Image
Evolving Models of HIV Care - Part 2 Overcoming Barriers: Successful Rapid ART Initiation

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 2 Program Description

In Part 2, we will address common real-world barriers to rapid ART implementation at the levels of systems, clinics, providers, and patients. We will then review guideline-based antiretroviral selection in the Rapid ART context and show how you can move beyond perceived barriers to quickly and safely initiate ART and achieve viral suppression.

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 - 0530-9999-21-051-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 1 of this two-part CME activity, visit: www.ExchangeCME.com/RapidARTPart1.

 

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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Context properties
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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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Context properties
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Context properties
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Context ActivitiesController
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Connection ID: db (CDbConnection)

Driver mysql
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Uptime 14w 1d 6h 13m 3s
Threads 1
Questions 40790533
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Opens 195
Flush tables 1
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Queries per second avg 4.756
Query Count Total (s) Avg. (s) Min. (s) Max. (s)
UPDATE activities SET archived=1 WHERE finishDate<now();
1 0.005853 0.005853 0.005853 0.005853
INSERT INTO `users` (`role`, `sendEmails`, `sendSms`, `source`, `session`, `lastLogin`, `phone`, `createDate`) VALUES (:yp0, :yp1, :yp2, :yp3, :yp4, :yp5, :yp6, :yp7)
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1 0.003078 0.003078 0.003078 0.003078
SHOW COLUMNS FROM `activities`
1 0.001645 0.001645 0.001645 0.001645
SHOW COLUMNS FROM `events`
1 0.001555 0.001555 0.001555 0.001555
SELECT * FROM `activities` `t` WHERE `t`.`id`=244 LIMIT 1
5 0.001466 0.000293 0.000278 0.000312
SHOW COLUMNS FROM `users`
1 0.001385 0.001385 0.001385 0.001385
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1 0.001161 0.001161 0.001161 0.001161
SHOW COLUMNS FROM `resources`
1 0.001093 0.001093 0.001093 0.001093
SHOW COLUMNS FROM `view_log`
1 0.001035 0.001035 0.001035 0.001035
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 0.001002 0.000334 0.000254 0.000468
SHOW COLUMNS FROM `user_activitiesstatus`
1 0.000996 0.000996 0.000996 0.000996
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
2 0.000993 0.000496 0.000490 0.000503
SHOW COLUMNS FROM `interactions`
1 0.000988 0.000988 0.000988 0.000988
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)
3 0.000854 0.000285 0.000246 0.000352
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
2 0.000579 0.000290 0.000265 0.000314
SELECT `activity_id` AS `c`, COUNT(*) AS `s` FROM `user_activitiesstatus` `t` WHERE (user_id=:user AND isFinished=1) AND (`t`.`activity_id`=244) GROUP BY `activity_id`
1 0.000449 0.000449 0.000449 0.000449
SHOW CREATE TABLE `resources`
1 0.000369 0.000369 0.000369 0.000369
SHOW CREATE TABLE `activities`
1 0.000361 0.000361 0.000361 0.000361
SHOW CREATE TABLE `events`
1 0.000346 0.000346 0.000346 0.000346
SHOW CREATE TABLE `view_log`
1 0.000329 0.000329 0.000329 0.000329
SHOW CREATE TABLE `users`
1 0.000326 0.000326 0.000326 0.000326
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`=244)
1 0.000313 0.000313 0.000313 0.000313
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 0.000312 0.000312 0.000312 0.000312
SHOW CREATE TABLE `user_activitiesstatus`
1 0.000284 0.000284 0.000284 0.000284
SHOW CREATE TABLE `interactions`
1 0.000274 0.000274 0.000274 0.000274
SHOW CREATE TABLE `questionnaires`
1 0.000274 0.000274 0.000274 0.000274
SELECT * FROM `questionnaires` `t` WHERE t.activity_id=:id AND t.type=:type LIMIT 1
1 0.000267 0.000267 0.000267 0.000267
# Query Time (s)
0
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000314
1
SHOW COLUMNS FROM `activities`
0.001645
2
SHOW CREATE TABLE `activities`
0.000361
3
SHOW COLUMNS FROM `users`
0.001385
4
SHOW CREATE TABLE `users`
0.000326
5
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000503
6
INSERT INTO `users` (`role`, `sendEmails`, `sendSms`, `source`, `session`, `lastLogin`, `phone`, `createDate`) VALUES (:yp0, :yp1, :yp2, :yp3, :yp4, :yp5, :yp6, :yp7)
0.003627
7
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000490
8
UPDATE `users` SET `lastLogin`=:yp0 WHERE `users`.`id`=2491840
0.003078
9
SELECT * FROM `activities` `t` WHERE `t`.`id`=244 LIMIT 1
0.000312
10
SHOW COLUMNS FROM `events`
0.001555
11
SHOW CREATE TABLE `events`
0.000346
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)
0.000246
13
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000265
14
SELECT * FROM `activities` `t` WHERE `t`.`id`=244 LIMIT 1
0.000288
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)
0.000352
16
SELECT * FROM `activities` `t` WHERE `t`.`id`=244 LIMIT 1
0.000302
17
SHOW COLUMNS FROM `user_activitiesstatus`
0.000996
18
SHOW CREATE TABLE `user_activitiesstatus`
0.000284
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)
0.000468
20
UPDATE activities SET archived=1 WHERE finishDate<now();
0.005853
21
SHOW COLUMNS FROM `view_log`
0.001035
22
SHOW CREATE TABLE `view_log`
0.000329
23
INSERT INTO `view_log` (`source`, `unique_id`, `resource_id`, `type`) VALUES (:yp0, :yp1, :yp2, :yp3)
0.003328
24
SHOW COLUMNS FROM `interactions`
0.000988
25
SHOW CREATE TABLE `interactions`
0.000274
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`=244)
0.000313
27
SELECT `activity_id` AS `c`, COUNT(*) AS `s` FROM `user_activitiesstatus` `t` WHERE (user_id=:user AND isFinished=1) AND (`t`.`activity_id`=244) GROUP BY `activity_id`
0.000449
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)
0.000256
29
SELECT * FROM `activities` `t` WHERE `t`.`id`=244 LIMIT 1
0.000286
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)
0.000254
31
SELECT * FROM `activities` `t` WHERE `t`.`id`=244 LIMIT 1
0.000278
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)
0.000280
33
SHOW COLUMNS FROM `questionnaires`
0.001161
34
SHOW CREATE TABLE `questionnaires`
0.000274
35
SELECT * FROM `questionnaires` `t` WHERE t.activity_id=:id AND t.type=:type LIMIT 1
0.000267
36
SHOW COLUMNS FROM `resources`
0.001093
37
SHOW CREATE TABLE `resources`
0.000369
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)
0.000312
Log Messages
Message (details) Level Category Time