This page includes the latest East Bay HIV updates, which include practice-changing studies and developments. Please click here to share feedback.
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East Bay HIV updates
These East Bay HIV updates will be on summer break from June to September 2023, then will be updated as needed with practice-changing updates rather than monthly. Thanks for visiting and reading!
- Check out our new Injectables webpage! You can find the latest East Bay resources and updates on injectable HIV medication and PrEP on this page.
- Injectable Sunlenca (lenacapavir, or LEN) is now available on Medi-Cal and ADAP. Sunlenca is a long-acting injectable HIV medication (capsid inhibitor) taken every 6 months for people who have drug-resistance has been a Medi-Cal pharmacy benefit since March 1 and on the CA ADAP formulary starting April 25, 2023. Prior authorization is required for ADAP coverage due to its high cost.
- The Medi-Cal re-enrollment requirement is back due to the end of pandemic emergency exemptions. Medi-Cal members should update their information to ensure they receive their Medi-Cal re-enrollment packet. To confirm mailing information is current in Alameda County, please contact Alameda County Social Services Agency online or at (888) 999-4772 to report changes including name, address, phone number, or e-mail address. Reenrollment information started mailing in April. Alameda County Medi-Cal members should receive their packet during the month of their initial enrollment.
- DoxyPEP for sexy peeps! Our new East Bay doxy-PEP resource guide has been posted and will be kept updated as new data, guidance and resources become available.
- The East Bay Rapid ART quick guide has been updated with the latest guidelines and practices. Many thanks to Drs. Doug White and Sunny Lai and the Highland ED and HIV teams for collaborating with us on this guide! GTZ-SF has also recently updated the GTZ-SF Rapid ART guide.
- Do you have new staff who want HIV training? Check out our Quick start guide for new HIV staff with free trainings and East Bay HIV resources recommended for case managers, clinicians, nurses, pharmacists and HIV all care team members.
New HIV/STD resources
updated May 2023
- Updated national pediatric HIV guidelines released in April include a shorter course of post-partum AZT prophylaxis (2 weeks instead of 4-6 weeks) for infants born to people living with HIV, and recommendations for shared decision-making around breast/chest-feeding with sustained undetectable viral loads.
- Updated perinatal HIV data (here and here; data from 2010-2019) found that the U.S. is approaching the goals set in 2012 for a perinatal HIV transmission rate below 1%, though disparities still persist. Infants born to Black parents have higher rates of HIV diagnosis, and infants born to Latinx parents still have HIV transmission rates higher than 1%.
- Alameda County released a health advisory on xylazine (“tranq”), a veterinary sedative detected in combination with fentanyl and other substances in a rising number of overdose deaths, particularly in the northeastern United States. Click for: more info on xylazine from CDPH, xylazine info and wound care handouts (PDF) in English and Spanish.
- On April 16, 2023, a Penicillin G Benzathine shortage (Bicillin L-A® or “BIC”) was announced. ACPHD recommends that Benzathine penicillin G (Bicillin L-A®) is prioritized for treatment of pregnant people infected with or exposed to syphilis and to use alternative treatments for other populations when available. ACPHD also recommends to stick with 2.4 million units of Bicillin L-A® for primary, secondary, and early latent syphilis, since additional doses do not increase efficacy, including among PLWH. The manufacturer anticipates the issue will be resolved in the next two months.
- Increase in extensively drug-resistant (XDR) shigellosis: Alameda County issued a health alert in March on this enteric bacterial infection, which is transmitted fecal-orally person-to-person, including through sex, as well as through contaminated water and food. A huge increase in recent years have disproportionately impacting MSM, PLWH, international travelers and people experiencing homelessness. Test people with more than 3 days of diarrhea and cramping with a stool culture and susceptibility testing.
The 2023 update of the East Bay HIV Strategic Plan in English is ready to read and use! The update includes latest HIV data and 2023 strategic activities. More details are posted on our Strategic Plan webpage. The updated plan in Spanish will be available in May 2023.
Did you miss our mental health workshop on March 30? Click here for our guide to East Bay mental health resources and watch the recording.
New HIV/STD studies
updated May 2023
Current lists of open Bay Area HIV, hepatitis and COVID studies at UCSF are posted here.
Recent COVID-19 is associated with increase in false positive HIV Ag/Ab tests: an observational study found that a positive SARS-CoV-2 PCR result within 2 weeks of HIV combo testing significantly increased the likelihood of a false-positive HIV Ag/Ab test (OR 4.22). The false-positive association was strongest for a positive HIV antigen result, which suggests that there may be cross-reactivity between HIV and SARS-CoV-2 proteins. This strengthens the importance of getting an HIV RNA test to confirm positive HIV Ag/Ab results.
HIV telemedicine visits had better outcomes than in-person visits in a 2022 comparison study at an HIV primary care clinic in Arizona. Patients in the study were given the option for telemedicine or in-person visits. Better performance was seen for those receiving telemedicine visits for visit show rate, medical outcomes (viral load suppression, diagnosis rates), cost-effectiveness, time management, and patient and employee acceptance of the clinics.
The CROI 2023 conference took place on February 19-22, one of the most important international scientific conferences covering HIV, STIs, mpox, hepatitis and COVID. You can read selected highlights below, our complete highlights here, more summaries on Dr. Paul Sax’s CROI 2023 Really Rapid Review and on NATAP’s website.
- Doxy-PEP: doxycycline post-exposure prevention for STIs was found again to be effective for MSM and transwomen but not in a group of ciswomen in Kenya. No marked doxycycline resistance has been found yet.
- CAB/RPV (Cabenuva) injectable ART: Thigh injections have drug levels equivalent to gluteal injections. CAB/RPV is highly effective even for people with viremia and adherence challenges and is non-inferior to BIK, but baseline viremia and NNRTI or INSTI resistance are associated with CAB/RPV failures so watch those starting with viremia closely and avoid using it alone with baseline resistance.
- CAB-LA (Apretude) injectable PrEP: there may be some forgiveness with late injections. Failures are rare and can be hard to detect, so get an HIV RNA and Ag/Ab at each injection and quarterly after stopping. Treat people with breakthrough infections with protease-inhibitor-based regimens, such as Symtuza.
Please click here to read our highlights from the updated IAS-USA HIV guidelines.