HIV and ID Observations

March 25th, 2017

HIV and Hepatitis C Are No Longer the Most Serious Infectious Threats to People Who Inject Drugs

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. Here’s an excerpt of our chat: Me:  There are way more cases of endocarditis in young people than there used to be, a complication of injecting drugs. People in their 20s and […]

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January 8th, 2017

Poll: Should Medicine and Family Practice Residency Programs Have a Dedicated HIV Track?

A few medicine and family practice residency programs around the country have a dedicated track that focuses on HIV care. Though the programs naturally differ somewhat in structure — here are two examples from University of Washington and Yale — they generally involve placing the resident into an HIV clinic for their longitudinal outpatient experience. We don’t have […]

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January 1st, 2017

Top Stories in HIV Medicine for 2016

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. Now this list, however, appears just as 2016 is in […]

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November 20th, 2016

Seven ID/HIV Things to Be Grateful For This Holiday Season, 2016 Edition

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. […]

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November 13th, 2016

Poll: Should We Be Starting HIV “Elite Controllers” On Antiretroviral Therapy?

(Note to readers: This will have nothing to do with the election — for obvious reasons. Yes, there’s a poll at the end, but your political views will not matter one bit. There, I feel better.) Just received this email from a longstanding leader in HIV care and research: I would like to ask for you a favor. […]

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November 6th, 2016

Do ID Clinicians Perpetuate Our Own Stigma?

Infectious Diseases doctors will find this exchange familiar: New person you’re meeting:  What to do you do? ID Doc:  I’m a doctor. New person:  Oh — what kind? ID Doc:  A specialist in Infectious Diseases. New person (making a face, or moving a few feet back, either to be humorous or truly frightened, or both):  Yuck! […]

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October 2nd, 2016

“Brink of HIV Cure” ID Link-o-Rama

There, that title got your attention, didn’t it? Anyway, this HIV cure news thing and a few other ID/HIV topics to contemplate while buying your pumpkin, celebrating the New Year in October, or shaking your head that all the stores seem to be putting out their Christmas stuff already. I mean, come on — it’s not even Halloween! Are […]

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September 4th, 2016

The Most Common Question About the New HIV Testing Algorithm, Answered

A primary care doctor in the Boston area recently emailed me this question: Hi Paul, 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 […]

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July 14th, 2016

Must-Read Item: This Year’s JAMA HIV/AIDS Issue

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. Here are some highlights: In serodiscordant couples practicing “condomless sex”, there were zero transmissions if the infected partner […]

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May 22nd, 2016

Drug Prior Authorizations Are a Very Blunt Tool for Cost Containment — And They’re Annoying

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.” As readers of this site probably know, there are now three tenofovir alafenamide (TAF)-based coformulations […]

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