An ongoing dialogue on HIV/AIDS, infectious diseases,
August 29th, 2025
Watching the Chaos at the CDC — with Sadness and Alarm
Throughout my career as an infectious diseases doctor, the CDC has been a rock-solid source. Need reliable data on an outbreak? The CDC. Need thoughtful, evidence-based guidelines? The CDC. Need an authoritative reference for a consult question or to steer a colleague or trainee to the right place? The CDC. Need the latest, most accurate […]
August 22nd, 2025
On the Internet, Nobody Read My First Blog
In 2007, during the boom in online blogging, and right before the economy crashed, a medical education company contacted me and three other ID doctors to write a blog about HIV. The pitch was irresistible — write something about HIV on a regular basis (they didn’t say what), and we’ll promote it widely. Oh, and […]
August 16th, 2025
Anal Cancer Screening in HIV: When Guidelines Get Ahead of the Evidence
Should every person with HIV over age 35 (if MSM or transgender woman) or 45 (everyone else) have an anal Pap smear, a digital anal rectal exam (DARE), and possibly a high-resolution anoscopy every 1–2 years? According to recent guidelines, yes. But here’s the problem: we don’t know if this screening effort actually prevents cancer. […]
August 6th, 2025
Does the Fact That AI Is Brilliant at Writing “Learning Objectives” Prove They’re Not Really Needed?
Recently, I was invited to speak at a primary care conference on a terrific topic: “Can’t Miss Diagnoses in ID for the PCP.” Love it. So many great examples come to mind — endocarditis, Lemierre syndrome, vertebral osteomyelitis, acute HIV. A wonderful opportunity to teach about the “rare but there” diagnoses hidden among everyday outpatient […]
August 2nd, 2025
The Short Political Half-life of a Medical Contrarian
In early May, I wrote about the surprising FDA appointment of Dr. Vinay Prasad to lead the FDA’s Center for Biologics Evaluation and Research. Prasad is a UCSF hematologist-oncologist known for his views on COVID-19, oncology clinical trials, and his sometimes sharp-elbowed communication style, in particular directed at people with whom he disagrees. My goal was […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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