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safely via routine clinical care as needed (ClinicalTrials.gov, NCT03945981; see Supplemental Digital Content 1, video abstract (Video abstract summarizing the STAT study design and results.), http//links.lww.com/QAD/C189).

UNAIDS aims for HIV testing, treatment and viral suppression rates to be 95%-95%-95% by 2025. Patented drug prices remain a barrier to HIV treatment. Generic alternatives are being produced and exported from countries without patent barriers at a fraction of the cost.

We collated export records of active pharmaceutical ingredient for HIV drugs to estimate the minimum costs of production. Using epidemiological data describing national HIV epidemics, we calculated the cost to treat 164 countries at 95%-95%-95%. Using weighted log-linear regression models we estimated the mother-to-child transmissions (MTCTs), HIV-related deaths and new HIV infections preventable every year by increased treatment.

We estimated that TDF/3TC/DTG could be produced for $59 per person per year. At this price, the 164 countries in our analysis could be treated at 95%-95%-95% for $2 billion a year, preventing 66,308 MTCTs, 241,811 HIV-related deaths and 631,398 new HIV infections every year. In comparison, global expenditure on HIV pharmaceuticals in 2019 was $28 billion.

At $2 billion/year, the 164 countries in our analysis could be treated for the price of four weeks of current global sales. Global access to generic alternatives could reduce expenditure and improve clinical outcomes.

At $2 billion/year, the 164 countries in our analysis could be treated for the price of four weeks of current global sales. Global access to generic alternatives could reduce expenditure and improve clinical outcomes.

Persistent immune activation in the central nervous system and systemically are common in people living with HIV (PLHIV) despite antiretroviral therapy. It is not known whether this is generated by HIV replication or other components such as coinfections and lifestyle-related factors.

To determine the importance of different factors, it is crucial to find well-matched HIV-negative controls. In this context, HIV-negative persons on pre-exposure prophylaxis (PrEP) may constitute a suitable control group to PLHIV with similar lifestyle-related factors.

Cerebrospinal fluid (CSF) and blood were collected from 40 HIV-negative persons on PrEP and 20 controls without PrEP. Biomarkers of immune activation, blood-brain barrier (BBB) integrity, and neuronal injury were analysed.

CSF and serum β2-microglobulin, serum neopterin, and CSF neurofilament light protein were higher in persons on PrEP compared to controls. ODQ datasheet Furthermore, persons on PrEP had higher CSF/plasma albumin ratio, and matrix metalloproteinase-3 coduals and in drug users compared to non-users. These findings are important to consider when analyzing immune activation and CNS injury in PLHIV, and emphasize the importance of appropriate controls.

To compare rates and trends of HIV diagnoses among Indigenous peoples in Canada (First Nations, Métis, Inuit, and other non-specified), Australia (Aboriginal and Torres Strait Islanders), the USA (American Indian, Alaska Native, Native Hawaiian, and Other Pacific Islanders), and New Zealand (Māori).

We employed publicly available surveillance data from 2009 to 2017 to estimate the rate per 100 000 of HIV diagnoses. Estimated annual percentage change (EAPC) in diagnosis rates was calculated using Poisson regression.

The four countries have passive population-based HIV surveillance programs.

Population estimates from respective census programs were used as rate denominators.

Estimated annual HIV diagnosis rate per 100 000 and EAPC were calculated for total Indigenous peoples, women, and men.

As of 2017, rates of HIV were highest in Canada (16.22, 95% confidence interval (CI) 14.30--18.33) and lowest in New Zealand (1.36, 95% CI 0.65--2.50). Australia had a rate of 3.81 (95% CI 2.59--5.40) and the USA 3.22 (95% CI 2.85--3.63). HIV diagnosis rates among the total Indigenous population decreased in Canada (-7.92 EAPC, 95% CI -9.34 to -6.49) and in the USA (-4.25 EAPC, 95% CI -5.75 to -2.73) but increased in Australia (5.10 EAPC, 95% CI 0.39--10.08). No significant trends over time were observed in New Zealand (2.23 EAPC, 95% CI -4.48 to 9.47).

Despite limitations to conducting cross-national comparisons, there are substantial differences in HIV diagnosis rates in these four countries that may be reflective of divergent national policies and systems that affect the health status of Indigenous peoples.

Despite limitations to conducting cross-national comparisons, there are substantial differences in HIV diagnosis rates in these four countries that may be reflective of divergent national policies and systems that affect the health status of Indigenous peoples.

To measure associations between participation in community-based microfinance groups, retention in HIV care, and death among people living with HIV (PLHIV) in low-resource settings.

We prospectively analyzed data from 3,609 patients enrolled in an HIV care program in western Kenya. HIV patients who were eligible and chose to participate in a Group Integrated Savings for Health Empowerment (GISHE) microfinance group were matched 12 on age, sex, year of enrollment in HIV care, and location of initial HIV clinic visit to patients not participating in GISHE. Follow-up data were abstracted from medical records for January 2018 through February 2020. Logistic regression analysis examined associations between GISHE participation and two outcomes retention in HIV care (i.e., >1 HIV care visits attended within 6 months prior to the end of follow up) and death. Socioeconomic factors associated with HIV outcomes were included in adjusted models.

The study population was majority female (78 3%) with a median age of 37 4 years. Microfinance group participants were more likely to be retained in care relative to HIV patients not participating in a microfinance group (adjusted OR (aOR) = 1 31, 95% CI 1 01 - 1 71; p = 0.046). Participation in group microfinance was associated with a reduced odds of death during the follow-up period (aOR = 0 57, 95% CI 0 28 - 1 09; p = 0.105).

Participation in group-based microfinance appears to be associated with better HIV treatment outcomes. A randomized trial is needed to assess whether microfinance groups can improve clinical and socioeconomic outcomes among PLHIV in similar settings.

Participation in group-based microfinance appears to be associated with better HIV treatment outcomes. A randomized trial is needed to assess whether microfinance groups can improve clinical and socioeconomic outcomes among PLHIV in similar settings.