{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:22:03Z","timestamp":1787642523157,"version":"build-2736575974"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite an overall recent decline of 28% in the region, AIDS\u2010related deaths have increased among women in some Latin American countries. Low HIV risk perception among women may contribute to late diagnosis. We compared advanced HIV disease (AHD) at care enrolment between males and females in Latin America and the Caribbean.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults (\u226518 years old) from clinical sites in the Central and South America network for HIV epidemiology who enrolled between 2003 and 2022 were stratified by sex\u2010at\u2010birth\/HIV acquisition group as females, males with male\u2010to\u2010male sexual contact and heterosexual males (HMs). We classified location as within a generalized epidemic (GE: Haiti) or a concentrated epidemic (CE: Argentina, Brazil, Chile, Honduras and Mexico). We estimated the probability of AHD (AIDS diagnosis or CD4&lt;200 cells\/\u00b5L) at enrolment in care using logistic regression models, stratifying by sex\u2010at\u2010birth\/acquisition group and CE\/GE setting, adjusting for age, education level and calendar year of enrolment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 47,548 people living with HIV, 51% were from GE sites (58% females), and 49% were from CE sites (20% females, 22% HMs and 58% males with male\u2010to\u2010male sexual contact). In GE, 27.7% of persons presented with AHD (23.5% of females; 33.3% of males), while in CE, 44.9% of persons presented with AHD (37.4% of males with male\u2010to\u2010male sexual contact, 47.8% of females and 61.8% of HMs). Males in GE had higher odds of AHD compared with females (aOR: 1.48 [95% CI: 1.40\u20131.57]). The odds of AHD decreased from 2003 to 2022 (aOR: 0.29 [95% CI: 0.26\u20130.33] in GE and aOR: 0.32 [95% CI: 0.29\u20130.36] in CE). In sex\u2010at\u2010birth\/acquisition stratified models, in CE sites, odds decreased more in males with male\u2010to\u2010male sexual contact (aOR: 0.22 [95% CI: 0.19\u20130.25]) than in females (aOR: 0.57 [95% CI: 0.46\u20130.79]) and HMs (aOR: 0.47 [95% CI: 0.38\u20130.58]) in 2022\u00a0versus 2003.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In CE sites, the slight decreasing trend of AHD at enrolment among females and HMs contrasts with the steeper decline among males with male\u2010to\u2010male sexual contact. In the GE site, risk of AHD at enrolment decreased in both males and females over time. Interventions to increase awareness, improve HIV testing, and hasten linkage to care among females and HMs are needed in CE settings in addition to addressing structural and social barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70161","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:22:03Z","timestamp":1786339323000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Differences in Advanced HIV Disease at Presentation in Care Among People Living With HIV in Latin America and the Caribbean"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9212-1560","authenticated-orcid":false,"given":"Yanink","family":"Caro\u2010Vega","sequence":"first","affiliation":[{"name":"Departamento De Infectolog\u00eda Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  M\u00e9xico City M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Mej\u00eda\u2010Castrej\u00f3n","sequence":"additional","affiliation":[{"name":"Departamento De Infectolog\u00eda Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  M\u00e9xico City M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Guerrero\u2010Torres","sequence":"additional","affiliation":[{"name":"Departamento De Infectolog\u00eda Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  M\u00e9xico City M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Cesar","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Hu\u00e9sped  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia P.","family":"Cortes","sequence":"additional","affiliation":[{"name":"Universidad De Chile School of Medicine &amp; Fundaci\u00f3n Arriar\u00e1n  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisy Maria","family":"Machado","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo (UNIFESP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9746-719X","authenticated-orcid":false,"given":"Paula M.","family":"Luz","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Infectologia Evandro Chagas Fundacao Oswaldo Cruz  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Andrade\u2010Pinto","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Tulio","family":"Luque","sequence":"additional","affiliation":[{"name":"Instituto Hondure\u00f1o de Seguridad Social  Tegucigalpa Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Gotuzzo","sequence":"additional","affiliation":[{"name":"Instituto De Medicina Tropical Alexander von Humboldt  Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Rouzier","sequence":"additional","affiliation":[{"name":"Le Groupe Ha\u00eftien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port\u2010au\u2010Prince (GHESKIO)  Port\u2010au\u2010Prince Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Castilho","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-9104","authenticated-orcid":false,"given":"Peter F.","family":"Rebeiro","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Crabtree\u2010Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Departamento De Infectolog\u00eda Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  M\u00e9xico City M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Caribbean, Central & South American Network for HIV Epidemiology (CCASAnet)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,9]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Fact Sheet 2025: Global HIV Statistics [Internet]","author":"The Joint United Nations Programme on HIV\/AIDS (UNAIDS)","year":"2025"},{"key":"e_1_2_13_3_1","volume-title":"The Urgency of Now: AIDS at a Crossroads [Internet]","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS)","year":"2024"},{"key":"e_1_2_13_4_1","volume-title":"Latin America Regional Profile \u2014 2024 Global AIDS Update The Urgency of Now: AIDS at a Crossroads","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS)","year":"2024"},{"key":"e_1_2_13_5_1","volume-title":"Regional Profile: Latin America. 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