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Happy New Year from the Autism Society!

We are grateful for you.

Let’s Ring in the New Year! The Autism Society of America extends our New Year wishes and gratitude to you and our entire community. Because of your support this year, we’ve connected with over half a million people in the Autism community with the supports, services, resources, and advocacy to create a world where all those with Autism can live to their fullest extent.  Be the connection for even more people in the Autism community today when you support the Autism Society with an end-of-year gift. You can help us kick off the new year with the resources and support needed! Learn how you can also impact future generations by including the Autism Society in your will. Simply use our online tool, FreeWill, and write your will for free in 20 minutes. We hope 2022 brings health, happiness, and opportunity to you and yours. Make A Gift Visit Website Donate Get Support Follow Us Contact Line 1 (800) 328-8476

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Having trouble viewing this email? View it as a Web page. HHS Selects Phase 1 Winners of the National Competition to Reduce HIV-Related Stigma and Disparities Fifteen organizations and individuals have won the first phase of the HIV Challenge, sponsored by the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) in partnership with the Office of the Assistant Secretary for Health (OASH) Office of Infectious Disease and HIV/AIDS Policy (OIDP). The HIV Challenge was created to engage individuals, communities, and community-based organizations to identify innovative and practical approaches to reduce HIV stigma and disparities and increase prevention and treatment among racial and ethnic minority communities. The 15 winners were chosen from more than 80 submissions from individuals and organizations from around the U.S. Each Phase 1 winner will receive a prize of $20,000 and will advance to the second phase of the challenge. "We have treatments that have been proven effective at keeping HIV at an undetectable level and preventing the transmission of the virus to others. Despite these advances in HIV prevention and treatment tools, not everyone is benefiting equally," said RADM Felicia Collins, M.D., HHS Deputy Assistant Secretary for Minority Health and OMH Director. "With this challenge, we are looking for community-driven approaches to reduce stigma and reach those living with HIV who are not accessing pre-exposure prophylaxis medication (PrEP) and antiretroviral therapy (ART)." "The HIV Challenge supports our efforts to end the HIV epidemic in America by engaging community voices and mobilizing them to identify new approaches to improve the use of effective HIV prevention and treatment options," said OIDP Acting Director, Kaye Hayes. "To address inequalities, this challenge prioritizes racial and ethnic minorities disproportionally impacted by HIV." The HIV Challenge is divided into three phases with a total award of $760,000. During Phase I, HHS identified innovative concepts for community engagement strategies to reduce stigma related to HIV prevention and treatment within a specific target population. During the second phase, the participants will advance in the competition for the chance to win up to $40,000. The 15 Phase 2 participants will expand upon their winning concepts by developing approaches that can enhance community engagement and mobilization regarding the reduction of HIV stigma and disparities. Up to seven approaches will be selected to move on to Phase 3, where participants will conduct small-scale testing on the dissemination and uptake of their approaches to demonstrate how well the population of focus accesses the approaches. A panel of judges, all federal employees, will select three submissions as the overall HIV Challenge winners to receive a prize of $60,000 each. For more information about the HIV Challenge, visit the OMH website. The 15 Phase 1 awardees are:   Organization/Individual State Aima Ahonkhai TN Dorelle Dushime AR The Drew CARES Team CA Edson College of Nursing and Health Innovation SC Equitas Health Institute OH Girls Talk TV, Inc. VA House of Shadez Coordinator PA Hispanic Health Initiatives, Inc. FL Michigan Organization on Adolescent Sexual Health MI Miguel Bujanda CA Pride Center of Maryland MD Southside Health Advocacy Resource Partnership (S.H.A.R.P.) IL The T.R.U.T.H. Project TX University of Southern California: M.S. Global Medicine CA West Alabama AIDS Outreach, Inc. DBA Five Horizons Health Services AL   The Office of the Assistant Secretary for Health (OASH), a division of the U.S. Department of Health and Human Services, provides public health and science advice to the Secretary, and oversees the Department's broad-ranging public health offices, whose missions include minority health, HIV policy, women's health, disease prevention, human research protections, and others. OASH also includes the Office of the Surgeon General and the U.S. Public Health Service Commissioned Corps. The OASH Office of Infectious Disease and HIV/AIDS Policy (OIDP) mission is to provide strategic leadership and management, while encouraging collaboration, coordination, and innovation among federal agencies and stakeholders to reduce the burden of infectious diseases. The HHS Office of Minority Health (OMH) is dedicated to improving the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities.

 

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The Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission

View as a webpage  /  Share December 30, 2021 Updates to Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States The Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission updated the following sections of the Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States.  Highlights from the sections are summarized below:  Introduction As part of continuing efforts to be inclusive of transgender and gender diverse individuals assigned female sex at birth, the Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission (the Panel) has made revisions to incorporate gender inclusive language; for example, using "pregnant people" or "pregnant patients" versus "pregnant women" where appropriate. When reviewing data, results will be presented using the same terms used in the studies and publications being described, such as "pregnant women." A new section has been added to address the unique needs of this population, Perinatal HIV Prevention for Transgender and Gender Diverse People Assigned Female Sex at Birth. Maternal HIV Testing and Identification of Perinatal HIV Exposure Section content has been updated to include a list of states with statutes or regulations that require repeat HIV testing in the third trimester and to recommend that this testing be offered to pregnant people who perceive themselves at increased risk for HIV infection. Pre-Exposure Prophylaxis (PrEP) to Prevent HIV During Periconception, Antepartum, and Postpartum Periods Because HIV risk factors may be underreported, the Panel recommends that health care providers discuss PrEP with those with behaviors or experiences that can be associated with HIV, such as intimate partner violence and repeated post-exposure prophylaxis courses. Prepregnancy Counseling and Care for Persons of Childbearing Age with HIV This section has been retitled in alignment with the transition from preconception care to prepregnancy care by the American College of Obstetricians and Gynecologists. Prepregnancy counseling and care has been updated to include vaccination to SARS-CoV-2 and considerations for the care of gender diverse and transgender individuals. Reproductive Options for Couples When One or Both Partners Have HIV The section has been updated to address family building options for people with HIV across the spectrum of gender identity and sexual orientation. General Principles Regarding Use of Antiretroviral Drugs During Pregnancy Recommendations and content about stopping antiretroviral (ARV) drugs during pregnancy have been incorporated into this section rather than presented in a separate section. Recommendations for Use of Antiretroviral Drugs During Pregnancy The Panel continues to recommend dolutegravir (DTG) as a Preferred ARV drug for pregnant people, irrespective of trimester, and for people who are trying to conceive. The most recent data from the Tsepamo study in Botswana indicate that, although the prevalence of infant neural tube defects (NTDs) with periconception use of DTG was higher than the prevalence of NTDs in infants born to women who were receiving efavirenz and women without HIV, the prevalence was not significantly increased compared with women with HIV receiving non-DTG ARV regimens at conception. Based on these and other data, the Panel has removed bulleted recommendations with DTG-specific cautions. Based on additional data about the use and safety of tenofovir alafenamide (TAF), the Panel now recommends TAF as a Preferred nucleoside reverse transcriptase inhibitor for ARV regimens in people who are pregnant or are trying to conceive. Available data about weight gain with TAF and with DTG during pregnancy have been reviewed and incorporated in this section. Oral cabotegravir (CAB) and the new long-acting injectable regimen of CAB and rilpivirine (RPV) have been classified as Not Recommended for use in pregnancy and as Insufficient Data for persons who are trying to conceive or who become pregnant while on this regimen. Revisions have been made to the sections listed below to incorporate the Panel's updated recommendations about ARV drugs during pregnancy and for people who are trying to conceive. Pregnant People with HIV Who Have Never Received Antiretroviral Drugs (Antiretroviral Naive) Table 4. What to Start: Initial Antiretroviral Regimens During Pregnancy for People Who Are Antiretroviral-Naive Table 5. Situation-Specific Recommendations for Use of Antiretroviral Drugs in Pregnant People and Nonpregnant People Who Are Trying to Conceive Pregnant People with HIV Who Are Currently Receiving Antiretroviral Therapy Appendix C: Antiretroviral Counseling Guide for Health Care Providers Pregnant People with HIV Who Are Currently Receiving Antiretroviral Therapy Although no data exist on the use of two-drug oral ARV regimens during pregnancy (e.g., DTG plus lamivudine [3TC], DTG plus RPV), the component drugs are recommended for use in pregnancy. The Panel recommends that pregnant persons who present to care on DTG/3TC or DTG/RPV and have successfully maintained viral suppression can continue the two-drug regimen with more frequent viral load monitoring, every 1 to 2 months throughout pregnancy (CII). For people with HIV who have achieved virologic suppression and become pregnant while receiving ARV drugs with insufficient data about their use in pregnancy—such as bictegravir (BIC) or doravirine—clinicians should consider whether to continue or change the regimen, because a regimen change carries a risk for viral rebound at the time of the switch. If a decision is made with the patient to continue the same regimen, viral load should be monitored more frequently (i.e., every 1 to 2 months). Because data about the use of long-acting injectable CAB and RPV during pregnancy are extremely limited, the Panel recommends that pregnant persons who present to care on this regimen should be switched to a Preferred or Alternative three-drug ARV regimen recommended for use in pregnancy (CIII). HIV-2 Infection and Pregnancy Now that TAF is a Preferred ARV drug for use in pregnancy, it has been added to recommended options in ARV regimens for the treatment of HIV-2 infection during pregnancy. Acute HIV The Panel recommends DTG plus tenofovir disoproxil fumarate (TDF) or TAF with emtricitabine (FTC) or 3TC as the Preferred ARV regimen for pregnant people with acute HIV, irrespective of trimester (AII). Ritonavir-boosted darunavir (DRV/r) plus TDF or TAF with FTC or 3TC is an Alternative ARV regimen for pregnant people with acute HIV (AIII). See Table 4, Table 5, and Recommendations for Use of Antiretroviral Drugs During Pregnancy for more information. One of the following ARV regimens is recommended for people diagnosed with acute HIV infection when they are breastfeeding: BIC/TAF/FTC; DTG with TAF or TDF plus FTC or 3TC; boosted DRV with TAF or TDF plus FTC or 3TC (AIII) (see Acute and Recent [Early] HIV Infection in Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV). Perinatal HIV Prevention for Transgender and Gender Diverse People Assigned Female Sex at Birth This section provides an overview about the Panel's recommendations regarding perinatal HIV prevention and treatment of HIV in pregnancy for transgender and gender diverse people assigned female sex at birth. The Panel has determined that, in most cases, it is appropriate to extrapolate its recommendations based on data in presumed cisgender women to all people assigned female sex at birth, including transgender and gender diverse people, with modification when indicated (e.g., drug interactions with gender-affirming hormones) (AIII). Patient-centered HIV and perinatal services should be provided using gender-affirming and shared decision-making approaches and models of care that address the unique and varied needs of transgender and gender diverse people and reduce barriers to ongoing engagement in care (AII). Some transgender and gender diverse patients may experience the onset or worsening of gender dysphoria and associated symptoms—such as depression—during prepregnancy, antepartum, and postpartum periods; health care providers should regularly assess patients' comfort with their care and provide referrals for mental health or other support services as needed (AIII). Intrapartum Care for People with HIV The Panel has clarified when viral load tests should be done to inform decisions about mode of delivery and need for intravenous zidovudine prophylaxis during labor, changing from "near delivery" to "within 4 weeks of delivery/anticipated delivery." Counseling and Managing Individuals with HIV in the United States Who Desire to Breastfeed Guidance about ARV prophylaxis for breastfeeding infants has been updated to address the provision of infant prophylaxis beyond the recommended time period of 4 weeks in an infant of a parent receiving ART with viral suppression, which is controversial. Antiretroviral Management of Newborns with Perinatal HIV Exposure or HIV Infection The Panel has clarified when viral load tests should be done to inform decisions about ARV prophylaxis or presumptive HIV therapy for infants with perinatal HIV exposure, changing from "near delivery" to "within 4 weeks prior to delivery." Table 9. Antiretroviral Drug Dosing Recommendations for Newborns has been updated to include abacavir (ABC) dosing recommendations for infants and nevirapine dosing for infants ≥32 to <34 weeks' gestation at birth. The Panel does not recommend ABC for presumptive HIV therapy. However, in situations where ZDV is not available or the infant has ZDV-associated toxicity, ABC could be considered an alternative to ZDV. Appendix B: Supplement: Safety and Toxicity of Individual Antiretroviral Agents in Pregnancy Table 11: Antiretroviral Drug Use in Pregnant People with HIV Infection: Pharmacokinetic and Toxicity Data in Human Pregnancy and Recommendations for Use in Pregnancy and the individual drug sections in Appendix B have been updated with new data for each drug, and a new section has been added for Cabotegravir. Clinical Info welcomes your feedback on the latest revisions to the Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States. Please send your comments with the subject line "Perinatal Guidelines" to ContactUs@hivinfo.nih.gov by January 13, 2022.  Stay Connected with HIVinfo:       SUBSCRIBER SERVICES: Manage Subscriptions  |  Unsubscribe All  |  Help

 

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