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Scott Webb (Host): I'm Scott Webb. And today, we're discussing HIV and AIDS and the advanced prevention and treatment options that are available today with Dr. Praveen Sudhindra. He's a critical care doctor who specializes in infectious diseases with Carle.

Doctor, it's nice to have you here today. I was just mentioning to you that it seems over the past few years, whether it's because of COVID or whatever the reasons, we don't seem to talk much about HIV and AIDS anymore, but I know it's still a medical issue. So, I want to have you share some recent diagnosis data. Like, where do we stand with HIV and AIDS diagnosis?

Dr. Praveen Sudhindra: Yes. You're right. With a lot of more pertinent global issues HIV's kind of gone to the back burner a little bit. But it's still around. In the United States there are about 30,000 or 35,000 new infections diagnosed each year, which is much lower than it used to be at its peak in the 1990s. But it's still very much an important medical issue and something that the public needs to be aware of.

Host: Yeah. As you say, like some things have been moved to the front burner a little bit. But I'm glad we're having this conversation today. And I want to have you just tell us, give us a sense anyway, you know, for folks who are living with, who've been diagnosed with HIV, maybe how have things changed in terms of medications and the prognosis and all of that. But just generally, what is it like to live with HIV today in 2026?

Dr. Praveen Sudhindra: The landscape certainly changed a lot over the last two to three decades. About three decades ago was when the first effective combination treatments for HIV were introduced to patients. And in the last 20 or 25 years, things have only improved as far as treatments are concerned. Today, a patient diagnosed with HIV will usually be prescribed a combination pill that's taken once a day for life. And the vast majority of cases that succeeds in suppressing the virus and enabling the patient to lead a near-normal life.

Host: Yeah. It's really amazing. And from my perspective, of course, it is just you know, anecdotally, but it does seem that the prognosis is pretty good for most. Whereas at one time, having lived through this, because I'm in my 50s, you know, it seemed like a death sentence, and it's really not anymore, right?

Dr. Praveen Sudhindra: Yes, certainly. I think when it first came into the public consciousness in the 1980s and the '90s, at least the first half of the '90s, it certainly was most of the treatment at that time focused on really treating the other infections that might come about because of the weakened immune system and supporting the patient symptomatically.

But today, the treatment focuses more on long-term prevention and also treating all the other chronic medical conditions that come with aging to a certain degree, because patients who live longer with HIV today may be slightly more prone to heart-related complications and bone and other metabolic complications. So, there certainly are other issues to focus on, but it is nowhere near the dire prognosis that it used to be.

Host: Right, which of course is great news. And one of the many reasons it's good, we're having this conversation. And I want to have you maybe identify some of the new treatments or therapies that you're using to treat HIV and AIDS.

Dr. Praveen Sudhindra: The most commonly prescribed medication is a combination pill called Biktarvy. And that's generally the first-line medication we use. There are several other combination pills that we use as well. They are tolerated pretty well by the vast majority of patients, and there are newer injectable formulations, which are administered as intramuscular injections every one or two months, which spares the patient from having to take a medication every day.

Host: Yeah. Really, you know, science medicine, it's just so amazing and fascinating and it's all happening so fast. And, as you say, folks who are diagnosed and living with HIV, great prognosis. I guess we should probably talk a little bit about discussing preventative strategies for HIV and just other sexually transmitted infections.

Dr. Praveen Sudhindra: Yes. That's a really important aspect that we focus on more and more in our clinics. Preventative strategies have been around now for over a decade. They're called PrEP for short, pre-exposure prophylaxis. And it's a component of the treatment. So, two out of the three medications that we would normally use as a part of a treatment strategy is combined in a single pill that's taken daily. And it works very well to reduce the risk of acquiring HIV.

The newer injectable formulations that I mentioned are also utilized as preventative strategies, and their advantage lies in the fact that you don't have to take a medication every day. And this usually works well when combined with other preventative strategies for other sexually transmitted infections, which have increased in incidence over the last several years, most notably syphilis and gonorrhea.

Host: It is interesting. Yeah. You know, some of these things that you feel like because of science and medicine and all of that, you feel like they're just not around anymore, but. You know, other sexually transmitted infections are still around. They are on the rise. And, maybe you can just address that a little bit. Do you have any sense of why that is? Are folks just being, less cautious than they used to be? Not listening to the preventative strategies from experts like yourself? Like, do you have any sense of that?

Dr. Praveen Sudhindra: To an extent this may be a case of being victims of our own success. With the advent of very effective antibiotic therapies and antiviral therapies, the sense of importance or urgency in the popular consciousness may have receded a little bit. For the most part, a lot of these infections are readily treatable. The challenge lies in diagnosing them and preventing spread in population. And that's something that requires constant vigilance and education.

Host: Right. And we hope that podcasts like this help at least a little bit in that regard, the education piece of that. I'll just give you a chance here, Doctor. I'm glad we got a chance to catch up on HIV and AIDS today. Just final thoughts, takeaways for folks, whether it's prevention, diagnosis, treatment, all the above.

Dr. Praveen Sudhindra: Yeah. I think the important thing for the public to know is that HIV is still out there, but it's readily diagnosable and very treatable. The treatment regimens available are well-tolerated, and they're improving year on year. There are a number of preventative strategies available, which are safe and effective. And we know from a number of studies today that a patient living with HIV who has suppressed virus in the bloodstream or undetectable virus in the bloodstream cannot transmit the infection sexually. And that is a very important tool to prevent the spread of the infection.

Host: Yeah. That's perfect. Well, I appreciate your time and your expertise today. I love hearing some of those things, you know, that it's preventable, it's diagnosable, it's treatable, all the -ables, you know. It's great stuff and I appreciate your time. Thanks so much.

Dr. Praveen Sudhindra: Thank you so much for having me.

Host: For more information and to get connected with one of our providers, please visit carle.org. And that wraps up this episode of Expert Insights with the Carle Foundation Hospital. I'm Scott Webb. Stay well.