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TropicalMed
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HIV Elimination: Addressing Challenges in Vulnerable Populations and Reducing Discrimination
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HIV Elimination: Addressing Challenges in Vulnerable Populations and Reducing Discrimination

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: 31 August 2026 | Viewed by 4537

Special Issue Editors

Dr. Eliã Pinheiro Botelho

E-Mail Website
Guest Editor
Graduate Program in Nursing, Universidade Federal do Pará, R. Augusto Corrêa, 01-Guamá, Belém 66075-110, PA, Brazil
Interests: HIV; AIDS; populations in vulnerability; sexually transmissible infections; syphilis; ecologic studies; spatial analysis; temporal analysis; cross-sectional studies; epidemiology
Dr. Glenda Roberta Oliveira Naiff Ferreira

E-Mail Website
Guest Editor
Graduate Program in Nursing, Universidade Federal do Pará, R. Augusto Corrêa, 01-Guamá, Belém 66075-110, PA, Brazil
Interests: HIV/AIDS; sexually transmissible infections; epidemiology

Special Issue Information

Dear Colleagues,

As we strive towards the UNAIDS goal of eliminating HIV by 2030, we have seen the implementation of various policies and strategies; however, significant gaps remain in understanding the successes achieved and the ongoing challenges faced by countries worldwide in the fight against this epidemic. This editorial aims to provide a comprehensive situational diagnosis by examining the global epidemiologic landscape of HIV, with a focus on fragile and marginalized populations.

Key topics to be explored include:

  • HIV/AIDS Among Key Populations: Including men who have sex with men, sex workers, transgender people, individuals who inject drugs, and people in prisons or other closed settings.
  • HIV/AIDS and Socioeconomically Marginalized Communities: Exploring how HIV disproportionately affects migrants, low-education settings, and other vulnerable groups.
  • HIV Prevention and Intervention Strategies: Addressing the accessibility, affordability, and barriers to antiretroviral therapy, particularly in fragile populations.
  • Addressing Discrimination: Approaches to reducing stigma and discrimination related to HIV, with an emphasis on inclusive and non-discriminatory frameworks in health policies and practices.
  • HIV and Women: Special focus on the impact of HIV on women and mother-to-child transmission.
  • HIV and Aging: The unique challenges faced by aging populations living with HIV.
  • HIV/AIDS Knowledge and Risk Behavior: Investigating how knowledge of HIV and related behaviors affect prevention and transmission. In terms of risk behavior, investigating how knowledge of HIV and related behaviors affect prevention and transmission.
  • HIV/AIDS and Adherence to Antiretroviral Therapy: Challenges surrounding medication adherence, including viral resistance.
  • Role of Community Engagement: How communities can be involved in disseminating preventive messages and supporting individuals at risk.

This Special Issue welcomes observational and experimental research, as well as reviews from a diverse range of disciplines, including infectious disease specialists, anthropologists, public health experts, and social scientists, which can contribute to the progress of HIV elimination.

Dr. Eliã Pinheiro Botelho
Dr. Glenda Roberta Oliveira Naiff Ferreira
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • HIV/AIDS among key populations
  • socioeconomically marginalized communities
  • HIV prevention and intervention strategies
  • antiretroviral therapy access
  • stigma and discrimination in HIV Care
  • HIV and women
  • mother-to-child HIV transmission
  • HIV and aging populations
  • HIV/AIDS knowledge and risk behavior
  • adherence to antiretroviral therapy
  • viral resistance in HIV Treatment
  • community engagement in HIV Prevention
  • HIV in fragile populations
  • global HIV epidemiology
  • marginalized populations and HIV

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Published Papers (4 papers)

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Research

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14 pages, 591 KB  
Article
Hearing Assessment in HIV-Exposed-Uninfected Infants
by Amanda Zanatta Berticcelli, Andréa Lúcia Corso, Pâmela Panassol, Leticia Petersen Schmidt Rosito, Roberta Rahal de Albuquerque, Letícia de Paula e Souza, Milena Lessa da Silva, Sady Selaimen da Costa and Luciana Friedrich
Trop. Med. Infect. Dis. 2026, 11(5), 115; https://doi.org/10.3390/tropicalmed11050115 - 27 Apr 2026
Viewed by 329
Abstract
Background: Among the complications caused directly or indirectly by the Human Immunodeficiency Virus (HIV) are alterations in the auditory system. Children who are HIV-exposed but uninfected (HEU) appear to have a higher risk of hearing loss (HL) compared to their unexposed peers, but [...] Read more.
Background: Among the complications caused directly or indirectly by the Human Immunodeficiency Virus (HIV) are alterations in the auditory system. Children who are HIV-exposed but uninfected (HEU) appear to have a higher risk of hearing loss (HL) compared to their unexposed peers, but a lower risk than those infected with HIV. However, the literature remains inconclusive regarding this association. This study aims to evaluate the hearing function of HEU infants during the first months of life and to correlate these findings with maternal, gestational, and neonatal variables. Methods: This prospective cohort study included all HIV-exposed infants born in a quaternary hospital in southern Brazil between 2021 and 2023. Maternal, gestational, and neonatal data were collected, as well as the results of neonatal auditory screening. At approximately 6 months of age, otolaryngological and audiological assessments were performed, including wideband tympanometry and electrophysiological evaluation using Auditory Brainstem Response with frequency-specific stimuli. The prevalence of hearing loss refers to the number of infants affected. Results: Thirty-eight infants, with a mean age of 8 months (±3.3), completed the study. Of these, 1 (2.6%) presented with bilateral sensorineural HL, and 13 (34.2%) presented with conductive HL, with 6 cases being unilateral and 7 bilateral. No associations were found between hearing loss and maternal, gestational, or neonatal variables, except for maternal CD4 count, where higher CD4 cell counts were associated with an increased risk of conductive HL. Conclusion: The findings provide relevant data on auditory alterations in HEU infants, demonstrating a high prevalence of conductive HL. These results highlight the importance of monitoring the hearing of these children during the first years of life. Full article
(This article belongs to the Special Issue HIV Elimination: Addressing Challenges in Vulnerable Populations and Reducing Discrimination)
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21 pages, 1847 KB  
Article
Development and Validation of an Integrated HIV/STI, and Pregnancy Prevention Programme: Improving Adolescent Sexual Health Outcomes
by Mukovhe Rammela and Lufuno Makhado
Trop. Med. Infect. Dis. 2025, 10(9), 273; https://doi.org/10.3390/tropicalmed10090273 - 22 Sep 2025
Cited by 1 | Viewed by 1617
Abstract
In developing countries, adolescent girls and young women (AGYW) continue to experience high rates of unintended pregnancy and sexually transmitted infections (STIs), including Human Immunodeficiency Virus (HIV). Several healthcare services are available at the primary level of healthcare to address the sexual and [...] Read more.
In developing countries, adolescent girls and young women (AGYW) continue to experience high rates of unintended pregnancy and sexually transmitted infections (STIs), including Human Immunodeficiency Virus (HIV). Several healthcare services are available at the primary level of healthcare to address the sexual and reproductive needs of adolescents in South Africa. Healthcare providers often face challenges such as limited resources, inadequate funds, and inadequate training, which hinder their ability to provide integrated care. Furthermore, cultural stigma and a lack of privacy prevent adolescents from seeking care. In response to increasing international calls for developing and implementing integrated person-centered care, which addresses both quality and access to care, this paper aims to develop and validate an integrated HIV/STI, and pregnancy prevention program for adolescent girls and young women in the Vhembe District of Limpopo. Multiphase mixed methods were employed in this study. This study consisted of three interconnected phases. As part of phase 1 of this study, a comprehensive literature review was conducted. In phase 2, an empirical study conducted using a concurrent triangulation strategy to collect and analyze both qualitative and quantitative data as a form of confirmation, dis-confirmation, cross-validation or corroboration of the findings. Consequently, a conceptual framework was developed using qualitative and quantitative analysis by merging, comparing, and interpreting the results. The findings of phase 2 interface were analyzed using the Political, Environmental, Social, and Technological (PEST) and Strength, Weakness, Opportunity, and Threat (SWOT) analyses. Additionally, the outcomes of the Logical Framework Analyses (LFA) informed the development of an integrated programme aimed at preventing HIV, STIs, and teenage pregnancy. Several stakeholders and experts (n = 35) were consulted as part of the Reduce the Risk (RTR) Coalition to validate the proposed integrated programme with an average of 94.3% on acceptability, feasibility, and appropriateness. In the Vhembe District of Limpopo province, there has been no published study that has developed an integrated HIV, STIs, and pregnancy prevention programme to improve the sexual health outcomes of adolescent girls and young women. Full article
(This article belongs to the Special Issue HIV Elimination: Addressing Challenges in Vulnerable Populations and Reducing Discrimination)
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13 pages, 298 KB  
Article
Socioeconomic, Behavioural, and Protective Factors Influences on the Combined Prevention of HIV Infection Among Brazilian Amazon Men Who Have Sex with Men: A Cross-Sectional Study
by Thiago Vilhena Silva, Iaron Leal Seabra, Glenda Roberta Oliveira Naiff Ferreira, João Gabriel Alves da Luz, Cecília Conceição Viana, Lucas Barros de Paiva, Glauber Weder dos Santos Silva, Caio Lacerda dos Santos, Luiz Fernando Almeida Machado and Eliã Pinheiro Botelho
Trop. Med. Infect. Dis. 2025, 10(8), 231; https://doi.org/10.3390/tropicalmed10080231 - 16 Aug 2025
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Abstract
We analysed the socioeconomic, behavioural, and protection factors (PFs) influences on the HIV combined prevention (CP) strategy among Brazilian Amazonian men who have sex with men (MSMs). PFs are resources that reduce the effect of adversity and help people maintain their well-being. Methods: [...] Read more.
We analysed the socioeconomic, behavioural, and protection factors (PFs) influences on the HIV combined prevention (CP) strategy among Brazilian Amazonian men who have sex with men (MSMs). PFs are resources that reduce the effect of adversity and help people maintain their well-being. Methods: Cross-sectional study employing a convenient sample of MSMs living in the metropolitan region of Belém. A questionnaire containing socioeconomic, behavioural, PFs, and behaviour/knowledge concerning CP questions was used. “Behaviour/knowledge concerning CP” was defined as a dependent variable and received a maximum score of 16 points. The Mann–Whitney and Kruskal–Wallis tests and multiple linear regression were employed. Results: Our sample comprised 384 MSMs scoring an average of 7.83 points (±1.9). Contributing to lower scores were “not talking about sex life with confidants”, “not talking with work colleagues about personal life and sexually transmissible infections”, and “not participating in non-governmental organisations.” On the other hand, “not being happy in the neighbourhood of residency” contributed to higher scores. Conclusion: Peer support and social inclusion are essential for increasing MSMs’ access to CP. Full article
(This article belongs to the Special Issue HIV Elimination: Addressing Challenges in Vulnerable Populations and Reducing Discrimination)

Review

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24 pages, 1428 KB  
Review
Beyond Antiretroviral Therapy: Molecular and Immunological Innovations in HIV Treatment
by Awadh Alanazi, Mohamed N. Ibrahim and Mohamed A. Elithy
Trop. Med. Infect. Dis. 2026, 11(5), 114; https://doi.org/10.3390/tropicalmed11050114 - 26 Apr 2026
Viewed by 694
Abstract
Despite prolonged viral inhibition with combination antiretroviral therapy (ART), HIV-1 survives as genetically intact, replication-capable proviruses within durable CD4+ T-cell fractions, involving central memory, transitional memory, and stem cell-like memory populations, as well as within tissue-resident compartments including lymphoid follicles and gut-associated lymphoid [...] Read more.
Despite prolonged viral inhibition with combination antiretroviral therapy (ART), HIV-1 survives as genetically intact, replication-capable proviruses within durable CD4+ T-cell fractions, involving central memory, transitional memory, and stem cell-like memory populations, as well as within tissue-resident compartments including lymphoid follicles and gut-associated lymphoid tissue. Reservoir stability is preserved via clonal growth of infected cells and epigenetic processes that impose proviral transcriptional silencing. As a result, current therapeutic approaches seek to either directly alter proviral survival or to improve immune-driven elimination of infected cells. At the molecular level, investigational strategies such as CRISPR–Cas9 and CRISPR–Cas12 gene-editing systems are intended to remove or induce inactivating mutations inside embedded proviral DNA, as well as alter host entrance co-receptors such as CCR5 to provide cellular resistance to infection. In addition, pharmacologic latency regulation is being studied via histone deacetylase inhibitors, protein kinase C agonists, and bromodomain inhibitors to reverse latency, along with Tat inhibitors and other transcriptional repressors aimed to persistently silence proviral expression. Moreover, immunological techniques aim to counteract inefficient endogenous antiviral defenses. Broadly neutralizing antibodies with tailored Fc-driven effector functions are under examination for both neutralization and antibody-dependent cellular cytotoxicity. Therapeutic vaccine approaches seek to elevate polyfunctional HIV-specific CD8+ T-cell responses, while adoptive cellular approaches, involving CAR-T cells aiming HIV envelope epitopes, remain in early clinical research. Immune checkpoint blockade is also being investigated to reverse T-cell depletion inside reservoir-rich tissues. Nevertheless, the key obstacles continue to be the diverse reservoir composition, restricted tissue penetration, viral escape, and safety limitations. The molecular and translational obstacles that characterize attempts toward an HIV cure must be addressed through ongoing multidisciplinary research. Full article
(This article belongs to the Special Issue HIV Elimination: Addressing Challenges in Vulnerable Populations and Reducing Discrimination)
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