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

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Expanding HIV Prevention Choices: What’s on the Horizon?Expanding HIV Prevention Choices: What’s on the Horizon?

At the most recent HIV Research for Prevention (HIVR4P) convention in Madrid, advocates from around the world were marching and chanting in support for more choices in HIV prevention modalities. And the prevention pipeline is very interesting! This presentation by Craig Hendrix targets the drugs, delivery systems, safety and efficacy of agents currently used for PrEP in diverse populations, including cisgender and transgender women, as well as the many agents in development that will help you in your next conversation with a patient wishing or waiting for more prevention choices.

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Clinical Controversies in HIV Clinical Controversies in HIV

We are fortunate in HIV medicine to have robust treatment and prevention guidelines, but there is always room for improvement. The advances we continue to see are driven, in part, by the controversies surrounding optimal prevention, treatment and cure strategies as evidence-based outcomes are continually reassessed. So, don’t miss this up-to-date review of current controversies by Raj Gandhi, focusing on prevention, treatment, complications of treatment, and efforts to find a cure.

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Advances in the Treatment and Prevention of HIV Infection: CROI 2019, Focus on ARTAdvances in the Treatment and Prevention of HIV Infection: CROI 2019, Focus on ART

Every year the Conference on Retrovirology and Opportunistic Infections (CROI) is packed with important new information and this program focuses on the advances in antiretroviral therapy to improve standards of care and point the way to future advances through emerging research and drug development. Don’t miss this engaging review by Trip Gulick on CROI 2019 highlights in HIV cure, treatment strategies and drug resistance, new drugs and mechanisms of action, HIV prevention, and TB coinfection.

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Visualizing HIV Transmission and PreventionVisualizing HIV Transmission and Prevention

What happens after genital or anal exposure to HIV, and how fast can infection take hold? When and where can this infection be stopped after exposure and what is the virus doing during the eclipse and window periods before it can be detected in blood? In this thought-provoking program, Tom Hope will sharpen your view of pathogenesis with his research into the earliest events of HIV transmission and dissemination utilizing non-human primate mucosal-challenge models, human tissue explant cultures, whole animal PET/CT and PET/MRI imaging, and electron microscopy.

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ChemSex and HIV: An Holistic Approach to HIV Treatment and Prevention for Crystal Meth UsersChemSex and HIV: An Holistic Approach to HIV Treatment and Prevention for Crystal Meth Users

Internet hook-up trends for gay men, in combination with recreational drugs, including crystal meth, to decrease inhibitions and increase sexual pleasure, are the drivers of what has become known as chemsex. This phenomenon is not limited to the UK and Europe, where the term was first used—it is international in scope, including New York City, and can lead to substance use disorders and mental illness. Chemsex also greatly increases the risk for non-adherence to HIV medication, PrEP, and condom use, while elevating the risk for transmission of HIV and other sexually transmitted diseases. How can we understand and help in a non-judgmental way? This program by Drs. Vaty Poitevien and Pierre Arty tackles this important and too-often overlooked problem.

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Ending the HIV Epidemic by 2020: Are We Still on Track?Ending the HIV Epidemic by 2020: Are We Still on Track?

We are making great strides in New York to end the HIV epidemic, as this presention by Demetre Daskalakis demonstrates. But how are the demographics changing? What are the emerging disparities? And how can we address the evolving needs of New Yorkers who are newly infected or at ongoing risk for transmission in all of our diverse communities? Don’t miss this important presentation on where we stand and the problems we currently face in the struggle to end the HIV epidemic once and for ALL by the end of 2020.

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Therapeutic Strategies Aimed at Achieving Antiretroviral Drug-Free HIV RemissionTherapeutic Strategies Aimed at Achieving Antiretroviral Drug-Free HIV Remission

Achieving a scalable and broad-based cure for HIV-infected individuals is a daunting challenge, but Cure research is ongoing, including immune-based strategies that boost the host immune response against the virus. Clinical trials aimed at achieving ART-free HIV-remission will need to include placebo groups and analytical treatment interruption and plasma viremia as an end point. Don’t miss this important presentation on current Cure research and ways that you and your eligible patients may be able to contribute to the science by which research outcomes can be effectively measured.

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Update on HCV Management in People Living with HIV and Other Key PopulationsUpdate on HCV Management in People Living with HIV and Other Key Populations

The newer drugs we now have to treat Hepatitis C have never been more tolerable, efficacious, or easier to use. And better yet, they can be used safely in acute HCV, people who continue to inject drugs, and even in people with end-stage liver disease and cirrhosis. If you are not already treating your patients with HCV, now is the time to watch this exciting program by Kristen Marks, and consider expanding your practice to treat and cure your patients with hepatitis C. Yes, its curable, and you can do this!

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Lipodystrophy 20 Years after Initial Descriptions: Body Fat Changes in Persons Living with HIVLipodystrophy 20 Years after Initial Descriptions: Body Fat Changes in Persons Living with HIV

You may not be seeing facial lipoatrophy or buffalo humps like we did in the early years of HAART, but body fat changes persist now, even with newer regimens. In this program, Todd Brown discusses the past and present body fat changes in the long-term management of HIV disease, the critical importance of lifestyle changes for the management of liopohypertrophy and obesity in HIV, the risk and benefits of pharmacologic approaches to treatment, and research strategies to guide treatment in the future.

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Conference Updates from IDWeek in San Francisco and IAS in AmsterdamConference Updates from IDWeek in San Francisco and IAS in Amsterdam

The treatment and prevention of HIV disease, Hepatitis C and their myriad complications are constantly changing—and the evolution of state-of-the-art management is almost always forecasted by research presented at major scientific meetings both nationally and internationally. In this program, David Hardy targets some of the highlights from AIDS 2018, the International AIDS Society’s conference in Amsterdam, and IDWeek 2018, the Infectious Diseases Society of America’s annual conference. Don’t miss this important review on diverse topics of interest to our primary care audience.

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Immune Activation in Treated HIV Infection: Does It Still Matter?Immune Activation in Treated HIV Infection: Does It Still Matter?

Even with early initiation of combination antiretroviral therapy, there is still a gap in life expectancy between our HIV-positive and HIV-negative patients, and age-associated morbidities and multimorbidities are more common in people aging with HIV. Don’t miss this fascinating and clinically important presentation by Peter Hunt on the effects of immune activation in our patients aging with HIV, what life-style changes and anti-inflammatory drugs may be helpful, and research strategies targeting root causes of chronic inflammation that may help our patients age more normally with fewer complications in the future.

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What's New in Kaposi Sarcoma?What's New in Kaposi Sarcoma?

In the days before combination antiretroviral therapy, one of the most stigmatizing AIDS-defining complications of HIV disease was Kaposi Sarcoma (KS), caused by coinfection with Kaposi Sarcoma-associated Herpes Virus (KSHV), also known as Human Herpesvirus-8 (HHV-8). Thankfully, we see KS infrequently now, but still need to keep it in the back of our minds. KSHV infection is life-long, similar to other herpesviruses, and even though overall KSHV seroprevalence in the USA is less than 10%, it is much higher in HIV-negative MSM (20-30%) and even higher in HIV-positive MSM (30-60%). So what are the implications for these patient populations as they age? Don’t miss this important review by Susan Krown, a leader in KS diagnosis and treatment from the earliest days of the AIDS epidemic in NYC, who is still involved in the fight against KS internationally.

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Diagnosis and Treatment of Anal Cancer: High Cure Rates, but at What Cost?Diagnosis and Treatment of Anal Cancer: High Cure Rates, but at What Cost?

When anal cancer prevention efforts fail, or when initial physical exam and screening lead to the diagnosis of malignancy, what next? This presentation by Stephen Goldstone, a surgeon, and Peter Kozuck, an oncologist, will walk you through the typical and atypical presentations of anal cancer, standard approaches to therapy, post-treatment follow-up, and consequent morbidities that that your patients may face.

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Prevention of Anal Cancer in HIV-Positive Men and Women: An Evolving Landscape Prevention of Anal Cancer in HIV-Positive Men and Women: An Evolving Landscape

Current data shows that anal cancer is increasing in general population and will remain the most common preventable cancer in our HIV-positive patients. So, what can we do to help prevent HPV-associated anal cancer? The preventive HPV vaccine is safe and highly efficacious, but what about anal cancer prevention in our patients already infected with oncogenic strains of HPV? This presentation by Joel Palefsky will bring you up-to-date on all current prevention modalities, how to evaluate your patients at risk, efforts to block progression to cancer, and scientific advances that may help us improve screening and prevention moving forward.

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Update from IAS-Amsterdam: PART-1Update from IAS-Amsterdam: PART-1

In this program Trip Gulick discusses important events leading up to the International AIDS Society conference - AIDS 2018 - including the 2018 UNAIDS data report on the global AIDS response, the FDA approval of the first PI-based single-tablet regimen for HIV, and the publication in JAMA of the IAS-USA 2018 recommendations for antiretroviral treatment and prevention of HIV infection. With this background, Dr. Gulick proceeds to discuss highlights of the AIDS 2018 meeting in Amsterdam, including new research on HIV treatment initiation, HIV and TB coinfection, and HIV switch studies. Due to the length of this program, we have split this into two parts. Be sure to watch both!

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Update from IAS-Amsterdam: PART-2Update from IAS-Amsterdam: PART-2

In this continuation of highlights from AIDS 2018 in Amsterdam, Dr. Gulick finishes his review of HIV switch studies, and goes on to discuss drug toxicities, ARVs in pregnancy and pediatrics, drug resistance, PrEP, including important information for PrEP in trans women, and further efforts to discover a cure for HIV infection. Don’t miss either of the two parts of this important and exciting program!

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Elimination of Mother-to-Child Transmission of HIV: The Final Frontier?Elimination of Mother-to-Child Transmission of HIV: The Final Frontier?

Efforts to prevent mother-to-child transmission of HIV are the oldest and most successful examples of HIV prophylaxis, and a model for post-exposure prophylaxis and the expanded efforts we now have, such as Treatment as Prevention. But even though it is rare, we still see mother-to-child transmission of HIV, especially when mothers become acutely infected during pregnancy or while nursing. It is important to understand the deficiencies and oversights in routine standards of care, if we hope to finally reduce perinatal HIV infection to zero.

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Growing Up with HIV Growing Up with HIV

Growing up is always difficult. Remember? But growing up with perinatal HIV infection, adds new dimensions to the physical and psychosocial challenges that children face as they struggle simply to survive, and hopefully thrive. This important presentation by Elaine Abrams will help you identify interventions that may help you improve the outcomes of young people growing up with HIV and care for them with a deeper understanding when they transition to adult medical care.

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The World Within: The Microbiome and Mucosal Immunity in HIV MedicineThe World Within: The Microbiome and Mucosal Immunity in HIV Medicine

We hear more and more about the microbiome these days, but what impact does the microbiome have in people with or at risk for HIV infection? We know the gut lymphoid system is rapidly and permanently impaired by HIV, and chronic use of antiretroviral drugs for HIV and antibiotic prophylaxis against opportunistic infections can affect the gut, but need we be concerned about the microbiome? This fascinating program will help you understand what is presently known about the interplay of the bacterial microbiome and mucosal immunity, the resulting effects on HIV susceptibility and HIV-associated chronic inflammation, and the latest efforts to leverage the microbiome to prevent HIV transmission and improve health for those living with HIV.

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Hepatitis C Treatment in People Who Inject DrugsHepatitis C Treatment in People Who Inject Drugs

Injection drug use is a growing problem across the country, and a well-known risk for transmission of hepatitis C. But can HCV in our patients who continue to inject drugs be successfully be treated? Does HIV/HCV coinfection decrease the odds for success? Can they be re-infected with HCV once cured? Will treatment of HCV in in these patients help stop the HCV epidemic? Unlike HIV, HCV is now curable, but we will never end the HCV epidemic if we cannot adequately serve our most vulnerable populations. This important program grapples with the barriers, both real and imagined, that stand in our way.

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Expanding Your Competency at the Boundary of Behavioral Health and HIV MedicineExpanding Your Competency at the Boundary of Behavioral Health and HIV Medicine

As a medical provider, you can have a powerful impact on the behavioral health of your patients living with HIV, but you need to know how to sort out what is required and what is optional, and utilize practical behavioral strategies to evaluate and manage depression, anxiety and stress. This presentation by Dr. Francine Cournos is packed with clinical pearls that will help you serve your patients mental health needs more effectively, while preserving your own sanity.

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Confronting Mental Health Challenges in Our Efforts to End the HIV EpidemicConfronting Mental Health Challenges in Our Efforts to End the HIV Epidemic

If we do not address mental health issues at the primary care level, we are very unlikely to be able to bring an end to the HIV epidemic. Mental health problems contribute not only to HIV acquisition, but also to poorer outcomes at every step in the HIV treatment cascade. Since people living with HIV disease have significantly higher rates of mental health disorders than that of the general population, in this program, Dr. Robert Remien focuses on strategies we can use to integrate mental health assessment and treatment into routine HIV care. Only then will we be able to achieve our “90-90-90” and “EtE” goals.

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Immunizations in Adolescents and Adults with and at-risk for HIV DiseaseImmunizations in Adolescents and Adults with and at-risk for HIV Disease

This past year was another bad year for influenza, and a good reminder that vaccines can play an important role in the prevention of many infections, and even cancer, in our patients living with, and at risk for HIV disease, including the meningococcal vaccine, and vaccines for HAV, HBV, and HPV, just to name a few. But when should we offer them? How many can we give at one time. If and when are certain vaccines contraindicated? And how can we help our patients keep track of their vaccines in an online registry? Dr. Jane Zucker answers all of these questions, and more, in this important and stimulating presentation.

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Immune Activation in the Pathogenesis of HIV Infection: Causes and ConsequencesImmune Activation in the Pathogenesis of HIV Infection: Causes and Consequences

How do we explain where HIV comes from? Or how long it takes from exposure for infection to begin, and how do we detect it? What is the virus doing during the brief acute stages, and during lifelong chronic HIV infection? In this program Netanya Utay answers these questions related to HIV pathogenesis, its impact on the immune system during acute infection and the consequences of chronic immune activation, despite life-saving antiretroviral therapy.

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Current Approaches Toward the Cure of HIV DiseaseCurrent Approaches Toward the Cure of HIV Disease

When your patients ask you what progress is being made in efforts to cure HIV disease, what can you say? Currently, there are many different approaches to eliminating HIV from people living with it, but which ones show promise for a scalable cure in the real world? And is it time to give up on a magic bullet, and instead look to combinations of cure modalities? For up to date answers to all these questions, don’t miss this important program by Danny Douek.

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Opioids and Pain Management in HIV MedicineOpioids and Pain Management in HIV Medicine

There are many treatment options for chronic pain. But dealing with this common problem in clinical practice can be stressful due to patient expectations and the complex issues surrounding prescription opioid use and opioid use disorder. Hardly a day goes by that we don’t read something new in the papers about drug overdose and the opioid epidemic that is sweeping the country. So don’t miss this practical and helpful program on strategies for successful pain management, how to use tools such as urine testing to identify and treat opioid use disorder, and how to counsel patients on the risks of illicit drugs and the use of naloxone to prevent death from opioid overdose.

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Testing for HIV and HCV: What’s Current and What’s ComingTesting for HIV and HCV: What’s Current and What’s Coming

Just how fast and accurate are the rapid tests you are using at the point-of-care? And what about the laboratory tests you are ordering to confirm infection or sort out false positives from false negatives? The early diagnosis of HIV infection is critical to ending the epidemic, and our patients who seroconvert while on PrEP present a special challenge. Understanding the advantages as well as the limitations of current HIV diagnostic tests informs not only our interpretation of the tests results we receive, but the way we explain these results to our patients. We also have a commitment to diagnosing HCV in our patients with, or at risk for HIV. This presentation by Bernard Branson reviews and compares the current diagnostic tools available, as well as newer assays in the development pipeline.

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HIV Drug Resistance: A ReassessmentHIV Drug Resistance: A Reassessment

Resistance to antiretroviral therapy and virologic failure have been a challenge to optimal treatment of HIV throughout this epidemic. With the more potent and adherence-friendly regimens we have today, the treatment failures we used to see so often, are less frequent now, but no less important when they occur. We still need to be alert to the current risks for drug resistance, not just for our patients on chronic therapy for HIV, but also for our patients who seroconvert while failing PrEP. And that is why are pleased to present this important update on HIV drug resistance by one of the foremost experts in the field—Dan Kuritzkes.

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Improving the Diagnosis & Treatment of Other STIs in the Era of U=U and PrEPImproving the Diagnosis & Treatment of Other STIs in the Era of U=U and PrEP

In New York City, the number new HIV infections is dropping, thanks to PrEP (pre-exposure prophylaxis) and U=U (undetectable equals untransmittable). But with a simultaneous decrease in condom use, sexually transmitted bacterial infections are rising—especially the big three: syphilis, gonorrhea and Chlamydia. This important presentation, by Dr Susan Blank from the NYC DOHMH, will bring you up to date on the epidemiology and impact of these bacterial STIs in our communities, especially in MSM who are most highly affected, and women of child-bearing age who are most vulnerable to catastrophic outcomes. Dr Blank also targets best practices for treatment of these bacterial STIs, while reducing the risks for treatment failure and development of drug resistance.

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CME

PRN is pleased to offer this new CME opportunity designed for physicians, nurse practitioners and physician assistants caring for patients with or at risk for HIV disease and its many complications. Based on content from The PRN Notebook, credit for each course will be available for a limited period of time noted on each activity.

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