HIV and ID Observations

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 […]

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June 12th, 2025

Why the Sudden Firing of ACIP Members Should Put Every Clinician on High Alert

There are certain irrefutable verities when, like me, you’re an infectious diseases specialist married to a pediatrician. Here are our top two, which are deeply interrelated: Infectious deaths in children, or severe illnesses that lead to lifelong disability, are more devastating than similar events in adults. Each such case in a baby or child is […]

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May 22nd, 2025

The Pros and Cons of the Latest FDA Actions on COVID Vaccines

In case you missed it, last week the FDA granted full approval for the Novavax COVID-19 vaccine. This vaccine, which uses a more traditional protein-plus-adjuvant strategy instead of the mRNA approach of Pfizer and Moderna, is no longer in “Emergency Use Authorization (EUA)” limbo. Here’s what that means in practical terms: It shows the data the company […]

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May 18th, 2025

How ID Doctors Get Paid — The Bread, Butter, and Budget Deficits of Infectious Diseases

Two decades ago, Dr. Atul Gawande wrote a memorable piece for The New Yorker about how doctors in the United States get paid. Providing a nice mix of self-reflection about his own experience and some skillful reporting, he described the challenging process of figuring out what he, a newly hired surgeon, should earn for a salary. […]

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May 7th, 2025

FDA’s Latest Appointment Is … Interesting

Those of us who follow infectious diseases and vaccine science closely (OK, obsessively) know that the FDA’s Center for Biologics Evaluation and Research (CBER) plays an enormous role in public health. Vaccines, gene therapies, monoclonal antibodies, blood products — all pass through CBER on their path to approval. During the COVID-19 pandemic, this center became […]

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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 […]

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January 25th, 2025

Let’s Hope the MMWR Resumes Publication Sooner Rather Than Later

To us specialists in Infectious Diseases, there are certain verities we hold near and dear to our hearts: Antibiotics are miracle drugs, but the bugs will become resistant if we don’t use them responsibly. Certain childhood vaccines (e.g., measles, polio, H flu type B) stand as some of the greatest scientific accomplishments in human history. To […]

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December 8th, 2024

Who’s Going to Get Lenacapavir for HIV Prevention?

At the International AIDS Conference this past summer, Dr. Linda-Gail Bekker brought down the house presenting the results of the PURPOSE 1 trial of twice-yearly injectable lenacapavir for prevention of HIV in women. The results — zero infections out of over 2000 participants — demonstrated clear superiority over oral PrEP with TDF/FTC. The study simultaneously […]

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October 30th, 2024

The Riveting Conclusion of How PCP Became PJP

Before I get back to the saga of Brave New Name — How PCP Became PJP and Why It Matters, allow me to share that I had some trepidation about publishing this thing. A deep dive down a hole with very high-risk for tularemia exposure (see what I did there?), it veered off topic more than half-baked […]

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October 8th, 2024

Why We Have Antibiotic Shortages and Price Hikes — And What One Very Enterprising Doctor Did in Response

At the start of our weekly case conference, we get announcements from one of our ID pharmacists. New drug approvals, hospital policies, updated guidelines — that kind of thing. But over the last decade or so, the most common topic they’ll comment on is the latest important antibiotic shortage. For those not in medicine, you […]

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