Based on the patient’s history of asthma, physical examination, and radiograph findings, a diagnosis of right middle lung collapse was determined. Right middle lobe syndrome (RMLS) refers to chronic or recurrent atelectasis in the right middle lobe and can stem from numerous etiologies. It is characterized by wedge-shaped density that extends anteriorly and inferiorly from the hilum of the lung. Atelectasis typically occurs in the right middle lobe, but the lingula may be involved as well.

Asthma may predispose patients to atelectasis, resulting from bronchial inflammation that produces cellular debris, mucus plugs, and edema.Children are also more prone to developing atelectasis than adults because of smaller and more collapsible airways, among other features.

Lateral chest radiography is the most effective imaging technique in patients presenting with RMLS, revealing the condition's hallmark findings: a loss of volume in the right middle lobe and a blurred right heart border.

For appropriate treatment, a precise diagnosis of the pathology underlying the RMLS must be determined. This case represents a complication of uncontrolled asthma. The cornerstone of therapy is chest physical therapy and postural drainage, and the addition of mucolytics and dornase alfa may further clear airways. Children with asthma should be treated with aggressive anti-inflammatory therapy such as inhaled steroids, and the clinician may consider the addition of systemic steroids.  

Cases of RMLS involving neoplastic origin or bronchiectasis should be given special consideration. Diagnosis can be confirmed with high-resolution chest CT scanning, which is safer for younger patients or those with asthma than traditional bronchography. 

If a patient’s symptoms are not responsive to therapy or if the patient has predisposition to airway colonization, the clinician should perform a bronchoalveolar lavage culture to determine an appropriate antibiotic. In children with asthma, there is an association between right middle lobe collapse and infection.

Long-term follow-up has demonstrated that with treatment, RMLS typically resolves within 90 days.Soyer and colleagues also determined that baseline treatment of asthma with anti-inflammatory medications can accelerate the resolution of atelectasis. However, recurrent infections may cause parenchymal damage and bronchiectasis.

Based on the patient’s history of asthma, physical examination, and radiograph findings, a diagnosis of right middle lung collapse was determined. Right middle lobe syndrome (RMLS) refers to chronic or recurrent atelectasis in the right middle lobe and can stem from numerous etiologies. It is characterized by wedge-shaped density that extends anteriorly and inferiorly from the hilum of the lung. Atelectasis typically occurs in the right middle lobe, but the lingula may be involved as well.

Asthma may predispose patients to atelectasis, resulting from bronchial inflammation that produces cellular debris, mucus plugs, and edema.Children are also more prone to developing atelectasis than adults because of smaller and more collapsible airways, among other features.

Lateral chest radiography is the most effective imaging technique in patients presenting with RMLS, revealing the condition's hallmark findings: a loss of volume in the right middle lobe and a blurred right heart border.

For appropriate treatment, a precise diagnosis of the pathology underlying the RMLS must be determined. This case represents a complication of uncontrolled asthma. The cornerstone of therapy is chest physical therapy and postural drainage, and the addition of mucolytics and dornase alfa may further clear airways. Children with asthma should be treated with aggressive anti-inflammatory therapy such as inhaled steroids, and the clinician may consider the addition of systemic steroids.  

Cases of RMLS involving neoplastic origin or bronchiectasis should be given special consideration. Diagnosis can be confirmed with high-resolution chest CT scanning, which is safer for younger patients or those with asthma than traditional bronchography. 

If a patient’s symptoms are not responsive to therapy or if the patient has predisposition to airway colonization, the clinician should perform a bronchoalveolar lavage culture to determine an appropriate antibiotic. In children with asthma, there is an association between right middle lobe collapse and infection.

Long-term follow-up has demonstrated that with treatment, RMLS typically resolves within 90 days.Soyer and colleagues also determined that baseline treatment of asthma with anti-inflammatory medications can accelerate the resolution of atelectasis. However, recurrent infections may cause parenchymal damage and bronchiectasis.

Based on the patient’s history of asthma, physical examination, and radiograph findings, a diagnosis of right middle lung collapse was determined. Right middle lobe syndrome (RMLS) refers to chronic or recurrent atelectasis in the right middle lobe and can stem from numerous etiologies. It is characterized by wedge-shaped density that extends anteriorly and inferiorly from the hilum of the lung. Atelectasis typically occurs in the right middle lobe, but the lingula may be involved as well.

Asthma may predispose patients to atelectasis, resulting from bronchial inflammation that produces cellular debris, mucus plugs, and edema.Children are also more prone to developing atelectasis than adults because of smaller and more collapsible airways, among other features.

Lateral chest radiography is the most effective imaging technique in patients presenting with RMLS, revealing the condition's hallmark findings: a loss of volume in the right middle lobe and a blurred right heart border.

For appropriate treatment, a precise diagnosis of the pathology underlying the RMLS must be determined. This case represents a complication of uncontrolled asthma. The cornerstone of therapy is chest physical therapy and postural drainage, and the addition of mucolytics and dornase alfa may further clear airways. Children with asthma should be treated with aggressive anti-inflammatory therapy such as inhaled steroids, and the clinician may consider the addition of systemic steroids.  

Cases of RMLS involving neoplastic origin or bronchiectasis should be given special consideration. Diagnosis can be confirmed with high-resolution chest CT scanning, which is safer for younger patients or those with asthma than traditional bronchography. 

If a patient’s symptoms are not responsive to therapy or if the patient has predisposition to airway colonization, the clinician should perform a bronchoalveolar lavage culture to determine an appropriate antibiotic. In children with asthma, there is an association between right middle lobe collapse and infection.

Long-term follow-up has demonstrated that with treatment, RMLS typically resolves within 90 days.Soyer and colleagues also determined that baseline treatment of asthma with anti-inflammatory medications can accelerate the resolution of atelectasis. However, recurrent infections may cause parenchymal damage and bronchiectasis.

Most patients will not make a full recovery from attention-deficit/hyperactivity disorder in adulthood. This late-breaking finding headlined the World Congress on ADHD – Virtual Event. Held under the specter of SARS-CoV-2, the virtual program delved into the latest research on ADHD pathophysiology, imaging, genetics, and issues on medical and psychiatric comorbidities.

However, one of the conference’s highlights was a piece of unpublished work on remission patterns by Margaret Sibley, PhD, associate professor of psychiatry and behavioral sciences at the University of Washington, Seattle.

Anywhere from 65% to 67% of young adults have desistant ADHD – meaning that they no longer meet criteria. Only up to 23% experience full remission, said Dr. Sibley during a special late-breaking session. All research on remission and most on persistence consider just one endpoint – nothing is known about longitudinal fluctuations in remission status over time.

Her research sought to answer a key question: Do people fully recover from ADHD?

Using data from the Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) Study, Dr. Sibley prospectively followed over 550 children aged 7-9.9 years with DSM-IV combined-type ADHD over 14 years, until 16 years after baseline, using interviews, questionnaires, and rating scales to track symptoms, impairment, and treatment history.

The researchers also came up with a “winning” definition for full remission, which included three or fewer symptoms of inattention and hyperactive impulsivity from all available reporters, negligible ADHD-related impairment based on preestablished impairment rating thresholds, and discontinuation of medication and behavioral treatments for at least a month prior to assessment.

In the longitudinal results, Dr. Sibley and colleagues reported that the majority (63.8%) demonstrated fluctuations between full or partial remission and ADHD recurrence. Only 9.1% sustained full remission over the course of the study. From these findings, ADHD appears to be a fluctuating disorder. While it continues into adulthood for most people, there may also be periods of remission or “good functioning.”

Most desistance from ADHD represents partial, not full remission, said Dr. Sibley. The results also show that recovery by young adulthood is very rare – most patients with remitted ADHD have recurrences.

These are important findings, said Luis Augusto Rohde, MD, PhD, who co-organized the congress’ scientific program committee with Manfred Gerlach, PhD. It shows that a patient’s ADHD may sometimes be more definitive and at other times, no clear phenotype expression emerges.

COVID’s influence

COVID-19 greatly influenced this year’s program’s agenda, said Dr. Rohde. “There’s a lot of evidence that ADHD patients are at greater risk for COVID-19, which is not a surprise,” said Dr. Rohde, professor of child and adolescent psychiatry at the Federal University of Rio Grande do Sul’s department of psychiatry in Porto Alegre, Brazil.

ADHD is a combination of genetic liability and the demands of the environment. “In times like we are living in right now, if you have increasing demands and stress from the environment, you trigger symptoms in those even with lower genetic liability,” he said. ADHD’s pathophysiology involves attention and executive deficit disorder, which means these patients may not follow strategies to avoid infection.

This shows why COVID was so important to the discussion of program topics, he said.

Two experts addressed this subject head on in a point-counterpoint debate, “Residual effects of the 2019 pandemic will mirror the 1918 pandemic: Will we have lots of new ADHD cases?” James Swanson, PhD, professor of pediatrics at the University of California, Irvine, projected that biological coeffects of COVID-19 will lead to ADHD symptoms, generating potentially 5 million new ADHD cases.

David Coghill, MBChB, MD, a professor of child adolescent mental health at the University of Melbourne, countered that not enough data are available yet to back this hypothesis. “Researchers are asking this question, but clinically we don’t know enough.”

While the COVID virus might not directly lead to more cases of ADHD, this could potentially happen indirectly through environmental agents of the pandemic, offered Dr. Rohde. “We’ve clearly seen in our appointments with families and children that they can’t face the amount of schooling and working from home,” he said.

 

Novel treatments

The conference also addressed new treatments and nonpharmacologic interventions in the pipeline for ADHD. “We had a chance to discuss the possibilities about new medications that address the problems in the current market and to show the potential usefulness of nonpharma interventions such as neuromodulations in ADHD,” said Dr. Rohde. Speakers discussed strategies ranging from family-based mindfulness interventions to oligoantigenic diets in children with ADHD.

Other researchers are looking at novel digital tools to help patients manage and treat ADHD. Adherence is a major problem in chronic disorders like hypertension, diabetes, epilepsy, and ADHD, said Dr. Rohde. “Due to ADHD symptomatology including inattention, novelty-seeking, executive deficits, and difficulties in persistence, it is an even bigger problem in this disorder.”

Speakers at the “ADHD in the digital age – From pitfalls to challenges” session discussed video game strategies to reduce ADHD impairment, and a texting app to improve adherence. Dr. Rohde talked about the FOCUS app, which fosters collaboration between patients, families, and caregivers to efficiently track ADHD symptoms and help customize treatments.

Studies suggest these tools can significantly improve adherence. They’re also well accepted by patients, said Dr. Rohde. While the expectations are high, digital interventions are not a substitute for medication. “More data is needed to include them as part of the clinical interventions for ADHD.”

Dr. Sibley received book royalties from Guilford Press. Dr. Rohde has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Bial, Medice, Novartis/Sandoz, Pfizer, and Shire/Takeda in the last 3 years. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr. Rohde have received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Novartis/Sandoz and Shire/Takeda. Dr. Rohde has received authorship royalties from Oxford Press and ArtMed and travel grants from Shire to take part in the 2018 APA annual meeting. Dr. Swanson has two patents: (PIXA4), which uses a “time-of-flight” camera to measure growth of infants, and a provisional patent on the mechanism of tolerance to stimulant medication (PATSMTA). He has received travel support from Medice and has done legal review for NLS. Dr. Coghill worked for several pharmaceutical companies but had no disclosures relevant to the session debate on the pandemic.

Most patients will not make a full recovery from attention-deficit/hyperactivity disorder in adulthood. This late-breaking finding headlined the World Congress on ADHD – Virtual Event. Held under the specter of SARS-CoV-2, the virtual program delved into the latest research on ADHD pathophysiology, imaging, genetics, and issues on medical and psychiatric comorbidities.

However, one of the conference’s highlights was a piece of unpublished work on remission patterns by Margaret Sibley, PhD, associate professor of psychiatry and behavioral sciences at the University of Washington, Seattle.

Anywhere from 65% to 67% of young adults have desistant ADHD – meaning that they no longer meet criteria. Only up to 23% experience full remission, said Dr. Sibley during a special late-breaking session. All research on remission and most on persistence consider just one endpoint – nothing is known about longitudinal fluctuations in remission status over time.

Her research sought to answer a key question: Do people fully recover from ADHD?

Using data from the Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) Study, Dr. Sibley prospectively followed over 550 children aged 7-9.9 years with DSM-IV combined-type ADHD over 14 years, until 16 years after baseline, using interviews, questionnaires, and rating scales to track symptoms, impairment, and treatment history.

The researchers also came up with a “winning” definition for full remission, which included three or fewer symptoms of inattention and hyperactive impulsivity from all available reporters, negligible ADHD-related impairment based on preestablished impairment rating thresholds, and discontinuation of medication and behavioral treatments for at least a month prior to assessment.

In the longitudinal results, Dr. Sibley and colleagues reported that the majority (63.8%) demonstrated fluctuations between full or partial remission and ADHD recurrence. Only 9.1% sustained full remission over the course of the study. From these findings, ADHD appears to be a fluctuating disorder. While it continues into adulthood for most people, there may also be periods of remission or “good functioning.”

Most desistance from ADHD represents partial, not full remission, said Dr. Sibley. The results also show that recovery by young adulthood is very rare – most patients with remitted ADHD have recurrences.

These are important findings, said Luis Augusto Rohde, MD, PhD, who co-organized the congress’ scientific program committee with Manfred Gerlach, PhD. It shows that a patient’s ADHD may sometimes be more definitive and at other times, no clear phenotype expression emerges.

COVID’s influence

COVID-19 greatly influenced this year’s program’s agenda, said Dr. Rohde. “There’s a lot of evidence that ADHD patients are at greater risk for COVID-19, which is not a surprise,” said Dr. Rohde, professor of child and adolescent psychiatry at the Federal University of Rio Grande do Sul’s department of psychiatry in Porto Alegre, Brazil.

ADHD is a combination of genetic liability and the demands of the environment. “In times like we are living in right now, if you have increasing demands and stress from the environment, you trigger symptoms in those even with lower genetic liability,” he said. ADHD’s pathophysiology involves attention and executive deficit disorder, which means these patients may not follow strategies to avoid infection.

This shows why COVID was so important to the discussion of program topics, he said.

Two experts addressed this subject head on in a point-counterpoint debate, “Residual effects of the 2019 pandemic will mirror the 1918 pandemic: Will we have lots of new ADHD cases?” James Swanson, PhD, professor of pediatrics at the University of California, Irvine, projected that biological coeffects of COVID-19 will lead to ADHD symptoms, generating potentially 5 million new ADHD cases.

David Coghill, MBChB, MD, a professor of child adolescent mental health at the University of Melbourne, countered that not enough data are available yet to back this hypothesis. “Researchers are asking this question, but clinically we don’t know enough.”

While the COVID virus might not directly lead to more cases of ADHD, this could potentially happen indirectly through environmental agents of the pandemic, offered Dr. Rohde. “We’ve clearly seen in our appointments with families and children that they can’t face the amount of schooling and working from home,” he said.

 

Novel treatments

The conference also addressed new treatments and nonpharmacologic interventions in the pipeline for ADHD. “We had a chance to discuss the possibilities about new medications that address the problems in the current market and to show the potential usefulness of nonpharma interventions such as neuromodulations in ADHD,” said Dr. Rohde. Speakers discussed strategies ranging from family-based mindfulness interventions to oligoantigenic diets in children with ADHD.

Other researchers are looking at novel digital tools to help patients manage and treat ADHD. Adherence is a major problem in chronic disorders like hypertension, diabetes, epilepsy, and ADHD, said Dr. Rohde. “Due to ADHD symptomatology including inattention, novelty-seeking, executive deficits, and difficulties in persistence, it is an even bigger problem in this disorder.”

Speakers at the “ADHD in the digital age – From pitfalls to challenges” session discussed video game strategies to reduce ADHD impairment, and a texting app to improve adherence. Dr. Rohde talked about the FOCUS app, which fosters collaboration between patients, families, and caregivers to efficiently track ADHD symptoms and help customize treatments.

Studies suggest these tools can significantly improve adherence. They’re also well accepted by patients, said Dr. Rohde. While the expectations are high, digital interventions are not a substitute for medication. “More data is needed to include them as part of the clinical interventions for ADHD.”

Dr. Sibley received book royalties from Guilford Press. Dr. Rohde has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Bial, Medice, Novartis/Sandoz, Pfizer, and Shire/Takeda in the last 3 years. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr. Rohde have received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Novartis/Sandoz and Shire/Takeda. Dr. Rohde has received authorship royalties from Oxford Press and ArtMed and travel grants from Shire to take part in the 2018 APA annual meeting. Dr. Swanson has two patents: (PIXA4), which uses a “time-of-flight” camera to measure growth of infants, and a provisional patent on the mechanism of tolerance to stimulant medication (PATSMTA). He has received travel support from Medice and has done legal review for NLS. Dr. Coghill worked for several pharmaceutical companies but had no disclosures relevant to the session debate on the pandemic.

Most patients will not make a full recovery from attention-deficit/hyperactivity disorder in adulthood. This late-breaking finding headlined the World Congress on ADHD – Virtual Event. Held under the specter of SARS-CoV-2, the virtual program delved into the latest research on ADHD pathophysiology, imaging, genetics, and issues on medical and psychiatric comorbidities.

However, one of the conference’s highlights was a piece of unpublished work on remission patterns by Margaret Sibley, PhD, associate professor of psychiatry and behavioral sciences at the University of Washington, Seattle.

Anywhere from 65% to 67% of young adults have desistant ADHD – meaning that they no longer meet criteria. Only up to 23% experience full remission, said Dr. Sibley during a special late-breaking session. All research on remission and most on persistence consider just one endpoint – nothing is known about longitudinal fluctuations in remission status over time.

Her research sought to answer a key question: Do people fully recover from ADHD?

Using data from the Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) Study, Dr. Sibley prospectively followed over 550 children aged 7-9.9 years with DSM-IV combined-type ADHD over 14 years, until 16 years after baseline, using interviews, questionnaires, and rating scales to track symptoms, impairment, and treatment history.

The researchers also came up with a “winning” definition for full remission, which included three or fewer symptoms of inattention and hyperactive impulsivity from all available reporters, negligible ADHD-related impairment based on preestablished impairment rating thresholds, and discontinuation of medication and behavioral treatments for at least a month prior to assessment.

In the longitudinal results, Dr. Sibley and colleagues reported that the majority (63.8%) demonstrated fluctuations between full or partial remission and ADHD recurrence. Only 9.1% sustained full remission over the course of the study. From these findings, ADHD appears to be a fluctuating disorder. While it continues into adulthood for most people, there may also be periods of remission or “good functioning.”

Most desistance from ADHD represents partial, not full remission, said Dr. Sibley. The results also show that recovery by young adulthood is very rare – most patients with remitted ADHD have recurrences.

These are important findings, said Luis Augusto Rohde, MD, PhD, who co-organized the congress’ scientific program committee with Manfred Gerlach, PhD. It shows that a patient’s ADHD may sometimes be more definitive and at other times, no clear phenotype expression emerges.

COVID’s influence

COVID-19 greatly influenced this year’s program’s agenda, said Dr. Rohde. “There’s a lot of evidence that ADHD patients are at greater risk for COVID-19, which is not a surprise,” said Dr. Rohde, professor of child and adolescent psychiatry at the Federal University of Rio Grande do Sul’s department of psychiatry in Porto Alegre, Brazil.

ADHD is a combination of genetic liability and the demands of the environment. “In times like we are living in right now, if you have increasing demands and stress from the environment, you trigger symptoms in those even with lower genetic liability,” he said. ADHD’s pathophysiology involves attention and executive deficit disorder, which means these patients may not follow strategies to avoid infection.

This shows why COVID was so important to the discussion of program topics, he said.

Two experts addressed this subject head on in a point-counterpoint debate, “Residual effects of the 2019 pandemic will mirror the 1918 pandemic: Will we have lots of new ADHD cases?” James Swanson, PhD, professor of pediatrics at the University of California, Irvine, projected that biological coeffects of COVID-19 will lead to ADHD symptoms, generating potentially 5 million new ADHD cases.

David Coghill, MBChB, MD, a professor of child adolescent mental health at the University of Melbourne, countered that not enough data are available yet to back this hypothesis. “Researchers are asking this question, but clinically we don’t know enough.”

While the COVID virus might not directly lead to more cases of ADHD, this could potentially happen indirectly through environmental agents of the pandemic, offered Dr. Rohde. “We’ve clearly seen in our appointments with families and children that they can’t face the amount of schooling and working from home,” he said.

 

Novel treatments

The conference also addressed new treatments and nonpharmacologic interventions in the pipeline for ADHD. “We had a chance to discuss the possibilities about new medications that address the problems in the current market and to show the potential usefulness of nonpharma interventions such as neuromodulations in ADHD,” said Dr. Rohde. Speakers discussed strategies ranging from family-based mindfulness interventions to oligoantigenic diets in children with ADHD.

Other researchers are looking at novel digital tools to help patients manage and treat ADHD. Adherence is a major problem in chronic disorders like hypertension, diabetes, epilepsy, and ADHD, said Dr. Rohde. “Due to ADHD symptomatology including inattention, novelty-seeking, executive deficits, and difficulties in persistence, it is an even bigger problem in this disorder.”

Speakers at the “ADHD in the digital age – From pitfalls to challenges” session discussed video game strategies to reduce ADHD impairment, and a texting app to improve adherence. Dr. Rohde talked about the FOCUS app, which fosters collaboration between patients, families, and caregivers to efficiently track ADHD symptoms and help customize treatments.

Studies suggest these tools can significantly improve adherence. They’re also well accepted by patients, said Dr. Rohde. While the expectations are high, digital interventions are not a substitute for medication. “More data is needed to include them as part of the clinical interventions for ADHD.”

Dr. Sibley received book royalties from Guilford Press. Dr. Rohde has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Bial, Medice, Novartis/Sandoz, Pfizer, and Shire/Takeda in the last 3 years. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr. Rohde have received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Novartis/Sandoz and Shire/Takeda. Dr. Rohde has received authorship royalties from Oxford Press and ArtMed and travel grants from Shire to take part in the 2018 APA annual meeting. Dr. Swanson has two patents: (PIXA4), which uses a “time-of-flight” camera to measure growth of infants, and a provisional patent on the mechanism of tolerance to stimulant medication (PATSMTA). He has received travel support from Medice and has done legal review for NLS. Dr. Coghill worked for several pharmaceutical companies but had no disclosures relevant to the session debate on the pandemic.

The Biden administration is reversing a Trump-era policy that allowed health care providers to bar services to lesbian, gay, bisexual, transgender, or queer (LGBTQ) patients.

The U.S. Department of Health and Human Services gave notice on Monday that it would interpret the Affordable Care Act’s Section 1557 – which bars discrimination on the basis of sex – to include discrimination on the basis of sexual orientation or gender identity. The department said its position is consistent with a June 2020 U.S. Supreme Court ruling in Bostock v. Clayton County, GA. The ruling determined that the Civil Rights Act’s prohibition of employment discrimination on the basis of sex includes sexual orientation and gender identity.

“The mission of our Department is to enhance the health and well-being of all Americans, no matter their gender identity or sexual orientation,” said HHS Assistant Secretary for Health Rachel Levine, MD, in a statement released Monday.

“All people need access to health care services to fix a broken bone, protect their heart health, and screen for cancer risk,” she said. “No one should be discriminated against when seeking medical services because of who they are.”

Many physician organizations applauded the decision.

“The Biden administration did the right thing by terminating a short-lived effort to allow discrimination based on gender or sexual orientation when seeking health care,” said Susan R. Bailey, MD, president of the American Medical Association, in a statement.

When, in 2019, the Trump administration proposed to allow providers to deny care to LGBTQ people, the AMA said in a letter to the HHS that its interpretation “was contrary to the intent and the plain language of the law.”

Now, said Bailey, the AMA welcomes the Biden administration’s interpretation. It “is a victory for health equity and ends a dismal chapter in which a federal agency sought to remove civil rights protections,” she said.

An alliance of patient groups – including the American Cancer Society, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association, the Epilepsy Foundation, the National Multiple Sclerosis Society, and the National Organization for Rare Disorders – also applauded the new policy. “This community already faces significant health disparities,” the groups noted in a statement. People with chronic illness such as HIV and cancer “need to be able to access care quickly and without fear of discrimination,” they said.

The groups had filed a friend of the court brief in a case against the Trump administration rule.

“We welcome this positive step to ensure access is preserved without hindrance, as intended by the health care law,” they said.

Twenty-two states and Washington, D.C. – led by former California Attorney General Xavier Becerra, who is now HHS secretary – sued the Trump administration in July 2020, aiming to overturn the rule.

Chase Strangio, deputy director for Trans Justice with the American Civil Liberties Union LGBTQ & HIV Project, noted that the HHS announcement was crucial in the face of efforts in multiple states to bar health care for transgender youth. “The Biden administration has affirmed what courts have said for decades: Discrimination against LGBTQ people is against the law. It also affirms what transgender people have long said: Gender-affirming care is life-saving care,” he said in a statement.

Lambda Legal, which led another lawsuit against the Trump administration rule, said it welcomed the HHS action but noted in a statement by the organization’s senior attorney, Omar Gonzalez-Pagan, that it “does not address significant aspects of the Trump-era rule that we and others have challenged in court.”

The Trump rule also “limited the remedies available to people who face health disparities, limited access to health care for people with Limited English Proficiency, unlawfully incorporated religious exemptions, and dramatically reduced the number of health care entities and insurance subject to the rule, all of which today’s action does not address,” said Gonzalez-Pagan.

“We encourage Secretary Xavier Becerra and the Biden administration to take additional steps to ensure that all LGBTQ people are completely covered wherever and whenever they may encounter discrimination during some of the most delicate and precarious moments of their lives: When seeking health care,” he said.

A version of this article first appeared on Medscape.com.

The Biden administration is reversing a Trump-era policy that allowed health care providers to bar services to lesbian, gay, bisexual, transgender, or queer (LGBTQ) patients.

The U.S. Department of Health and Human Services gave notice on Monday that it would interpret the Affordable Care Act’s Section 1557 – which bars discrimination on the basis of sex – to include discrimination on the basis of sexual orientation or gender identity. The department said its position is consistent with a June 2020 U.S. Supreme Court ruling in Bostock v. Clayton County, GA. The ruling determined that the Civil Rights Act’s prohibition of employment discrimination on the basis of sex includes sexual orientation and gender identity.

“The mission of our Department is to enhance the health and well-being of all Americans, no matter their gender identity or sexual orientation,” said HHS Assistant Secretary for Health Rachel Levine, MD, in a statement released Monday.

“All people need access to health care services to fix a broken bone, protect their heart health, and screen for cancer risk,” she said. “No one should be discriminated against when seeking medical services because of who they are.”

Many physician organizations applauded the decision.

“The Biden administration did the right thing by terminating a short-lived effort to allow discrimination based on gender or sexual orientation when seeking health care,” said Susan R. Bailey, MD, president of the American Medical Association, in a statement.

When, in 2019, the Trump administration proposed to allow providers to deny care to LGBTQ people, the AMA said in a letter to the HHS that its interpretation “was contrary to the intent and the plain language of the law.”

Now, said Bailey, the AMA welcomes the Biden administration’s interpretation. It “is a victory for health equity and ends a dismal chapter in which a federal agency sought to remove civil rights protections,” she said.

An alliance of patient groups – including the American Cancer Society, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association, the Epilepsy Foundation, the National Multiple Sclerosis Society, and the National Organization for Rare Disorders – also applauded the new policy. “This community already faces significant health disparities,” the groups noted in a statement. People with chronic illness such as HIV and cancer “need to be able to access care quickly and without fear of discrimination,” they said.

The groups had filed a friend of the court brief in a case against the Trump administration rule.

“We welcome this positive step to ensure access is preserved without hindrance, as intended by the health care law,” they said.

Twenty-two states and Washington, D.C. – led by former California Attorney General Xavier Becerra, who is now HHS secretary – sued the Trump administration in July 2020, aiming to overturn the rule.

Chase Strangio, deputy director for Trans Justice with the American Civil Liberties Union LGBTQ & HIV Project, noted that the HHS announcement was crucial in the face of efforts in multiple states to bar health care for transgender youth. “The Biden administration has affirmed what courts have said for decades: Discrimination against LGBTQ people is against the law. It also affirms what transgender people have long said: Gender-affirming care is life-saving care,” he said in a statement.

Lambda Legal, which led another lawsuit against the Trump administration rule, said it welcomed the HHS action but noted in a statement by the organization’s senior attorney, Omar Gonzalez-Pagan, that it “does not address significant aspects of the Trump-era rule that we and others have challenged in court.”

The Trump rule also “limited the remedies available to people who face health disparities, limited access to health care for people with Limited English Proficiency, unlawfully incorporated religious exemptions, and dramatically reduced the number of health care entities and insurance subject to the rule, all of which today’s action does not address,” said Gonzalez-Pagan.

“We encourage Secretary Xavier Becerra and the Biden administration to take additional steps to ensure that all LGBTQ people are completely covered wherever and whenever they may encounter discrimination during some of the most delicate and precarious moments of their lives: When seeking health care,” he said.

A version of this article first appeared on Medscape.com.

The Biden administration is reversing a Trump-era policy that allowed health care providers to bar services to lesbian, gay, bisexual, transgender, or queer (LGBTQ) patients.

The U.S. Department of Health and Human Services gave notice on Monday that it would interpret the Affordable Care Act’s Section 1557 – which bars discrimination on the basis of sex – to include discrimination on the basis of sexual orientation or gender identity. The department said its position is consistent with a June 2020 U.S. Supreme Court ruling in Bostock v. Clayton County, GA. The ruling determined that the Civil Rights Act’s prohibition of employment discrimination on the basis of sex includes sexual orientation and gender identity.

“The mission of our Department is to enhance the health and well-being of all Americans, no matter their gender identity or sexual orientation,” said HHS Assistant Secretary for Health Rachel Levine, MD, in a statement released Monday.

“All people need access to health care services to fix a broken bone, protect their heart health, and screen for cancer risk,” she said. “No one should be discriminated against when seeking medical services because of who they are.”

Many physician organizations applauded the decision.

“The Biden administration did the right thing by terminating a short-lived effort to allow discrimination based on gender or sexual orientation when seeking health care,” said Susan R. Bailey, MD, president of the American Medical Association, in a statement.

When, in 2019, the Trump administration proposed to allow providers to deny care to LGBTQ people, the AMA said in a letter to the HHS that its interpretation “was contrary to the intent and the plain language of the law.”

Now, said Bailey, the AMA welcomes the Biden administration’s interpretation. It “is a victory for health equity and ends a dismal chapter in which a federal agency sought to remove civil rights protections,” she said.

An alliance of patient groups – including the American Cancer Society, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association, the Epilepsy Foundation, the National Multiple Sclerosis Society, and the National Organization for Rare Disorders – also applauded the new policy. “This community already faces significant health disparities,” the groups noted in a statement. People with chronic illness such as HIV and cancer “need to be able to access care quickly and without fear of discrimination,” they said.

The groups had filed a friend of the court brief in a case against the Trump administration rule.

“We welcome this positive step to ensure access is preserved without hindrance, as intended by the health care law,” they said.

Twenty-two states and Washington, D.C. – led by former California Attorney General Xavier Becerra, who is now HHS secretary – sued the Trump administration in July 2020, aiming to overturn the rule.

Chase Strangio, deputy director for Trans Justice with the American Civil Liberties Union LGBTQ & HIV Project, noted that the HHS announcement was crucial in the face of efforts in multiple states to bar health care for transgender youth. “The Biden administration has affirmed what courts have said for decades: Discrimination against LGBTQ people is against the law. It also affirms what transgender people have long said: Gender-affirming care is life-saving care,” he said in a statement.

Lambda Legal, which led another lawsuit against the Trump administration rule, said it welcomed the HHS action but noted in a statement by the organization’s senior attorney, Omar Gonzalez-Pagan, that it “does not address significant aspects of the Trump-era rule that we and others have challenged in court.”

The Trump rule also “limited the remedies available to people who face health disparities, limited access to health care for people with Limited English Proficiency, unlawfully incorporated religious exemptions, and dramatically reduced the number of health care entities and insurance subject to the rule, all of which today’s action does not address,” said Gonzalez-Pagan.

“We encourage Secretary Xavier Becerra and the Biden administration to take additional steps to ensure that all LGBTQ people are completely covered wherever and whenever they may encounter discrimination during some of the most delicate and precarious moments of their lives: When seeking health care,” he said.

A version of this article first appeared on Medscape.com.

Key clinical point: Women in rural areas were less likely to receive counseling about emergency contraception than urban women, but counseling rates were low for both groups (2% and 3%, respectively). 

Major finding: Between 2006 and 2017, 10% of rural women and 19% of urban women who had ever had sex reported ever using emergency contraception pills, and ever-use of emergency contraception pills more than doubled in both groups between 2006-2008 and 2015-2017.

Study details: The data come from 28,448 teens and women aged 15-44 years who participated in the National Survey of Family Growth between 2006 and 2017.

Disclosures: The study received no outside funding; one coauthor was supported by the Maine Economic Improvement Fund. The other researchers had no financial conflicts to disclose.

Source: Milkowski CM et al. Contracep X. 2021 Feb 8. doi: 10.1016/j.conx.2021.100061. 

Key clinical point: Women in rural areas were less likely to receive counseling about emergency contraception than urban women, but counseling rates were low for both groups (2% and 3%, respectively). 

Major finding: Between 2006 and 2017, 10% of rural women and 19% of urban women who had ever had sex reported ever using emergency contraception pills, and ever-use of emergency contraception pills more than doubled in both groups between 2006-2008 and 2015-2017.

Study details: The data come from 28,448 teens and women aged 15-44 years who participated in the National Survey of Family Growth between 2006 and 2017.

Disclosures: The study received no outside funding; one coauthor was supported by the Maine Economic Improvement Fund. The other researchers had no financial conflicts to disclose.

Source: Milkowski CM et al. Contracep X. 2021 Feb 8. doi: 10.1016/j.conx.2021.100061. 

Key clinical point: Women in rural areas were less likely to receive counseling about emergency contraception than urban women, but counseling rates were low for both groups (2% and 3%, respectively). 

Major finding: Between 2006 and 2017, 10% of rural women and 19% of urban women who had ever had sex reported ever using emergency contraception pills, and ever-use of emergency contraception pills more than doubled in both groups between 2006-2008 and 2015-2017.

Study details: The data come from 28,448 teens and women aged 15-44 years who participated in the National Survey of Family Growth between 2006 and 2017.

Disclosures: The study received no outside funding; one coauthor was supported by the Maine Economic Improvement Fund. The other researchers had no financial conflicts to disclose.

Source: Milkowski CM et al. Contracep X. 2021 Feb 8. doi: 10.1016/j.conx.2021.100061. 

Key clinical point: Successful implementation of immediate postpartum LARC was associated with clinical implementation champions, often supported by an interdisciplinary team, and favorable payer reimbursement policies.

Major finding: On average, maternity hospitals used 18 suggested strategies to implement immediate postpartum long-active reversible contraception (LARC) services.

Study details: The data come from a case study of 11 maternity hospitals and included semi-structured interviews with 78 clinicians, nurses, residents, pharmacy and revenue cycle staff, and hospital administrators.

Disclosures: Lead author Dr. Moniz was supported by the Agency for Healthcare Research and Quality (AHRQ); coauthors were supported by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases.

Source: Moniz MH et al. Implement Sci Commun. 2021 Apr 12. doi: 10.1186/s43058-021-00136-7.

Key clinical point: Successful implementation of immediate postpartum LARC was associated with clinical implementation champions, often supported by an interdisciplinary team, and favorable payer reimbursement policies.

Major finding: On average, maternity hospitals used 18 suggested strategies to implement immediate postpartum long-active reversible contraception (LARC) services.

Study details: The data come from a case study of 11 maternity hospitals and included semi-structured interviews with 78 clinicians, nurses, residents, pharmacy and revenue cycle staff, and hospital administrators.

Disclosures: Lead author Dr. Moniz was supported by the Agency for Healthcare Research and Quality (AHRQ); coauthors were supported by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases.

Source: Moniz MH et al. Implement Sci Commun. 2021 Apr 12. doi: 10.1186/s43058-021-00136-7.

Key clinical point: Successful implementation of immediate postpartum LARC was associated with clinical implementation champions, often supported by an interdisciplinary team, and favorable payer reimbursement policies.

Major finding: On average, maternity hospitals used 18 suggested strategies to implement immediate postpartum long-active reversible contraception (LARC) services.

Study details: The data come from a case study of 11 maternity hospitals and included semi-structured interviews with 78 clinicians, nurses, residents, pharmacy and revenue cycle staff, and hospital administrators.

Disclosures: Lead author Dr. Moniz was supported by the Agency for Healthcare Research and Quality (AHRQ); coauthors were supported by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases.

Source: Moniz MH et al. Implement Sci Commun. 2021 Apr 12. doi: 10.1186/s43058-021-00136-7.

Key clinical point: African American males aged 14-15 years were more likely than 18- to 19- year-old males to use a condom the last time they had sex.

Major finding: Increased condom use was associated with personal factors including high positive attachment to the boyfriend/girlfriend as was a greater number of sexual partners, younger age at first sexual encounter, and knowledge that the individual had a sexually-transmitted infection in the past year.

Study details: The data come from the Mobile Youth Survey, a community-based survey of adolescents in Mobile, Alabama, between 1998 and 2011; the study population included 3,718 individuals.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Chambliss JT et al. Am J Mens Health. 2021 Apr 15. doi: 10.1177/15579883211009039.

Key clinical point: African American males aged 14-15 years were more likely than 18- to 19- year-old males to use a condom the last time they had sex.

Major finding: Increased condom use was associated with personal factors including high positive attachment to the boyfriend/girlfriend as was a greater number of sexual partners, younger age at first sexual encounter, and knowledge that the individual had a sexually-transmitted infection in the past year.

Study details: The data come from the Mobile Youth Survey, a community-based survey of adolescents in Mobile, Alabama, between 1998 and 2011; the study population included 3,718 individuals.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Chambliss JT et al. Am J Mens Health. 2021 Apr 15. doi: 10.1177/15579883211009039.

Key clinical point: African American males aged 14-15 years were more likely than 18- to 19- year-old males to use a condom the last time they had sex.

Major finding: Increased condom use was associated with personal factors including high positive attachment to the boyfriend/girlfriend as was a greater number of sexual partners, younger age at first sexual encounter, and knowledge that the individual had a sexually-transmitted infection in the past year.

Study details: The data come from the Mobile Youth Survey, a community-based survey of adolescents in Mobile, Alabama, between 1998 and 2011; the study population included 3,718 individuals.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Chambliss JT et al. Am J Mens Health. 2021 Apr 15. doi: 10.1177/15579883211009039.

Key clinical point: Immediate postpartum insertion of copper intrauterine devices is effective and acceptable for women living in low- and middle-income countries.

Major finding: The six-month continuation rate for immediate postpartum copper IUDs was 87% in low- and middle-income countries; pooled estimated rates of adverse outcomes at six months were 6% for expulsion, 5% for removal, and 0.2% for infection.

Study details: The data come from a meta-analysis of 11 studies of the use and continuation of postpartum long-acting reversible contraception in low- and middle-income countries, including 2 randomized, controlled trials and 9 prospective cohort studies.

Disclosures: The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Doris Duke Charitable Foundation. The researchers had no financial conflicts to disclose.

Source: Marchin A et al. J Womens Health Dev. 2021 Mar 18. doi: 10.26502/fjwhd.2644-28840059. 

Key clinical point: Immediate postpartum insertion of copper intrauterine devices is effective and acceptable for women living in low- and middle-income countries.

Major finding: The six-month continuation rate for immediate postpartum copper IUDs was 87% in low- and middle-income countries; pooled estimated rates of adverse outcomes at six months were 6% for expulsion, 5% for removal, and 0.2% for infection.

Study details: The data come from a meta-analysis of 11 studies of the use and continuation of postpartum long-acting reversible contraception in low- and middle-income countries, including 2 randomized, controlled trials and 9 prospective cohort studies.

Disclosures: The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Doris Duke Charitable Foundation. The researchers had no financial conflicts to disclose.

Source: Marchin A et al. J Womens Health Dev. 2021 Mar 18. doi: 10.26502/fjwhd.2644-28840059. 

Key clinical point: Immediate postpartum insertion of copper intrauterine devices is effective and acceptable for women living in low- and middle-income countries.

Major finding: The six-month continuation rate for immediate postpartum copper IUDs was 87% in low- and middle-income countries; pooled estimated rates of adverse outcomes at six months were 6% for expulsion, 5% for removal, and 0.2% for infection.

Study details: The data come from a meta-analysis of 11 studies of the use and continuation of postpartum long-acting reversible contraception in low- and middle-income countries, including 2 randomized, controlled trials and 9 prospective cohort studies.

Disclosures: The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Doris Duke Charitable Foundation. The researchers had no financial conflicts to disclose.

Source: Marchin A et al. J Womens Health Dev. 2021 Mar 18. doi: 10.26502/fjwhd.2644-28840059. 

Key clinical point: Women taking oral contraceptives showed lower volume in the hypothalamic and pituitary gland compared to normally cycling women based on magnetic resonance imaging (MRI) data.

Major finding: Hypothalamic and pituitary volumes were significantly lower in women using oral contraceptives compared to naturally cycling women (B = -81.2 for both; P = 0.002 and P = -0.04, respectively).

Study details: The data come from a prospective study of 50 healthy women aged 18 and older, including 21 oral contraceptive users, and 29 naturally cycling women.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Chen KX et al. PLos One. 2021 Apr 21.  doi: 10.1371/journal.pone.0249482. eCollection 2021.

Key clinical point: Women taking oral contraceptives showed lower volume in the hypothalamic and pituitary gland compared to normally cycling women based on magnetic resonance imaging (MRI) data.

Major finding: Hypothalamic and pituitary volumes were significantly lower in women using oral contraceptives compared to naturally cycling women (B = -81.2 for both; P = 0.002 and P = -0.04, respectively).

Study details: The data come from a prospective study of 50 healthy women aged 18 and older, including 21 oral contraceptive users, and 29 naturally cycling women.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Chen KX et al. PLos One. 2021 Apr 21.  doi: 10.1371/journal.pone.0249482. eCollection 2021.

Key clinical point: Women taking oral contraceptives showed lower volume in the hypothalamic and pituitary gland compared to normally cycling women based on magnetic resonance imaging (MRI) data.

Major finding: Hypothalamic and pituitary volumes were significantly lower in women using oral contraceptives compared to naturally cycling women (B = -81.2 for both; P = 0.002 and P = -0.04, respectively).

Study details: The data come from a prospective study of 50 healthy women aged 18 and older, including 21 oral contraceptive users, and 29 naturally cycling women.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Chen KX et al. PLos One. 2021 Apr 21.  doi: 10.1371/journal.pone.0249482. eCollection 2021.

Key clinical point: Women’s attitudes towards contraceptives affect their willingness to accept a novel HIV prevention product in the form of a vaginal ring; pre-emptive counseling to address women’s concerns may encourage acceptance.

Major finding: Women surveyed about their experience using a monthly dapivirine vaginal ring reported side effects related to menses, and expressed some concern about the long-term impact of the ring and contraception use on fertility.

Study details: The data come from a subset of 214 women of childbearing age enrolled in the ASPIRE trial at 15 sites in Malawi, South Africa, Uganda, and Zambia who received a monthly dapivirine vaginal ring designed for HIV prevention.

Disclosures: The study was supported by the e National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health. The vaginal rings were supplied by the International Partnership for Microbicides (IPM). The researchers had no financial conflicts to disclose.

Source: Leslie J et al. BMC Womens Health. 2021 Apr 23. doi: 10.1186/s12905-021-01321-5.

Key clinical point: Women’s attitudes towards contraceptives affect their willingness to accept a novel HIV prevention product in the form of a vaginal ring; pre-emptive counseling to address women’s concerns may encourage acceptance.

Major finding: Women surveyed about their experience using a monthly dapivirine vaginal ring reported side effects related to menses, and expressed some concern about the long-term impact of the ring and contraception use on fertility.

Study details: The data come from a subset of 214 women of childbearing age enrolled in the ASPIRE trial at 15 sites in Malawi, South Africa, Uganda, and Zambia who received a monthly dapivirine vaginal ring designed for HIV prevention.

Disclosures: The study was supported by the e National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health. The vaginal rings were supplied by the International Partnership for Microbicides (IPM). The researchers had no financial conflicts to disclose.

Source: Leslie J et al. BMC Womens Health. 2021 Apr 23. doi: 10.1186/s12905-021-01321-5.

Key clinical point: Women’s attitudes towards contraceptives affect their willingness to accept a novel HIV prevention product in the form of a vaginal ring; pre-emptive counseling to address women’s concerns may encourage acceptance.

Major finding: Women surveyed about their experience using a monthly dapivirine vaginal ring reported side effects related to menses, and expressed some concern about the long-term impact of the ring and contraception use on fertility.

Study details: The data come from a subset of 214 women of childbearing age enrolled in the ASPIRE trial at 15 sites in Malawi, South Africa, Uganda, and Zambia who received a monthly dapivirine vaginal ring designed for HIV prevention.

Disclosures: The study was supported by the e National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health. The vaginal rings were supplied by the International Partnership for Microbicides (IPM). The researchers had no financial conflicts to disclose.

Source: Leslie J et al. BMC Womens Health. 2021 Apr 23. doi: 10.1186/s12905-021-01321-5.

Key clinical point: Women who used progestin-only contraceptives experienced significantly greater weight gain than those using nonhormonal copper intrauterine devices.

Major finding: After 18 months, all treatment groups gained weight, but the average gain in the DMPA-IM group (3.5 kg) was significantly higher compared with both the LNG implant group (2.4 kg) and copper IUD group (1.5 kg).

Study details: The data come from a secondary analysis of women enrolled in the Evidence for Contraceptive options and HIV Outcomes (ECHO) trial and included 7,829 women aged 16-35 years seen at 12 sites in Kenya, South Africa, and Zambia between December 2015 and October 2018. Of these, 2,609 received intramuscular depot medroxyprogesterone acetate (DMPA-IM), 2,613 received a levonorgestrel (LNG) implant, and 2,607 received a copper intrauterine device (IUD).

Disclosures: The study was supported by the Bill & Melinda Gates Foundation, US Agency for International Development (USAID) and the President's Emergency Plan for AIDS Relief, Swedish International Development Cooperation Agency, South African Medical Research Council, and UNFPA.

Source: Beksinska M et al. EClinicalMedicine. 2021 Apr 6. doi: 0.1016/j.eclinm.2021.100800.

Key clinical point: Women who used progestin-only contraceptives experienced significantly greater weight gain than those using nonhormonal copper intrauterine devices.

Major finding: After 18 months, all treatment groups gained weight, but the average gain in the DMPA-IM group (3.5 kg) was significantly higher compared with both the LNG implant group (2.4 kg) and copper IUD group (1.5 kg).

Study details: The data come from a secondary analysis of women enrolled in the Evidence for Contraceptive options and HIV Outcomes (ECHO) trial and included 7,829 women aged 16-35 years seen at 12 sites in Kenya, South Africa, and Zambia between December 2015 and October 2018. Of these, 2,609 received intramuscular depot medroxyprogesterone acetate (DMPA-IM), 2,613 received a levonorgestrel (LNG) implant, and 2,607 received a copper intrauterine device (IUD).

Disclosures: The study was supported by the Bill & Melinda Gates Foundation, US Agency for International Development (USAID) and the President's Emergency Plan for AIDS Relief, Swedish International Development Cooperation Agency, South African Medical Research Council, and UNFPA.

Source: Beksinska M et al. EClinicalMedicine. 2021 Apr 6. doi: 0.1016/j.eclinm.2021.100800.

Key clinical point: Women who used progestin-only contraceptives experienced significantly greater weight gain than those using nonhormonal copper intrauterine devices.

Major finding: After 18 months, all treatment groups gained weight, but the average gain in the DMPA-IM group (3.5 kg) was significantly higher compared with both the LNG implant group (2.4 kg) and copper IUD group (1.5 kg).

Study details: The data come from a secondary analysis of women enrolled in the Evidence for Contraceptive options and HIV Outcomes (ECHO) trial and included 7,829 women aged 16-35 years seen at 12 sites in Kenya, South Africa, and Zambia between December 2015 and October 2018. Of these, 2,609 received intramuscular depot medroxyprogesterone acetate (DMPA-IM), 2,613 received a levonorgestrel (LNG) implant, and 2,607 received a copper intrauterine device (IUD).

Disclosures: The study was supported by the Bill & Melinda Gates Foundation, US Agency for International Development (USAID) and the President's Emergency Plan for AIDS Relief, Swedish International Development Cooperation Agency, South African Medical Research Council, and UNFPA.

Source: Beksinska M et al. EClinicalMedicine. 2021 Apr 6. doi: 0.1016/j.eclinm.2021.100800.