CDC/ACIP [to 3 June 2017]

CDC/ACIP [to 3 June 2017]
Media Statement
Friday, June 02, 2017
CDC updates Zika guidance for Miami-Dade County, Florida
The Centers for Disease Control and Prevention (CDC) has updated guidance for people who travel to or live in Miami-Dade County to lift the Zika cautionary (yellow) area designation. There have been no new cases of local Zika virus transmission identified and no cases under investigation in Miami-Dade County for more than 45 days. Lifting the yellow area designation means that there are no longer any travel recommendations related to Zika virus for Miami-Dade County, Florida…

MMWR News Synopsis for June 1, 2017
Strategies for Preventing HIV Infection Among HIV-Uninfected Women Attempting Conception with HIV-Infected Men — United States
While insemination with HIV-uninfected donor sperm remains an option for achieving conception among couples in which the male partner is HIV-infected and the female partner is uninfected, couples who want to conceive a biologic child together can consider using HAART, PrEP, and “sperm washing” in combination with timed intercourse, insemination, or IVF. In a comprehensive scientific update, CDC outlines the best strategies for preventing transmission from an HIV-infected male partner to his uninfected female partner while attempting conception. This new resource can help providers improve counseling for assisting conception among HIV-discordant couples. Based on available science, for discordant couples in which the male partner is HIV-infected and the female partner is uninfected, insemination with HIV-uninfected donor sperm remains an option for achieving conception. However, for couples who want to conceive a biologic child together, several risk-reduction strategies are available. One strategy is viral suppression with HIV medications for the male partner (highly-active antiretroviral therapy, or HAART), with condomless sex around the time of ovulation, while the female partner takes daily oral HIV medication to prevent infection (pre-exposure prophylaxis, or PrEP). Alternatively, combining HAART and PrEP use among the male and female partner, respectively, with “sperm washing” and subsequent intrauterine insemination or in vitro fertilization can further reduce risk. Because each method carries a unique risk profile and degree of effectiveness, which may be affected by underlying fertility factors, patients should discuss all options with a medical provider who can help them select a treatment plan.

Trends in Prevalence of Advanced HIV Disease at Antiretroviral Therapy Enrollment — 10 Countries, 2004–2015
While people with HIV in multiple low- and middle-income countries are increasingly starting treatment earlier, many still do not begin treatment until their disease has reached an advanced stage. This puts their health at risk and greatly increases their chances of transmitting HIV to others. A CDC study of 10 countries in Africa, Asia, and the Caribbean suggests that in most of them, more people with HIV are starting treatment before they reach advanced stages of infection. From 2004-2015, the percentage of people who started HIV treatment at later stages decreased significantly in Mozambique, Namibia, and Haiti. Five other countries also experienced declines. However, at least a third of people with HIV in these 10 countries still began treatment too late in 2015. The research sheds light on approaches countries can take to ensure more people with HIV begin treatment sooner, including earlier testing and connecting people to care. Research shows that early and effective HIV treatment improves the health of people living with HIV and reduces transmission of the disease.