To address the specific HIV care needs of transgender and nonbinary people, the Panel has created a new section of the guidelines. The Transgender People with HIV section discusses the importance of providing HIV care services within a gender-affirmative care model, the role of gender-affirming hormonal therapy and the potential interactions between these drugs and certain antiretroviral (ARV) drugs, and the potential health impacts of gender-affirming hormonal therapy on transgender persons with HIV.
The Panel has completely rewritten the “HIV and People Who Use Illicit Drugs” section. Now called Substance Use Disorders and HIV, this section includes information on alcohol, benzodiazepines, cannabinoids, club drugs, opioids, stimulants (cocaine and methamphetamines), and tobacco. The discussions focus on the potential health consequences of each substance for persons with HIV, the role of providers in managing patients with substance use disorders (SUDs), the impact of SUDs on the HIV continuum of care and antiretroviral therapy (ART), and treatment options for these SUDs.
The HIV-2 Infection section has been revised to focus on when to start ART and which ARV regimens to use in persons with HIV-2 monoinfection or HIV-1/HIV-2 coinfection. The Panel now recommends starting ART at or soon after HIV-2 diagnosis to prevent disease progression and transmission of HIV-2 to others. In addition, the Panel recommends using an integrase strand transfer inhibitor-based regimen as an initial ART regimen for treatment-naive patients. A regimen that includes a boosted protease inhibitor that is active against HIV-2 can be used as an alternative regimen.
For a complete list of guideline updates, please see What’s New in the Guidelines. Additions and revisions are also highlighted in yellow throughout the PDF version of the guidelines.
To view or download the guidelines, go to the Adult and Adolescent ARV Guidelines section of AIDSinfo’s website. The guideline tables and the boxed recommendations can also be downloaded as separate PDF files.
Send Comments on the Revised Guidelines to AIDSinfo
Feedback on the revised Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV is welcome. Please email your comments with the subject line “Comments on the Adult and Adolescent ARV Guidelines” to ContactUs@aidsinfo.nih.gov by July 24, 2019.