State of HIV research in Venezuela: A systematic review

BACKGROUND: Venezuela’s recent economic and political instability has severely compromised its healthcare infrastructure, impacting the management of infectious diseases, including human immunodeficiency virus (HIV). This disruption hinders progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets and potentially impedes HIV-related research. The current landscape of HIV research within Venezuela remains poorly characterized. METHODS: A systematic review, adhering to PRISMA 2020 guidelines, was conducted using PubMed, Scopus, and Biblioteca Virtual en Salud databases. Original research articles pertaining to HIV in Venezuela, published between January 2003 and August 2023, were included. Commentaries, editorials, narrative reviews, and case reports were excluded. Data on study characteristics and key findings were extracted and synthesized to characterize the research landscape. RESULTS: From 683 identified articles, 101 met the inclusion criteria. Thematic analysis revealed a concentration of studies focusing on clinical manifestations (50%), followed by epidemiological characterizations (14%), antiretroviral therapy (ART) and pediatric populations (11%). Notably, research on HIV in pregnancy was limited (4%). Epidemiological studies were often restricted to specific subpopulations, and clinical studies frequently exhibited methodological limitations, including small sample sizes and single-center designs, limiting generalizability. Conversely, research on HIV in Venezuelan migrants has increased in the past five years. Significant knowledge gaps were identified in the epidemiology of infection, ART efficacy and resistance, clinical aspects (including co-infections and opportunistic infections), and HIV in pregnancy. CONCLUSION: This systematic review provides a comprehensive overview of HIV research in Venezuela over the past two decades, revealing significant research gaps and potentially outdated research priorities. The paucity of comprehensive scientific production hinders accurate assessment of progress towards UNAIDS targets. Targeted research initiatives and increased investment are critical to address these knowledge gaps and improve HIV management within Venezuela.

• Epidemiology and Determinants of Health
  • Epidemiology
  • Determinants of Health
• Determinants of Health
  • Employment
  • Income
  • Education
  • Health services
  • Stigma/discrimination
  • Other
• Population(s)
  • General HIV+ population
• Prevention, Engagement and Care Cascade
  • Engagement and Care Cascade
  • Prevention
• Engagement and Care Cascade
  • Treatment
• Prevention
  • Biomedical interventions
• Health Systems
  • Governance arrangements