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CME: HIV Prevention: The Role of Pre-Exposure Prophylaxis (HIV-PrEP)

Activity Description / Statement of Need:

In this online CME self-learning activity:

The development of antiretroviral therapy (ART) has had a dramatic impact on HIV-related morbidity and mortality. The use of ART in HIV-infected patients has been the core strategy to not only treat HIV but also prevent vertical HIV transmission. Antiretrovirals can be used for HIV prevention in patients who are not HIV-infected but are repeatedly exposed to HIV in a strategy termed pre-exposure prophylaxis (PrEP). Although the rationale for PrEP stems from successful HIV prevention in HIV exposed infants with the use of ART during labor, early post-partum period, and throughout breastfeeding, it has more recently applied to been applied to sexual transmission (e.g., people with multiple partners or HIV serodiscordant couples) and people who inject drugs illicitly with support from the literature. Because much of what comprises evidence and guidelines supporting PrEP has been published relatively recently and because healthcare professionals are oftentimes unable to keep up with the steady publishing of literature and evolution of clinical practice in a timely manner, continuing healthcare education activities in this area are warranted.

Podcast available at: Apple Podcasts or wherever you get your podcasts. 

Target Audience:

The following healthcare professionals: infectious disease specialists, primary care physicians, and public health; physician assistants, nurse practitioners, nurses, and pharmacists who practice in infectious disease; and any other healthcare professionals with an interest in or who clinically encounter HIV.


Commercial Support Disclosure: This activity is supported by an educational grant from Gilead.

Learners may participate in this activity free of charge.


Release Date: September 23, 2019 -- Expiration Date: September 23, 2021

Faculty: Geeta Gupta, MD

Agenda

Introduction, disclosures

 

Epidemiology and prevalence of HIV including risk factors

Define PrEP

  • Types of available PrEP options (antiretroviral options, microbicides, oral versus topical, etc.)
  • Appropriate at-risk groups

Supporting data, recommendations for use, and limitations

  • Literature support
  • Safety and efficacy considerations generally and in specific patient populations: chronic kidney disease, women taking PrEP while breastfeeding or pregnant, hepatitis coinfections
  • Patient case(s)

Recommendations for use and limitations

  • CDC recommendations
  • Appropriate use
  • Recommended monitoring and follow-up
  • Controversies that led to the cessation of preliminary PrEP trials
  • Challenges and barriers to care: adherence, access, and behavioral disinhibition

Cost-effectiveness of PrEP versus cost of HIV acquisition

Patient cases

Summary, conclusions, and best practices review

Learning Objectives

By the end of the session the participant will be able to:

  • Define the role of pre-exposure prophylaxis (PrEP) including identification of high-risk patient populations for appropriate use
  • Analyze the data that support the use of PrEP for the prevention of HIV infection and apply it to patient cases
  • Assess the safety and efficacy of PrEP in the context of the medical literature and apply that knowledge to patient cases
  • Describe recommendations for PrEP use and the limitations to PrEP, and apply them to patient cases
  • Recall the economic impact of the widespread use of PrEP including benefits and limitations

Accreditation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of  1.00 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

PhysiciansFor maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in this section, then it does NOT provide MOC credit.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. This activity is approved for 1.00 hours (0.10 CEUs) of continuing education.  Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test.   Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit.  ACPE # 0574-0000-20-029-H01-P.  CPE credit effective 6/23/20 and expires 9/23/21. This is a Knowledge (K)-type activity.

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure:  Geeta Gupta, MD, University of California, Irvine, has has received funding for research grants and/or advisory boards from Pfizer and ViiV.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant conflicts of interest to disclose.

Commercial Support Disclosure: This activity is supported by an educational grant from Gilead.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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