aidsmap news: No increased risk of diabetes with integrase inhibitors in people starting HIV treatment, 14 September 2020

News from aidsmap

No increased risk of diabetes with integrase inhibitors in people starting HIV treatment

Among people with HIV taking antiretroviral therapy for the first time, integrase inhibitors are not associated with an increased risk of incident diabetes, according to a French study recently published in the Journal of Antimicrobial Chemotherapy. This result was observed after comparing HIV-treatment regimens in which the third agent was either an integrase inhibitor, a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor (NNRTI).

HIV programmes in Africa need new models of care for people’s first six months on treatment

With many HIV treatment programmes in sub-Saharan Africa still expecting new patients to attend a clinic monthly for their first six months of antiretroviral therapy (ART), but persistently high rates of loss to follow-up during this time, research to develop differentiated models of care for the first six-month period is needed, argue Professor Sydney Rosen of Boston University and colleagues in Gates Open Research.

A third of people living with HIV have not discussed U=U with their healthcare provider

Data from an international survey of people living with HIV in high-income and upper-middle-income countries show that while two-thirds have talked about ‘undetectable equals untransmittable’ (U=U) with a healthcare provider, one third have not had such a discussion. Having talked about U=U was significantly associated with favourable health outcomes such as better adherence and being comfortable sharing their HIV status, Chinyere Okoli and colleagues report in Sexually Transmitted Infections.

India progresses towards eliminating vertical transmission of HIV but is not there yet

The global targets to eliminate vertical transmission of HIV by 2020 were set in 2014. But till now, only a dozen countries have been able to do so. With less than four months left to meet the 2020 goal of eliminating vertical transmission of HIV, India has a long way to go despite having made considerable progress in the past five years. HIV testing among pregnant women rose from 18% to 78% during 2015-2019 in 14 states, while early infant diagnosis within two months of birth upped from 51% to 82% in the remaining 22 states during 2017-2019.

Why do people in southern Africa stop taking PrEP?

People who start taking pre-exposure prophylaxis (PrEP) in sub-Saharan Africa often discontinue taking it. A team led by Kate Bärnighausen of University of Witwatersrand, South Africa, interviewed former PrEP users in the general population in Eswatini to discover why this might be. They found that reasons for discontinuing included objections from male partners, decisions about perceived necessity of taking PrEP, and barriers to attending clinic appointments. Cost of PrEP itself was not an issue because it is free at point of care in Eswatini.

Trans and cis women and men all have similar levels of PrEP drugs in blood, directly observed dosing study finds

A study in which 24 trans women and 24 trans men who were taking gender-affirming hormone therapy were directly observed to take a daily dose of the standard formulation of the HIV prevention medication PrEP found that the levels of the two PrEP drugs tenofovir and emtricitabine were similar to the levels seen in similar cis men and women, and were all above levels associated with efficacy.

Two different cases of PrEP failure despite high adherence underline that such events are rare, but should not be ignored

Two reports of HIV infection occurring despite apparent adequate adherence to PrEP, confirmed by drug level testing, are the first reliably documented cases to be published in peer-reviewed journals since 2018.

Loreen Willenberg's HIV seems to have disappeared. Is this good news for the rest of us?

Last year, a 66-year-old Californian woman, diagnosed with HIV in 1992, appeared in a local magazine as “The World’s First Known Person Who Naturally Beat HIV.” Loreen Willenberg had always been an 'elite controller' – a person who maintains an undetectable viral load without having to take HIV drugs – but now her doctors can find no trace of the virus anywhere in her body.

“Telling lies every day”: secrecy as a means of resisting stigma and asserting identity

Young women living with HIV in Zambia find multiple ways of keeping their HIV status secret, including hiding their medication and using veiled language to discuss HIV. These strategies are used as a way of resisting stigma and maintaining identities separate from HIV, but can lead to feelings of guilt and anxiety.

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Editors' picks from other sources

Q&A: What clinicians should know about starting, stopping and restarting PrEP | Healio

The need for HIV PrEP fluctuates as risk behaviors change. In a recent viewpoint published in The Lancet HIV, researchers reviewed current guidelines and the clinical implications of starting, stopping and restarting the daily medication.

San Francisco HIV cases fell by 19% in 2019 | Bay Area Reporter

New HIV diagnoses in San Francisco continue to fall but disparities remain, according to the latest HIV epidemiology report from the San Francisco Department of Public Health. While acknowledging last year's good news, health officials are concerned that the COVID-19 crisis could compromise the city's progress going forward.

Vaginal ring: The beauty of choice | RTI International

Is the ring perfect? Absolutely not. Is it 100% efficacious? Probably not. Is it still essential to add the ring to the HIV prevention toolbox? Absolutely! Whereas the ring is a match for some, it will not be every woman’s choice.

Mobile ‘fix room’ begins operating in Glasgow | BBC News

A drug consumption van where addicts can inject heroin has been launched in – despite warnings it could be breaking the law.

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