Since 1990, helping busy clinicians master the science and art of caring for people with HIV disease.

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The PRN Notebook
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A Message from the President of PRN

PRN is closing at the end of 2024 and no longer offers CME or ABIM MOC.
Thank you all for your support of our organization these past 34 years! It has been my honor to provide monthly educational programs for licensed clinicians committed to the diagnosis, treatment and prevention of HIV/AIDS and its coinfections and complications. Thanks to enormous strides in research and evidence-based medicine, HIV is no longer the horror that it was in the 1980s, or when I founded PRN for peer support in 1990. The urgency of our past efforts has eased considerably and in many ways our original mission for PRN has been accomplished.

All the best, Jim

James F. Braun, DO
Founding President & Course Director/Planner
Physicians’ Research Network (PRN)
New York, NY
Featured Articles & VideosVisit The PRN Notebook
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management
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HIV Management: Where Are We Now? Where Are We Going?HIV Management: Where Are We Now? Where Are We Going?

Dr. Gandhi brings his expertise and clinical experience back to PRN for another compelling presentation on the management of HIV and its complications and comorbidities. Dr. Gandhi is Professor of Medicine at Harvard Medical School and the Co-Director and Principal Investigator of the Harvard University Center for AIDS Research (CFAR). He is the Director of HIV Clinical Services and Education at Massachusetts General Hospital (MGH). Dr. Gandhi is site leader of the MGH Clinical Research Site in the ACTG and Vice-Chair-elect of the ACTG. Dr. Gandhi is Vice-Chair of the Infectious Diseases Society of America (IDSA) Covid-19 Treatment Guidelines Panel and a member of the Board of Directors of IDSA. He is also Chair of the International Antiviral Society-USA Panel on Antiretroviral Drugs for Treatment and Prevention of HIV in Adults. Dr. Gandhi is Editor-in-Chief of NEJM Journal Watch Infectious Diseases.
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Highlights from the 2024 HIV Research for Prevention (R4P) ConferenceHighlights from the 2024 HIV Research for Prevention (R4P) Conference

PRN welcomes Dr. Beatriz Grinsztejn, the current President of the International AIDS Society (IAS), as she leads us through highlights of HIVR4P 2024: the 5th HIV Research for Prevention Conference which took place in Lima, Peru earlier this year. HIVR4P is the only global scientific conference focused exclusively on the challenging and fast-growing field of HIV prevention research and the conference drives key discussions and innovations in the field.
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Targeting Inflammation in Treated HIV, version 3.0 Targeting Inflammation in Treated HIV, version 3.0

A complex interaction of genetic factors, coinfections, immune activation and chronic inflammation persist throughout the course of HIV disease and contribute to the multimorbidities that complicate the management of our patients as they age. Asymptomatic CMV coinfection seems to be a particularly troublesome cofactor for many PLWH. Peter Hunt from UCSF returns with an update on the most recent research pertinent to our understanding of these complexities as they relate to aging.
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HPV-positive Oropharyngeal Cancer: Pathogenesis, Epidemiology, Prevention, Diagnosis and TreatmentHPV-positive Oropharyngeal Cancer: Pathogenesis, Epidemiology, Prevention, Diagnosis and Treatment

You are probably aware that HPV is the most common STI, that HPV-16 is the most common cause of anogenital cancer, and that HPV vaccines are most effective when administered before sexual debut. But we now know that the most common cause of oropharyngeal cancer is also HPV-16, and the risk is 2 to 3 times greater in people with HIV. It is critical that we providers at the primary care level keep up to date on the prevention, early diagnosis, and appropriate specialist referral for the spectrum of HPV-related disease. This presentation by Anil Chaturvedi from the NIH, and Scott Roof from Mount Sinai addresses the etiology and impact of oropharyngeal cancer, as well as the clinical signs/symptoms, diagnosis and treatment.
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Developing Sex and Gender-tailored Strategies for Healthy Aging with HIV: The Effect of Low-level Viremia and Non-AIDS Comorbidity BurdenDeveloping Sex and Gender-tailored Strategies for Healthy Aging with HIV: The Effect of Low-level Viremia a...

As our patients with HIV are aging, we are well aware of the increased risks for non-AIDS comorbidities that interfere with both quality and\or duration of life. But are there sex and gender differences that can contribute to more precision-targeted outcomes in individual patients? Don’t miss this presentation by Dr. Lauren Collins, whose clinical and research interests focus on improving the care and outcomes of persons with HIV across the lifespan, and in particular, women and those affected by the HIV/AIDS epidemic.
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New Drugs for HIV Treatment and PreventionNew Drugs for HIV Treatment and Prevention

Throughout the history of the HIV/AIDS epidemic, the most critical advances in care and prevention have been made possible through the research and development of better and better antiretroviral treatments and strategies. As far as we have come, this basic tenet is still true as we continue the search for safer and even more effective agents. To bring us up to date, PRN is proud to welcome back Dr. Roy (Trip) Gulick for his perspective of the drug development pipeline and emerging treatment and prevention strategies.
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coinfections
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From Hepatitis A to Zoster: 2024 Update on Immunization Recommendations for People With and At-risk for HIVFrom Hepatitis A to Zoster: 2024 Update on Immunization Recommendations for People With and At-risk for HIV

Every year we must grapple with vaccine recommendations to be sure that we are up to date in the prevention of infectious diseases for our vulnerable patient populations. In addition to routine vaccines, we must also be aware of new generations of vaccines for COVID-19 and influenza. We also have the ongoing risk of mpox, especially in gay and bisexual MSM. This year, Dr. Dorothy Knutsen will help guide us as we seek to provide the best preventive care possible.
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Insights from 56 Dean Street: Europe’s Busiest STI Clinic Insights from 56 Dean Street: Europe’s Busiest STI Clinic

Rapid access to diagnosis, treatment and prevention of HIV and other sexually transmitted infections not only provides more optimal patient care to individuals, but also interrupts chains of transmission, thus benefitting the public health as well. There are many barriers to rapid access to care but the 56 Dean Street clinic in London has raised the bar higher than any other clinic in Europe, and we have much to learn from them as well. In this presentation, Dr. Gary Whitlock will share the insights that have led to their remarkable success.
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More News from AIDS 2024 (Munich) on Antiretroviral Therapy, Cardiometabolic Health, and Anal Cancer ScreeningMore News from AIDS 2024 (Munich) on Antiretroviral Therapy, Cardiometabolic Health, and Anal Cancer Screening

The annual conference of the International AIDS Society (IAS) is widely attended by researchers from around the world but is often hard to travel to, especially for busy clinicians. This year we will have two presentations by international thought leaders covering different aspects of the clinical track that are most useful to our audience of HIV primary care providers.
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News from AIDS 2024 (Munich) on HIV Prevention and Cure, STIs, and CoinfectionsNews from AIDS 2024 (Munich) on HIV Prevention and Cure, STIs, and Coinfections

The annual conference of the International AIDS Society (IAS) is widely attended by researchers from around the world but is often hard to travel to, especially for busy clinicians. This year we will have two presentations by international thought leaders covering different aspects of the clinical track that are most useful to our audience of HIV primary care providers.
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Raising the Bar: Updates In Organ Transplantation for People with HIV/AIDSRaising the Bar: Updates In Organ Transplantation for People with HIV/AIDS

PRN has been following issues surrounding organ transplantation in people with HIV since it was first proposed years ago. With steady improvement in clinical outcomes, the options for people living with HIV who need organ transplantation as well as HIV-positive donors have never been better. In this program, Sapna Mehta returns with good news from transplantation through the HOPE Act, including living donor kidney transplantation from HIV-positive donors to HIV-positive recipients.
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Kidney Health and Disease in People With and At-risk for HIV in the ART Era Kidney Health and Disease in People With and At-risk for HIV in the ART Era

With the increased use in ART and PrEP in diverse populations, it is critical that we monitor kidney health for optimal outcomes and prevention of complications. We are pleased to welcome Molly Fisher for this comprehensive review of renal function, potential side effects of antiretroviral medication, the spectrum of disease associated with ART, and what you can do about it.
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Mpox Now: Update on Prevention, Diagnosis & Treatment for People With or At-risk for HIVMpox Now: Update on Prevention, Diagnosis & Treatment for People With or At-risk for HIV

Mpox is not in the news as much this year as it was when it first exploded into our awareness in 2022. But mpox is still a concern as we approach the summer months, with its constant circulation in NYC and a large outbreak overseas that poses risk for a larger resurgence in the U.S. Mpox continues to mostly affect our patients with and at-risk for HIV, especially MSM. Understanding its epidemiology and vaccinating people at risk is critical in mitigating the ongoing effects of this STI. Don’t miss this important update on mpox from Dr. Preeti Pathela from the New York City Department of Health & Mental Hygiene.
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Sexually Transmitted Infections: What's New in Prevention, Diagnosis & ManagementSexually Transmitted Infections: What's New in Prevention, Diagnosis & Management

Early diagnosis and treatment of sexually transmitted infections (STIs) are critical for people with and at-risk for HIV infection. STI vaccination for HAV, HBV, HPV, and mpox not only prevents infection but also, in the case of HBV and HPV, reduce risk of cancer. There is also promising research showing that post-exposure prophylaxis with doxycycline (doxy-PEP) can help prevent certain STIs, which may become increasingly important due to the current shortage of long-acting benzathine penicillin G. Don’t miss this dynamic update from Dr. Rosalyn Plotzker.
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A Closer Look at HIV and Antibody-Based Interventions for Prevention, Treatment, and CureA Closer Look at HIV and Antibody-Based Interventions for Prevention, Treatment, and Cure

Multi-scale imaging reveals new insights into the interactions between HIV and host immune responses that allow the virus to persist during antiviral treatment. The new technology being utilized will be described, as will the emerging insights and potential new approaches for intervention in the clinic. Don’t miss this visually dazzling presentation by Tom Hope that will help you understand infection and interventions from a nanoscopic perspective.
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GLP-1 RA and SGLT2i: New Treatment Strategies for Diabetes and Obesity in the Context of HIVGLP-1 RA and SGLT2i: New Treatment Strategies for Diabetes and Obesity in the Context of HIV

With all the recent advances in the treatment strategies for obesity and for diabetes, it is hard to keep up-to-date, especially if many of your patients are already on antiretroviral regimens for HIV. This presentation by Todd Brown will help you more deeply understand how GLP-1 receptor agonists and SGLT2 inhibitors work, and their efficacy and long-term safety in the treatment of diabetes and obesity in HIV medicine.
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From Abstract to Concrete: Co-infections, Comorbidities and Complications from CROI 2024From Abstract to Concrete: Co-infections, Comorbidities and Complications from CROI 2024

This year we are pleased to announce that PRN will expand its coverage of CROI 2024, with Marshall Glesby focusing on other important highlights, including co-infections, comorbidities and complications.
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ART Highlights from CROI 2024ART Highlights from CROI 2024

Every year, the Conference on Retrovirology and Opportunistic Infections (CROI) leads the way in the science and clinical trials of HIV treatment and prevention. Once again, PRN is proud to have Trip Gulick spotlight the most important developments in ART from CROI 2024.
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Advances in Anal Cancer Prevention in People with HIVAdvances in Anal Cancer Prevention in People with HIV

PRN has long supported efforts to prevent the devastating outcomes of anal cancer in people living with HIV (PLWH). Much progress has been made through the success of the ANCHOR Study which was ended ahead of schedule due to the indisputably favorable outcomes for people receiving treatment for pre-cancerous anal lesions. This confirmation of proactive efforts to destroy high-grade squamous intraepithelial lesions in and around the anus using high-resolution anoscopy emphasizes the role that we in HIV primary care must routinely incorporate into our care for all PLWH. In this program, Dr. Joel Palefsky, the principal investigator of the ANCHOR Study, will update us on the most recent guidelines for anal cancer prevention.
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Looking Beyond Bugs to Consider Drugs: Drug User Health and HIV/HCV Prevention and TreatmentLooking Beyond Bugs to Consider Drugs: Drug User Health and HIV/HCV Prevention and Treatment

The principles of harm reduction in HIV medicine have been most highly driven through their empathic incorporation in strategies to minimize the harms caused by injection drug use, as exemplified by the effect of needle exchange on the reduction of HIV and HCV transmission and the evolution to HCV treatment as prevention. In this program, Dr. Brianna Norton will help prepare us to prevent, diagnose, and treat HCV coinfection and re-infection in people living with HIV as a continuous effort in harm reduction.
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HIV Elite Controllers and What We’ve Learned from ThemHIV Elite Controllers and What We’ve Learned from Them

Soon after HIV was discovered, clinicians and researchers became fascinated by a small group of people with HIV who did not progress even though they were not taking antiretroviral therapy (ART). Initially termed long-term non-progressors, some of these individuals maintain undetectable HIV RNA without taking ART and are called HIV elite controllers. In this talk, Dr. Gandhi will talk about how best to diagnose elite controllers in the era of early ART initiation and summarize the factors associated with HIV control. He will talk about the price of this control – namely immune activation and inflammation – in some elite controllers and why ART may be warranted.
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HIV Post-Treatment Control: Insights On Remission from a Unique European CohortHIV Post-Treatment Control: Insights On Remission from a Unique European Cohort

Antiretroviral treatment cannot eliminate HIV reservoir cells that cause viral rebound if treatment is interrupted, requiring lifelong treatment. However, some people who were diagnosed and initiated ART in the earliest stages of primary HIV infection have demonstrated the ability to stably control viremia after treatment interruption, achieving a status of durable HIV remission. Dr. Sáez-Cirión from the Institut Pasteur in Paris, France, has been studying a cohort of these rare post-treatment controllers for years in the VISCONTI Study, finding that early treatment may favor the maturation of the memory response against the virus, allowing a more efficient secondary response after treatment interruption. A better understanding of the mechanisms of post-treatment control may lead to the development of new immunotherapies to achieve HIV remission.
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Empowering Cisgender Women: Inclusion and Awareness of PrEPEmpowering Cisgender Women: Inclusion and Awareness of PrEP

While much effort is utilized to promote HIV pre-exposure prophylaxis (PrEP) in gay and bisexual MSM as well as trans women, we must not diminish the critical need for PrEP for at-risk cisgender women, especially those of childbearing age. To focus on the specific needs of cisgender women, we are pleased to present Dr. Shobha Swaminathan, Director of HIV Programs at Rutgers New Jersey Medical School. Dr. Swaminathan will speak on PrEP eligibility and benefits in cisgender women, navigating the prescription process and adherence strategies for these women, as well as new PrEP options favorable to cisgender women in the pipeline.
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EACS 2023: Highlights from the European AIDS Conference in WarsawEACS 2023: Highlights from the European AIDS Conference in Warsaw

Every two years the European AIDS Clinical Society (EACS) holds its biannual conference on HIV/AIDS, coinfections, and complications, similar in many respects to the annual Conference on Retroviruses and Opportunistic Infections (CROI) in the United States.This year the EACS conference, known as EACS 2023, will be held in Warsaw, Poland. We are fortunate to have Juergen Rockstroh, the current EACS guidelines chair, report to PRN on the highlights of this important international conference, including an update on the evolving epidemiology in Europe, the challenges around HIV care in migrant populations, new data on ART, as well as updates on HIV comorbidities and aging.
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Update on Hepatitis B and D in People With or At-Risk for HIV CoinfectionUpdate on Hepatitis B and D in People With or At-Risk for HIV Coinfection

The risks for hepatitis B and D lurk in the background for anyone with or at-risk for HIV. It is particularly important to keep this in mind when patients initiate or change medications for HIV and PrEP. Of course, we have had safe and effective vaccinations to prevent hepatitis B for many years, but for patients who have a history of hepatitis B, and are therefore at risk for hepatitis D, additional monitoring is necessary, and extra caution is advised when changing HIV treatment or prevention strategies, to guard against hepatic flare or rebound.  In this important program, Dr. Debika Bhattacharya. the Chair of the Hepatitis Transformative Science Group (TSG) within the AIDS Clinical Trials Group (ACTG), will address these issues and provide updates in the management of hepatitis B and D.
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Towards an HIV Cure: Understanding HIV Persistence and Therapeutic ApproachesTowards an HIV Cure: Understanding HIV Persistence and Therapeutic Approaches

HIV cure has been limited to only a few cases over the past couple decades, starting with the Berlin Patient, but what is needed is a safer and scalable cure aimed at far broader populations of people living with HIV. This year, the International AIDS Society focused on HIV cure research from around the world at IAS 2023. We are fortunate to have Dr. Sharon Lewin, the current President of the IAS, who presided over IAS 2023, speak on this critical area of research so that one day we may hopefully be able to transform HIV from a manageable to a curable disease.
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Treatment Challenges of Multi-Drug Resistant HIV-1 Infection Treatment Challenges of Multi-Drug Resistant HIV-1 Infection

On a recent survey, approximately one-third of our audience responded that they have patients with multi-drug resistant (MDR) HIV-1, which was higher than we anticipated. Although we hope the absolute number of patients failing therapy is small, this statistic underscores the reality that a significant number of us need to continue searching for new treatment options/classes/strategies that can serve the needs of our most vulnerable patients. PRN continues to spotlight emerging treatment research, and we are pleased to continue this effort with Dr. Ali Rai, from the National Institute of Allergy and Infectious Diseases (NIAID), who will help us understand the dimensions of the current challenge, utilize the most up-to-date methods for determining HIV resistance, and ways that you can help your patients access research studies for novel treatment modalities.
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What is Chemsex? Epidemiology, Harms & ImpactsWhat is Chemsex? Epidemiology, Harms & Impacts

Chemsex is something we don’t often talk about, but it plays a critical role in the spread of HIV and other STIs. Dr. Gary Whitlock is Service Director at 56 Dean Street, a sexual health clinic in the heart of London’s Soho, specialising in reducing infections and promoting sexual wellbeing amongst the LGBTQI+ community, and an international leader in dealing with this important challenge to clinical care and harm reduction. We hope that this presentation will be of help to you in coping with some of the most difficult barriers that our patients face.
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Update on HIV-1 bNAbs for the Prevention, Therapy, and Cure of HIVUpdate on HIV-1 bNAbs for the Prevention, Therapy, and Cure of HIV

Anti-HIV broadly neutralizing antibodies (bNAbs), alone or in combination, are some of the most exciting agents in the pipeline for the prevention, management, salvage, and potential cure of HIV. Dr. Marina Caskey, one of the most prominent researchers leading the way in this new field of immunotherapy, returns with an update on bNAbs in clinical development, and results from HIV-prevention trials utilizing bNAbs.
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Kaposi Sarcoma and KSHV Transmission in MSM and Other High Risk GroupsKaposi Sarcoma and KSHV Transmission in MSM and Other High Risk Groups

Although we see Kaposi Sarcoma less frequently these days, it is far from gone, as we know from seroprevalence data for the causative virus, KSHV. We have had numerous talks at PRN over the past 30 years on the discovery of KSHV and the evolving therapies for the manifestations of KS. Now it is time to focus again on the silent sexual transmission of this infection and a reminder of the various manifestations of this disease in people living with HIV. In this presentation, Sheena Knights will share her recent research in the ongoing spread of KSHV in at-risk populations and health disparities that may still contribute to mortality among MSM with HIV.
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Update on Mpox and Preventing Future OutbreaksUpdate on Mpox and Preventing Future Outbreaks

The explosion of mpox that caught everybody by surprise and most severely affected our immunodeficient patients has receded, but is not gone. It is important now that mpox be included in our pantheon of sexually transmitted infections and include necessary preventive immunization for our patients at risk moving forward.
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Sexual Transmission of HCV Among MSMSexual Transmission of HCV Among MSM

For men who have sex with men and for transgender women who have sex with men, acute or primary hepatitis C has been shown to be a sexually transmitted infection. Similarly, HCV reinfection has been shown to be sexually transmitted as well. It is of critical importance that we keep this in mind for our patients on PrEP to prevent HIV infection, as well as our patients living with HIV. In this presentation, Daniel S. Fierer explains the risks, the incidence, early diagnosis, and treatment strategies for both HCV primary infection and reinfection.
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Body Fat Changes with Aging in People with HIV: Implications for Healthspan and LifespanBody Fat Changes with Aging in People with HIV: Implications for Healthspan and Lifespan

Aging with HIV disease is often accompanied by bothersome body fat changes that affect our patients’ self-images. But fat depots also have variable effects on health outcomes that we need to understand in order to best serve our aging patient population.
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Update on Inflammation, Aging, and CMV Co-Infection in Treated HIVUpdate on Inflammation, Aging, and CMV Co-Infection in Treated HIV

Immune activation and chronic inflammation persist throughout the course of HIV disease and contribute to the multimorbidities that complicate the management of our patients as they age. CMV coinfection seems to be a particularly troublesome cofactor for many PLWH. Peter Hunt returns with an update on the most recent research pertinent to understanding these complexities as they relate to aging.
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Getting to the Heart of the Matter: Updates on Cardiovascular Disease in HIVGetting to the Heart of the Matter: Updates on Cardiovascular Disease in HIV

Cardiovascular disease is an ongoing problem in HIV management. We are pleased that Mabel Toribio is able to provide an update for cisgender and transgender men and women with or at risk for CVD.
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Non-AIDS-Defining Cancers in People Living with HIVNon-AIDS-Defining Cancers in People Living with HIV

Thanks to the benefits of antiretroviral therapy, we rarely see AIDS-defining cancers in people living with HIV. Yet as our patients age, they are at higher risk for other cancers and Dr. Keith Sigel will bring us up to date on screening, diagnosis, and treatment of non-AIDS-defining cancers in PLWH.
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Black Lives (with HIV) Matter: Dismantling Systemic Racism to End the HIV Epidemic Among Black MSMBlack Lives (with HIV) Matter: Dismantling Systemic Racism to End the HIV Epidemic Among Black MSM

It is vital for HIV clinicians to focus on the ongoing inequities in health care that our Black and brown patients continue to face today. Dr. Ofole Mgbako will help us recognize the ongoing nuances of systemic racism in HIV care, appreciate its historical roots, and consider potential strategies to dismantle systemic racism along the HIV care continuum.

The PRN Notebook

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TRANSMISSION

Transmission, Diagnosis and the HIV Epidemic

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PROGRESSION

Pathogenesis and Progression of HIV Disease.

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MANAGEMENT

Treatment, Resistance and Management of HIV/AIDS

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COMPLICATIONS

Complications and Comorbidities

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COINFECTIONS

Coinfections and Opportunistic Infections

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Provider Resources

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THANK YOU

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THANK YOU

For 34 years, PRN has enjoyed the honor of providing monthly educational programs for licensed clinicians committed to the diagnosis, treatment and prevention of HIV/AIDS and its coinfections and complications. Thanks to the enormous strides in research and evidence-based medicine, HIV is no longer the horror that it was in the 1980s, or when Dr. Jim Braun founded PRN for peer support in 1990. The urgency of our past efforts has eased considerably and in many ways our original mission for PRN has been accomplished. Thank you all for your support of our organization these past 34 years!

This website is partially funded by educational grants from:

Gilead Sciences ViiV Healthcare

And by a generous charitable contribution from:

Northwell Center for AIDS Research