassen and colleagues in BMC Public Health. Condoms are no longer seen as the only means of preventing HIV infection.

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Gay men in New York rate an undetectable viral load as less effective than PrEP

Gay, bisexual and other men who have sex with men in New York City rate daily pre-exposure prophylaxis (PrEP) as the most effective HIV prevention strategy when condoms aren’t used, and considerably more effective than treatment as prevention or event-based PrEP, according to survey results published in AIDS and Behavior. Men rated these biomedical approaches far ahead of ‘strategic positioning’ or withdrawal before ejaculation.

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Smoking cannabis is an independent risk factor for lung disease in people with HIV

Frequent cannabis smoking is a risk factor for lung disease in HIV-positive men, according to US research published in EClinicalMedicine. Smoking cannabis increased the risk of pulmonary diseases – especially those with an infectious cause – independent of smoking and CD4 cell count. The research involved approximately 2500 men who have sex with men (MSM), half of whom were HIV positive. No independent associations were detected between smoking cannabis and lung disease in HIV-negative men, showing that HIV-positive individuals are especially vulnerable to lung disease caused by smoking the drug.

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HIV prevention cascades could highlight gaps in prevention programmes

A simple HIV prevention cascade could be a powerful tool for advocates, policy makers and funders, researchers argue in The Lancet HIV. It could help us understand where the gaps in prevention are, to monitor implementation and to set meaningful targets.

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DAA treatment reduces the risk of death and liver cancer in people with hepatitis C

Treatment with direct-acting antivirals (DAAs) reduced the risk of death, liver cancer and death from liver-related causes in French people with hepatitis C, according to results of one of the largest studies to date of the impact of the drugs.

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First evidence of HIV reservoirs in macrophages

Basic scientists in France have recently discovered that macrophages located in urethral tissue can contribute to cellular HIV reservoirs, and that the quantity of these specific immune cells is surprisingly high. Results were published in Nature Microbiology.

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Editors' picks from other sources

Stories of African-American women ageing with HIV: "My life wasn’t what I hoped it to be"

from The Conversation

African-American women ageing with HIV often have histories of abuse and trauma, in addition to other medical conditions. Here, a few share their stories.

REACH trial comparing vaginal ring to PrEP for HIV prevention begins

from Healio

The National Institutes of Health announced the start of a clinical trial that will explore the preference among adolescent girls and young women between pre-exposure prophylaxis, or PrEP, and a vaginal ring for HIV prevention.

Viral load monitoring motivates HIV treatment adherence in eSwatini

from AVERT

The treat-all policy will only succeed if people keep taking their HIV treatment. It is important to motivate people who started treatment while they were still feeling well. 

HIV situation is “critical” in Venezuela as military withholds meds

from Poz

Venezuelans with HIV are dying because they can’t access antiretroviral meds – despite the fact that 300,000 bottles of the drugs have been shipped to the country since the end of December. The lifesaving treatment sits in a warehouse on a military base, reports the Washington Blade, because the Venezuelan government claims it doesn’t have working trucks to distribute the meds.

Viet Nam announces nationwide rollout of PrEP

from World Health Organization

On the eve of World AIDS Day 2018, Viet Nam’s Ministry of Health announced a national plan to scale up pre-exposure prophylaxis (PrEP) for the prevention of HIV. Under this plan for 2018-2020, PrEP will be made available to at least 7300 people in at least eleven provinces by 2020.

Efavirenz and psychological performance in children living with HIV

from AVERT

Efavirenz remains a clinically effective and relevant antiretroviral drug for people living with HIV – but adverse side-effects need to be screened for and monitored in children.