HIV Testing, Prevention and Care Interventions, 2nd Edition

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: 20 December 2025 | Viewed by 4718

Special Issue Editors


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Guest Editor
School of Public Health and Health Sciences, College of Health, Human Services and Nursing, California State University Dominguez Hills, Carson, CA, USA
Interests: parasitic diseases; public health; communicable diseases
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Guest Editor
Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
Interests: HIV testing; HIV treatment; pharmacology; infectious diseases; global health; neglected diseases; pharmacogenetics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Human immunodeficiency virus (HIV) infection is a growing problem all around the world that, if not diagnosed and treated early, might cause acquired immunodeficiency syndrome (AIDS), the most advanced stage of HIV infection. The worldwide strategy promoted by the World Health Organization (WHO) and the United Nations UNAIDS aims for 95% of people living with HIV to know their status, 95% of people diagnosed with HIV to be on antiretroviral therapy (ART), and 95% of people on ART to achieve viral suppression. It is well known that the risk factors for HIV include having vaginal or anal sex with someone who is HIV-positive or whose HIV status is unknown; having sex with many partners; and injecting drugs and sharing needles, syringes, or other drug equipment with others. For example, the Centers for Disease Control and Prevention (CDC) in the US recommends that everyone 13 to 64 years of age get tested for HIV at least once as part of routine healthcare and that people at higher risk for HIV get tested more often. The healthcare provider of those over 64 years of age and at risk of HIV may recommend HIV testing. Also, the CDC recommends that all pregnant women get tested for HIV so that they can begin taking HIV medicines if they are HIV-positive. In addition, to achieve viral suppression, it is crucial that laboratory monitoring of this parameter is performed in the person living with HIV. However, full access to testing is not possible everywhere; this is not only due to a lack of resources but also as a result of legal, cultural, and religious barriers, plus the stigma associated with HIV. For those reasons, this Special Issue is primarily focused on sharing experiences and pitfalls in individuals’ realities with the aim of overcoming HIV testing barriers and developing strategies to set proper prevention and care interventions.

In addition, this Special Issue intends to be enriched with quantitative data, rather than descriptive studies, to provide additional tools for decision-makers focused on the important public health aspects concerning people with HIV, particularly to ensure that HIV is completely under control and improve the awareness of the HIV-negative population.

Dr. Ricardo Izurieta
Prof. Dr. Enrique Terán
Guest Editors

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Keywords

  • HIV testing
  • HIV stigma
  • HIV prevention
  • HIV care

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Related Special Issue

Published Papers (5 papers)

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Research

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17 pages, 712 KB  
Article
Prevalence of Intestinal Protozoa Among Patients Living with HIV in the Peruvian Amazon
by Silvia Otero-Rodriguez, Viviana Pinedo-Cancino, Martin Casapia-Morales, Victoria-Ysabel Villacorta-Pezo, Seyer Mego-Campos, Jorge Parráguez-de-la-Cruz, Esperanza Merino, Eva H. Clark and José-Manuel Ramos-Rincón
Trop. Med. Infect. Dis. 2025, 10(11), 324; https://doi.org/10.3390/tropicalmed10110324 - 18 Nov 2025
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Abstract
Intestinal protozoa are a common cause of morbidity in people living with HIV (PWH), particularly in tropical regions with poor sanitation. We conducted a cross-sectional study in 315 PWH from Iquitos, Peru, between October 2023 and May 2024, to assess their prevalence and [...] Read more.
Intestinal protozoa are a common cause of morbidity in people living with HIV (PWH), particularly in tropical regions with poor sanitation. We conducted a cross-sectional study in 315 PWH from Iquitos, Peru, between October 2023 and May 2024, to assess their prevalence and risk factors. Stool samples were examined using Lugol’s iodine, modified Ziehl–Neelsen (MZN) staining, and immunochromatography (ICT). The mean age was 41 years, with a median CD4+ count of 431 cells/µL; 12.4% were in the AIDS stage, and 21.5% had a detectable viral load. 51.4% of the participants tested positive for any intestinal protozoa. The overall Cryptosporidium spp. prevalence (by combining MZN and ICT results) was 25.7%. The overall Giardia spp. and Entamoeba spp. prevalences (by combining Lugol’s iodine and ICT results) were 2.9% and 1.9%, respectively. Blastocystis spp. was frequently isolated, though its pathogenicity remains uncertain. Diagnostic agreement was almost perfect between Lugol and ICT for Giardia and Entamoeba (κ = 0.87; p < 0.001 and κ = 0.91; p < 0.001, respectively), but only slight between MZN and ICT. Homosexual practices were identified as a significant risk factor for pathogenic protozoa infection (AOR 2.52; 95% CI: 1.04–6.12). In conclusion, the high prevalence of protozoa infection reflects ongoing fecal–oral exposure, underscoring the need for public health education, routine diagnosis, and treatment in similar settings. Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)
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12 pages, 493 KB  
Article
High Rate of Human T-Cell Lymphotropic Virus-2 in Patients with HIV in the Peruvian Amazon
by Silvia Otero-Rodriguez, Martin Casapia-Morales, Carmen de Mendoza, Viviana Pinedo-Cancino, Seyer Mego-Campos, Vicente Soriano, Esperanza Merino and José-Manuel Ramos-Rincón
Trop. Med. Infect. Dis. 2025, 10(9), 267; https://doi.org/10.3390/tropicalmed10090267 - 17 Sep 2025
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Abstract
HTLV-1/2 in people with HIV (PWH) has been little studied in the Peruvian Amazon, an endemic area for both viruses. We aimed to estimate its prevalence and describe the main clinical and epidemiological features of individuals with HTLV-HIV co-existence. We conducted a cross-sectional [...] Read more.
HTLV-1/2 in people with HIV (PWH) has been little studied in the Peruvian Amazon, an endemic area for both viruses. We aimed to estimate its prevalence and describe the main clinical and epidemiological features of individuals with HTLV-HIV co-existence. We conducted a cross-sectional study (October–December 2023) at the Division of Infectious Diseases and Tropical Medicine at the Regional Hospital of Loreto in Iquitos. We performed a screening test (recombinant HTLV I+II ELISA) and confirmed the results with INNO-LIA. Among 293 PWH analyzed, 14 (4.8%) were HTLV-positive: 1/293 was HTLV-1-positive (0.3%; 95% CI 0.06–0.9), 11/293 were HTLV-2-positive (3.8%; 95% CI 2.1–6.8), and 2/293 were non-typeable (0.7%; 95% CI 0.1–2.7). Compared with HIV-monoinfected individuals, superinfected patients were older (55 vs. 39 years; p = 0.001). Low education was more frequent in the univariate analysis (35.7% vs. 15.4%; p = 0.05) but was not retained in the multivariable model. In conclusion, HIV–HTLV-2 co-existence is relatively common (~4%) in the Peruvian Amazon, particularly among older individuals, highlighting the need for targeted screening and prevention strategies. Integrating HTLV testing into routine HIV clinic workflows, along with brief and focused counseling for superinfected patients, may help optimize follow-up and care. Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)
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14 pages, 290 KB  
Article
Patterns of Reverse Transcriptase Inhibitor Resistance Mutations in People Living with Human Immunodeficiency Virus in Libreville, Gabon
by Guy Francis Nzengui-Nzengui, Gaël Mourembou, Euloge Ibinga, Ayawa Claudine Kombila-Koumavor, Hervé M’boyis-Kamdem, Edmery Muriel Mpouho-Ntsougha, Alain Mombo-Mombo and Angélique Ndjoyi-Mbiguino
Trop. Med. Infect. Dis. 2025, 10(8), 216; https://doi.org/10.3390/tropicalmed10080216 - 30 Jul 2025
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Abstract
Objective: To characterize the profiles of resistance mutations to HIV reverse transcriptase inhibitors in Gabon. Design: Cross-sectional study conducted over 37 months, from October 2019 to October 2022, at the IST/HIV/AIDS Reference Laboratory, a reference center for the biological monitoring of people living [...] Read more.
Objective: To characterize the profiles of resistance mutations to HIV reverse transcriptase inhibitors in Gabon. Design: Cross-sectional study conducted over 37 months, from October 2019 to October 2022, at the IST/HIV/AIDS Reference Laboratory, a reference center for the biological monitoring of people living with the human immunodeficiency virus (PWHIV) in Gabon. Methods: Plasma from 666 PWHIV receiving antiretroviral treatment was collected, followed by RNA extraction, amplification, and reverse transcriptase gene sequencing. Statistical analyses were performed using Stata® 14.0 software (USA). Results: Six hundred and sixty-six (666) PWHIV plasma collected from 252 male and 414 female patients were analyzed and 1654 mutations were detected in 388 patients, including 849 (51.3%) associated with nucleoside reverse transcriptase inhibitors (NRTIs) and 805 (48.7%) with non-nucleoside reverse transcriptase inhibitors (NNRTIs). Three of the most prescribed treatment regimens were associated to the appearance of both NRTIs and NNRTIs resistance mutations: TDF + 3TC + EFV (24.02%; 160/666); TDF + FTC + EFV) (17.2%; 114/666) and AZT + 3TC + EFV (14.6%; 97/666). Additionally, stage 3 of CD4 T-lymphocyte deficiency, the higher viral load, and treatment duration are risk factors influencing the appearance of virus mutations. Also, treatment containing TDF-3TC + DTG is more protective against mutations. Conclusions: Drug resistance mutations are common in Gabon and compromise the efficacy of ART. Further study must search for other causes of therapeutic failure in Gabon in PWHIV. Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)
27 pages, 1879 KB  
Article
Syndemic Synergy of HPV, HIV, and HSV-2 for Oncogenic HPV Replication in Female Sex Workers
by Jonathan Muwonga Tukisadila, Ralph-Sydney Mboumba Bouassa, Serge Tonen-Wolyec, Hugues Loemba, Jeremie Muwonga and Laurent Belec
Trop. Med. Infect. Dis. 2025, 10(6), 157; https://doi.org/10.3390/tropicalmed10060157 - 7 Jun 2025
Cited by 1 | Viewed by 2183
Abstract
Background: Female sex workers (FSWs) in sub-Saharan Africa bear a disproportionate burden of sexually transmitted infections, including HIV, high-risk HPV (HR-HPV), and herpes simplex virus type 2 (HSV-2). This study evaluated possible association between HR-HPV, HIV, and HSV-2 among FSWs in the Democratic [...] Read more.
Background: Female sex workers (FSWs) in sub-Saharan Africa bear a disproportionate burden of sexually transmitted infections, including HIV, high-risk HPV (HR-HPV), and herpes simplex virus type 2 (HSV-2). This study evaluated possible association between HR-HPV, HIV, and HSV-2 among FSWs in the Democratic Republic of the Congo. Methods: A cross-sectional study was conducted among 432 FSWs (mean age, 28.1 years) recruited via respondent-driven sampling. Genital self-sampling using the V-Veil UP2™ device was performed, followed by HPV genotyping and quantification by multiplex PCR, and HSV-2 DNA detection by PCR. Results: Among 415 participants, HR-HPV prevalence was 36.9%, with HPV-52 (14.9%), HPV-58 (10.1%), and HPV-16 (6.5%) as leading genotypes. Overall, 89% of HR-HPV-positive women harbored genotypes covered by Gardasil-9®. Co-infection with HIV and HSV-2 significantly increased HPV prevalence, genotype diversity, and viral load. Notably, HSV-2 positivity was the sole independent predictor of elevated replication of HR-HPV (p < 0.001), vaccine HR-HPV (p < 0.001), and non-vaccine HR-HPV (p < 0.021). Conclusions: FSWs exhibit a high burden of HR-HPV, shaped by co-infections with HIV and HSV-2. HSV-2 independently drives HR-HPV replication, highlighting its role in HPV persistence and cervical cancer risk. Integrated HSV-2 detection and Gardasil-9® vaccination should be prioritized in cervical cancer elimination strategies targeting high-risk populations in sub-Saharan Africa. Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)
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Review

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30 pages, 1077 KB  
Review
A Contemporary Multidimensional Insight into the Clinical and Pathological Presentation of Urological Conditions Associated with HIV: A Narrative Review
by Hannah Faherty, Jamshaid Nasir Shahid, Yousef Abu Osba, Maryam Jamshaid, Dushyant Mital and Mohamed H. Ahmed
Trop. Med. Infect. Dis. 2025, 10(11), 318; https://doi.org/10.3390/tropicalmed10110318 - 11 Nov 2025
Viewed by 424
Abstract
Human Immunodeficiency Virus (HIV) infection is associated with a wide spectrum of urological manifestations, reflecting both the direct effects of viral infection and the indirect consequences of immunosuppression, opportunistic infections, malignancies and long-term combined antiretroviral therapy (cART). This narrative review provides a contemporary, [...] Read more.
Human Immunodeficiency Virus (HIV) infection is associated with a wide spectrum of urological manifestations, reflecting both the direct effects of viral infection and the indirect consequences of immunosuppression, opportunistic infections, malignancies and long-term combined antiretroviral therapy (cART). This narrative review provides a contemporary, multifaceted overview of the clinical and pathological presentations of urological conditions in people living with HIV (PLWHIV), based on articles published between 1989 and 2025. Conditions discussed include HIV-associated nephropathy (HIVAN), opportunistic genitourinary infections, malignancies such as Kaposi sarcoma and lymphoma, as well as non-infectious complications such as HIV-associated nephropathy and erectile dysfunction (ED). The review highlights the evolving epidemiology of these conditions in the cART era, with a noted decline in opportunistic infections but a rising burden of chronic kidney disease and malignancies, largely due to improved survival and ageing of the HIV-positive population. Pathological insights are explored and discussed, including mechanisms of HIV-associated renal injury, such as direct viral infection of renal epithelial cells and genetic predispositions linked to Apolipoprotein L1 (APOL1) variants. In addition, psychosocial factors, including anxiety, stress, stigma, and alcohol use, are discussed, as they may contribute to late presentation to clinical urology services. The review also considers the challenges faced in low and middle-income countries, the impact of HIV on urological services, and the important role of palliative care in advanced disease. Ultimately, this review underscores the need for early recognition, comprehensive diagnostic and surgical evaluation, and integrated social, psychological, and palliative management strategies tailored to the unique needs of PLWHIV. A deeper understanding of the interplay between HIV, cART, psychosocial determinants, and urological health is essential for improving patient outcomes and guiding future research in this evolving field. Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)
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