Primary Care Guidance for Persons With Human Immunodeficiency Virus: 2020 Update by the HIV Medicine Association of the Infectious Diseases Society of America

TLDR

Advances in antiretroviral therapy have enabled people with HIV to live near‑normal lifespans, shifting focus to lifelong health maintenance amid growing comorbidities and polypharmacy challenges as the population ages. The guidance aims to promote continuous engagement and uninterrupted antiretroviral treatment by fostering patient‑centered, stigma‑free care and reducing barriers at all levels, underscoring the growing importance of comprehensive evidence‑based primary care. It outlines clinician responsibilities across diverse populations, including those of childbearing potential, pregnancy, children, adolescents, and transgender and gender‑diverse patients. The updated 2020 guidelines, developed by an expert panel, replace the 2013 version and emphasize the heightened importance of evidence‑based primary care.

Abstract

Abstract Advances in antiretroviral therapy (ART) have made it possible for persons with human immunodeficiency virus (HIV) to live a near expected life span, without progressing to AIDS or transmitting HIV to sexual partners or infants. There is, therefore, increasing emphasis on maintaining health throughout the life span. 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 healthcare for persons with HIV becomes increasingly complex, including management of multiple comorbidities and the associated challenges of polypharmacy, while not neglecting HIV-related health concerns. Clinicians must address issues specific to persons of childbearing potential, including care during preconception and pregnancy, and to 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 previous 2013 primary care guidelines.