▪May consider stopping secondary prophylaxis in those with history of pneumonia and clinically respond to ≥12 months antifungal therapy with CD4+ count ≥ 250 cells/μL and receiving effective ART, with monitoring for recurrence with serial chest imaging and Coccidioides serology.▪For people with diffuse pulmonary, disseminated, or meningeal disease, suppressive therapy should be continued indefinitely. This evidence concerns the gene CD4 and susceptibility to pneumonia measurement.