Antiretroviral Therapy in Pregnancy: A 2023 Review of the Literature.

PURPOSE OF REVIEW: Selection of antiretroviral therapy during pregnancy must consider maternal physiology and resulting pharmacokinetic changes in pregnancy, resistance and efficacy profiles, tolerability and frequency of adverse effects, teratogenicity, and maternal, neonatal, and pregnancy outcomes. The objective of this review is to summarize the underlying data that informs the current clinical perinatal guidelines in the USA. RECENT FINDINGS: Data now supports the use of dolutegravir at all stages of pregnancy with no significant increase in neural tube defects. Safety and pharmacokinetic data on newer antiretroviral medications in pregnancy continue to lag behind the general population. While there are multiple safety and tolerability concerns with older regimens, there are now multiple options of regimens that are highly efficacious and have good safety data in pregnancy. Most pregnant patients who are virally suppressed on a well-tolerated regimen are able to safely continue those medications during pregnancy.

Depression, anxiety, and stress among students, faculty, and staff.

Objectives: To identify and compare the prevalence of depression, anxiety, and stress among and between students and faculty/staff; and to determine and contrast the coping mechanisms utilized and barriers to mental health care perceived within and between these two populations. Participants: A total of 448 students and faculty/staff from a Midwestern university. Methods: An electronic survey including the 21 question Depression, Anxiety, and Stress Scale and an exploration of individual coping mechanisms and perceived barriers to mental health care. Results: Approximately one-third of the campus community experience symptoms consistent with severe or extremely severe depression (28.3% faculty/staff, 31% students), anxiety (38.6% faculty/staff, 41.8% students), and/or stress (31.1% faculty/staff, 33.9% students). There were significant differences between faculty/staff and students in regard to mental health coping mechanisms utilized and perceived barriers to professional mental health treatment. Conclusion: Mental health problems are common in both faculty/staff and student populations.