In April, almost two years ago, I started experiencing stabbing pains. They were intense but intermittent and I was very busy at the time so I tried to ignore them. I had a live broadcast that I was scheduled to do for aidsmap and I didn’t want to miss that.

Monitoring of CD4/CD8 ratios should not be abandoned as HIV treatment programmes switch to streamlined monitoring, researchers from the University of Wisconsin argue in the journal AIDS. Highlighting recently published research that shows the value of CD4/CD8 ratios for predicting who is at greater risk of cancer and weak vaccine responses, they say that the CD4/CD8 ratio remains an important biomarker for guiding individualised care in people with HIV.

Taking an ACE inhibitor that crosses the blood-brain barrier reduced the risk of being diagnosed with dementia and delayed the time to a diagnosis of dementia in people with HIV receiving care in Veterans Affairs clinics in the United States, researchers report. The study compared people who took an ACE inhibitor that crosses the blood-brain barrier and those who took no medication or another type of medication to treat high blood pressure. The findings have been published as a pre-print but await full peer review.

Approximately half of all children receiving HIV care in Kenya have interruptions in their treatment lasting longer than 48 hours, and almost half are lost to follow-up care within five years. A study recently published in PLOS ONE linked these interruptions to the practical challenges of distributing paediatric medicines to small children. The authors argue that these interruptions, which they link to current paediatric ART formulations, contribute to ART ineffectiveness and poor outcomes for children living with HIV.

The rate of vertical transmission of HIV in India (from mother to the baby) has reduced from over 40% in 2010 to 24% in 2021. Still, unless the full package of evidence-based interventions that reduce vertical transmission are properly implemented, it will be difficult to meet the elimination targets – which are to reduce the transmission rate to below 5% in breastfeeding populations and below 2% in non-breastfeeding populations, by 2025. (The original 2020 goal has been changed to 2025).

Even though a review of 16 studies including almost 44,000 people found that social harms associated with HIV partner notifications are rare (less than 1%), with the most common being relationships ending, researchers warn that further research is crucial to fill in the knowledge gaps they identified.

People living with HIV in South Africa expressed a lack of awareness, confusion, and scepticism regarding U=U, according to a recent qualitative study published in PLoS ONE. Healthcare providers acted as gatekeepers and expressed fears that U=U knowledge would lead to increases in condomless sex.

Providing structured peer support to people with HIV after release from prison greatly improves enrolment in HIV treatment services, a randomised study carried out in South Africa has found. The study, conducted by the Aurum Institute and designed by researchers at the University of Witwatersrand, is published in Lancet HIV.

People with HIV who develop severe COVID-19 experience major changes in gut bacteria that persist for months after infection and may explain both the severity of COVID-19 and the extent of post-COVID symptoms, Japanese researchers report in the journal BMC Microbiology.

Blood pressure control using medication is feasible and highly effective in people with HIV taking antiretroviral treatment in Uganda, researchers from Makerere University report in the Journal of Human Hypertension. They found that using one drug (amlodipine) was sufficient to achieve blood pressure control in 96% of people with blood pressure below 160/100 (stage 1 hypertension).

Even when several risk factors for heart disease including cholesterol and diabetes are well controlled, people with HIV remain at higher risk of heart attacks, strokes or heart failure than people without HIV, a large study of people receiving medical care in California has found. The study, published in Clinical Infectious Diseases, also showed that unhealthy levels of alcohol consumption place people with HIV at substantially higher risk of heart disease than people without HIV.

Young gay and bisexual men in Kenya experienced high levels of stigma and discrimination in public healthcare facilities, while reporting more positive experiences in private and gay-friendly clinics. Online interventions were seen as a way of catering to priority needs and reducing stigmatising experiences, according to a recent qualitative study.

Traditionally, international HIV prevention efforts are managed by secular public health organisations or programmes, often internationally funded, that work with local health care providers, statutory organisations, and communities. In the early 2000s, UNICEF introduced a new initiative through which local religious leaders in South Asia, with little or no previous knowledge of HIV, would be invited to join their countries’ HIV prevention efforts.

A high proportion of older people with HIV are taking medicines they do not need that could increase the risk of falls and confusion, Spanish researchers have found in a review of studies looking at inappropriate medication prescribing in people with HIV.

Low drug concentrations do not automatically lead to virologic rebound in people receiving injectable treatment with cabotegravir and rilpivirine, Swiss researchers found in a study of people receiving injections for up to six months. They say they are uncertain why some people experience virologic rebound when they have low drug levels while others remain virologically suppressed, as well as why drug levels seem to be so much lower in everyday clinical practice than in clinical trials.

Although integrase inhibitors such as dolutegravir are recommended for the treatment of HIV-2, there is little clinical data showing their effectiveness.  In a small Portuguese cohort, dolutegravir combined with two other drugs suppressed HIV-2 viral load and maintained undetectable status after one year. In their paper published in the journal of Clinical Infectious Diseases, the authors conclude dolutegravir-based triple therapy is a safe and effective initial therapy option for the treatment of HIV-2.

People with HIV diagnosed with anal cancer have poorer survival after diagnosis, especially women, and survival rates for all people diagnosed with anal cancer have not improved significantly over the past 20 years, a US study published in Lancet HIV reports.

What do we want young women’s hearts to feel and minds to think about PrEP? This was the question a group of researchers and marketing experts sought to answer in order to build a strong, evidence-informed, and unified brand positioning for PrEP. After reviewing all the available campaigns that focus on young women and PrEP, holding consultative meetings with key stakeholders, including group discussions with 121 young women from Kenya, South Africa, and Zimbabwe, and finally analysing the data gathered using marketing insights, the team concluded that:

Any substance use treatment is better than none when it comes to reducing how often gay and bisexual men use methamphetamine (crystal meth), a study from Los Angeles has found. This study’s findings emphasise the importance of harm reduction over an abstinence-only approach to managing methamphetamine use.

Although half of new HIV diagnoses are in people born in another country, migrants have less access to HIV prevention, testing and treatment services across Europe. Many European countries have no data on migrants’ engagement with the HIV care continuum, which is likely to leave any barriers to care unaddressed, data from the European Centre for Disease Prevention and Control (ECDC) show. Rather than declining, new HIV diagnoses are increasing in gay and bisexual men born overseas. In many countries, migrants have limited access to the HIV prevention medication PrEP.