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Evolving Models of HIV Care - Part 1 Rapid ART Initiation: A Key Strategy for Ending the HIV Epidemic

Jonathan A. Colasanti, MD, MSPH; Jason Halperin, MD, MPH

This activity is jointly provided by Integritas Communications and Global Education Group.

 

This activity is supported by an independent educational grant from Gilead Sciences, Inc.

Part 1 Program Description

In Part 1, we introduce the central role rapid ART initiation can play in ending the HIV epidemic. This strategy has demonstrated increased immediate ART uptake and decreased time to viral suppression and holds hope for reducing HIV transmission risk, community viral load, and inequities in ART access. Yet, rapid ART is not a stand-alone solution. Ideally, this strategy should be paired with recognition and treatment of acute HIV, formally integrated in HIV-prevention programs, and augmented by effective retention-in-care strategies for long-term viral suppression. Part 1 also presents programs that model successful rapid ART implementation within different care-delivery systems and patient populations.

Faculty

Jonathan A. Colasanti, MD, MSPH
Associate Professor of Medicine
Emory University School of Medicine
Medical Director, Infectious Diseases Program
Grady Health System
Atlanta, Georgia

Jason Halperin, MD, MPH
Assistant Professor of Medicine
Tulane University School of Medicine
HIV/ID Clinician Lead, CrescentCare
New Orleans, Louisiana

Target Audience

This activity is intended for infectious disease and human immunodeficiency virus (HIV)-specialist physicians and other clinicians and stakeholders involved in the care of patients with HIV infection.

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.

Physician Credit Designation

Global designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Continuing Education

Global is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

This educational activity for 0.75 contact hour is provided by Global. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacist Accreditation Statement

Global is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

 

Credit Designation

Global designates this continuing education activity for 0.75 contact hour (0.075 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Activity Number - 0530-9999-20-184-H02-P).

This is a knowledge-based activity.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must score 75% or better on the posttest and complete the program evaluation. For ACPE learners, please check the CPE monitor for your CE credit within 60 days of the activity.

Disclosure of Conflicts of Interest

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:

Jonathan A. Colasanti, MD, MSPH:  Nothing to disclose

Jason Halperin, MD, MPH:  Nothing to disclose

The following planners and managers have reported no 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:

Ashley Marostica, RN, MSN, Lindsay Borvansky, Andrea Funk, Liddy Knight, Ashley Cann, Jeanette Ruby, MD, Gena Dolson, MS, Jim Kappler, PhD

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Global and Integritas 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 recommendations of other authorities.

Fee Information and 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.

 

To participate in Part 2 of this two-part CME activity, visit: www.ExchangeCME.com/RapidARTPart2.

 

We would like to thank the American Academy of HIV Medicine (AAHIVM) for their collaboration and support.

Click "Begin Activity" to acknowledge that you have reviewed the preamble information for this activity.

Begin Activity

credit amount 0.75

credit type CME/CE

release 03/29/2021

expiration 03/29/2022


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  •  => 
  •  => 
  •  => 
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Context properties
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Context properties
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Context properties
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Connection ID: db (CDbConnection)

Driver mysql
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Uptime 14w 1d 7h 15m 3s
Threads 1
Questions 40795899
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Query Count Total (s) Avg. (s) Min. (s) Max. (s)
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3 0.002385 0.000795 0.000268 0.001844
SELECT * FROM `activities` `t` WHERE `t`.`id`=239 LIMIT 1
5 0.001616 0.000323 0.000269 0.000479
SHOW COLUMNS FROM `events`
1 0.001530 0.001530 0.001530 0.001530
SHOW COLUMNS FROM `activities`
1 0.001521 0.001521 0.001521 0.001521
SHOW COLUMNS FROM `users`
1 0.001383 0.001383 0.001383 0.001383
SHOW COLUMNS FROM `resources`
1 0.001252 0.001252 0.001252 0.001252
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
2 0.001125 0.000562 0.000266 0.000859
SHOW COLUMNS FROM `interactions`
1 0.001111 0.001111 0.001111 0.001111
SELECT `activityStatus`.`id` AS `t1_c0`, `activityStatus`.`user_id` AS `t1_c1`, `activityStatus`.`activity_id` AS `t1_c2`, `activityStatus`.`current` AS `t1_c3`, `activityStatus`.`isFinished` AS `t1_c4`, `activityStatus`.`score` AS `t1_c5`, `activityStatus`.`create_date` AS `t1_c6`, `activityStatus`.`finishDate` AS `t1_c7` FROM `user_activitiesstatus` `activityStatus` WHERE (user_id=:user) AND (`activityStatus`.`activity_id`=:ypl0)
3 0.001096 0.000365 0.000247 0.000582
SHOW COLUMNS FROM `view_log`
1 0.001063 0.001063 0.001063 0.001063
SHOW COLUMNS FROM `questionnaires`
1 0.001021 0.001021 0.001021 0.001021
SHOW COLUMNS FROM `user_activitiesstatus`
1 0.000994 0.000994 0.000994 0.000994
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
2 0.000934 0.000467 0.000453 0.000481
SELECT `t`.`id` AS `t0_c0`, `t`.`group_id` AS `t0_c1`, `t`.`resource_id` AS `t0_c2`, `t`.`title` AS `t0_c3`, `t`.`type` AS `t0_c4`, `t`.`facultyNames` AS `t0_c5`, `t`.`shortDescription` AS `t0_c6`, `t`.`fullDescription` AS `t0_c7`, `t`.`creditAmount` AS `t0_c8`, `t`.`shortAddress` AS `t0_c9`, `t`.`creditType` AS `t0_c10`, `t`.`startDate` AS `t0_c11`, `t`.`finishDate` AS `t0_c12`, `t`.`sponsors` AS `t0_c13`, `t`.`status` AS `t0_c14`, `t`.`createDate` AS `t0_c15`, `t`.`image` AS `t0_c16`, `t`.`image_featured` AS `t0_c17`, `t`.`archived` AS `t0_c18`, `t`.`managers_list` AS `t0_c19`, `t`.`is_send_pp_email` AS `t0_c20`, `t`.`muvi_sync_date` AS `t0_c21`, `t`.`expert_questions` AS `t0_c22`, `interaction`.`id` AS `t1_c0`, `interaction`.`activity_id` AS `t1_c1`, `interaction`.`title` AS `t1_c2`, `interaction`.`link` AS `t1_c3`, `interaction`.`type` AS `t1_c4`, `interaction`.`status` AS `t1_c5`, `interaction`.`createDate` AS `t1_c6` FROM `activities` `t` LEFT OUTER JOIN `interactions` `interaction` ON (`interaction`.`activity_id`=`t`.`id`) WHERE (`t`.`id`=239)
1 0.000627 0.000627 0.000627 0.000627
SELECT `activity_id` AS `c`, COUNT(*) AS `s` FROM `user_activitiesstatus` `t` WHERE (user_id=:user AND isFinished=1) AND (`t`.`activity_id`=239) GROUP BY `activity_id`
1 0.000510 0.000510 0.000510 0.000510
SELECT * FROM `questionnaires` `t` WHERE t.activity_id=:id AND t.type=:type LIMIT 1
1 0.000458 0.000458 0.000458 0.000458
SHOW CREATE TABLE `activities`
1 0.000348 0.000348 0.000348 0.000348
SHOW CREATE TABLE `events`
1 0.000332 0.000332 0.000332 0.000332
SHOW CREATE TABLE `users`
1 0.000331 0.000331 0.000331 0.000331
SHOW CREATE TABLE `user_activitiesstatus`
1 0.000314 0.000314 0.000314 0.000314
SHOW CREATE TABLE `resources`
1 0.000304 0.000304 0.000304 0.000304
SHOW CREATE TABLE `interactions`
1 0.000294 0.000294 0.000294 0.000294
SHOW CREATE TABLE `questionnaires`
1 0.000294 0.000294 0.000294 0.000294
SHOW CREATE TABLE `view_log`
1 0.000289 0.000289 0.000289 0.000289
SELECT `resource`.`id` AS `t1_c0`, `resource`.`shortAddress` AS `t1_c1`, `resource`.`status` AS `t1_c2`, `resource`.`title` AS `t1_c3`, `resource`.`type` AS `t1_c4`, `resource`.`image` AS `t1_c5`, `resource`.`slides` AS `t1_c6`, `resource`.`linkedResources` AS `t1_c7`, `resource`.`reading` AS `t1_c8`, `resource`.`shortDescription` AS `t1_c9`, `resource`.`fullDescription` AS `t1_c10`, `resource`.`link` AS `t1_c11`, `resource`.`createDate` AS `t1_c12`, `resource`.`archived` AS `t1_c13` FROM `resources` `resource` WHERE (`resource`.`id`=:ypl0)
1 0.000278 0.000278 0.000278 0.000278
# Query Time (s)
0
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000859
1
SHOW COLUMNS FROM `activities`
0.001521
2
SHOW CREATE TABLE `activities`
0.000348
3
SHOW COLUMNS FROM `users`
0.001383
4
SHOW CREATE TABLE `users`
0.000331
5
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000481
6
INSERT INTO `users` (`role`, `sendEmails`, `sendSms`, `source`, `session`, `lastLogin`, `phone`, `createDate`) VALUES (:yp0, :yp1, :yp2, :yp3, :yp4, :yp5, :yp6, :yp7)
0.003726
7
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000453
8
UPDATE `users` SET `lastLogin`=:yp0 WHERE `users`.`id`=2491917
0.003072
9
SELECT * FROM `activities` `t` WHERE `t`.`id`=239 LIMIT 1
0.000479
10
SHOW COLUMNS FROM `events`
0.001530
11
SHOW CREATE TABLE `events`
0.000332
12
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.001844
13
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000266
14
SELECT * FROM `activities` `t` WHERE `t`.`id`=239 LIMIT 1
0.000285
15
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.000268
16
SELECT * FROM `activities` `t` WHERE `t`.`id`=239 LIMIT 1
0.000291
17
SHOW COLUMNS FROM `user_activitiesstatus`
0.000994
18
SHOW CREATE TABLE `user_activitiesstatus`
0.000314
19
SELECT `activityStatus`.`id` AS `t1_c0`, `activityStatus`.`user_id` AS `t1_c1`, `activityStatus`.`activity_id` AS `t1_c2`, `activityStatus`.`current` AS `t1_c3`, `activityStatus`.`isFinished` AS `t1_c4`, `activityStatus`.`score` AS `t1_c5`, `activityStatus`.`create_date` AS `t1_c6`, `activityStatus`.`finishDate` AS `t1_c7` FROM `user_activitiesstatus` `activityStatus` WHERE (user_id=:user) AND (`activityStatus`.`activity_id`=:ypl0)
0.000582
20
UPDATE activities SET archived=1 WHERE finishDate<now();
0.005873
21
SHOW COLUMNS FROM `view_log`
0.001063
22
SHOW CREATE TABLE `view_log`
0.000289
23
INSERT INTO `view_log` (`source`, `unique_id`, `resource_id`, `type`) VALUES (:yp0, :yp1, :yp2, :yp3)
0.003380
24
SHOW COLUMNS FROM `interactions`
0.001111
25
SHOW CREATE TABLE `interactions`
0.000294
26
SELECT `t`.`id` AS `t0_c0`, `t`.`group_id` AS `t0_c1`, `t`.`resource_id` AS `t0_c2`, `t`.`title` AS `t0_c3`, `t`.`type` AS `t0_c4`, `t`.`facultyNames` AS `t0_c5`, `t`.`shortDescription` AS `t0_c6`, `t`.`fullDescription` AS `t0_c7`, `t`.`creditAmount` AS `t0_c8`, `t`.`shortAddress` AS `t0_c9`, `t`.`creditType` AS `t0_c10`, `t`.`startDate` AS `t0_c11`, `t`.`finishDate` AS `t0_c12`, `t`.`sponsors` AS `t0_c13`, `t`.`status` AS `t0_c14`, `t`.`createDate` AS `t0_c15`, `t`.`image` AS `t0_c16`, `t`.`image_featured` AS `t0_c17`, `t`.`archived` AS `t0_c18`, `t`.`managers_list` AS `t0_c19`, `t`.`is_send_pp_email` AS `t0_c20`, `t`.`muvi_sync_date` AS `t0_c21`, `t`.`expert_questions` AS `t0_c22`, `interaction`.`id` AS `t1_c0`, `interaction`.`activity_id` AS `t1_c1`, `interaction`.`title` AS `t1_c2`, `interaction`.`link` AS `t1_c3`, `interaction`.`type` AS `t1_c4`, `interaction`.`status` AS `t1_c5`, `interaction`.`createDate` AS `t1_c6` FROM `activities` `t` LEFT OUTER JOIN `interactions` `interaction` ON (`interaction`.`activity_id`=`t`.`id`) WHERE (`t`.`id`=239)
0.000627
27
SELECT `activity_id` AS `c`, COUNT(*) AS `s` FROM `user_activitiesstatus` `t` WHERE (user_id=:user AND isFinished=1) AND (`t`.`activity_id`=239) GROUP BY `activity_id`
0.000510
28
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.000273
29
SELECT * FROM `activities` `t` WHERE `t`.`id`=239 LIMIT 1
0.000292
30
SELECT `activityStatus`.`id` AS `t1_c0`, `activityStatus`.`user_id` AS `t1_c1`, `activityStatus`.`activity_id` AS `t1_c2`, `activityStatus`.`current` AS `t1_c3`, `activityStatus`.`isFinished` AS `t1_c4`, `activityStatus`.`score` AS `t1_c5`, `activityStatus`.`create_date` AS `t1_c6`, `activityStatus`.`finishDate` AS `t1_c7` FROM `user_activitiesstatus` `activityStatus` WHERE (user_id=:user) AND (`activityStatus`.`activity_id`=:ypl0)
0.000267
31
SELECT * FROM `activities` `t` WHERE `t`.`id`=239 LIMIT 1
0.000269
32
SELECT `activityStatus`.`id` AS `t1_c0`, `activityStatus`.`user_id` AS `t1_c1`, `activityStatus`.`activity_id` AS `t1_c2`, `activityStatus`.`current` AS `t1_c3`, `activityStatus`.`isFinished` AS `t1_c4`, `activityStatus`.`score` AS `t1_c5`, `activityStatus`.`create_date` AS `t1_c6`, `activityStatus`.`finishDate` AS `t1_c7` FROM `user_activitiesstatus` `activityStatus` WHERE (user_id=:user) AND (`activityStatus`.`activity_id`=:ypl0)
0.000247
33
SHOW COLUMNS FROM `questionnaires`
0.001021
34
SHOW CREATE TABLE `questionnaires`
0.000294
35
SELECT * FROM `questionnaires` `t` WHERE t.activity_id=:id AND t.type=:type LIMIT 1
0.000458
36
SHOW COLUMNS FROM `resources`
0.001252
37
SHOW CREATE TABLE `resources`
0.000304
38
SELECT `resource`.`id` AS `t1_c0`, `resource`.`shortAddress` AS `t1_c1`, `resource`.`status` AS `t1_c2`, `resource`.`title` AS `t1_c3`, `resource`.`type` AS `t1_c4`, `resource`.`image` AS `t1_c5`, `resource`.`slides` AS `t1_c6`, `resource`.`linkedResources` AS `t1_c7`, `resource`.`reading` AS `t1_c8`, `resource`.`shortDescription` AS `t1_c9`, `resource`.`fullDescription` AS `t1_c10`, `resource`.`link` AS `t1_c11`, `resource`.`createDate` AS `t1_c12`, `resource`.`archived` AS `t1_c13` FROM `resources` `resource` WHERE (`resource`.`id`=:ypl0)
0.000278
Log Messages
Message (details) Level Category Time