|
Topics, Trends & Updates
March 2026
| | | New Guidance: Partner Treatment to Prevent Recurrent Bacterial Vaginosis | | |
The Guidance: Partner Treatment to Prevent Recurrent Bacterial Vaginosis was developed to guide clinicians providing care to patients with bacterial vaginosis (BV).
The goals of this guidance by authors Dr. Marguerite A. Urban and Maria Teresa Timoney, with the Medical Care Criteria Committee (MCCC), include:
- Educating clinicians about BV symptoms, prevalence, risk factors, and treatments, and the potential for recurrence after treatment
- Outlining current evidence for partner treatment of individuals with BV to prevent recurrence
- Discussing appropriate treatment for individuals with BV and their sex partners
| | | Updated: Use of Injectable CAB/RPV LA as Replacement ART | | |
The Use of Injectable CAB/RPV LA as Replacement ART guideline was developed to provide clinicians with evidence-based recommendations and information on the use of long-acting injectable cabotegravir/rilpivirine (CAB/RPV LA) as replacement antiretroviral therapy (ART) for adults (aged ≥18 years) with HIV.
Updates by author Dr. Joseph P. McGowan and the MCCC include:
-
Efficacy of CAB/RPV LA section: Text added on CAB/RPV LA use in virally unsuppressed individuals.
-
Benefits, Potential Risks, and Limitations of CAB/RPV LA section:
- Added recommendation: Clinicians should offer CAB/RPV LA as replacement ART for adults (aged ≥18 years) with HIV who are virally suppressed (HIV RNA level <50 copies/mL) and prefer an alternative to daily oral therapy. (A1)
- Added recommendation: For patients who are not virally suppressed and have ongoing adherence challenges with oral ART (even with support) or are mechanically unable to ingest oral ART, the clinician should engage the patient in shared decision-making and offer monthly CAB/RPV LA, if susceptible, coupled with intensified follow-up support. (A2) Once viral suppression is achieved and maintained, consider transition to every-8-weeks dosing. (A3)
- Added text in discussion and Box 1 indicating that CAB/RPV LA is safe and efficacious in patients with chronic renal disease or on intermittent hemodialysis.
| | | Updated: Second-Line ART After Treatment Failure for Regimen Simplification | | |
The Second-Line ART After Treatment Failure or for Regimen Simplification guideline was developed to provide information to assist clinicians in making evidence-based decisions to change ART regimens and formulate second-line and subsequent ART regimens for optimal viral suppression in patients with HIV.
Updates by author Dr. Joseph P. McGowan and the MCCC include:
-
ART Changes for Regimen Simplification section: Added recommendation:
- For patients who are not virally suppressed and have ongoing adherence challenges with oral ART (even with support) or are mechanically unable to ingest oral ART, the clinician should engage the patient in shared decision-making and offer monthly CAB/RPV LA, if susceptible, coupled with intensified follow-up support. (A2)
- Once viral suppression is achieved and maintained, consider transition to every-8-weeks dosing. (A3)
| | | |
Updated:
Selecting an Initial ART Regimen
| | |
Updated:
Diagnosis and Management of HIV-2 in Adults
| | Viremic—Cases in HIV Podcast | |
Join Hosts Eileen Scully and Christopher Hoffmann as they present cases, explore quandaries in adult HIV care, and discuss key evidence and guidelines that inform clinical decision-making.
New Episodes
| | Case 16. Mpox After the Outbreak: A 33-year-old man with HIV presents with a flu-like syndrome and a disseminated vesicular rash after sexual contact with a new partner. Differential diagnosis includes mpox, syphilis, other STIs, HSV and disseminated VZV. Listen as Eileen and her guest, Dr. Shauna Gunaratne work through the mpox diagnosis, and discuss the 2022 mpox outbreak, along with evidence-based recommendations for testing, treatment, and prevention. Listen Now | | Case 17. Trans Lives Matter: Affirmative HIV Care: Guest Dr. Asa Radix, from Callen-Lorde and the Clinical Guidelines Program (CGP), and Dr. Chris Hoffmann, from Johns Hopkins and the CGP, review the case of a 32-year-old transgender woman who was diagnosed with HIV, with testing performed while she was receiving gender-affirming care. With a viral load of 82,000 and CD4 count of 365, she had no resistance mutations and no other known major medical conditions. Asa walks Chris through the approach to ART and gender-affirming HIV and primary care for this patient. Listen Now | | Episode 18. What’s New from CROI 2026 With Dr. Paul Sax: In this episode, Dr. Eileen Scully, from Johns Hopkins, welcomes Dr. Paul Sax, from Brigham and Women’s Hospital, to discuss highlights of CROI 2026 and review new developments with clinical implications for HIV care. Listen March 17 | | Case 19. Similar, But Not the Same: HIV-2 Diagnosis and Treatment: Eileen presents the case of a 32-year-old woman newly diagnosed with HIV-2 and invites guest Dr. Sanjiv Shah to discuss HIV-2 epidemiology, diagnosis, treatment, and monitoring. Listen as they explore the difficulties in diagnosing HIV-2, the complexity of treatment, including in pregnant women, and resources available to clinicians. Listen March 31 | | We’re open to suggestions! To submit a clinical topic for a Viremic case discussion, email us at viremicpodcast@jh.edu. | | | Conversations With CEI Podcast | | |
What “The 72-Hour Rule” Update Means for New York State: Effective February 19, 2026, New York State law permits clinicians to dispense up to 72 hours (equivalent to a 3-day supply) of controlled substances, such as methadone and buprenorphine, for the management of opioid withdrawal while arranging referral and linkage to care for persons with opioid use disorder, as authorized by federal regulations (specifically, the Code of Federal Regulations or CFR number 1306.07). The federal regulations were updated in August 2023, and New York State law is just now catching up. We informally refer to the update as “The 72-Hour Rule.” Featuring Dr. Linda Wang, this episode reviews what this update means for New York State and how clinicians and healthcare administrators can think about its implementation. Listen Now
| | Upcoming Training, Education, and Events | | |
Are You a Subscriber?
If this newsletter was forwarded to you, please subscribe now to make sure you receive the Clinical Guidelines Program Topics, Trends, and Updates newsletter every month and stay current with new and updated guidelines. We send 1 email per month and do not share our mailing list.
| |  | |
Comments? Questions? Suggestions?
Email us: aiguidelines@jhmi.edu.
We'll get back to you as quickly as possible.
Note that we cannot answer questions about the care or treatment of specific patients and cannot provide clinical advice.
| | | | | |
