Clinical Practice Guidance for Persons with Human Immunodeficiency Virus: 2024 Update by HIVMA/IDSA
Published by Clinical Infectious Diseases,
Michael Horberg, Melanie Thompson, Allison Agwu, Jonathan Colasanti, Marwan Haddad, Mamta Jain, Grace McComsey, Asa Radix, Natella Rakhmanina, William R Short, Tulika Singh, Hansel Tookes on behalf of the HIV Medicine Association
Keywords: HIV primary care, HIV care engagement, HIV monitoring, HIV comorbidities, preventive health, sexually transmitted infections
Please submit your feedback and comments on the Primary Care Guidance by emailing us at PracticeGuidelines@idsociety.org.
Published: October 12, 2024
Clinical Infectious Diseases, ciae479, https://doi.org/10.1093/cid/ciae479
October 28, 2024
IDSA is committed to providing up-to-date guidance on HIV care. This version of the Primary Care Guidance emphasizes patient-centered approaches using multidisciplinary teams, telehealth, and street medicine. It includes new sections on immunizations, cancer screening, STIs (with a focus on mpox and doxyPEP), and updates on metabolic diseases and statin use. Additionally, it offers guidance for children with HIV, adolescents, individuals of childbearing potential, transgender and gender-diverse populations, and COVID-19 considerations, replacing previous versions of the document.
Update History
December 1, 2022
A correction has been published: Clinical Infectious Diseases, Volume 75, Issue 11, 1 December 2022, Page 2052, https://doi.org/10.1093/cid/ciac474.
May 15, 2022
A correction has been published: Clinical Infectious Diseases, Volume 74, Issue 10, 15 May 2022, Pages 1893–1898, https://doi.org/10.1093/cid/ciab801.
December 8, 2021
After the original publication of the 2020 manuscript [Thompson MA, Horberg MA, Agwu AL, et al. Primary Care Guidance for Persons With Human Immunodeficiency Virus: 2020 Update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis; November 2020. https://doi.org/10.1093/cid/ciaa1391], revisions were submitted for Table 5 under Section III, “ROUTINE HEALTHCARE MAINTENANCE CONSIDERATIONS FOR PEOPLE WITH HIV”.
Recommendation for Vaccinations have been updated to read: “Pneumococcus (PCV13 and PPV23): repeat PPV23 once 5 years after first vaccination. Give a third and final dose of PPV23 after age 65. All patients with HIV should receive 1 dose of PCV13. If not vaccinated previously, this should be the first dose, If previously vaccinated, give 1 dose of PCV13 at least 1 year after PPV23.”
Recommendation for Colon Cancer Screenings has been updated to read: “Age 45-75 years if average risk (including personal and family history). Age 76-85 years: individualize screening based on overall health and prior screening.”
The following table comment on Colon Cancer Screenings has been removed: ‘Begin screening in those patients who are high-risk (first degree relatives of a patient with a diagnosis of colorectal cancer at age ≤50 years) 10 years prior to age at which the relative was diagnosed with cancer.’
It was discovered that references in this guidance were also numbered incorrectly in some places, and the reference list of this article has been revised. The publisher regrets these errors.
A previous version of this erratum published on December 8, 2021 contained errors and has been revised. https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab801/6456476.
November 6, 2020
Primary Care Guidance for Persons with Human Immunodeficiency Virus: 2020 Update by the HIV Medicine Association of the Infectious Diseases Society of America has been released.
Abstract
Advances in antiretroviral therapy (ART) have made it possible for persons with human immunodeficiency virus (HIV) to live a lifespan approaching that of people without HIV, without progressing to AIDS or transmitting HIV to sexual partners or infants. There is, therefore, increasing emphasis on maintaining health throughout the lifespan. To receive optimal medical care and achieve desired outcomes, persons with HIV must be consistently engaged in care and able to access uninterrupted treatment, including ART. Comprehensive evidence-based HIV primary care guidance is, therefore, more important than ever. Creating a patient-centered, stigma-free care environment is essential for care engagement. Barriers to care must be decreased at the societal, health system, clinic, and individual levels. As the population ages and noncommunicable diseases arise, providing comprehensive health care for persons with HIV becomes increasingly complex, including management of multiple comorbidities and the associated challenges of polypharmacy, while also attending to HIV-specific health concerns. Clinicians must address issues specific to preventive health, including cancer screening, providing recommended vaccinations, as well as promoting sexual health, including sexually transmitted infection diagnosis, treatment, and prevention. Clinicians also must address issues for specific populations, including persons of childbearing potential, including during preconception and pregnancy; children; adolescents; and transgender and gender-diverse individuals. This guidance from an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America updates the previous 2020 HIV Primary Care Guidance.
Keywords: HIV primary care, HIV care engagement, HIV monitoring, HIV comorbidities, preventive health, sexually transmitted infections