CROI 2018: Epidemic Trends and Advances in HIV Prevention

摘要

At the 2018 Conference on Retroviruses and OpportunisticInfections, trends in and risk factors for in HIVinfection were highlighted. In the United States, newHIV diagnoses are highest in the South and among AfricanAmericans and are increasing in rural areas. Youthremain highly vulnerable to HIV infection globally. Theepidemiology of HIV infections among people who injectdrugs is changing, with overdose deaths, a major publichealth concern. Phylogenetics are being used to identifyHIV transmission clusters and hotspots, which caninform prevention efforts. Vaginal microbial dysbiosisand proteomic alterations are associated with increasedrisk of HIV acquisition, as are the pregnancy and postpartumperiods. HIV testing is a central first step for theHIV care and treatment continua, and several innovativestrategies to expand HIV testing coverage and frequencyshow promise. Preexposure prophylaxis (PrEP) uptakeis rapidly increasing in some cities, with reductions ofnew infections at the population level, but use is loweramong African Americans and Latinos, youth, cis- andtransgender women, and people who inject drugs. PrEPcontinuation remains a challenge. Two open-label extensionstudies of the dapivirine vaginal ring demonstratedhigh uptake, adherence, and reduced HIV infections.Several novel systemic and topical prevention agentsshow promise in non-human primates.