Studies have shown that HIV-1/HTLV-1 coinfected patients tend to have higher CD4+ counts than HIV singly infected patients. Two chart reviews were conducted at initial enrolment among patients attending a large HIV Clinic in Trinidad, one to determine the prevalence of HIV-1/HVLV-1 coinfection and another to compare the CD4+ counts and opportunistic infections among HIV-1/HTLV-1 coinfected patients compared to a randomly selected comparison group of HIV-1 singly infected patients. Sociodemographic, clinical and laboratory data were collected and analysed using SPSS Version 25. During the period April 2002–December 2018, 8916 HIV-1 patients were enrolled at the clinic; 159 were HIV-1/HTLV-1 coinfected; the age range was 18–81 years; the median age was 40 years; 87 (54.7%) were females; and the median CD4+ count and median HIV-1 viral load at enrolment were 300 cells/mm³ and 128,543 copies/mL, respectively, with an HTLV-1 seroprevalence of 1.78%. Among the 477 HIV-1 singly infected patients, the age range was 18–71 years; the median age was 33 years; 248 (52.0%) were males; and the median CD4+ count and the median HIV viral load were 295 cells/mm³ and 23,369 copies/mL, respectively. Opportunistic infections (OIs) were diagnosed in 59 (37.1%) of the coinfected patients versus 48 (10.1%) among those HIV singly infected (p < 0.001). HIV-1/HTLV-1 coinfected patients had higher HIV-1 viral loads (p < 0.001) and more OIs, suggesting a worse prognosis though there were no statistically significant differences in CD4+ counts (p = 0.96) as compared to the HIV-1 mono-infected patients.

The Caribbean continues to have high HIV prevalence globally with concurrently high mortality rates due to opportunistic Infections. This study addresses the prevalence of histoplasmosis and cryptococcosis among patients living with advanced HIV disease (AHD) in Trinidad and Tobago, focusing on the implementation of antigen-based diagnostic assays. Conducted as a cross-sectional survey across five HIV treatment sites, 199 participants with advanced HIV disease were enrolled between July 2022 and September 2023. Diagnostic testing was performed using the Clarus Histoplasma Galactomannan Enzyme Immunoassay (EIA), and the Immy CrAg^® LFA Cryptococcal Antigen Lateral Flow Assay on urine and blood samples, respectively. Results revealed that 14.6% of participants were found to be co-infected with either histoplasmosis or cryptococcosis, with histoplasmosis being more prevalent (10.5%) than cryptococcosis (4.0%). The study found no significant demographic differences between newly diagnosed and previously diagnosed participants. However, a lower median CD4 count was associated with a higher risk of fungal opportunistic infections. The findings underscore the critical role of systematic use of fungal antigen-based diagnostic assays among patients with AHD to improve the timely diagnosis and treatment of fungal infections among people living with HIV in resource-limited settings and to improve patient outcomes and survival.

The data on psoriasis in persons infected with HIV in the Caribbean is sparse. A cross-sectional study was conducted on patients attending the HIV Clinic diagnosed with psoriasis where sociodemographic data and data on the pattern of psoriasis were collected and analysed using SPSS version 25. Over the period April 2002–December 2018, 37 persons attending the HIV clinic were diagnosed with psoriasis, age range at psoriasis diagnosis 13–70 years, mean age at diagnosis 37.7 years and 32 (86.5%) were male. Over the study period, 8916 patients were registered at the HIV Clinic and the prevalence of psoriasis among these patients was 0.42% which is less than the reported prevalence of psoriasis among persons infected with HIV of 2–3% in other studies. Severe/generalised psoriasis was present in 7 (18.9%) patients while 30 (81.1%) patients had mild/moderate psoriasis. A family history of psoriasis was present in 1 (2.7%) patient, psoriatic arthritis was present in 2 (5.4%) patients and 31 (83.8%) patients reported that there was improvement in the psoriasis with the topical therapy provided. The study makes an original contribution in the determination of the prevalence and pattern of psoriasis among patients attending a HIV Clinic in Trinidad.

Background: Client satisfaction with HIV service delivery reflects the ability of healthcare providers to effectively deliver care and treatment that meets the requirements and expectations of clients, and is associated with improved health outcomes, including increased retention in care and HIV viral suppression. The aim of the study was to conduct a client satisfaction study among PLHIV attending a large HIV clinic in Trinidad to identify the gaps in service delivery and factors associated with reduced HIV viral suppression. Methods: This cross-sectional study was conducted over the period April 2023–March 2024 among 362 clients attending the HIV clinic. A structured, pre-tested questionnaire collected demographic data and factors that affected client clinic experiences, including wait time, communication with staff, confidentiality, physical amenities and HIV viral suppression. Multivariable logistic regression was used to assess the likelihood of reporting satisfaction based on key independent variables. Results: Among participants, 219 (60.5%) were females, 202 (55.8%) were aged 30–49 years and 337 (93.1%) were virally suppressed. Participants reported satisfaction with overall care (95.3%), confidentiality (95.9%) and interactions with doctors (96.1%), nurses (98.6%) and other staff. Dissatisfaction was reported with facility-related, elements including the outdoor/tented waiting area (46.1%), the toilet/washrooms (37.0%) and the clinic wait time (31.8%). Participants were less likely to be satisfied with the amount of medication received if they had unsuppressed viral loads (p = 0.035), were aged 20–29 years old (p = 0.048) or had a tertiary education (p = 0.008). Conclusions: The study showed that 93.1% of the study participants were virally suppressed, and there was a general level of satisfaction with the overall care at the clinic, confidentiality and healthcare workers’ service delivery; however, gaps involving the physical facilities, wait times and medication services should be prioritized.

HIV-1, Hepatitis B and HTLV-1 have similar risk factors and shared routes of transmission and MSM are disproportionately affected by HIV. The aim of the study was to determine the prevalence of HTLV-1 and HBsAg positivity at initial enrolment among MSM attending a large HIV Clinic in Trinidad. Chart reviews were conducted between 2 and 15 January 2024, among self-identified MSM and a comparative group of randomly selected self-identified heterosexual males where sociodemographic, clinical and laboratory data were collected and analysed using SPSS Version 25. During the period April 2002–31 October 2023, in total there were 10,424 patients registered at the clinic, of whom 1255 (12.0%) were self-identified MSM, with an age range of 19–85 years and a median age of 40 years. There were 1822 randomly selected heterosexual males, with an age range of 18–94 years old and a median age of 52 years. Among the MSM, there were 21 (1.67%) patients who were HIV-1/HTLV-1-coinfected, 64 (5.10%) who were HIV-1/HBsAg-coinfected and two (0.16%) who were coinfected with all three viruses (HIV-1/HTLV-1/HBsAg) as compared to 47 ((2.58%) HIV-1/HTLV-1-coinfected (p = 0.12), 69 (3.79%) HIV-1/HBsAg-coinfected (p = 0.10) and three (0.16%) patients coinfected with all three viruses among the heterosexual males. There were no patients with HTLV-1-related diseases among the HIV-1/HTLV-1-coinfected patients and there were no deaths from chronic liver disease in patients coinfected with HIV-1/HBsAg. Despite the availability of an efficacious vaccine, there is a prevalence of hepatitis B of 5.1% among MSM attending the HIV Clinic in Trinidad; therefore, programmes to increase health literacy, screening and immunization are urgently needed.

Background: Globally, Caribbean countries are among the most heavily burdened by both human immunodeficiency virus and cancer. Due to their immunocompromised status, people living with human immunodeficiency virus (PLWH) are more susceptible to human papillomavirus (HPV)–related cancers. Methods: We conducted a preliminary study evaluating HPV vaccination rates targeting PLWH in Trinidad and Tobago using data from local clinics. This study provided descriptive analysis results, including demographic characteristics of enrolled PLWH and HPV vaccination rates. Results: A total of 5,615 PLWH (age ranged from 18 to 51 years, with 51.4% women and 48.6% men) were enrolled in this evaluation. Of these, 1,178 patients (21.0%) received HPV vaccines: 22.8% were vaccinated with one dose, 25.6% were vaccinated with two doses, and 51.6% were vaccinated with three doses. The highest uptake of 22.3% was in 2021, followed by 20.1% in 2022, but in 2023, it dropped to 15.5%. Between 2018 and 2020, the uptakes were 13.6% for 2020, 12.7% for 2019, and 5.7% for 2018. Conclusions: Overall, the HPV vaccination rates among PLWH in Trinidad and Tobago are low; only one in five was vaccinated. Impact: Results suggest that by implementing comprehensive and targeted programs, clinics have the potential to successfully implement HPV vaccinations toward significantly reducing the incidence and mortality of HPV-related cancers and saving lives. There is a trend with the highest vaccination uptake during the peak years of COVID-19 vaccinations, with HPV vaccination rates almost doubling between 2019 and 2021. Hence, our data suggest that the COVID-19 vaccination program may have boosted HPV vaccination.