PrEP for Your Patients’ Needs

Faculty

Richard A. Elion, MD
Clinical Professor of Medicine
George Washington University School of Medicine
Codirector, HIV/HCV Program Providence Hospital 
Washington, DC

Raphael J. Landovitz, MD, MSc
Associate Professor of Medicine
Associate Director, UCLA Center for Clinical AIDS Research and Education
Co-Director, UCLA Center for HIV Identification, Prevention and Treatment Services
David Geffen School of Medicine at UCLA
Los Angeles, California

Target Audience

The educational design of this activity addresses the needs of PCPs, including family medicine and internal medicine physicians, nurse practitioners, and physician assistants who contribute to or will contribute to human immunodeficiency virus (HIV) prevention and/or management services.

Statement of Need/Program Overview

Although HIV incidence in the United States has declined over the last decade, the most recent data from the Centers for Disease Control and Prevention (CDC) identified 37,600 new HIV infections in 2014.¹ Moreover, despite the overall gains, certain cohorts remain at particularly high risk of acquiring HIV, including men who have sex with men, heterosexual persons who engage in certain high-risk behaviors, and people who inject drugs.² As part of a high-impact plan to reduce new HIV infections, the CDC has issued recommendations on the use of pre-exposure prophylaxis (PrEP)—a once-daily, FDA-approved antiretroviral therapy for HIV prophylaxis—as part of a comprehensive approach to reducing the risk of HIV acquisition by individuals in certain identified high-risk populations.³ Many health care providers, however, are unfamiliar with PrEP principles and protocols. This unfamiliarity is often further compounded by clinicians’ misinformation or personal attitudes that negatively affect the management of at-risk individuals.⁴ Primary care providers (PCPs) are very well-positioned to help close gaps in HIV prevention through guideline-driven testing, risk-reduction counseling, and effective patient education encompassing PrEP initiation and ongoing monitoring.⁵ In this Interactive Exchange™  webcast, expert faculty will discuss recent trends in HIV incidence, CDC guidelines for HIV testing and identification of individuals at substantial risk, and protocols for determination of PrEP eligibility and longitudinal on-PrEP monitoring. The goal is to offer PCPs the tools they need to effectively provide HIV-prevention services. 

References

1. CDC Fact Sheet. HIV Incidence: Estimated Annual Infections in the U.S., 2008-2014. 2017. Accessed December 14, 2017.
2. CDC. Surveillance Overview. Last updated January 2017. https://www.cdc.gov/hiv/statistics/surveillance/index.html. Accessed December 14, 2017.
3. US Public Health Service. Preexposure Prophylaxis for the Prevention of HIV Infection in the United States−2014: A Clinical Practice Guideline. www.cdc.gov/hiv/pdf/guidelines/PrEPguidelines2014.pdf. Accessed December 14, 2017.
4. Smith DK, et al. PrEP awareness and attitudes in a national survey of primary care clinicians in the United States, 2009–2015. PLoS One. 2016;11(6):e0156592.
5. Conniff J, Evensen A. Preexposure prophylaxis (PrEP) for HIV prevention: the primary care perspective. J Am Board Fam Med. 2016;29(1):143-151.

Educational Objectives

After completing this activity, the participant will be better able to:

• Demonstrate actionable knowledge of PrEP needs, principles, and goals, and fully implement the 2014 US Public Health Service (USPHS)/Centers for Disease Control and Prevention (CDC) clinical practice guideline: Preexposure Prophylaxis for the Prevention of HIV Infection in the United States—2014
• Create open patient-provider dialogue and engage the patient as an active, educated participant in clinical decision-making and ongoing patient-centric monitoring
• Provide proactive universal HIV-risk screening, establish substantial risk for HIV acquisition, determine PrEP eligibility, and assess patients’ PrEP readiness, preferences, and barriers to sustained adherence
• Counsel patients regarding PrEP efficacy and safety; provide ongoing guideline-based clinical and laboratory monitoring, risk-reduction strategies, and treatment-adherence counseling to patients receiving PrEP 

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Integritas Communications.  Global is accredited by the ACCME to provide continuing medical education for physicians. 

This CME/CE activity complies with all requirements of the federal Physician Payment Sunshine Act. If a reportable event is associated with this activity, the accredited provider managing the program will provide the appropriate physician data to the Open Payments database.

Physician Credit Designation

Global Education Group designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must score 70% or better on the posttest and complete the program evaluation

System Requirements

PC
Microsoft Windows 2000 SE or above.
Internet Explorer (v5.5 or greater), or Firefox

MAC
MAC OS 10.2.8
Safari
Internet Explorer is not supported on the Macintosh.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Global Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or cme@globaleducationgroup.com

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouses/life partners who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity: 

Richard A. Elion, MD Speakers Bureaus with Gilead Sciences, Inc., Janssen Pharmaceuticals, Inc.; Advisory Boards with Gilead Sciences, Inc., Janssen Pharmaceuticals, Inc., ViiV Healthcare; Expert Witness for Gilead Sciences, Inc. 

Raphael J. Landovitz, MD, MSc Contracted Research with Gilead Sciences, Inc.

The following planners and managers reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Andrea Funk  Nothing to disclose
Ashley Marostica, RN, MSN  Nothing to disclose
Jeanette Ruby, MD  Nothing to disclose
Jim Kappler, PhD  Nothing to disclose

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group (Global) and Integritas Communications do not recommend the use of any agent outside of the labeled indications.  

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommend