An ongoing dialogue on HIV/AIDS, infectious diseases,
August 16th, 2025
Anal Cancer Screening in HIV: When Guidelines Get Ahead of the Evidence
Should every person with HIV over age 35 (if MSM or transgender woman) or 45 (everyone else) have an anal Pap smear, a digital anal rectal exam (DARE), and possibly a high-resolution anoscopy every 1–2 years? According to recent guidelines, yes. But here’s the problem: we don’t know if this screening effort actually prevents cancer. First, […]
July 17th, 2025
Ceftriaxone Is a Narrow Antibiotic Now — and Other Musings
In no particular order, 20 things I’ve found interesting lately — a mix of ID (mostly), language quirks, clinical stuff, even tennis, and an apology (#21) at the very end. Bonus videos embedded because we all need a break. 1. Isn’t it amazing how, over time, an antibiotic once considered “broad spectrum” later becomes the […]
July 7th, 2025
Two Pandemics, Compared: Reflections on HIV and COVID-19
“Dr. Sax, what’s it like to have lived through two pandemics as an ID doctor?” The question came from a brand-new intern during afternoon sign-out. I took a breath — because wow, were they different. HIV: It Felt Like A Calling, One Miraculously Rewarded I started my internship in 1987, six years after the first […]
June 27th, 2025
The Mystery of the Isolated Hepatitis B Core Antibody, Solved
(A post inspired by years of doing eConsults, an extremely common query about hepatitis B testing, and the latest BritBox series, “Core Antibody Confidential,” starring a grizzled detective with a faded suit and a haunted past.) Your electronic medical record lists “deficiencies” in health care maintenance for one of your patients, so you order hepatitis B […]
June 20th, 2025
Federal HIV Guidelines Face a Shutdown — A Critical Loss for Clinicians and Patients
Each week, our HIV clinical group gathers to review active patients, share updates, and celebrate good news. On our whiteboard, we list four columns: Inpatients, Outpatients, Issues, and Celebrations. This week, under “Issues,” one of my colleagues wrote: HIV Guidelines: ☹️ Yes, you read that right. This week, we learned that the federal HIV guidelines — long […]
March 22nd, 2025
Really Rapid Review: CROI 2025 San Francisco
Wow, that was an interesting conference — in ways both good and bad. The good part was the content, as the Conference on Retroviruses and Opportunistic Infections (CROI) is our leading HIV research conference. There was plenty of interesting stuff. The not-so-good part was the stunned state of many HIV clinicians and researchers. So much of […]
February 6th, 2025
Could This Be the End of PEPFAR?
Short email from a longtime colleague, working in Africa at a PEPFAR site: Without USAID, PEPFAR is essentially dead. I got chills reading this. PEPFAR, the abbreviation for the President’s Emergency Plan for AIDS Relief, started in 2003 under the direction of President George W. Bush. To say it’s been a resounding success undersells the impact of the […]
December 28th, 2024
Notes from a Trip to China
Here are some observations from a recent trip to China, a country I’d never visited before. It was an 8-day trip related to my editor role at Clinical Infectious Diseases (there is a Chinese edition) and my particular area of focus within Infectious Diseases (HIV), so I’ll start with some epidemiology and medical stuff and […]
August 19th, 2024
More on Munich and the 25th Annual International AIDS Conference
Longtime readers may note the absence of this year’s Really Rapid Review™ (RRR) of the latest big HIV conference, the one that just happened in Munich. These RRR posts have been a regular on this site for a gazillion years, give or take a few, with a brief break during the peak of the pandemic. My […]
July 25th, 2024
Lenacapavir PrEP Trial Brings Down the House at the International AIDS Conference
Yesterday, at the 2024 AIDS Conference in Munich, we experienced one of those thrilling moments you always hope for when attending a scientific conference. Dr. Linda-Gail Bekker, speaking on behalf of the study investigators, presented the data on the PURPOSE-1 study of HIV prevention using twice-yearly injectable lenacapavir; results were simultaneously published in the New England […]
Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
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