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Using molecular epidemiology to trace the history of the injection-related HIV epidemic in New York City, 1985–2019

Torian, Lucia V.; Forgione, Lisa; Wertheim, Joel O.

AIDS. 36(6):889-895, May 1, 2022.

There is ample evidence that harm reduction programs including syringe service programs (SSPs) lower the risk of HIV transmission among people who inject drugs (PWID). However implementing these programs has been hampered by social and political opposition in many countries including the US. Two recent US studies present evidence about the importance of these programs for the prevention among PWID. One modelling study showed that closing SSPs among PWID in a rural US setting would lead to a significant increase of HIV among PWID even if this closure is temporary and short term. Another study using molecular epidemiological data was done in New York City (NYC) where harm reduction programs were slowly introduced and HIV spread rapidly among PWID in the eighties. The recent increase of injecting drug use in NYC led to concerns that this would lead to an increase of blood borne HIV transmission. Molecular epidemiological data present evidence that HIV transmission among PWID in NYC does occur but mainly through sexual transmission strongly suggesting that the now widely implemented harm reduction programs including SSPs have a major preventative impact on the spread of HIV through contaminated needles and syringes among this risk group.

The impact of syringe services program closure on the risk of rebound HIV outbreaks among people who inject drugs: a modeling study

Zang, Xiao; Goedel, Williams C.; Bessey, Sam E.; More

AIDS. 36(6):881-888, May 1, 2022.

There is ample evidence that harm reduction programs including syringe service programs (SSPs) lower the risk of HIV transmission among people who inject drugs (PWID). However implementing these programs has been hampered by social and political opposition in many countries including the US. Two recent US studies present evidence about the importance of these programs for the prevention among PWID. One modelling study showed that closing SSPs among PWID in a rural US setting would lead to a significant increase of HIV among PWID even if this closure is temporary and short term. Another study using molecular epidemiological data was done in New York City (NYC) where harm reduction programs were slowly introduced and HIV spread rapidly among PWID in the eighties. The recent increase of injecting drug use in NYC led to concerns that this would lead to an increase of blood borne HIV transmission. Molecular epidemiological data present evidence that HIV transmission among PWID in NYC does occur but mainly through sexual transmission strongly suggesting that the now widely implemented harm reduction programs including SSPs have a major preventative impact on the spread of HIV through contaminated needles and syringes among this risk group.

Comparison of dementia incidence and prevalence between individuals with and without HIV infection in primary care from 2000 to 2016

Lam, Jennifer O.; Lee, Catherine; Gilsanz, Paola; More

AIDS. 36(3):437-445, March 1, 2022.

This interesting study convincingly shows that since 2000 the dementia incidence among 50+ persons with HIV (PWH) has decreased, which likely reflects better and adequate ART treatment. However, even now, PWH appear still to be at higher dementia risk than persons without HIV, among whom the dementia incidence appears to be also declining. As is mentioned in an accompanying editorial comment of this paper, "The persistent disparity in brain health among aging people with HIV" by Jose Gutierrez, the majority of the persons studied were non-hispanic whites who were virally suppressed and had CD4 counts >500, so whether similar encouraging trends will also be found among populations that are less better-off, has to be shown.

SARS-CoV-2 incidence, testing rates, and severe COVID-19 outcomes among people with and without HIV

Spinelli, Matthew A.; Brown, Lillian B.; Glidden, David V.; More

AIDS. 35(15):2545-2547, December 1, 2021.

Early studies did not find an elevated risk of severe COVID-19 among people with HIV (PWH), though this could be due to bias. The group in San Francisco used a population-based approach to address this bias, matching by HIV status with cases of COVID in the city. They found the risk of severe COVID-19 was higher among PWH (adjusted relative risk=1.84, 95% CI=1.05-3.25), while SARS-CoV-2 incidence was lower despite higher testing rates. This well conducted study helps clarify the risk for more severe COVID among PWH.

Candidate host epigenetic marks predictive for HIV reservoir size, responsiveness to latency reversal, and viral rebound

Corley, Michael J.; Pang, Alina P.S.; Rasmussen, Thomas A.; More

AIDS. 35(14):2269-2279, November 15, 2021.

This article highlights the finding of 15 DNA methylation patterns in CD4 T cells in people living with HIV that are associated with the extent of viral rebound when anti-HIV drugs are stopped. The findings suggest pre-existing epigenetic states in infected CD4+ T cells that determine HIV rebound kinetics and maintenance of HIV reservoirs. The information could permit a better assessment of outcomes of ongoing and future clinical trials directed at a successful HIV cure.

Achieving national HIV prevention goals: the case for addressing depression and other mental health comorbidities

Koenig, Linda J.; McKnight-Eily, Lela R.

AIDS. 35(12):2035-2037, October 1, 2021.

The editor has highlighted the paper, Depression and HIV viral non-suppression among people engaged in HIV care in an urban clinic, 2014-2019 (Lesko, Catherine R. et al) as being of special interest to the field of HIV research. The editorial comment from Linda Koenig, Achieving national HIV prevention goals The case for addressing depression and other mental health comorbidities, has been published to accompany Lesko's paper.

Depression and HIV viral nonsuppression among people engaged in HIV care in an urban clinic, 2014–2019

Lesko, Catherine R.; Hutton, Heidi E.; Fojo, Anthony T.; More

AIDS. 35(12):2017-2024, October 1, 2021.

Depression, a common diagnosis among HIV-infected persons, has a negative impact on HIV care. The study by Lesko et al indicates that adequate treatment of depression is associated with a better viral suppression which is important for the patient and also to limit transmission to partners.

Rates of new HIV diagnoses among Indigenous peoples in Canada, Australia, New Zealand, and the United States: 2009–2017

Koehn, Katrina; Cassidy-Matthews, Chenoa; Pearce, Margo; More

AIDS. 35(10):1683-1687, August 1, 2021.

The authors studied the disproportionate impact of HIV on indigenous populations in the US, Canada, Australia and New Zealand over a period of nearly 10 years. The differences in HIV diagnoses and trends over time in these countries indicate the importance of the data for public health action. This should stimulate standardized data collection and more in depth studies which may help to target effective interventions for these populations.

Prevalence and association with birth outcomes of low vitamin D levels among pregnant women living with HIV

Bergløv, Anne; Moseholm, Ellen; Katzenstein, Terese L.; More

AIDS. 35(9):1491-1496, July 15, 2021.

This Danish study indicates that African and Asian pregnant women with HIV are at risk to have low Vit D levels, which has practical implementations if confirmed by others

Effect of Truvada lawsuit advertising on preexposure prophylaxis attitudes and decisions among sexual and gender minority youth and young adults at risk for HIV

Serrano, Pedro A.; Daubert, Elizabeth; Munoz, Alejandro; More

AIDS. 35(1):131-139, January 1, 2021.

This paper on the effect of Truvada lawsuit advertising has been picked by the editor, Roel Coutinho, as being of special interest to the field of HIV research.