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Medscape
2 days ago
- Health
- Medscape
Healthcare Access, Geography Predict HIV in Black Women
Limited healthcare access and sociostructural factors were stronger predictors of HIV than behavioral risk factors among Black women in the southern United States, based on modeling data from more than 300,000 women in or near Atlanta, Georgia. The findings were presented in a late-breaker study at the International AIDS Society Conference on HIV Science. Nonbehavioral factors such as structural and social determinants of health can complicate HIV risk assessment, wrote Meredith Lora, MD, of Emory University, Atlanta, and colleagues. Previous risk prediction models have underperformed in Black women, whose HIV risk is approximately 20 times that of White women, the researchers wrote. To better assess HIV risk in Black women, the researchers used machine learning to create a model that analyzed electronic medical records data from all women treated at a single center in Atlanta between 2012 and 2022. The study population included 333,263 women; 617 (0.19%) had incident HIV diagnoses and 89% of those with HIV identified as Black individuals. The model included features with a prevalence of 5% or higher in the electronic medical records data and included novel structural determinant features and healthcare utilization features. Overall, the top predictors of HIV included younger age, Black race, residing in high HIV incidence zip codes, and at least one change in phone number or address prior to HIV diagnosis. In addition, women who underwent more HIV screening tests were more likely to be diagnosed with HIV, and women with HIV were more likely than those without HIV to seek care in an emergency department (ED) vs primary care or women's healthcare settings. Although more women with HIV tested positive for sexually transmitted infectious compared to those without HIV in the 2 years before diagnosis, 'seeking sexual health was more important to the model than STI positivity,' the researchers wrote. The model achieved a test area under the receiver operating characteristic curve (AUROC) of 0.90 and area under a precision-recall curve (AUPRC) of 0.14. The appearance of frequent HIV testing as a predictor of risk suggests the presence of undisclosed risk factors that may merit further investigation, the researchers noted in their abstract. EHR models designed for racially diverse female populations may identify more candidates for pre-exposure prophylaxis (PrEP), but that is not enough, the researchers emphasized. 'Evaluating how these models are implemented to support PrEP uptake and behavior change is critical for real-world impact,' they concluded. Assistance in Risk Assessment The current study is important given the traditional and historical difficulty of women in the United States in predicting their own risk of HIV, said Monica Gandhi, MD, director of the University of California San Francisco Bay Area Center for AIDS Research, and a professor of medicine at UCSF, in an interview. Gandhi cited a recent study from the CDC showing that more than 2.2 million individuals in the US need PrEP, but only 336K have received prescriptions. 'Women may not be able to adjudicate their own risk of HIV, as that risk depends on the risk in their male sexual partners,' said Gandhi, who was not involved in the current study or the CDC study. 'Machine learning using electronic medical records [EMR] can make risk prediction more accurate by reporting both health and social factors,' she noted. The current study identified predictors of HIV risk using extracted EMR data, that the healthcare system may be able to mitigate, she said. 'I was surprised by the fact that seeking sexual health was a stronger predictor of HIV than STD positivity, which indicates that women actually are more aware of their risk for HIV in the US than suggested in previous studies that usually involved smaller sample sizes, Gandhi told Medscape Medical News . 'I was also surprised that women with frequent changes in address or phone number had higher risk,' she said. This suggests mobility as a risk factor, which has been identified more commonly in sub-Saharan Africa, she noted. However, Gandhi was not surprised by the preference for ED care or the increased HIV risk among Black women vs other races, both of which have implications for HIV prevention, she said. The preference for sexual health care in the ED setting in the study population suggests that the ED is an important setting in which to perform STD testing and start PrEP or set up an individual with HIV prevention services, said Gandhi. 'Designated PrEP services for women in historically Black neighborhoods are indicated, and women who are mobile and change their address or phone number frequently should be counseled on HIV prevention modalities, specifically PrEP,' she added. Looking ahead, qualitative research is needed to ask a subset of women with HIV who presented to the ED for sexual health services why they chose the ED; this could help inform how to re-engage women in care, Gandhi said. Additional research on women's knowledge of PrEP and whether women with HIV were offered PrEP in the past also would help identify more opportunities for HIV prevention, she said.
IOL News
3 days ago
- Health
- IOL News
South Africa's HIV Response: Hope, Tools, and Resolve
South Africa has the world's largest HIV treatment programme, with over 5.5 million people receiving antiretrovirals (ARVs). Yet we still see more than 100 000 new HIV infections each year. That is unacceptable — and preventable. Image: Tumi Pakkies/ Independent Newspapers Earlier this month, more than 3,600 scientists, activists, policymakers, and journalists gathered in Kigali, Rwanda, for the 13th International AIDS Society (IAS) Conference on HIV Science. It was the first time this major global event took place in an African city outside South Africa, marking a powerful recognition of the continent's critical role in the global HIV response. The conference came on the heels of deeply concerning news: in January, the US government announced sharp cuts to funding for the President's Emergency Plan for AIDS Relief (PEPFAR), a move that cast a long shadow over the global fight against HIV, particularly in Africa. The numbers are staggering: of the 40.8 million people living with HIV globally, over 26 million (65%) are in Africa. And more than half of all new infections in 2024 occurred on the continent. A Call to Stay the Course Despite fears about reduced funding, the mood in Kigali was one of resolve. Delegates affirmed their commitment to ending HIV, recognising the extraordinary progress made in Eastern and Southern Africa. Many echoed a common sentiment: "We cannot stop now. We must fight to the end", emphasising the need for sustained commitment and effort to achieve an AIDS-free future. That optimism was reinforced by encouraging developments. The pharmaceutical company Gilead announced that Lenacapavir, a new HIV prevention drug administered via two injections a year, has shown high efficacy in clinical trials. If made widely accessible, this could be a game-changer— especially for those who struggle with daily pill regimens. Further hope came when the US Congress ultimately approved continued PEPFAR funding, although uncertainties remain around the duration and scope of future support. Video Player is loading. Play Video Play Unmute Current Time 0:00 / Duration -:- Loaded : 0% Stream Type LIVE Seek to live, currently behind live LIVE Remaining Time - 0:00 This is a modal window. Beginning of dialog window. Escape will cancel and close the window. Text Color White Black Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Background Color Black White Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Transparent Window Color Black White Red Green Blue Yellow Magenta Cyan Transparency Transparent Semi-Transparent Opaque Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Proportional Sans-Serif Monospace Sans-Serif Proportional Serif Monospace Serif Casual Script Small Caps Reset restore all settings to the default values Done Close Modal Dialog End of dialog window. Advertisement Next Stay Close ✕ Ad loading What This Means for South Africa South Africa has the world's largest HIV treatment programme, with over 5.5 million people receiving antiretrovirals (ARVs). Yet we still see more than 100 000 new HIV infections each year. That is unacceptable — and preventable. To address this, the government launched the '1.1 Million Campaign' in February to close the gap between those who know their HIV status and those who are virally suppressed. But for this initiative to succeed, we need national mobilisation. Every political leader, community organiser, religious institution, and employer must actively support the campaign. Unfortunately, media coverage has been limited, and public awareness remains low. Doing More with Less With reductions in funding from the Global Fund and PEPFAR, and despite increased domestic investment, every rand in our HIV response must count. Managers and community activists in the health and social development sectors must track data rigorously: Who is being tested? Who is on treatment? Who is virally suppressed? Who is using Pre-Exposure Prophylaxis (PrEP) — and who should be, but isn't? We must also stand firm against stigma. There is no justification for discrimination against people living with HIV or those using preventive treatments like PrEP. They are taking responsible steps to protect themselves and others. They should be commended and supported, not shamed. The Tools Are in Our Hands We now have powerful tools to fight HIV. HIV self-test kits are available free at public clinics and affordable at private pharmacies. Oral PrEP— a once-a-day pill to prevent HIV — is also free at government health facilities. And injectable PrEP, which could significantly improve adherence, is expected to be available next year. Condoms remain a highly effective prevention method. Let's not forget—they also prevent sexually transmitted infections like syphilis and gonorrhoea and help avoid unplanned pregnancies. They are free at all public clinics. Let's also remember the link between HIV and tuberculosis (TB). People with HIV are more susceptible to TB. If you have symptoms or have been in contact with someone with TB, get tested. Early detection saves lives. Health Is Everyone's Business Building a healthier South Africa is not just about medicine—it is about national prosperity. A healthy population is more productive, more resilient, and more able to seize economic opportunity. Each of us has a role to play in protecting our health and the health of our communities. Let's work together to end HIV. The finish line is in sight—but only if we don't stop now. Prof Yogan Pillay is the Director for HIV and TB delivery at the Bill & Melinda Gates Foundation. He was previously the Country Director of the Clinton Health Access Initiative in South Africa and senior director for universal health coverage. He has worked in various capacities at the National Department of Health. In 2021, the University of Cape Town awarded him an honorary doctorate, and in the same year, he was appointed extraordinary professor in the Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University. Foster Mohale is the National Department of Health Spokesperson
Scoop
16-07-2025
- Health
- Scoop
IAS Welcomes US Bipartisan Move To Protect PEPFAR
16 July 2025 (Kigali, Rwanda) – IAS – the International AIDS Society – welcomes the bipartisan move in the US Senate to protect the President's Emergency Plan for AIDS Relief (PEPFAR) from proposed USD 400 million cuts in President Trump's rescission package. However, both the Senate and House must still vote on the final rescission package, and further changes could be reintroduced before the statutory deadline for action. 'PEPFAR has been one of the greatest success stories in global health, transforming the HIV response,' IAS President Beatriz Grinsztejn said. 'Global advocacy played a crucial role in persuading US lawmakers to protect this vital programme, reminding them that decisions about PEPFAR shape the health and futures of people around the world. Yet uncertainty remains, with ongoing threats to global health funding. We must stay vigilant.' IAS President-Elect Kenneth Ngure emphasized the importance of the decision for the African continent. 'PEPFAR is a lifeline for communities across Africa,' he said. 'Restoring this funding would mean hope for people living with and affected by HIV. But African leadership must remain at the centre of shaping our response, and we need to keep advancing conversations about sustainable financing – including stronger domestic investments and strategies to reduce dependence on global donors.' The IAS calls for swift action to protect essential HIV services and urges all leaders to ensure continued investments that save lives and support global health. About the International AIDS Society IAS – the International AIDS Society – convenes, educates and advocates for a world in which HIV no longer presents a threat to public health and individual well-being. After the emergence of HIV and AIDS, concerned scientists created the IAS to bring together experts from across the world and disciplines to promote a concerted HIV response. Today, the IAS and its members unite scientists, policy makers and activists to galvanize the scientific response, build global solidarity and enhance human dignity for all those living with and affected by HIV. The IAS also hosts the world's most prestigious HIV conferences: the International AIDS Conference, the IAS Conference on HIV Science and the HIV Research for Prevention Conference.
Politico
15-07-2025
- Health
- Politico
HIV prevention gets an AI upgrade
WORLD VIEW Artificial intelligence chatbots could help with the introduction of a twice-yearly shot that can help prevent HIV, experts said at the International AIDS Society conference on HIV science in Rwanda on Monday. How so: Chatbots that answer people's questions on sex, health and other issues; help them self-test and interpret results and then connect them with health providers for prevention and treatment options are being tested in countries like South Africa to increase HIV prevention and treatment. 'We see these tools as demand-generation engines,' said Sarah Morris, chief product officer at Audere, a Seattle-based digital health company that's been involved in creating and testing such chatbots. Why it matters: 'They can help people in a private safe space with counseling, help them understand why testing or [pre-exposure prophylaxis] might be right for them, and we're hoping that this lays a really nice glide path for [lenacapavir] introduction,' she said referring to Gilead's HIV prevention shot just approved by the FDA. HIV experts believe the drug will be transformative in decreasing the number of new HIV infections if made available at scale globally. AI companions aren't judgmental and don't gossip, but they can provide access to confidential advice and support, said Shawn Malone, HIV/AIDS project director at the global health nonprofit PSI, who's worked on another chatbot in South Africa. Malone stressed that the AI tool 'is in no way meant to replace face-to-face care,' but 'we are hoping that we can take some pressure off providers so that they can use the very limited time they have in a way that's most meaningful, that's most impactful.' WELCOME TO FUTURE PULSE This is where we explore the ideas and innovators shaping health care. Ancient Greek philosopher Plato would see AI as 'intriguing and persuasive – but misleading, and far from the truth,' said former Greek Prime Minister George Papandreou, Euronews reports. Share any thoughts, news, tips and feedback with Danny Nguyen at dnguyen@ Carmen Paun at cpaun@ Ruth Reader at rreader@ or Erin Schumaker at eschumaker@ Want to share a tip securely? Message us on Signal: Dannyn516.70, CarmenP.82, RuthReader.02 or ErinSchumaker.01. WORKFORCE President Donald Trump's Federal Trade Commission is considering whether to defend a Biden-era rule that would ban employers from requiring workers to sign agreements that would bar or restrict them from quitting and joining rivals. President Joe Biden's FTC approved the rule in 2024, but before it could go into effect, courts blocked it on the grounds that the agency had overstepped its authority. On Thursday, the deadline to decide whether to back the rule, the FTC requested a 60-day extension. Earlier that week, Sen. Chris Murphy (D-Conn.) urged the Trump administration to stand behind the rule. 'I would love for the Trump administration to defend the rule,' Murphy said during a livestream on social platform X last week. 'It's a pro-worker rule, it's a pro-startup, pro-entrepreneurship rule, and just because it has Biden's fingerprints on it shouldn't mean it's not worth pursuing.' Washington watch: With Sens. Todd Young (R-Ind.), Tim Kaine (D-Va.) and Kevin Cramer (R-N.D.),Murphy has introduced bipartisan legislation to limit the use of noncompete agreements except in certain circumstances. 'We'll continue to pursue our bipartisan legislation,' Murphy said. 'If we want to do something about wages in this country, we've got to stop this gimmick.' Why it matters for doctors and hospitals: Hospital administrators have said they rely on such contracts to protect their businesses from cutthroat competition for talent. Both the American Hospital Association and the Federation of American Hospitals are among the hospital groups that have lobbied for an exemption. Doctors would benefit from a noncompete ban: A large share of them — 45 percent in group practices and likely many more in other areas of medicine — are bound by the contract provisions. In the states: While a handful of states have laws that limit noncompete agreements, Florida is taking a different approach by expanding them. This spring, state legislators passed the CHOICE Act, which permits agreements of up to four years instead of two. Kevin Paule, an attorney who handles noncompete agreements and business divorce cases at the Florida-based law firm Hill Ward Henderson, described the law as unusual, but noted it's not an across-the-board extension since it applies only to workers with an income above a certain threshold. It also includes a carveout for licensed health care providers. 'In some respects, there's a limiting component of this, but it definitely draws out the period that somebody would have to sit on the sidelines,' Paule told Erin. 'This gives employers a lot more teeth to put in their employment agreements if they want to.' What's next: Since Florida doesn't have a pocket veto, the CHOICE Act became law on July 1 without GOP Gov. Ron DeSantis signing the bill. Nationally, the FTC's new deadline to decide whether to back the noncompetes rule is Sept. 8.
Deccan Herald
11-07-2025
- Health
- Deccan Herald
India has time-tested and proven capacity to manufacture HIV diagnostics, medicines: Expert
'Our HIV programmes should ensure that HIV prevention, diagnostics, treatment, care and support services are reaching everyone in need worldwide,' said Dr Gilada, President Emeritus, AIDS Society of India, and Governing Council Member, International AIDS Society.
