Notes

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Health inequities among people with HIV may be compounded by disparities in the prevalence of comorbidities associated with an increased risk of severe illness from COVID-19.

Complex sample survey designed to produce nationally representative estimates of behavioral and clinical characteristics of adults with diagnosed HIV in the United States.

We estimated the prevalence of having ≥1 diagnosed comorbidity associated with severe illness from COVID-19 and prevalence differences (PDs) by race/ethnicity, income level, and type of health insurance. We considered PDs ≥5 percentage points to be meaningful from a public health perspective.

An estimated 37.9% [95% confidence interval (CI) 36.6 to 39.2] of adults receiving HIV care had ≥1 diagnosed comorbidity associated with severe illness from COVID-19. Compared with non-Hispanic Whites, non-Hispanic Blacks or African Americans were more likely [adjusted PD, 7.8 percentage points (95% CI 5.7 to 10.0)] and non-Hispanic Asians were less likely [adjusted PD, -13.7 percentage points (95% CI -22.3 to -5.0)] to have ≥1 diagnosed comorbidity after adjusting for age differences. There were no meaningful differences between non-Hispanic Whites and adults in other racial/ethnic groups. GLXC-25878 research buy Those with low income were more likely to have ≥1 diagnosed comorbidity [PD, 7.3 percentage points (95% CI 5.1 to 9.4)].

Among adults receiving HIV care, non-Hispanic Blacks and those with low income were more likely to have ≥1 diagnosed comorbidity associated with severe COVID-19. Building health equity among people with HIV during the COVID-19 pandemic may require reducing the impact of comorbidities in heavily affected communities.
Among adults receiving HIV care, non-Hispanic Blacks and those with low income were more likely to have ≥1 diagnosed comorbidity associated with severe COVID-19. Building health equity among people with HIV during the COVID-19 pandemic may require reducing the impact of comorbidities in heavily affected communities.
Adoption of "Treat All" policies has increased antiretroviral therapy (ART) initiation in sub-Saharan Africa; however, unexplained early losses continue to occur. More information is needed to understand why treatment discontinuation continues at this vulnerable stage in care.

The Monitoring Early Treatment Adherence Study involved a prospective observational cohort of individuals initiating ART at early-stage versus late-stage disease in South Africa and Uganda. Surveys and HIV-1 RNA levels were performed at baseline, 6, and 12 months, with adherence monitored electronically. This analysis included nonpregnant participants in the first 6 months of follow-up; demographic and clinical factors were compared across groups with χ2, univariable, and multivariable models.

Of 669 eligible participants, 91 (14%) showed early gaps of ≥30 days in ART use (22% in South Africa and 6% in Uganda) with the median time to gap of 77 days (interquartile range 43-101) and 87 days (74, 105), respectively. Although 71 (78%) ultimately resumed care, having an early gap was still significantly associated with detectable viremia at 6 months (P ≤ 0.01). Multivariable modeling, restricted to South Africa, found secondary education and higher physical health score protected against early gaps [adjusted odds ratio (aOR) 0.4, 95% confidence interval (CI) 0.2 to 0.8 and (aOR 0.93, 95% CI 0.9 to 1.0), respectively]. Participants reporting clinics as "too far" had double the odds of early gaps (aOR 2.2 95% CI 1.2 to 4.1).

Early gaps in ART persist, resulting in higher odds of detectable viremia, particularly in South Africa. Interventions targeting health management and access to care are critical to reducing early gaps.
Early gaps in ART persist, resulting in higher odds of detectable viremia, particularly in South Africa. Interventions targeting health management and access to care are critical to reducing early gaps.
Falls are considered as a predictive marker of poorer outcomes for people living with HIV (PLWHIV). However, the available evidences on the predictive value of falls are controversial. Our aim is to summarize the existing data about falls in PLWHIV.

A literature search was conducted using electronic databases (MEDLINE, Embase, and LILACS) for original observational studies. The primary outcome was any and recurrent falls' frequency in PLWHIV, and secondary outcomes were factors associated with falls. We conducted a random-effects meta-analysis with meta-regression to obtain a summary frequency of falls and recurrent falls.

The pooled frequency for any fall was 26% [95% confidence interval (CI) 19% to 34%], compared with 14% for recurrent falls (95% CI 9% to 22%). In studies comparing PLWHIV and people without HIV, we found no difference for any (pooled odds ratio 1.03, 95% CI 0.90 to 1.17) or recurrent falls (pooled odds ratio 1.08, 95% CI 0.92 to 1.27) between groups, but falls in middle-aged PLWHIV mi falls in this population to prevent adverse outcomes is warranted.
The history of the AIDS epidemic in the United States has focused largely on the experience in coastal cities where the syndrome was first recognized among gay men. In Cleveland and in many other heartland cities, early recognition of this syndrome was primarily among men with hemophilia who were at risk because of exposure to HIV during treatment with lyophilized antihemophilic factor concentrates that were pooled from plasmas of thousands of donors. Disease and subclinical immune deficiency in these men and in other populations drove recognition that AIDS was due to a blood-borne and sexually transmissible agent. As the AIDS epidemic expanded, heartland cities mobilized their staff and resources to meet the needs of a growing epidemic that ultimately affected the entire nation.
The history of the AIDS epidemic in the United States has focused largely on the experience in coastal cities where the syndrome was first recognized among gay men. In Cleveland and in many other heartland cities, early recognition of this syndrome was primarily among men with hemophilia who were at risk because of exposure to HIV during treatment with lyophilized antihemophilic factor concentrates that were pooled from plasmas of thousands of donors. Disease and subclinical immune deficiency in these men and in other populations drove recognition that AIDS was due to a blood-borne and sexually transmissible agent. As the AIDS epidemic expanded, heartland cities mobilized their staff and resources to meet the needs of a growing epidemic that ultimately affected the entire nation.
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