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HIV continues to be a global public health concern, with around 1.3 million new HIV infections occurring in 2022 worldwide [1]. Until 2022, there were around 39 million people living with HIV worldwide. HIV imposes a tremendous health and economic burden on the world. Since the epidemic began, more than 40 million lives have been lost due to HIV-related illnesses [2]. Lifelong antiretroviral treatments require long-term health care services and medications [3].
JMIR Public Health Surveill 2025;11:e59519
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HIV remains an important health concern and an area of public health efforts in China, with a particular focus on HIV transmission among gay, bisexual, and other men who have sex with men due to high and sustained risk of HIV infection. A cross-sectional survey of 47,000 men who have sex with men from 61 cities in China in 2008 to 2009 found an overall HIV prevalence of 4.9% [1].
J Med Internet Res 2025;27:e63111
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The US HIV epidemic continues to disproportionately impact men who have sex with men (MSM), who comprise 2% of the US population but account for about two-thirds of all new HIV diagnoses in the United States [1]. Epidemic modeling studies [2-4], our National HIV/AIDS Prevention Strategy [5], and the Centers for Disease Control and Prevention (CDC) Ending the HIV Epidemic initiative [6] all emphasize the critical role of pre-exposure prophylaxis (Pr EP) in the national HIV prevention response.
JMIR Res Protoc 2025;14:e56096
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With the acceleration of global population aging, AIDS has become increasingly prevalent among older adults, and the age composition of people living with HIV has gradually tilted toward older people. According to the Joint United Nations Programme on HIV/AIDS data [1], there were approximately 38 million people living with HIV worldwide and about 8.1 million of them were aged ≥50 years old.
JMIR Public Health Surveill 2025;11:e65674
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AHRI: Africa Health Research Institute; BCT: behavior change taxonomy; EPIC-HIV1: Empowering People through Informed Choices for HIV; SDT: self-determination theory.
EPIC-HIV1 is 1 of 2 DHIs that make up the EPIC-HIV intervention. The second DHI, EPIC-HIV2, was designed to support engagement in care for those who did not link to care within a month after a positive HIV diagnosis and is described elsewhere [29].
JMIR Form Res 2025;9:e65185
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The UNAIDS (Joint United Nations Programme on HIV and AIDS) 2024 global AIDS report showed that Sub-Saharan Africa (SSA) accounted for approximately 67% of the 38.4 million people living with HIV (PLHIV) globally [1]. In response to this burden, governments and development partners have implemented various strategies to increase access to HIV prevention services and provide robust care and treatment.
J Med Internet Res 2025;27:e68352
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Molecular HIV surveillance (MHS) is used in public health to help identify and respond to clusters of rapidly spreading HIV transmissions, a practice known as cluster detection and response (CDR). In the United States, MHS relies on partial HIV gene sequences obtained from antiretroviral resistance testing (ARVRT) performed during routine clinical care of people living with HIV [1].
JMIR Public Health Surveill 2025;11:e64663
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Young adults living with HIV face difficulty with care engagement [1]. While existing studies of young adults with HIV include varying age ranges, spanning 13 to 29 years, most agree that young adults with HIV across the age spectrum face unique challenges in care engagement. These include limited opportunities for care, higher rates of missed appointments, and medication nonadherence, all of which contribute to difficulties in achieving viral suppression [2-4].
JMIR Form Res 2025;9:e60531
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With the advent of antiretroviral therapy (ART) for HIV, people with HIV can now achieve near-normal life expectancies [1-4]. At the end of 2021, >50% of people with HIV in the United States were aged ≥50 years, primarily due to the effectiveness of ART [5]. However, the rates of viral suppression among the 1.2 million people with HIV in the United States continue to remain low, with current estimates of approximately 66% among people with HIV, despite the wider availability of ART [5].
JMIR Form Res 2025;9:e67997
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For example, mathematical models estimate that 50% of the MSM at substantial risk of HIV infection need to use Pr EP for it to have a significant impact on the hypothetical end of the HIV epidemic [9].
In addition to increasing Pr EP uptake, maintaining proper use and adherence is a major challenge in the context of combined HIV prevention. Inadequate use and discontinuation of Pr EP are complex phenomena that undermine its effectiveness as both an individual and collective strategy.
J Med Internet Res 2025;27:e67445
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