This February, Zambia took an important step forward in the fight against HIV and became the first African country to offer cabotegravir long-acting injectable (CAB-LA) for HIV prevention outside of a study setting. The long-expected roll-out of CAB-LA for pre-exposure prophylaxis (PrEP) comes thanks to a partnership between Zambia's Ministry of Health and the United States Agency for International Development (USAID). It kickstarted with an initial drug donation from USAID that will provide HIV prevention to 2000 Zambians for 12 months ..read more

Integrase strand-transfer inhibitors (INSTIs) have almost entirely replaced non-nucleoside reverse transcriptase and protease inhibitors for naive, second-line, and even subsequent-line treatment of HIV. As with any widely prescribed class of drug, potential adverse events undergo intense scrutiny. When an association between early pregnancy use of dolutegravir—currently the world's most prescribed INSTIs—and neural tube defects was reported in an observational cohort, there were several years of uncertainty until the issue was resolved ..read more

Although residual confounding cannot be entirely excluded, the use of INSTIs was associated with incident hypertension, and the use of tenofovir alafenamide was associated with dyslipidaemia, with the latter association partly mediated by weight gain. These results reiterate the need for hypertension and dyslipidaemia screening in people with HIV ..read more

Young children are often left behind when it comes to accessing the newest medicines approved in adults. Delays are primarily driven by little availability of child-friendly formulations, no dosing guidance, and no relevant safety information. The enactment of new laws governing regulatory drug approvals in the USA and Europe have endeavoured to address this inequity by requiring drug developers to perform paediatric studies in parallel with adult development. Now, Carina A Rodriguez and colleagues report the 1-year outcomes of coformulated bictegravir, emtricitabine, and tenofovir alafenamide ..read more

Data support the use of single-tablet coformulated bictegravir (30 mg), emtricitabine (120 mg), and tenofovir alafenamide (15 mg) for treatment of HIV in children aged at least 2 years and weighing 14 kg to less than 25 kg ..read more

Collective antiretroviral protection is an evolving sexual health strategy in HIV prevention, used in particular by gay, bisexual, and other men who have sex with men. The strategy involves HIV-negative individuals who engage in condomless sexual activities but, instead of using pre-exposure prophylaxis (PrEP) themselves, choose partners who either have undetectable viral loads or are on PrEP. This biomedical-sorting practice, rooted in the scientific principles of undetectable equals untransmittable (U=U) and PrEP, relies on an indirect protection strategy ..read more

The scale-up of antiretroviral therapy (ART) and the integrated continuum of services from HIV testing to viral load monitoring has enabled a growing number of countries to achieve UNAIDS’ 95-95-95 Fast Track goals. Globally, 71% (60–83%) of all people living with HIV are virally suppressed, although progress has been inequitable in key populations such as people who inject drugs and men who have sex with men, populations who often access ART at rates well below the general population. To optimise public health impact, implementation models that work for the broader community must be adapted f ..read more

Current models of climate change and HIV acknowledge the impact of social determinants of health (eg, geographic location, socioeconomic status) but do not include theorised causal pathways linked to systems-level influences. Nations in the Global South (eg, sub-Saharan African, South American, and southeast Asian countries) and individuals with minoritised identities face a disproportionate burden of the HIV syndemic (ie, the way that HIV interacts with other infectious diseases and health concerns to yield increased health burden ..read more

Despite high intervention engagement, incentives did not improve survival with viral suppression among people who inject drugs and men who have sex with men living with HIV in India. The poor outcomes overall underscore the need for innovative, multilevel approaches to engage marginalised people living with HIV in low-income and middle-income settings ..read more

March 8 marks International Women's Day—the annual event that gives focus to issues including gender equity and inclusion, reproductive rights, and violence against women. In the field of HIV, the concerns posed by International Women's Day resonate particularly strongly. Women are disproportionately affected by HIV globally, and in some of the hardest hit regions, women bear the brunt of the epidemic in terms of both disease burden and care for those affected. UNAIDS estimates that 53% of people living with HIV in 2022 were women and girls ..read more