HIV Care Today http://www.thebodypro.com/content/art60462.html HIV Care Today is a multi-author blog featuring people on the frontlines of HIV treatment, prevention and patient/client care. This blog serves as a platform for these health care professionals to discuss the everyday challenges of their jobs, recent developments in their fields and issues relevant to the evolution of HIV/AIDS care. http://img.thebody.com/thebody/blogfeeds/bluehands_140x140.gif HIV Care Today http://www.thebodypro.com/content/art60462.html 140 140 Italian Study Explores Dual Drug Regimens as Maintenance Treatment http://www.thebodypro.com/content/81530/italian-study-explores-dual-drug-regimens-as-maint.html Researchers at several clinics in Italy have conducted an observational study of induction-maintenance therapy for HIV. In the induction phase of this approach to treatment, patients are given standard three- and four-drug combinations. Once their viral load has been suppressed to 50 copies/mL and stays suppressed for some time afterward (usually a period of months), doctors can offer maintenance therapy by reducing their regimen to just two drugs.

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]]> http://www.thebodypro.com/content/81530/italian-study-explores-dual-drug-regimens-as-maint.html Tue, 11 Dec 2018 18:17:00 GMT HIV and HCV Treatment, Shorter Antibiotic Courses, Malaria-Sniffing Dogs, and Other ID and HIV Reasons to Be Grateful, 2018 Edition http://www.thebodypro.com/content/81475/hiv-and-hcv-treatment-shorter-antibiotic-courses-m.html Paul E. Sax, M.D.[T]he primary purpose of Thanksgiving is expressing gratitude, a very healthy impulse that makes everyone happier -- and since this is an ID blog, here are bunch of things ID and HIV specialists can be thankful for over the past year.

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]]> http://www.thebodypro.com/content/81475/hiv-and-hcv-treatment-shorter-antibiotic-courses-m.html Mon, 19 Nov 2018 19:33:00 GMT How Providers Can Address HIV, Aging, and Polypharmacy http://www.thebodypro.com/content/81442/how-providers-can-address-hiv-aging-and-polypharma.html David Fawcett, Ph.D., L.C.S.W.By 2020, about 70% of people living with HIV will be over the age of 50, and as they age, they will inevitably be administered even more medications. Long-term survivors have taken a variety of different antiretrovirals for decades, to which have been added other drugs to control not only complications of HIV but also side effects of the medications themselves, including hypertension, diabetes, cognitive impairment, hypogonadism, bone density problems, and high cholesterol. Because normal aging typically results in a variety of other conditions, those who are aging and living with HIV find themselves taking more pills more often.

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]]> http://www.thebodypro.com/content/81442/how-providers-can-address-hiv-aging-and-polypharma.html Tue, 30 Oct 2018 17:11:00 GMT Canadian Study Examines Why Some Women Fall Out of the HIV Care Cascade http://www.thebodypro.com/content/81372/canadian-study-examines-why-some-women-fall-out-of.html thumbnail imageIn a study of more than 1,400 women living with HIV, nearly 30% did not achieve viral suppression and some groups of women had greater challenges with adherence and staying in care.

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]]> http://www.thebodypro.com/content/81372/canadian-study-examines-why-some-women-fall-out-of.html Wed, 3 Oct 2018 16:18:00 GMT California: A Health Care Laboratory With Mixed Results http://www.thebodypro.com/content/81303/california-a-health-care-laboratory-with-mixed-res.html thumbnail imageCalifornia's expansion of Medicaid under the Affordable Care Act enabled many low-income HIV patients to get health insurance previously denied to them. Still, those with mental health needs, who had been receiving coordinated care through a separate federal program, suddenly faced gaps in treatment, payment disputes and doctors who had little understanding of life with HIV.

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]]> http://www.thebodypro.com/content/81303/california-a-health-care-laboratory-with-mixed-res.html Fri, 7 Sep 2018 19:10:00 GMT To Understand Challenges Black Men With HIV Face on Re-Entry From Prisons, an Intersectional Approach Is Needed, Study Shows http://www.thebodypro.com/content/81265/to-understand-challenges-black-men-with-hiv-face-o.html thumbnail imageThere are multiple reasons why re-entry into communities from prison for black men with HIV is a difficult proposition, according to a recent study published in Social Science and Medicine. The researchers show that the intersectionality framework is applicable to understanding the challenges these men face after serving time in prison.

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]]> http://www.thebodypro.com/content/81265/to-understand-challenges-black-men-with-hiv-face-o.html Tue, 28 Aug 2018 16:48:00 GMT To Breastfeed or Not to Breastfeed While Living With HIV? Data Needed! http://www.thebodypro.com/content/81163/to-breastfeed-or-not-to-breastfeed-while-living-wi.html thumbnail imageAfter the United States' recent opposition to a World Health Organization (WHO) resolution promoting breastfeeding, U.S. president Donald Trump said that infant formula was needed especially for women in resource-poor situations. However, that's exactly when breastfeeding is safer than formula, Michele Barry, M.D., FACP, of the Stanford School of Medicine, argued in a New York Times article on this controversy.

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]]> http://www.thebodypro.com/content/81163/to-breastfeed-or-not-to-breastfeed-while-living-wi.html Wed, 18 Jul 2018 16:00:00 GMT Lung Cancer Risk and Screening With HIV -- and an Intriguing New Treatment Opportunity http://www.thebodypro.com/content/81135/lung-cancer-risk-and-screening-with-hiv.html Keith M. Sigel, M.D., Ph.D., M.P.H.Highly regarded for his contributions to cancer research in people with HIV, Dr. Sigel is Assistant Professor of Medicine in the Division of General Internal Medicine and the Division of Infectious Diseases at the Icahn School of Medicine at Mount Sinai in New York City. With a focus on two non-AIDS-defining malignancies -- lung cancer and anal cancer -- Dr. Sigel has led numerous innovative studies on these conditions and others in people with HIV. His work addresses unique aspects of HIV-related malignancy, including risk, prevention, treatment, and prognosis. He cochairs the Cancer Core of the Veterans Aging Cohort Study, a large longitudinal comparison of HIV-positive and -negative veterans with equivalent access to care and a high lung cancer burden. With an MD and a Masters in Public Health from the University of North Carolina and a PhD from Mount Sinai, Dr. Sigel devotes time to the primary care of people with HIV infection and hepatitis C infection. His many speaking invitations include talks at Yale University, the University of Massachusetts, and the University of North Carolina.

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]]> http://www.thebodypro.com/content/81135/lung-cancer-risk-and-screening-with-hiv.html Mon, 2 Jul 2018 17:52:00 GMT Today Is the Day: A Call to Action for Providers During LGBTQ Pride Month http://www.thebodypro.com/content/81087/today-is-the-day-a-call-to-action-for-providers-du.html Jessica Halem, M.B.A.By the looks of my Instagram feed and this month's events calendar, everything is going great for LGBTQ people. The bright colors and loud music are a good balm to ward off the extra stress we carry with us as sexual and gender minorities; lesbians; gay men; and bisexual, transgender, non-binary, and intersex people. What bad day couldn't be helped by a little glitter?

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]]> http://www.thebodypro.com/content/81087/today-is-the-day-a-call-to-action-for-providers-du.html Tue, 12 Jun 2018 16:25:00 GMT Why the Dolutegravir Pregnancy Warning Is Important -- and What We Should Do Now http://www.thebodypro.com/content/81046/why-the-dolutegravir-pregnancy-warning-is-importan.html Paul E. Sax, M.D.Last week, in response to newly available surveillance data, multiple agencies issued a warning about the HIV integrase inhibitor dolutegravir (DTG) and pregnancy. The warnings cite an increased risk of neural tube defects in babies born to women who became pregnant while receiving the drug.

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]]> http://www.thebodypro.com/content/81046/why-the-dolutegravir-pregnancy-warning-is-importan.html Wed, 23 May 2018 15:56:00 GMT Why Experienced HIV/ID Doctors Leave Clinical Practice http://www.thebodypro.com/content/81029/why-experienced-hivid-doctors-leave-clinical-pract.html Paul E. Sax, M.D.Three of my good friends -- they're way more than just colleagues after all this time -- in the HIV/ID world have left clinical practice recently.

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]]> http://www.thebodypro.com/content/81029/why-experienced-hivid-doctors-leave-clinical-pract.html Wed, 16 May 2018 19:39:00 GMT Primary Care for People With HIV Should Encompass More Than Viral Suppression http://www.thebodypro.com/content/81003/primary-care-for-people-with-hiv-should-encompass-.html Doctor and patient consultingIdeally, primary care for people living with HIV should include management of the virus, comorbidities (such as cardiovascular diseases or mental health issues), and common health conditions (such as hypertension), as well as counseling on risk reduction and transmission prevention. However, the non-HIV components of care may be neglected during health care visits because the focus is on HIV, said Steven C. Johnson, M.D., of the University of Colorado, in a recent webinar. His clinic therefore includes not only infectious disease specialists but also a family care practitioner and a primary care intern.

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]]> http://www.thebodypro.com/content/81003/primary-care-for-people-with-hiv-should-encompass-.html Thu, 3 May 2018 16:18:00 GMT The Patient as Partner http://www.thebodypro.com/content/81000/the-patient-as-partner.html Vincent DumezThe idea that a person should be an active participant, not just a recipient, of their own healthcare has deep roots. Feminists, people living with HIV and people with hemophilia have been making the case for decades: People should have control over their own bodies. We introduce you to one man who speaks from experience about the life-changing benefits of being a healthcare partner. Nine years ago, Vincent Dumez set out to transform the healthcare system so that it harnesses the skills and expertise of patients.

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]]> http://www.thebodypro.com/content/81000/the-patient-as-partner.html Wed, 2 May 2018 16:58:00 GMT Excessive Online Support Can Be Harmful to HIV Patients http://www.thebodypro.com/content/80959/excessive-online-support-can-be-harmful-to-hiv-pat.html David Fawcett, Ph.D., L.C.S.W.From the beginning of the internet era, both HIV-positive people and heath care providers alike have sought medical information online. Over the course of the HIV epidemic, web-based platforms have grown in numbers and sophistication. However, because anyone can post virtually anything on the internet, it is necessary to employ both caution and critical thinking when attempting to self-diagnose a medical condition or to evaluate health care information, including implausible cures.

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]]> http://www.thebodypro.com/content/80959/excessive-online-support-can-be-harmful-to-hiv-pat.html Wed, 18 Apr 2018 17:27:00 GMT Case Management Improves Linkage to Care for People Living With HIV Post-Release From Prison or Jail, New Study Shows http://www.thebodypro.com/content/80910/case-management-improves-linkage-to-care-for-peopl.html People living with HIV who spent time in Connecticut correctional facilities and received transitional case management were more likely to be promptly linked to care after their release than those who did not receive such services, a study published in The Lancet found. The study found several factors that negatively impacted linkage to care when released from custody, including sentences less than 30 days, serving more than one year, conditional release, and reincarceration.

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]]> http://www.thebodypro.com/content/80910/case-management-improves-linkage-to-care-for-peopl.html Wed, 28 Mar 2018 12:00:00 GMT Depression in People With HIV May Increase Missed Appointments, Detectable Viral Load, and Mortality, Says New Study http://www.thebodypro.com/content/80888/depression-in-people-with-hiv-may-increase-missed-.html Depression has long been recognized not only as a condition that increases risk for acquiring the HIV virus but also as a factor that dramatically impacts the quality of life of and health outcomes for persons living with HIV/AIDS. Researchers have fair agreement on the high occurrence of depression in HIV-positive patients (as high as 40%), but the long-term impact of co-occurring depression and HIV has received little attention. A new study examines the association between increased chronicity of depression in people living with HIV and health outcome indicators, such as HIV appointment attendance, treatment failure, and mortality. The findings reveal both the significant impact of depression and the need for more comprehensive assessment and treatment of depression among people with HIV at various stages in the care continuum.

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]]> http://www.thebodypro.com/content/80888/depression-in-people-with-hiv-may-increase-missed-.html Fri, 16 Mar 2018 12:00:00 GMT Long-Term Treated HIV No Defense Against Diabetes Risk http://www.thebodypro.com/content/80851/long-term-treated-hiv-no-defense-against-diabetes-.html It has long been thought that the heightened risk of diabetes among people living with HIV was mostly due to early-generation antiretroviral drugs that raised glucose levels. But a longitudinal Australian study published in the Feb. 20, 2018, issue of AIDS found that, even in the modern treatment era, HIV-positive men who have sex with men (MSM) developed diabetes at an extremely high rate.

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]]> http://www.thebodypro.com/content/80851/long-term-treated-hiv-no-defense-against-diabetes-.html Fri, 2 Mar 2018 12:00:00 GMT Why Finding New HIV Targets Takes So Long: Some Basics About Basic Research http://www.thebodypro.com/content/80725/why-finding-new-hiv-targets-takes-so-long-some-bas.html Although great strides have been made at combating human immunodeficiency virus, leading to better quality of life and a longer life expectancy for those living with the virus, significant problems remain.

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]]> http://www.thebodypro.com/content/80725/why-finding-new-hiv-targets-takes-so-long-some-bas.html Thu, 4 Jan 2018 19:50:00 GMT Injection Drug Use-Related HIV Cases Increase in Massachusetts -- Is This the Start of a Trend? http://www.thebodypro.com/content/80675/injection-drug-use-related-hiv-cases-increase-in-m.html Paul E. Sax, M.D.Recently the Massachusetts Department of Public Health sent out this concerning notice:

The Massachusetts Department of Public Health (MDPH) has noted an increase in newly diagnosed and acute HIV infections among persons who inject drugs (PWID). To date in calendar year 2017 (through November 21), there have been 64 HIV infections reported among individuals who inject drugs in Massachusetts ... Over the past 5-10 years, newly diagnosed HIV infection in PWID amounted to 32-62 cases annually, representing a stable proportion of 4-8% of all reported HIV infections. Investigation of cases is ongoing.

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]]> http://www.thebodypro.com/content/80675/injection-drug-use-related-hiv-cases-increase-in-m.html Mon, 11 Dec 2017 17:15:00 GMT Could We Safely Reduce the Frequency of Treatments for HIV-Positive People? http://www.thebodypro.com/content/80664/could-we-safely-reduce-the-frequency-of-treatments.html Most HIV-positive people in France under treatment take a daily dose of antiviral drugs for life. However, a major trial is currently underway that may confirm that patients could omit several days of treatment a week without risk to their health.

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]]> http://www.thebodypro.com/content/80664/could-we-safely-reduce-the-frequency-of-treatments.html Thu, 7 Dec 2017 12:00:00 GMT Price's 'Quarantine' Comment a Startling Example of Remaining HIV Stigma and Ignorance http://www.thebodypro.com/content/80535/prices-quarantine-comment-a-startling-example-of-r.html Paul E. Sax, M.D.In case you missed it, Betty Price, a Georgia state representative, said the following last week:

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]]> http://www.thebodypro.com/content/80535/prices-quarantine-comment-a-startling-example-of-r.html Mon, 23 Oct 2017 12:00:00 GMT The Best Antiretroviral Therapy for Pregnant Women? The Controversy Continues http://www.thebodypro.com/content/80521/the-best-antiretroviral-therapy-for-pregnant-women.html Paul E. Sax, M.D.There's considerable controversy in an area of HIV medicine that one would think should be all but solved by now.

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]]> http://www.thebodypro.com/content/80521/the-best-antiretroviral-therapy-for-pregnant-women.html Tue, 17 Oct 2017 16:18:00 GMT What Should We Do About Persistent Low-Level Viremia? http://www.thebodypro.com/content/80505/what-should-we-do-about-persistent-low-level-virem.html Paul E. Sax, M.D.Here's a most entertaining email about a tricky case (some details changed for the usual reasons), with my annotations in brackets:

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]]> http://www.thebodypro.com/content/80505/what-should-we-do-about-persistent-low-level-virem.html Tue, 10 Oct 2017 12:00:00 GMT How to Help Long-Term HIV Survivors Embrace an Unanticipated Life http://www.thebodypro.com/content/80456/how-to-help-long-term-hiv-survivors-embrace-an-una.html David Fawcett, Ph.D., L.C.S.W.I never expected to have AIDS, let alone to survive. I got sober in my 20s and could count my sexual partners on one hand. When diagnosed in 1988, at age 34, I had been out as a gay man less than a decade, was years into my first significant relationship and was quickly progressing in my career. Out of the blue, that first opportunistic infection began an endless series of precarious conditions that, almost overnight, wrenched my life into a non-stop struggle for survival. After countless hospitalizations, coming close to death with non-Hodgkin's lymphoma and losing more friends than I could count, a dark sense of hopelessness and inevitable doom settled in that was validated by everything around me. I spent my 30s and 40s preparing to die, having little energy to feel loss, sadness and anger.

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]]> http://www.thebodypro.com/content/80456/how-to-help-long-term-hiv-survivors-embrace-an-una.html Mon, 25 Sep 2017 17:33:00 GMT Really Rapid Review -- Paris IAS 2017 http://www.thebodypro.com/content/80229/really-rapid-review--paris-ias-2017.html Paul E. Sax, M.D.Last week, the International AIDS Society meeting returned to Paris for the first time since 2003.

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]]> http://www.thebodypro.com/content/80229/really-rapid-review--paris-ias-2017.html Sun, 30 Jul 2017 12:00:00 GMT Should You Answer Medical Questions From Clinicians You Don't Know About Patients You've Never Seen? http://www.thebodypro.com/content/80149/should-you-answer-medical-questions-from-clinician.html Paul E. Sax, M.D.This email popped into my inbox the other day from a person I've never met:

Hi Dr. Sax,
I do mostly hospital-based ID in Pennsylvania, and was consulted on a newly diagnosed HIV patient with CD4 10, viral load 210,000, and lymphoma. I started him on Truvada and dolutegravir, which is going well so far. Because he complained of blurred vision, he had an ophtho evaluation yesterday which showed CMV retinitis. My drug-interaction checker says I can't use valganciclovir with either tenofovir or abacavir, and if I replace the Truvada with a boosted PI, it will interact with his chemotherapy. What should I do for his ART?
Thanks so much.
Marie

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]]> http://www.thebodypro.com/content/80149/should-you-answer-medical-questions-from-clinician.html Sun, 9 Jul 2017 12:00:00 GMT Can't HIV Serodiscordant Couples Now Just Have Children the Regular Way? http://www.thebodypro.com/content/79996/cant-hiv-serodiscordant-couples-now-just-have-chil.html Paul E. Sax, M.D.MMWR just published a paper entitled, Strategies for Preventing HIV Infection Among HIV-Uninfected Women Attempting Conception with HIV-Infected Men -- United States, and it's both a welcome and a very strange document indeed.

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]]> http://www.thebodypro.com/content/79996/cant-hiv-serodiscordant-couples-now-just-have-chil.html Sun, 4 Jun 2017 12:00:00 GMT The Curious Case of M184V, Part 1 http://www.thebodypro.com/content/79985/the-curious-case-of-m184v-part-1.html Paul E. Sax, M.D.Thanks to our sophisticated research team here at NEJM Journal Watch, we have an excellent idea who reads this thing for its scintillating ID/HIV content.

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]]> http://www.thebodypro.com/content/79985/the-curious-case-of-m184v-part-1.html Sun, 21 May 2017 12:00:00 GMT Celebrating the Invaluable Knowledge and Expertise of ID Specialist Pharm.D.'s http://www.thebodypro.com/content/79842/celebrating-the-invaluable-knowledge-and-expertise.html Paul E. Sax, M.D.Since expression of gratitude makes you happier -- hey, I read it on the internet -- and whining does the reverse, I've decided to turn what was going to be a typical rant about dealing with insurance companies into an expression of thanks to a remarkable group of professionals.

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]]> http://www.thebodypro.com/content/79842/celebrating-the-invaluable-knowledge-and-expertise.html Sun, 30 Apr 2017 12:00:00 GMT Mark Wainberg and the Enduring Importance of 3TC http://www.thebodypro.com/content/79762/mark-wainberg-and-the-enduring-importance-of-3tc.html Paul E. Sax, M.D.Last week, the HIV/ID research world lost one of its leaders and pioneers when Dr. Mark Wainberg unexpectedly died. An astute, thoughtful virologist -- and a warm, engaging person -- he led the HIV research program at McGill University in Montreal for years, contributing to the field both through his research and patient advocacy. A strong voice in the effort to expand HIV therapy to Africa in the early 2000s, Mark was also a vocal critic of HIV denialism.

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]]> http://www.thebodypro.com/content/79762/mark-wainberg-and-the-enduring-importance-of-3tc.html Sun, 16 Apr 2017 12:00:00 GMT HIV and Hepatitis C Are No Longer the Most Serious Infectious Threats to People Who Inject Drugs http://www.thebodypro.com/content/79599/hiv-and-hepatitis-c-are-no-longer-the-most-serious.html Paul E. Sax, M.D.I had dinner with my daughter Mimi the other evening, and was ruminating about how things have changed since I started work as an Infectious Diseases doctor around 25 years ago.

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]]> http://www.thebodypro.com/content/79599/hiv-and-hepatitis-c-are-no-longer-the-most-serious.html Sat, 25 Mar 2017 12:00:00 GMT Improving Outcomes With ID Consultation: Three More Papers for the Collection http://www.thebodypro.com/content/79432/improving-outcomes-with-id-consultation-three-more.html Paul E. Sax, M.D.

Several years ago, one of my very brilliant colleagues posed an interesting question.

Why do ID specialists even exist?

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]]> http://www.thebodypro.com/content/79432/improving-outcomes-with-id-consultation-three-more.html Sun, 26 Feb 2017 12:00:00 GMT Really Rapid Review -- CROI 2017, Seattle http://www.thebodypro.com/content/79398/really-rapid-review--croi-2017-seattle.html Paul E. Sax, M.D.The Conference on Retroviruses and Opportunistic Infections (CROI) returned to Seattle this past week for its 24th meeting. It's the 4th time CROI has been held in Seattle, an excellent city for a meeting of this size, which includes "only" 4200 people. The convention center is pleasant and user-friendly -- big but not cavernous, actually encourages interactions with colleagues -- and there are numerous hotels and restaurants within walking distance, plus more Starbucks per square foot than any place on the planet.

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]]> http://www.thebodypro.com/content/79398/really-rapid-review--croi-2017-seattle.html Sun, 19 Feb 2017 12:00:00 GMT In the Eye of the Storm: One Doctor's 30-Year Journey Through the AIDS Crisis http://www.thebodypro.com/content/79388/in-the-eye-of-the-storm-one-doctors-30-year-journe.html Ross A. Slotten, M.D.A couple of years ago, I reread some journals I'd kept during the worst years of the AIDS epidemic. I hadn't looked at them in more than a decade and was surprised not only by their vividness but also by the rawness of their content. They brought back memories of a time I'd almost forgotten or, rather, repressed because of the intense sadness they evoked. As a doctor, I was taught to keep an emotional distance from my patients. Too much emotion clouds one's judgment. But how does one keep an emotional distance from men who were like me at the time, young and gay and who ought to have had more tomorrows than yesterdays?

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]]> http://www.thebodypro.com/content/79388/in-the-eye-of-the-storm-one-doctors-30-year-journe.html Fri, 17 Feb 2017 12:00:00 GMT How to Make Preventing Heart Disease in HIV Fun and Exciting: The REPRIEVE Trial http://www.thebodypro.com/content/79349/how-to-make-preventing-heart-disease-in-hiv-fun-an.html Paul E. Sax, M.D.The people researching cardiovascular disease in HIV have quite the challenge.

Because when you think about it for a second, we HIV treaters are a pretty spoiled bunch when it comes to therapeutic success.

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]]> http://www.thebodypro.com/content/79349/how-to-make-preventing-heart-disease-in-hiv-fun-an.html Mon, 13 Feb 2017 12:00:00 GMT Purple Maze: The Dismaying State of Health Insurance, Even in a Healthy State http://www.thebodypro.com/content/79330/purple-maze-the-dismaying-state-of-health-insuranc.html Keith Henry, M.D.Working in the HIV field at a public hospital for 30 years has exposed me to a host of challenging clinical and social situations. I spend all of my professional time on HIV-related issues (mostly clinical, but also research, teaching and lecturing), yet only a small fraction of it is spent on matters directly related to HIV or antiretroviral therapy. Most is spent on primary care and social or insurance issues that are nonetheless important to our patients.

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]]> http://www.thebodypro.com/content/79330/purple-maze-the-dismaying-state-of-health-insuranc.html Thu, 9 Feb 2017 17:25:00 GMT Case Report of PrEP Failure: What Can We Learn From It? http://www.thebodypro.com/content/79292/case-report-of-prep-failure-what-can-we-learn-from.html Paul E. Sax, M.D.The New England Journal of Medicine has published the first well-documented case of HIV pre-exposure prophylaxis (PrEP) failure despite good medication adherence.

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]]> http://www.thebodypro.com/content/79292/case-report-of-prep-failure-what-can-we-learn-from.html Sun, 5 Feb 2017 12:00:00 GMT A Necessary Moment of Self-Care for Black Gay, Trans and Queer People Living and Working on the HIV Front Lines http://www.thebodypro.com/content/79281/a-necessary-moment-of-self-care-for-black-gay-tran.html George M. JohnsonThis year, the National African American MSM Leadership Conference on HIV/AIDS and Other Health Disparities met in Dallas, Texas, during the inauguration of Donald Trump as our 45th president. As our new commander-in-chief was being sworn in with no HIV policy in sight, over 500 black gay men were meeting to discuss the future of HIV prevention, treatment and care in our country as we move into unchartered territory. For many of us, this meeting was a necessary moment of self-care that allowed us as black gay, trans and queer people to be at peace with one another, knowing what the fight ahead is going to be. We all met together for the conference highlight, a session called "Convergence: Living and Working on the Front Lines."

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]]> http://www.thebodypro.com/content/79281/a-necessary-moment-of-self-care-for-black-gay-tran.html Thu, 2 Feb 2017 12:00:00 GMT Supporting All People With HIV Around Fertility, Conception and Family Building http://www.thebodypro.com/content/79224/supporting-all-people-with-hiv-around-fertility-co.html Keiko LaneOn a conference call working out the details of a brochure about fertility and family building for gay men affected by HIV, something was nagging at me. Eventually I asked the question, "But what do we actually mean by 'men'?" The call was silent for a minute as we all thought about it. "When we're talking about gay men or 'men' in the context of family planning, fertility and reproductive technology, do we mean people who identify as men, or do we mean bodies that produce sperm? Because if we mean 'men' as a signifier, we also have to talk about fertility options for trans men, and if we mean 'bodies that produce sperm,' we also have to talk about trans women. Either way, the language is more complicated."

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]]> http://www.thebodypro.com/content/79224/supporting-all-people-with-hiv-around-fertility-co.html Wed, 25 Jan 2017 16:51:00 GMT Top Stories in HIV Medicine for 2016 http://www.thebodypro.com/content/79112/top-stories-in-hiv-medicine-for-2016.html Paul E. Sax, M.D.A lot of these "Best of ..." or "Top Stories in ..." lists have already been published, as they seem to be appearing earlier and earlier each year. Pretty soon we'll start reading them around the same time they sell Halloween Candy -- and that's just too early, sorry.

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]]> http://www.thebodypro.com/content/79112/top-stories-in-hiv-medicine-for-2016.html Sun, 1 Jan 2017 12:00:00 GMT Ebola Vaccine, A New Use for Listerine, USPSTF on HSV, Nether Grooming, and More: A Christmas and Hanukkah Overlap ID Link-o-Rama http://www.thebodypro.com/content/79095/ebola-vaccine-a-new-use-for-listerine-uspstf-on-hs.html Paul E. Sax, M.D.A few notable ID stories out there for this remarkable convergence in our Judeo-Christian holiday calendar.

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]]> http://www.thebodypro.com/content/79095/ebola-vaccine-a-new-use-for-listerine-uspstf-on-hs.html Sun, 25 Dec 2016 12:00:00 GMT Seven ID/HIV Things to Be Grateful for This Holiday Season, 2016 Edition http://www.thebodypro.com/content/78831/seven-idhiv-things-to-be-grateful-for-this-holiday.html Paul E. Sax, M.D.I know, I know -- you read that title and thought, "Grateful now? He must be out of his mind."

But with the (unsurprising) concession that I too felt that watching the election returns was akin to witnessing a slowly developing and incomprehensible train wreck, I remind you that the expression of gratitude is well known to make you happier. Plus, it's the season.

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]]> http://www.thebodypro.com/content/78831/seven-idhiv-things-to-be-grateful-for-this-holiday.html Sun, 20 Nov 2016 21:58:00 GMT Anticipating Trump, an HIV Psychotherapist Considers Long-Term Survival and Solidarity http://www.thebodypro.com/content/78764/trump-an-hiv-psychotherapist-considers-long-term-s.html Keiko LaneThe morning after the election, my parents left on a road trip to Manzanar, the internment camp in central California where my family was imprisoned during World War II. My mother was born there. When I talked to them before they left, they were glad to be getting offline and out of range for a few days. They were going to scatter more origami cranes on the now empty, dusty block where my family was housed when my mother was a baby.

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]]> http://www.thebodypro.com/content/78764/trump-an-hiv-psychotherapist-considers-long-term-s.html Fri, 11 Nov 2016 20:16:00 GMT Do ID Clinicians Perpetuate Our Own Stigma? http://www.thebodypro.com/content/78729/do-id-clinicians-perpetuate-our-own-stigma.html Paul E. Sax, M.D.The stigma associated with Infectious Diseases is as much a part of the field as knowing why Pneumocystis carinii is now Pneumocystis jirovecii, and how to pronounce the drug class that includes linezolid and tedizolid. (Oxazolidinone.)

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]]> http://www.thebodypro.com/content/78729/do-id-clinicians-perpetuate-our-own-stigma.html Sun, 6 Nov 2016 12:00:00 GMT New Clinical Resources: Mental Health Needs of People Aging With HIV/AIDS http://www.thebodypro.com/content/78668/new-clinical-resources-mental-health-needs-of-peop.html David Fawcett, Ph.D., L.C.S.W.We have not been here before. Over 50% of Americans with HIV are now over 50, and that number continues to grow. Mental health professionals treating older persons living with HIV are confronted with complex comorbidities that are just beginning to be documented and understood. When compounded by HIV, the routine medical, psychological and psychosocial stressors of aging grow more complex and present unique challenges to providers.

Read more ...

]]> http://www.thebodypro.com/content/78668/new-clinical-resources-mental-health-needs-of-peop.html Wed, 26 Oct 2016 20:31:00 GMT Why Guessing an Infectious Disease/HIV Doctor's Political Affiliation Is Easy http://www.thebodypro.com/content/78561/why-guessing-an-infectious-diseasehiv-doctors-poli.html Paul E. Sax, M.D.One of our medical school's most beloved teachers gives a wonderful lecture on how to give an effective presentation. He offers many invaluable tips for a successful talk, such as 1) Show up early; 2) Know your audience; 3) Don't read your slides; 4) Never include a slide that you need to preface by saying, "I know you can't read this, but ..."

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]]> http://www.thebodypro.com/content/78561/why-guessing-an-infectious-diseasehiv-doctors-poli.html Sun, 9 Oct 2016 12:00:00 GMT The Trauma of Hope: A Psychotherapist Reflects on False Cure News http://www.thebodypro.com/content/78546/the-trauma-of-hope-a-psychotherapist-reflects-on-f.html Keiko LaneThis time, at least the "cure" news broke over the weekend, so I got to understand the science and anticipate the full range of responses and feelings before my week started.

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]]> http://www.thebodypro.com/content/78546/the-trauma-of-hope-a-psychotherapist-reflects-on-f.html Thu, 6 Oct 2016 20:01:00 GMT Ten Years After Landmark HIV Testing Guidelines, How Are We Doing? Specifically in Emergency Departments? http://www.thebodypro.com/content/78410/ten-years-after-landmark-hiv-testing-guidelines-ho.html Paul E. Sax, M.D.In the late 1990s, a patient was admitted to our hospital with HIV-associated PCP. He had advanced AIDS, a CD4 cell count < 100, and was sick enough to require a temporary stay in our ICU.

Those clinical details aren't so remarkable -- "late" diagnoses of HIV still happen, and happened even more back then. What's remarkable is what happened to him before he got admitted.

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]]> http://www.thebodypro.com/content/78410/ten-years-after-landmark-hiv-testing-guidelines-ho.html Sun, 18 Sep 2016 12:00:00 GMT My Transition Toward Trans Awareness http://www.thebodypro.com/content/78345/my-transition-toward-trans-awareness.html Robert M. Grant, M.D., M.P.H.I recall when a colleague told me in 2014 that some transgender women advocates were unhappy with iPrEx. I was surprised and disappointed. Since the study was conceived in 2004, I had struggled to include trans women for so many reasons and against so many objections.

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]]> http://www.thebodypro.com/content/78345/my-transition-toward-trans-awareness.html Wed, 7 Sep 2016 12:00:00 GMT The Most Common Question About the New HIV Testing Algorithm, Answered http://www.thebodypro.com/content/78311/the-most-common-question-about-the-new-hiv-testing.html Paul E. Sax, M.D.A 28yo woman had a positive 4th gen +Ag/Ab assay, but a negative HIV-1/2 differentiation assay and negative HIV viral load. She had no signs of acute HIV, but is not using condoms with her partner, whose HIV status she doesn't know. We repeated the test yesterday and she is again Ag/Ab+, the remainder of the test is pending. If we get the same results again, would you try to get a Western blot?

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]]> http://www.thebodypro.com/content/78311/the-most-common-question-about-the-new-hiv-testing.html Sun, 4 Sep 2016 12:00:00 GMT Really Rapid Review -- AIDS 2016, Durban http://www.thebodypro.com/content/78010/really-rapid-review--aids-2016-durban.html Paul E. Sax, M.D.The International AIDS Conference returned this year to Durban, South Africa, where it was famously first held in 2000. At that time the HIV epidemic was exploding in South Africa; funding for HIV treatment was essentially non-existent, and there was ongoing HIV denialism quite openly from some very influential figures in the South African government (including the President). Globally, fewer than 1 million people were receiving antiretroviral therapy, hardly any of them in Africa.

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]]> http://www.thebodypro.com/content/78010/really-rapid-review--aids-2016-durban.html Sun, 24 Jul 2016 12:00:00 GMT Must-Read Item: This Year's JAMA HIV/AIDS Issue http://www.thebodypro.com/content/77937/must-read-item-this-years-jama-hivaids-issue.html Paul E. Sax, M.D.The folks over at the Journal of the American Medical Association have been doing a periodic HIV/AIDS themed issue for years, generally around the time of the International AIDS Conference. The latest issue is out this week, and it's terrific.

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]]> http://www.thebodypro.com/content/77937/must-read-item-this-years-jama-hivaids-issue.html Thu, 14 Jul 2016 21:49:00 GMT Velpatasvir/Sofosbuvir Makes HCV Treatment Simpler, Especially for Genotypes 2 and 3 http://www.thebodypro.com/content/77868/velpatasvirsofosbuvir-makes-hcv-treatment-simpler-.html Paul E. Sax, M.D.One of the ways ID and hepatology hepatitis C experts like to show off is by discoursing on the nuances of cleverly named clinical trials, and how these impact treatment guidelines.

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]]> http://www.thebodypro.com/content/77868/velpatasvirsofosbuvir-makes-hcv-treatment-simpler-.html Sun, 3 Jul 2016 12:00:00 GMT Drug Prior Authorizations Are a Very Blunt Tool for Cost Containment -- And They're Annoying http://www.thebodypro.com/content/77624/drug-prior-authorizations-are-a-very-blunt-tool-fo.html Paul E. Sax, M.D.Insurance prior authorizations, or prior approvals (PAs) -- those dreaded forms clinicians have to fill out, usually triggered by prescribing a non-formulary drug -- are much on my mind these days. And most of it has to do with three letters, specifically "TAF."

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]]> http://www.thebodypro.com/content/77624/drug-prior-authorizations-are-a-very-blunt-tool-fo.html Sun, 22 May 2016 12:00:00 GMT Why Getting Old Isn't Always so Terrible -- and Why People With HIV Can Now Get Life Insurance http://www.thebodypro.com/content/77485/why-getting-old-isnt-always-so-terrible--and-why-p.html Paul E. Sax, M.D.Two patient-related anecdotes, then a news item.

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]]> http://www.thebodypro.com/content/77485/why-getting-old-isnt-always-so-terrible--and-why-p.html Sun, 24 Apr 2016 12:00:00 GMT Zika and HIV: Connecting the Science http://www.thebodypro.com/content/77281/zika-and-hiv-connecting-the-science.html Artur Timerman, M.D.In my first years of medical practice, dealing with AIDS at that time was invariably fatal. Years later, still battling HIV, we are now faced with another outbreak of a similar nature -- the Zika virus. I remember the time when we did not have a clinical-epidemiological diagnosis of a new disease. I remember the era when we did not have a precise etiologic diagnosis. I remember a time when we had not yet discovered the virus responsible for AIDS. Pathogenesis was discussed by inferences but it took us four years to discover HIV (then HTLV-III or LAV) and even more time to understand how it caused immunodeficiency, although a lot still needs to be learned.

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]]> http://www.thebodypro.com/content/77281/zika-and-hiv-connecting-the-science.html Thu, 17 Mar 2016 17:54:00 GMT Approval of TAF/FTC/RPV, Another Single Pill HIV Treatment Option http://www.thebodypro.com/content/77288/approval-of-tafftcrpv-another-single-pill-hiv-trea.html Paul E. Sax, M.D.The approval last week of TAF/FTC/RPV -- that's coformulated tenofovir alafenamide, emtricitabine, and rilpivirine -- brings us another one-pill, once-daily option for HIV treatment.

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]]> http://www.thebodypro.com/content/77288/approval-of-tafftcrpv-another-single-pill-hiv-trea.html Wed, 9 Mar 2016 12:00:00 GMT Twelve Zika Questions, One HIV Doctor's Answers (Sort Of) http://www.thebodypro.com/content/77094/twelve-zika-questions-one-hiv-doctors-answers-sort.html Paul E. Sax, M.D.Got a Zika question? Welcome to the club -- once again, as with any "new" or "emerging" infection, this is uncharted territory, and there are plenty of answers to these questions that could be summarized with 3 words: We Don't Know.

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]]> http://www.thebodypro.com/content/77094/twelve-zika-questions-one-hiv-doctors-answers-sort.html Sun, 7 Feb 2016 12:00:00 GMT IV and Injectable HIV Treatments Are Much Discussed -- But Won't Be Here Anytime Soon http://www.thebodypro.com/content/76975/iv-and-injectable-hiv-treatments-are-much-discusse.html Paul E. Sax, M.D.Something interesting happens when you poll people who treat HIV -- and people who have HIV -- about whether they'd prefer a treatment option that consists of a periodic injection or infusion in place of the pill or pills that they take every day.

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]]> http://www.thebodypro.com/content/76975/iv-and-injectable-hiv-treatments-are-much-discusse.html Mon, 18 Jan 2016 12:00:00 GMT Medical Marijuana and Painful Neuropathy -- An Opportunity to Make Us Believers http://www.thebodypro.com/content/76946/medical-marijuana-and-painful-neuropathy--an-oppor.html Paul E. Sax, M.D.Medical marijuana is now officially available in New York, the city with by far the largest number of people living with HIV/AIDS in the country. Reporting on the first dispensary in Manhattan, the aptly named Julie Weed (yes! her real name!) writes ...

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]]> http://www.thebodypro.com/content/76946/medical-marijuana-and-painful-neuropathy--an-oppor.html Sun, 10 Jan 2016 12:00:00 GMT Do Electronic Health Records Make You a Better (or Worse) Clinician? http://www.thebodypro.com/content/76844/do-electronic-health-records-make-you-a-better-or-.html Paul E. Sax, M.D.Earlier this week, JAMA Internal Medicine published a study entitled, "Level of Computer Use in Clinical Encounters Associated with Patient Satisfaction".

A more descriptive title would have been "More Computer Use in Clinical Encounters Associated with Reduced Patient Satisfaction", as here's the take home point:

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]]> http://www.thebodypro.com/content/76844/do-electronic-health-records-make-you-a-better-or-.html Sun, 6 Dec 2015 12:00:00 GMT Five (OK, Six) ID/HIV Things to Be Grateful for This Holiday Season, 2015 Edition http://www.thebodypro.com/content/76832/five-ok-six-idhiv-things-to-be-grateful-for-this-h.html Paul E. Sax, M.D.Some quick ID/HIV gratitude items for 2015, done rapidly as we're hosting a big meal later today.

I wonder what that might be.

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]]> http://www.thebodypro.com/content/76832/five-ok-six-idhiv-things-to-be-grateful-for-this-h.html Thu, 26 Nov 2015 12:00:00 GMT An HIV Vaccine: Imagining the Future of HIV Prevention http://www.thebodypro.com/content/76654/an-hiv-vaccine-imagining-the-future-of-hiv-prevent.html Tian JohnsonIn this article, South African HIV prevention activist and member of the Vaccine Advocacy Resource Group -- a small, global group of advocates specifically focused on the HIV vaccine research field -- Tian Johnson reflects on his participation in the recent HVTN Conference in Cape Town, his hope for a vaccine and the necessity of advocates' involvement in the search. This first appeared in NGO Pulse.

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]]> http://www.thebodypro.com/content/76654/an-hiv-vaccine-imagining-the-future-of-hiv-prevent.html Tue, 10 Nov 2015 20:27:00 GMT New HIV Treatment Genvoya Is Really All About the TAF Part http://www.thebodypro.com/content/76653/new-hiv-treatment-genvoya-is-really-all-about-the-.html Paul E. Sax, M.D.HIV providers and patients recently got this news from the FDA:

The U.S. Food and Drug Administration today approved Genvoya (a fixed-dose combination tablet containing elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide) as a complete regimen for the treatment of HIV-1 infection in adults and pediatric patients 12 years of age and older.

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]]> http://www.thebodypro.com/content/76653/new-hiv-treatment-genvoya-is-really-all-about-the-.html Tue, 10 Nov 2015 19:49:00 GMT Should Doctors Still Be Allowed to Wear White Coats? You Decide http://www.thebodypro.com/content/76633/should-doctors-still-be-allowed-to-wear-white-coat.html Paul E. Sax, M.D.If you're not immersed in the ID or the Infection Control world, you might not be aware that there's currently quite the controversy about whether doctors should wear white coats.

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]]> http://www.thebodypro.com/content/76633/should-doctors-still-be-allowed-to-wear-white-coat.html Sun, 1 Nov 2015 12:00:00 GMT The Most Important HIV Study at IDWeek 2015 http://www.thebodypro.com/content/76632/the-most-important-hiv-study-at-idweek-2015.html Paul E. Sax, M.D.After reporting my choice for the most important HIV study at ICAAC, I received this email from a colleague ...

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]]> http://www.thebodypro.com/content/76632/the-most-important-hiv-study-at-idweek-2015.html Thu, 29 Oct 2015 12:00:00 GMT WHO Decision to Recommend Treatment for All With HIV an Easy One -- Now Comes the Hard Part http://www.thebodypro.com/content/76511/who-decision-to-recommend-treatment-for-all-with-h.html Paul E. Sax, M.D.In the newspaper today -- and yes, we still do get it delivered (some habits die hard) -- is this headline: "Millions More Need H.I.V. Treatment, W.H.O. Says"

It's true -- these updated guidelines say that all should be treated soon after diagnosis, regardless of CD4 cell count or whether they have symptoms.

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]]> http://www.thebodypro.com/content/76511/who-decision-to-recommend-treatment-for-all-with-h.html Thu, 1 Oct 2015 12:00:00 GMT Decision to Lower Price of Pyrimethamine a Good One, Especially Given the Weak Defense of the Price Hike http://www.thebodypro.com/content/76512/decision-to-lower-price-of-pyrimethamine-a-good-on.html Paul E. Sax, M.D.The big ID story the past couple of weeks is that the price of pyrimethamine -- a drug that's been available generically for decades -- went from $13.50 to $750 for one pill after the exclusive rights to the drug were purchased by Turing Pharmaceuticals.

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]]> http://www.thebodypro.com/content/76512/decision-to-lower-price-of-pyrimethamine-a-good-on.html Thu, 24 Sep 2015 12:00:00 GMT Electronic Health Record and Drug Prescribing Warnings: The Good, the Bad, the Ugly http://www.thebodypro.com/content/76513/electronic-health-record-and-drug-prescribing-warn.html Paul E. Sax, M.D.Recently, an ENT colleague (fictionally named "Clint" below), sent me two emails triggered by drug-drug interaction warnings he received while seeing HIV patients.

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]]> http://www.thebodypro.com/content/76513/electronic-health-record-and-drug-prescribing-warn.html Sun, 20 Sep 2015 12:00:00 GMT The Overlooked Secondary Benefits of PrEP http://www.thebodypro.com/content/76437/the-overlooked-secondary-benefits-of-prep.html Howard Grossman, M.D.Pre-exposure prophylaxis (PrEP) against HIV infection utilizing tenofovir/emtricitabine (Truvada) has been nothing short of revolutionary in changing the landscape of HIV prevention. What has been less discussed are the enormous secondary benefits that have followed the introduction of PrEP.

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]]> http://www.thebodypro.com/content/76437/the-overlooked-secondary-benefits-of-prep.html Fri, 18 Sep 2015 10:12:00 GMT Is PrEP 100 % Effective or 100 % Over-Hyped? http://www.thebodypro.com/content/76436/is-prep-100--effective-or-100--over-hyped.html Tim Lahey, M.D., M.M.Sc.Recently we got great news from a real-world study of HIV pre-exposure prophylaxis (PrEP).

Researchers at San Francisco's Kaiser Permanente Medical Center reported on the real-world experience of 657 people who started PrEP between 2012 and 2015. Over 99% were men who have sex with men, 84% reported multiple sexual partners, and 30% had HIV-positive partners. Together they were observed for over 388 person-years of PrEP use.

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]]> http://www.thebodypro.com/content/76436/is-prep-100--effective-or-100--over-hyped.html Fri, 18 Sep 2015 09:27:00 GMT We're in an HIV Prevention Revolution. Where Is the Excitement? http://www.thebodypro.com/content/76404/were-in-an-hiv-prevention-revolution-where-is-the-.html Marc-André LeBlancWe're in the midst of an HIV prevention revolution. Over the past few years, we have gained new tools and knowledge to prevent HIV, from pre-exposure prophylaxis (PrEP) to the knowledge that an undetectable viral load dramatically reduces the risk of transmission.

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]]> http://www.thebodypro.com/content/76404/were-in-an-hiv-prevention-revolution-where-is-the-.html Thu, 10 Sep 2015 18:35:00 GMT Post-Exposure Prophylaxis for HCV Can't Be Cost-Effective -- but We Might End Up Recommending It Anyway http://www.thebodypro.com/content/76360/post-exposure-prophylaxis-for-hcv-cant-be-cost-eff.html Paul E. Sax, M.D.An email query from a colleague:

Hi Paul,
Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV+. Any post-exposure prophylaxis recommended?

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]]> http://www.thebodypro.com/content/76360/post-exposure-prophylaxis-for-hcv-cant-be-cost-eff.html Sun, 23 Aug 2015 12:00:00 GMT The Pain -- and Potential Power -- of Electronic Health Records in One Little Anecdote http://www.thebodypro.com/content/76267/the-pain--and-potential-power--of-electronic-healt.html Paul E. Sax, M.D.Here's a scintillating series of events that happened recently on our inpatient consult service.

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]]> http://www.thebodypro.com/content/76267/the-pain--and-potential-power--of-electronic-healt.html Sun, 9 Aug 2015 12:00:00 GMT Patching the Leaky Cascade: Report From the 2015 Adherence Conference http://www.thebodypro.com/content/76202/patching-the-leaky-cascade-report-from-the-2015-ad.html David Fawcett, Ph.D., L.C.S.W.Thirty-three million people are infected with HIV worldwide, but less than 50% receive antiretroviral therapy. This was the stark reality addressed in June at the 10th International Conference on HIV Treatment and Prevention Adherence (Adherence 2015), which is jointly provided by the International Association of Providers of AIDS Care (IAPAC) and the Postgraduate Institute for Medicine (PIM). Every aspect of the ubiquitous treatment cascade was addressed in an effort to stop the "leaks" of people not engaging in treatment, falling out of care or not maintaining viral suppression. While access to prevention and treatment has significantly improved worldwide, certain issues such as stigma still impact prevention and treatment, and gender, age, race and sexual orientation continue to make certain populations vulnerable and in need of interventions tailored to their specific needs.

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]]> http://www.thebodypro.com/content/76202/patching-the-leaky-cascade-report-from-the-2015-ad.html Mon, 27 Jul 2015 20:46:00 GMT Really Rapid Review: IAS 2015 http://www.thebodypro.com/content/76196/really-rapid-review-ias-2015.html Paul E. Sax, M.D.Vancouver will always have a special place in HIV treatment history. It was here, in 1996, that many of us first saw the potential of combination antiretroviral therapy to control this disease.

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]]> http://www.thebodypro.com/content/76196/really-rapid-review-ias-2015.html Sun, 26 Jul 2015 12:00:00 GMT Right Thing, Right Place, Right Time: Utilizing Data to Strengthen the Fight Against HIV http://www.thebodypro.com/content/76195/right-thing-right-place-right-time-utilizing-data-.html David Fawcett, Ph.D., L.C.S.W.Because current levels of HIV spending are unsustainable, HIV prevention and intervention efforts must become highly targeted in order to maximize their impact. This was the theme of many presentations at the 10th International Conference on HIV Treatment and Prevention Adherence. The conference, held June 28 to 30 in Miami, Florida, was jointly provided by the International Association of Providers of AIDS Care (IAPAC) and the Postgraduate Institute for Medicine (PIM).

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]]> http://www.thebodypro.com/content/76195/right-thing-right-place-right-time-utilizing-data-.html Sat, 25 Jul 2015 21:10:00 GMT Top 10 Things Public Health Practitioners, Government Policymakers and Community Advocates Need to Do to Move to the End of HIV and HCV http://www.thebodypro.com/content/76139/top-10-things-public-health-practitioners-governme.html Murray PennerLast month, I spoke at the closing plenary of the HIV Forum for Collaborative HIV Research National Summit in Arlington, Virginia. I began with a brief look back at how the fight against the HIV epidemic has evolved. I reflected on a time when there were only a few tools and even fewer resources available to make an impact on the disease. This is in direct contrast to the progress that we have made in today's fight, where we have many tools available to us that work to combat and bring an end to the HIV and HCV epidemics. But I am reminded, and wanted to remind everyone in attendance, that a challenge still remains. We need to work differently and more effectively to bring an end to both of these epidemics. The following is an excerpt from the presentation I gave, where I provided a top 10 list of things that we must consider and incorporate in our work to end both epidemics.

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]]> http://www.thebodypro.com/content/76139/top-10-things-public-health-practitioners-governme.html Tue, 14 Jul 2015 12:00:00 GMT For HIV in the USA, Not in Care Exceeds the Undiagnosed -- Solutions Welcome http://www.thebodypro.com/content/76080/for-hiv-in-the-usa-not-in-care-exceeds-the-undiagn.html Paul E. Sax, M.D.In last week's post, I asked about two of the key components of the HIV care cascade -- the "undiagnosed" vs the "diagnosed but not in care," and which group was larger in the USA. Here are your answers as of now.

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]]> http://www.thebodypro.com/content/76080/for-hiv-in-the-usa-not-in-care-exceeds-the-undiagn.html Tue, 7 Jul 2015 12:00:00 GMT Undiagnosed or Not in Care? For HIV, Which Is the Bigger Problem? http://www.thebodypro.com/content/76079/undiagnosed-or-not-in-care-for-hiv-which-is-the-bi.html Paul E. Sax, M.D.These days, it's hard to have a "closed book" examination.

The information is everywhere -- on your computer, your phone, your tablet -- whatever screen happens to be glowing in front of you.

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]]> http://www.thebodypro.com/content/76079/undiagnosed-or-not-in-care-for-hiv-which-is-the-bi.html Wed, 1 Jul 2015 12:00:00 GMT Post-Exposure Prophylaxis (PEP): A Pilot Program for Uninsured Patients http://www.thebodypro.com/content/75937/post-exposure-prophylaxis-pep-a-pilot-program-for-.html Joel L. Zive, B.S., Pharm.D.Two years ago, the Alachua County Community Support Services, Victim Services and Rape Crisis Center in Gainesville, Florida, contacted me to inquire about Walgreens' partnership in assisting uninsured sexual assault victims to obtain HIV post-exposure prophylaxis (PEP) prescriptions during weekends and holidays. This issue is of great importance because once an individual is sexually assaulted, there is only a 72-hour window to begin PEP. Ideally, it is recommended to start the regimen as soon as possible. I have learned that when a person is sexually assaulted, local emergency rooms only provide a one-day dose of the regimen. As a result, this leaves the victim advocate and patient foraging for medication to cover the remaining days of the typical 28-day regimen. In addition, the problem is further compounded if the assault occurs on a holiday weekend.

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]]> http://www.thebodypro.com/content/75937/post-exposure-prophylaxis-pep-a-pilot-program-for-.html Thu, 4 Jun 2015 12:00:00 GMT A Slightly Less Painful Way to Learn the 3-Letter Abbreviations for HIV Meds http://www.thebodypro.com/content/75909/a-slightly-less-painful-way-to-learn-the-3-letter-.html Paul E. Sax, M.D.One of the stupid things about being an HIV/ID specialist is the highly arcane code we use to abbreviate HIV treatments.

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]]> http://www.thebodypro.com/content/75909/a-slightly-less-painful-way-to-learn-the-3-letter-.html Thu, 4 Jun 2015 12:00:00 GMT START Is STOPPED: Study Confirms HIV Treatment Is Beneficial for All, Even Those With High CD4 Cell Counts http://www.thebodypro.com/content/75908/start-is-stopped-study-confirms-hiv-treatment-is-b.html Paul E. Sax, M.D.The Strategic Timing of AntiRetroviral Treatment (START) study began in 2009, enrolling over 4000 asymptomatic people with HIV and CD4 cell counts > 500, and randomizing them to immediate ART or to wait until the count dropped to 350. Now, from the National Institute of Allergy and Infectious Diseases comes this important announcement.

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]]> http://www.thebodypro.com/content/75908/start-is-stopped-study-confirms-hiv-treatment-is-b.html Wed, 27 May 2015 12:00:00 GMT A Drug for Neck Fat, and Some Thoughts on Fat Accumulation Syndromes in HIV http://www.thebodypro.com/content/75784/a-drug-for-neck-fat-and-some-thoughts-on-fat-accum.html Paul E. Sax, M.D.It's not often that a FDA drug approval for cosmetic dermatologists and plastic surgeons will get the attention of HIV/ID specialists, but this past week was an exception

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]]> http://www.thebodypro.com/content/75784/a-drug-for-neck-fat-and-some-thoughts-on-fat-accum.html Mon, 4 May 2015 09:24:00 GMT New HIV Treatment Guidelines, and the End of an Era http://www.thebodypro.com/content/75686/new-hiv-treatment-guidelines-and-the-end-of-an-era.html Paul E. Sax, M.D.The new Department of Health and Human Services (DHHS) HIV treatment guidelines are out, and thanks to skillful direction by Alice Pau, it's as usual a must-read document -- all 288 pages, of course!

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]]> http://www.thebodypro.com/content/75686/new-hiv-treatment-guidelines-and-the-end-of-an-era.html Wed, 8 Apr 2015 09:05:00 GMT Why Frontiers Must Retract HIV/AIDS Denialist Paper http://www.thebodypro.com/content/75636/why-frontiers-must-retract-hivaids-denialist-paper.html Kenneth WitwerThe scientific publisher Frontiers recently published a paper disputing the link between HIV and AIDS. Yet, the belief system known as HIV/AIDS denialism has no scientific basis. As demonstrated anew with every person who begins a successful therapeutic program, the causative link between HIV and AIDS is among the strongest and most investigated, in modern medical science. The published manuscript was also weak -- a one-sided, poorly researched, inaccurate screed by a non-expert on HIV/AIDS with training in theology and education.

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]]> http://www.thebodypro.com/content/75636/why-frontiers-must-retract-hivaids-denialist-paper.html Thu, 26 Mar 2015 17:00:06 GMT HIV Conspiracy Theories and the Black Community http://www.thebodypro.com/content/75615/hiv-conspiracy-theories-and-the-black-community.html Kimberly A. Parker, Ph.D.Imagine a phenomenon that elicits distress and shame by simply mentioning its name. With heightened social anxiety, preexisting stigmas and correlations between risk factors, miseducation and distrust, HIV/AIDS is a phenomenon that has spawned rumors and conspiracy theories. From conflicting statements on transmission, to claims of the existence of a secret cure, skeptical narratives about HIV/AIDS still exist. The practice of HIV prevention can be at the mercy of these rumors and conspiracy theories, and those disproportionately affected by this epidemic are often the most difficult to convince that these misinformed notions can be life threatening.

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]]> http://www.thebodypro.com/content/75615/hiv-conspiracy-theories-and-the-black-community.html Fri, 20 Mar 2015 12:00:00 GMT In Childhood Vaccine Controversy, an Indirect Lesson for HIV/AIDS Advocates http://www.thebodypro.com/content/75523/in-childhood-vaccine-controversy-an-indirect-lesso.html AIDS Vaccine Advocacy CoalitionFrom all the recent attention to parents' rejection (and some politicians' naiveté) of vaccines and a possible resurgence of measles in the United States, one welcome theme has emerged: Such a controversy could never occur if vaccines weren't so powerfully effective in the first place.

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]]> http://www.thebodypro.com/content/75523/in-childhood-vaccine-controversy-an-indirect-lesso.html Thu, 19 Feb 2015 13:43:00 GMT To Russia (and Eastern Europe and Central Asia), With Love http://www.thebodypro.com/content/75448/to-russia-and-eastern-europe-and-central-asia-with.html Benjamin Young, M.D., Ph.D.We've made tremendous strides in the treatment of HIV. Antiretroviral therapy can prevent immune decline and death. Additionally, antiretroviral therapy can prevent new infections among babies born to HIV-infected mothers and at-risk HIV-uninfected people. Around many parts of the world, death rates have declined. In some southern African nations, these declines have exceeded 50% in the past five years. Life expectancy for people living with HIV who have access to treatment is approaching normal in several high-income countries and is estimated by UNDP (United Nations Development Programme) to have increased in sub-Saharan Africa by six years from 2002 to 2012.

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]]> http://www.thebodypro.com/content/75448/to-russia-and-eastern-europe-and-central-asia-with.html Fri, 23 Jan 2015 16:40:00 GMT The Cynical Connectedness of Gilead's Hepatitis C Pricing and Anti-Diversion Policies http://www.thebodypro.com/content/75407/the-cynical-connectedness-of-gileads-hepatitis-c-p.html Brook K. BakerGilead has announced both the highest recorded prices ever for its direct acting hepatitis C antiviral, ledipasvir/sofosbuvir (Harvoni), and one of the most stringent anti-diversion programs ever devised. The price, highest in the U.S., comes in at a whopping US$94,000 for a 12-week course of treatment, with slightly lower prices in Europe. Before this combo was approved, Gilead charged US$84,000 -- US$1,000 a pill -- for stand-alone sofosbuvir, earning US$8billion to US$10 billion in the first year of sales. This is for a course of treatment that experts have estimated can be manufactured for approximately US$100. In turn, the emerging anti-diversion program requires patients in low- and middle-income countries to physically come to designated Gilead distribution sites to exchange an empty 30-day pill bottle for the next month's supply. This program undermines the physician-patient and pharmacist-patient relationships, patient autonomy, adherence, and confidentiality. The question arises: Are the excessive pricing and the draconian anti-diversion policies related? The answer is, like gold and diamonds all the way to the bank.

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]]> http://www.thebodypro.com/content/75407/the-cynical-connectedness-of-gileads-hepatitis-c-p.html Fri, 16 Jan 2015 08:00:00 GMT