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December 11, 2019

Comorbidities in Persons With HIV: The Lingering Challenge

Author Affiliations
  • 1Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
JAMA. 2020;323(1):19-20. doi:10.1001/jama.2019.19775

The United States recently announced an initiative for ending the HIV epidemic in the United States.1 The initiative is a joint effort of agencies across the US Department of Health and Human Services that is designed to decrease HIV transmissions in the United States by 75% over 5 years and by 90% over the next 10 years. This initiative represents the first time a coordinated effort of resources, programs, and infrastructure will focus on geographic areas and demographic groups with the highest rates of new HIV diagnoses in the United States.1 If successful, this effort would substantially decrease HIV transmission in the United States, thus ending the epidemic as an epidemiological phenomenon and could serve as a model for implementation of similar plans on a global scale.

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    1 Comment for this article
    Cancer Survivorship Programs as a Model for HIV Survivorship Care
    Stewart Fleishman, MD | Coachella Valley Volunteers in Medicine. Indio, CA
    What an extraordinary feat to be able to think about the optimal treatment for long-term survivors of HIV disease. As a resident in 1982, one could not anticipate that need would ever materialize.

    As oncology and HIV care have cross-fertilized since those days in the early 1980s, it would be reasonable to adapt existing Cancer Survivorship Programs -- now routine in cancer centers accredited by the American College of Surgeons Commission on Cancer (1) - to long-term HIV care. Such programs involve specialty level services in nutrition, rehabilitation, and psychosocial support as well as guidelines for the early diagnoses
    of secondary cancers or organ dysfunction, vigilance plans for recurrence or relapse, and adopting minimal to even less use of tobacco products, alcohol or recreational drugs. One not need re-invent the proverbial wheel (2,3)


    (1) American College of Surgeons Commission on Cancer. Optimal Resources for Cancer Care. Chicago, 2019, Standard 4.8, page 36

    (2) Fleishman, SB. Manual of Cancer Treatment Recovery: What the Practitioner Needs to Know and Do. 2012, New York. Demos Medical

    (3) Fleishman, SB. Learn to Live Through Cancer: What You Need to Know and Do. 2011, New York. Demos Health