Updated guidance on HIV, periop management, and more stories

Decades ago, patients with HIV infection would have been more likely to be managed by subspecialists than primary care physicians. Today, HIV is one of the many chronic diseases that internal medicine physicians can oversee in their practices. The Infectious Diseases Society of America released updated guidance last fall on providing primary care for those living with HIV, including new sections on immunizations, cancer screening, and sexually transmitted infections and an updated discussion of statin use. Our story in this issue talks to experts about the recommendations and reviews key points that primary care physicians need to know.

Another recent guideline that's relevant to primary care was released jointly in September by the American College of Cardiology and the American Heart Association, focusing on perioperative cardiovascular management for noncardiac surgery. Our story looks at what's new, including a more focused approach to preoperative cardiac testing and updated advice on continuing or holding medications like beta-blockers, statins, and antiplatelets in the perioperative period. And for more on perioperative medicine, read our coverage from the Society for Perioperative Assessment and Quality Improvement's 2025 Perioperative Medicine Summit, held in Denver in March.

Becoming involved in advocacy, especially at the beginning of your medical career, is often an intimidating prospect, but diving in where you see the need can also make a big difference, to your life and to the lives of others. In this issue's I.M. Ready, advocacy experts share their rules of engagement, including tips on getting started, finding the time, and staying the course.

Five years ago, COVID-19 was just taking hold across the world, and physicians and other health care professionals were facing a trial by fire as they raced to contain, treat, and prevent this brand-new infection. Much progress has been made since then, but there are always new questions to be answered, especially about postacute sequelae of COVID-19, also known as "long COVID." I.M. Matters recently talked to ACP Member Linda N. Geng, MD, PhD, an investigator for the federal RECOVER (Researching COVID to Enhance Recovery) Initiative, about how understanding of this condition has evolved.

Also in this issue, a researcher explains why one postdischarge phone call might not be enough to keep a patient from returning to the hospital and our Pearls from I.M. Peers expert describes the importance of looking a patient over from head to toe. Finally, our Senior Advocacy Officer outlines challenges to rural health care and ACP's outgoing President provides some advice on how ACP and its members can live and thrive through these "interesting times."

How do you handle periop assessments? What causes are most dear to your heart? Let us know.

Sincerely,

Jennifer Kearney-Strouse
Executive Editor