Recent Advances and Challenges in HIV Clinical Care and Prevention

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RECENT ADVANCES AND CHALLENGES IN HIV CLINICAL CARE AND PREVENTION

From the Recent Advances and Challenges in HIV Clinical Care and Prevention Luncheon Symposium - Family Medicine Section held at the National Medical Association’s 2012 Scientific Assembly in New Orleans, Louisiana.

Introduction

As individuals with HIV live longer, treatment for HIV goes beyond the highly active antiretroviral therapy (HAART) regimen. There is an ongoing need for HIV/AIDS system strengthening in existing nationwide treatment programs and should be integrated within institutions whether they are managed in a vertical or stand alone fashion. One key first step is to ensure a qualified clinical workforce. To this end, these treatment regimens must also take into account other co-morbid conditions, such as renal failure, hyperlipidemia, cardiovascular complications, bone absorption, diabetes, avascular necrosis, neoplasms, active tuberculosis, sexually transmitted diseases, and hepatitis B and C. Recommendations for earlier diagnosis and treatment by incorporating routine HIV testing into primary care settings suggest physicians become more familiar with advances in HIV clinical care and prevention.

One of the greatest challenges in HIV care among minority populations is the heavy burden of medical co-morbidities for which the true impact is difficult to assess because exclusion criteria often exist for participation in HIV clinical trials. Co-morbidities may affect the progression of HIV disease, increase the likelihood of the patient being on interacting medications or predispose the patient to toxicities from antiretroviral agents (ARVs).

The rationale for this educational workshop therefore, is that despite a reported current decline in HIV prevalence nationwide, an estimated 1.1 million people aged 13 and older in the United States are living with HIV or AIDS. With geographic diffusion of cases, decreasing numbers of HIV specialists, and multiple co-morbidities affecting a large, aging cohort of HIV-infected patients, family physicians can play a strategic role in HIV care in the current era. Based on a Centers for Disease Control and Prevention (CDC) recent analysis, the CDC reported that only 24 percent to 27 percent of the individuals identified as HIV infected persons are linked to medical, prevention, and other services as soon as possible after they become infected.

References

 

  • CDC revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 206; 55(RR-14).
  • Centers for Disease Control and Prevention: HIV/AIDS Surveillance Report, 2009, 2011. Available at www.cdc.gov/hiv/topics/surveillance/resources/reports.
  • Chu C, Selwyn P. An epidemic in evolution: the need for new models of HIV care in the chronic disease era. Journal of Urban Health, Online First, March 2011. [Epub ahead of print].

 


Objectives:

Upon completion of this online activity participants should be able to:

  1. Discuss current approaches in management of HIV infection.
  2. Utilize new antiretroviral agents and strategies for effective use.
  3. Identify most effective culturally appropriate approaches to screen and treat patients with HIV.
  4. Describe treatment regimen for co-morbid conditions.

 

Acknowledgement of Commercial Support:
This activity was supported educational grants from Abbott Laboratories, Inc.