Search Results (73)

People living with HIV (PLWH) faced diverse challenges during the COVID-19 pandemic, including disruptions to care, housing instability, emotional distress, and economic hardship. This study used graph-based clustering methods to analyze pandemic-era experiences of PLWH in a national sample from the NIH’s All of Us dataset (n = 242). Across three graph configurations we identified consistent subgroups shaped by social connectedness, housing stability, emotional well-being, and engagement with preventive behaviors. Comparison with an earlier local study of PLWH in Illinois confirmed recurring patterns of vulnerability and resilience while also revealing additional national-level subgroups not observed in the smaller sample. Subgroups with strong social or institutional ties were associated with greater emotional stability and proactive engagement with COVID-19 preventive behaviors, while those facing isolation and structural hardship exhibited elevated distress and limited engagement with COVID-19 preventive measures. These findings underscore the importance of precision public health strategies that reflect the heterogeneity of PLWH and suggest that strengthening social support networks, promoting housing stability, and leveraging institutional connections may enhance pandemic preparedness and HIV care in future public health crises. Full article

Background/Objectives: Syphilis, a re-emerging global public health issue, has shown increasing incidence over the past decade, particularly among key populations such as men who have sex with men (MSM), people living with HIV, and pregnant women. This narrative review aimed to synthesize global epidemiological trends of syphilis from 2015 to 2025, with a focus on surveillance gaps, regional disparities, and structural determinants. Methods: A broad narrative approach was used to collect and analyze epidemiological data from 2015 to 2025. The literature was retrieved from databases (PubMed, Scopus) and official reports from the WHO, CDC, and ECDC. Included materials span observational studies, surveillance reports, and modeling data relevant to global trends and public health responses. Results: Globally, syphilis incidence has increased, with notable surges in North America, Europe, and Asia. MSM remain disproportionately affected, while congenital syphilis is resurging even in high-income countries. Low- and middle-income countries report persistent burdens, especially among women of reproductive age, often exacerbated by limited screening and surveillance infrastructure. The COVID-19 pandemic disrupted syphilis-related services and further exacerbated underreporting, hindering timely detection and response efforts. Surveillance systems vary widely in their completeness and quality, which significantly hinders global data comparability and coordinated public health responses. Conclusions: Despite its curability, syphilis continues to spread due to fragmented prevention strategies, inequities in access to care, and insufficient surveillance. Strengthening diagnostic access, integrating prevention efforts into broader health systems, and addressing social determinants are essential. Improved surveillance, equitable access, and innovation—including diagnostics and potential vaccine research—are critical to controlling the global syphilis epidemic. Full article

RNA viruses pose significant threats to global health, causing diseases such as COVID-19, HIV/AIDS, influenza, and dengue. These viruses are characterized by high mutation rates, rapid evolution, and the ability to evade traditional antiviral therapies, making effective treatment and prevention particularly challenging. In recent years, CRISPR/Cas13 has emerged as a promising antiviral tool due to its ability to specifically target and degrade viral RNA. Unlike conventional antiviral strategies, Cas13 functions at the RNA level, providing a broad-spectrum and programmable approach to combating RNA viruses. Its flexibility allows for rapid adaptation of guide RNAs to counteract emerging viral variants, making it particularly suitable for highly diverse viruses such as SARS-CoV-2 and HIV. This review discusses up-to-date applications of Cas13 in targeting a wide range of RNA viruses, including SARS-CoV-2, HIV, dengue, influenza, and other RNA viruses, focusing on its therapeutic potential. Preclinical studies have demonstrated Cas13’s efficacy in degrading viral RNA and inhibiting replication, with applications spanning prophylactic interventions to post-infection treatments. However, challenges such as collateral cleavage, inefficient delivery, potential immunogenicity, and the development of an appropriate ethical framework must be addressed before clinical translation. Future research should focus on optimizing crRNA design, improving delivery systems, and conducting rigorous preclinical evaluations to enhance specificity, safety, and therapeutic efficacy. With continued advancements, Cas13 holds great promise as a revolutionary antiviral strategy, offering novel solutions to combat some of the world’s most persistent viral threats. Full article

The COVID-19 pandemic triggered a public health crisis that significantly impacted sexually transmitted infections (STIs), particularly syphilis. However, data on syphilis incidence during the pandemic remains inconsistent globally. Key groups affected include women of reproductive age, pregnant women, individuals living with HIV, and men who have sex with men (MSM). This paper reviews available literature from databases such as PubMed, Scopus, and Google Scholar to analyse the pandemic’s influence on congenital and gestational syphilis, focusing on high-risk populations. We discuss the pandemic’s impact on the incidence of gestational and congenital syphilis, including changes in screening and treatment protocols. Additionally, we examine alterations in syphilis prevalence and testing among people living with HIV and MSM, including implications observed in blood donors. The findings underscore the consequences of impaired STI diagnostics for public health. We emphasise the need for uninterrupted access to diagnostics and treatment during public health crises. To prevent rising syphilis rates post-pandemic, it is crucial to implement robust education and accessible testing measures. Full article

Background: Vietnam has made significant strides in reducing the prevalence of HIV infection and achievements in its antiretroviral treatment program. However, the COVID-19 pandemic and financial challenges in the healthcare system have posed significant obstacles to maintaining effective HIV treatment and monitoring, particularly among vulnerable populations. This study aims to evaluate the situation of HIV drug resistance among patients who have experienced treatment failure in the Mekong Delta region and to compare data from 2019 to 2022. Methods: The study material was blood plasma samples from HIV-infected individuals with ART failure: 316 collected in 2019 and 326 collected in 2022. HIV-1 genotyping and mutation detection were performed based on an analysis of the nucleotide sequences of the Pol gene region. A total of 116 HIV-infected individuals with virological failure in 2019 and 2022 were assessed for HIV drug resistance. Results: The study revealed a high proportion of participants with viral loads exceeding 1000 copies/mL, significantly increasing from 12.0% in 2019 to 23.9% in 2022 (OR = 2.3; p = 0.0001). HIV drug resistance mutations were detected in 84.21% of cases in 2019 and 92.59% in 2022. The prevalence of concurrent resistance to NRTIs and NNRTIs was 37.5% and 30.13% in 2019 and 2022, respectively. There was a statistically significant decrease in NNRTI resistance (OR = 0.32, χ² = 5.43, p < 0.05). In contrast, multi-drug resistance to protease inhibitors rose from 18.52% to 45.21% (φ* = 0.00403, p < 0.05). Triple-class resistance was identified only in 2022 (17.81%). The most common mutations included M184I/V, D67N, K103N, Y181C, and V82A/S/T, with D67N rising significantly from 3.13% to 21.92%. The predominant subtype was CRF01_AE. Conclusion: A high prevalence of viral non-suppression and HIV drug resistance was observed among patients in the Mekong Delta region, particularly after the onset of the COVID-19 pandemic. Our study highlights the ongoing challenges that the HIV/AIDS treatment program in Vietnam must address in the post-pandemic period to sustain its success and achieve the goals of the country’s HIV prevention strategies. Full article

Tuberculous meningitis (TBM) is a very severe form of childhood tuberculosis (TB), requiring hospitalisation for diagnosis. We investigated trends in admission, disease spectrum, outcomes, and healthcare system factors in children with TBM managed at a tertiary referral hospital in Cape Town, South Africa. We conducted a retrospective cohort study of children (<13 years) with TBM admitted from 2017 to 2021. An innovative surveillance algorithm was used to identify all possible TBM episodes using integrated electronic health data. Episodes were clinically verified and data were extracted using medical records. A total of 263 children (median age 2.2 years; IQR: 1.1–5.1), 17 (6.5%) living with HIV were admitted with TBM during 2017 to 2021. There was a significant reduction in TBM admissions during the COVID-19 pandemic (IRR: 0.57, 95% CI:0.39–0.84), particularly in children < 2 years (IRR: 0.31, 95% CI: 0.15–0.62). BCG vaccination was documented in 137/263 (52.1%) and 10/87 (11.5%) eligible children who initiated TB preventive therapy. During the pandemic, children with TBM were significantly more likely to be living with HIV (aOR: 4.01, 95% CI: 1.39–11.62). COVID-19 was associated with a significant reduction in the number of young children admitted with TBM. Many missed opportunities to prevent TBM were identified regardless of COVID-19. Paediatric TBM surveillance is a useful marker to monitor epidemiological trends. Full article

Communication for development and social change is an evolving field both in research and practice, transcending paradigms of conventional communication towards engaging and somewhat exposing some of the real-life communicative disorders experienced by communities. While public health and communication for development and social change operate from diverse paradigmatic thinking and are applied quite independently as disciplinary fields of study, health communication converges these fields in research and practice. In this paper, I discuss these interdisciplinary perspectives that draw from communication for development and social change principles and public health through a process of divergence and convergence towards new ways of thinking about decision making. Much of this discourse stems from understanding many health problems as a development problem first, one that recognises the role of community responses during pandemics yet at the same time places the agency back with individuals to make informed choices. Communicating for health decision making from this perspective is what I call Communicating for Health-as-Development (C4HD). C4HD foregrounds health as development, which caters to the messy, unidirectional, non-process-orientated, non-measurable and often non-data-driven approaches to health outcomes. It is in these messy health communication efforts that real development takes place. This paper, using examples from HIV and COVID-19, discusses these ongoing developments in the field and the convergence of public health and communication for development and social change from an interdisciplinary perspective, by exploring three key concepts: community engagement to influence decision making, community agency and ownership, and context and collaboration, which contribute to understanding communication for health-as-development. Full article

mRNA vaccines represent a milestone in the history of vaccinology, because they are safe, very effective, quick and cost-effective to produce, easy to adapt should the antigen vary, and able to induce humoral and cellular immunity. Methods: To date, only two COVID-19 mRNA and one RSV vaccines have been approved. However, several mRNA vaccines are currently under development for the prevention of human viral (influenza, human immunodeficiency virus [HIV], Epstein–Barr virus, cytomegalovirus, Zika, respiratory syncytial virus, metapneumovirus/parainfluenza 3, Chikungunya, Nipah, rabies, varicella zoster virus, and herpes simplex virus 1 and 2), bacterial (tuberculosis), and parasitic (malaria) diseases. Results: RNA viruses, such as severe acute respiratory syndrome coronavirus (SARS-CoV)-2, HIV, and influenza, are characterized by high variability, thus creating the need to rapidly adapt the vaccines to the circulating viral strain, a task that mRNA vaccines can easily accomplish; however, the speed of variability may be higher than the time needed for a vaccine to be adapted. mRNA vaccines, using lipid nanoparticles as the delivery system, may act as adjuvants, thus powerfully stimulating innate as well as adaptive immunity, both humoral, which is rapidly waning, and cell-mediated, which is highly persistent. Safety profiles were satisfactory, considering that only a slight increase in prognostically favorable anaphylactic reactions in young females and myopericarditis in young males has been observed. Conclusions: The COVID-19 pandemic determined a shift in the use of RNA: after having been used in medicine as micro-RNAs and tumor vaccines, the new era of anti-infectious mRNA vaccines has begun, which is currently in great development, to either improve already available, but unsatisfactory, vaccines or develop protective vaccines against infectious agents for which no preventative tools have been realized yet. Full article

Marginalized groups in Manitoba, Canada, especially females and people who inject drugs, are overrepresented in new HIV diagnoses and disproportionately affected by HIV and structural disadvantages. Informed by syndemic theory, our aim was to understand people living with HIV’s (PLHIV) gendered and intersecting barriers and facilitators across the cascade of HIV care before and during the COVID-19 pandemic. This study was co-designed and co-led alongside people with lived experience and a research advisory committee. We employed semi-structured interviews with thirty-two participants and three questionnaires. Interviews were audio-recorded, transcribed, and coded, and descriptive statistics were performed on the first two questionnaires. Qualitative data analysis used thematic analysis and focused on identifying categories (individual, healthcare, and social/structural) related to the barriers and facilitators to HIV care. A total of 32 PLHIV completed this study and over 70% of females and 50% of males reported severe and moderate sexual abuse among other traumatic childhood experiences. Barriers to accessing or continuing in the cascade of HIV care included navigating the initial shock of receiving an HIV diagnosis, mental health challenges and inaccessible supports, substance use, violence (including intimate partner), internalized and enacted compounded stigma related to houselessness and substance use, discrimination by primary care service providers and social networks, lack of preventative and social supports, lack of accessible housing, and programmatic issues. COVID-19 increased mental health problems and disrupted relationships with HIV service providers and peers living with HIV. Facilitators to HIV care included stopping substance use, caring service providers particularly during HIV diagnosis, welcoming healthcare environments, social opportunities and integrated supports, and supportive social networks. Women, men, and non-binary PLHIV experience interconnected factors complicating their experiences with HIV care. Interventions should consider holistic, person-centered, and trauma-informed care options to address the barriers found in this research and appropriately serve PLHIV. Full article

According to the WHO, more than 90,000 cases of mpox have been reported since the 2022 worldwide outbreak, which resulted in 167 deaths, while a new outbreak in Africa since 2023 has resulted in over 18,000 cases and 617 deaths. Mpox is a zoonosis caused by the monkeypox virus, a double-stranded DNA virus belonging to the Orthopoxvirus genus, which causes smallpox-like illness. Until 2022, cases were predominately located in West and Central Africa, with only sporadic cases and outbreaks reported in other parts of the world. During the 2022 outbreak, the primary mode of transmission was sexual contact among men who have sex with men. The changing epidemiology of mpox resulted in new disease phenotypes and populations at risk, disproportionally affecting people who live with HIV. Commonly presenting as a mild, self-limiting illness, mpox can cause severe and protracted disease in people with HIV with a CD4 count < 200 cell/mm³. The global emergence of mpox that followed and intersected with COVID-19 mobilized the scientific community and healthcare stakeholders to provide accurate diagnostics, preventive vaccines and treatment to those most affected. Despite existing gaps, this rapid response helped to contain the outbreak, but challenges remain as new variants emerge. Preparedness and readiness to respond to the next outbreak is crucial in order to minimize the impact to the most vulnerable. Full article

Although South Africa was the first country to register and roll out oral pre-exposure prophylaxis (PrEP) biomedical human immunodeficiency virus (HIV) prevention intervention in sub-Saharan Africa (SSA), its uptake remains low, particularly among adolescent girls and young women (AGYW). The uptake of PrEP may have worsened during the Coronavirus disease 2019 (COVID-19) pandemic. Some innovative interventions to improve PrEP uptake among AGYW have been implemented. This study aims to evaluate the effectiveness of PrEP innovative interventions implemented during COVID-19 towards reducing the risk of HIV infection among AGYW in South Africa. An exploratory, descriptive design will be conducted to carry out four study objectives. Firstly, to carry out a systematic review of innovative PrEP interventions implemented during COVID-19 in SSA countries. Secondly, to conduct a stakeholder analysis to identify PrEP stakeholders and interview them on their views on the implemented interventions. Thirdly, to assess the implementation outcomes of the innovative interventions using document reviews and Consolidated Framework for Implementation Research. Fourthly, to develop a framework for an improved PrEP service delivery among AGYW. Qualitative data will be captured in ATLAS.ti software (Technical University, Berlin, Germany) version 23 and analysed via thematic analysis. A statistical software package (STATA) version 18 (College Station, TX, USA) will be used to capture quantitative data and analyse them via descriptive analysis. The generated evidence will be used towards the development of framework, guidelines, and policies to strengthen the uptake of, scale-up, and adherence to PrEP among AGYW. Full article

The beginning of the COVID-19 pandemic was marked by a sharp decline in syphilis infections in many countries worldwide, including Greece. However, a resurgence of positive cases started to appear in the second half of 2020. The aim of this study was to explore the impact of the pandemic on the incidence of new syphilis infections and reinfections and analyze the sociodemographic characteristics associated with recurrent episodes. We analyzed medical records from a 14-month period after the beginning of the pandemic and compared them with the respective period before the start of the pandemic. Our participants consisted mainly of men, with a median age of 43 years, homosexual orientation, and higher education. During COVID-19, more HIV patients presented for syphilis testing (38.0% vs. 34.6%, p = 0.025). Overall, we observed almost a two-fold increase in positive syphilis cases during COVID-19 (21.1% vs. 12.4%, p < 0.001), with new infections rising from 8.4% to 13.2% and reinfections from 4.0% to 7.9%. Multivariable logistic regression analysis revealed that the COVID-19 pandemic, among different parameters (such as age, gender, sexual orientation, HIV status, and educational level), was the only factor associated with higher positive syphilis rates (OR 1.47, 95% CI: 1.07–2.01, p = 0.003). Our results highlight the need to ensure enhanced prevention and undisrupted healthcare services, with a focus on future pandemics. Full article

Cardiovascular disease (CVD) is a significant health concern influenced by various determinants. Stigma and resilience have emerged as factors in CVD development and management. Women with HIV (WWH) have higher CVD rates than women without HIV. To improve cardiovascular health for WWH, a comprehensive understanding of how these factors interact, the understanding about individual awareness and willingness to engage in risk-reduction interventions are needed. Methods: As part of a study examining CVD risk among WWH aged >35 years old, 90-min focus groups were conducted (May 2022) in the English language. Focus groups aimed to elicit participants’ CVD risk knowledge and potential prevention strategies. Transcripts underwent a qualitative analysis. Results: Nineteen WWH participated in three focus groups. Participants experienced the following: (a) enacted stigma related to their HIV diagnosis (e.g., family, church member, healthcare staff); (b) a recent event (e.g., hospitalization of self/family, death in family, chest pain) triggered both heart health-promoting lifestyle changes and suboptimal health behaviors (e.g., COVID-19 pandemic: unhealthy snacking). Participants wanted to obtain more knowledge (“on a mission”) about CVD risk. In total, 100% expressed willingness to take medication or embark on other lifestyle changes to prevent future CVD events. Although participants identified preventative heart health behaviors (e.g., eating healthy foods; exercising; limiting stress, substances, and smoking), misconceptions were also identified (e.g., “catching” heart disease). Conclusions: Understanding the interplay of the different factors related to heart health is needed both at the provider and the patient level to inform interventions that reduce CVD risk amongst racial/ethnic minoritized women with HIV, living in the Southern region of the US. Full article

The presence of the anti-SARS-CoV-2-RBD antibody (anti-RBD) prevents severe COVID-19. We aimed to determine the accuracy of a point-of-care anti-RBD testing implemented in persons living with HIV (PLWH), systemic lupus erythematosus (SLE), and chronic kidney disease (CKD). We enrolled 182 non-comorbid subjects and 335 comorbid subjects (PLWH, SLE, CKD) to test the anti-RBD assay compared to the surrogate viral neutralization test (sVNT) as the reference test. We performed linear correlation analysis between anti-RBD and sVNT, along with an ROC analysis to ascertain the anti-RBD cutoff at 30%, 60%, and 90% inhibition of sVNT, to calculate accuracy. The correlations between anti-RBD and sVNT among all groups were excellent, with R = 0.7903, R = 0.7843, and R = 0.8153 among the non-comorbid, SLE, and CKD groups, respectively, and with significantly higher correlation among the PLWH group (R = 0.8877; p-value = 0.0072) compared to the non-comorbid group. The accuracy of the anti-RBD test among the PLWH and CKD groups was similar to that among the non-comorbid group but showed lower sensitivity in the SLE group (p = 0.000014). The specificity of the test remained high in all groups. In conclusion, the anti-RBD test had excellent correlation with the sVNT. The persistently high specificity in all groups suggests that this test can be reliably utilized to detect the presence of low neutralization capacity, prompting additional vaccination. Full article

Platelets are metabolically active, anucleated and small circulating cells mainly responsible for the prevention of bleeding and maintenance of hemostasis. Previous studies showed that platelets mitochondrial content, function, and energy supply change during several diseases such as HIV/AIDS, COVID-19, pulmonary arterial hypertension, and in preeclampsia during pregnancy. These changes in platelets contributed to the severity of diseases and mortality. In our previous studies, we have shown that the seahorse-based cellular stress assay (CSA) parameters are crucial to the understanding of the mitochondrial performance in peripheral blood mononuclear cells (PBMCS). Moreover, the results of CSA parameters were significantly influenced by the PBMC preparation methods. In this study, we assessed the correlation of CSA parameters and intracellular ATP content in platelets and evaluated the effects of platelet preparation methods on the results of CSA parameters and intracellular ATP content. We compared the results of CSA parameters and intracellular ATP content in platelets isolated by density centrifugation with Optiprep and simple centrifugation of blood samples without Optiprep. Platelets isolated by centrifugation with Optiprep showed a higher spare capacity, basal respiration, and maximal respiration than those isolated without Optiprep. There was a clear correlation between basal respiration and maximal respiration, and the whole-ATP content in both isolation methods. Moreover, a positive correlation was observed between the relative spare capacity and whole-cell ATP content. In conclusion, the results of seahorse-based CSA parameters and intracellular ATP content in platelets are markedly influenced by the platelet isolation methods employed. The results of basal respiration and maximal respiration are hallmarks of cellular activity in platelets, and whole-cell ATP content is a potential hint for basic platelet viability. We recommend further studies to evaluate the role of CSA parameters and intracellular ATP content in platelets as biomarkers for the diagnosis and prediction of disease states. Full article