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Abstract Dr. Pedro Cahn, International AIDS Society (IAS) President and Mr. Craig McClure, IAS Executive Director, provide their thoughts and analysis on the current and future role of the IAS as part of the global response to HIV/AIDS.

Introduction Vertical transmission of HIV from mother to child during pregnancy, childbirth, and breastfeeding can be reduced to PMTCT has been widely implemented in developing countries for a number of [...], Introduction: Mother?to?child transmission of HIV can be reduced to Methods: To examine the availability, feasibility, acceptability and possible negative consequences of the Minimum PMTCT Package, data from a 2009 qualitative and quantitative study and a 2010 facility assessment were used. To examine the effects on ANC and facility?based delivery rates, a difference?in?differences analytic approach was applied to 2009 Demographic and Health Survey data for HIV?tested women who gave birth before and after Minimum PMTCT Package implementation. Results: The Minimum PMTCT Package was feasible and acceptable to providers and clients. Problems with test kit and medicine stock?outs occurred, and 46% of women did not receive the Minimum PMTCT Package until at least their second ANC visit. Providing adequate instruction on the use of multiple medications represented a challenge. The proportion of HIV?positive women delivering in facilities declined after Minimum PMTCT Package implementation, although it increased among HIV?negative women (difference?in?differences=14.5%, p=0.05). The mean number of ANC visits declined more among HIV?positive women than among HIV?negative women after implementation, though the difference was not statistically significant (p=0.09). Changes in the percentage of women receiving?4 ANC visits did not differ between the two groups. Conclusions: If supply issues can be resolved and adequate client educational materials provided, take?away co?packages have the potential to increase access to PMTCT commodities in countries where women have limited access to health services. However, efforts must be made to carefully monitor potential changes in ANC visits and facility deliveries, and further evaluation of adherence, safety and effectiveness are needed.

On behalf of the International AIDS Society (IAS), Medscape, and our editors, we are pleased to introduce eJIAS: eJournal of the International AIDS Society, a new peer‐reviewed journal dedicated to [...]

Objective To determine whether integrating antiretroviral therapy (ART) into antenatal care (ANC) and maternal and child health (MCH) clinics could improve programmatic and patient outcomes. Methods The authors systematically searched PubMed, Embase, African Index Medicus and LiLACS for randomized controlled trials, prospective cohort studies, or retrospective cohort studies comparing outcomes in ANC or MCH clinics that had and had not integrated ART. The outcomes of interest were ART coverage, ART enrolment, ART retention, mortality and transmission of human immunodeficiency virus (HIV). Findings Four studies met the inclusion criteria. All were conducted in ANC clinics. Increased enrolment of pregnant women in ART was observed in ANC clinics that had integrated ART (relative risk, RR: 2.09; 95% confidence interval, CI; 1.78-2.46; I2: 15%). Increased ART coverage was also noted in such clinics (RR: 1.37; 95% CI: 1.05-1.79; I2: 83%). Sensitivity analyses revealed a trend for the national prevalence of HIV infection to explain the heterogeneity in the size of the effect of ART integration on ART coverage (P = 0.13). Retention in ART was similar in ANC clinics with and without ART integration. Conclusion Although few data were available, ART integration in ANC clinics appears to lead to higher rates of ART enrolment and ART coverage. Rates of retention in ART remain similar to those observed in referral-based models. INSET: Box 1. Strategy used to conduct systematic search of studies.... [ABSTRACT FROM AUTHOR]

Objectives: Given limited data on factors associated with hepatitis C virus (HCV) treatment discontinuation and failure in low- and middle-income countries, we aimed to describe patient populations treated for HCV in five countries and identify patient groups that may need additional support., Design: Retrospective cohort analysis using routinely collected data., Setting: Public sector HCV treatment programmes in India (Punjab), Indonesia, Myanmar, Nigeria (Nasarawa) and Vietnam., Participants: 104 957 patients who initiated treatment in 2016-2022 (89% from Punjab)., Primary Outcomes: Treatment completion and cure., Results: Patient characteristics and factors associated with outcomes varied across countries and facilities. Across all patients, median age was 40 years (IQR: 29-52), 30.6% were female, 7.0% reported a history of injecting drugs, 18.2% were cirrhotic and 4.9% were coinfected with HIV. 79.8% were prescribed sofosbuvir+daclastasvir. Of patients with adequate follow-up, 90.6% (89,551) completed treatment. 77.5% (69,426) of those who completed treatment also completed sustained virological testing at 12 weeks (SVR12), and of those, 92.6% (64 305) were cured. In multivariable-adjusted models, in most countries, significantly lower treatment completion was observed among patients on 24-week regimens (vs 12-week regimens) and those initiated in later years of the programme. In several countries, males, younger patients <20 years and certain groups of cirrhotic patients were less likely to complete treatment or be cured. In Punjab, treatment completion was also lower in those with a family history of HCV and people who inject drugs (PWID); in other countries, outcomes were comparable for PWID., Conclusion: High proportions of patients completed treatment and were cured across patient groups and countries. SVR12 follow-up could be strengthened. Males, younger people and those with decompensated cirrhosis on longer regimens may require additional support to complete treatment and achieve cure. Adequate programme financing, minimal user fees and implementation of evidence-based policies will be critical to close gaps., Competing Interests: Competing interests: Dr. Christian Ramers declares the following competing interests: Consulting: Gilead Sciences, AbbVie, Viiv healthcare, Janssen Speaking/Teaching: Gilead Sciences, Abbvie, Viiv healthcare Grants/research funding to his institution: Gilead Sciences, AbbVie The other authors declare no competing interests., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)