PLWH & SUD: A Clinical Perspective

PWH. People living with HIV. They’re growing older. And they’re experiencing the same illnesses of aging — CVD, kidney and liver diseases, cancers — as their HIV-seronegative counterparts.  The question is: how should they be treated?  Should the comorbidities of aging PWH be managed with the same agents and dosing regimens as people the same age who have not been fighting a chronic infective condition? How do the treatments that have increased PWH wellness and expected lifespans affect the safety and efficacy of the preferred comorbidity management options? What does the evidence-based data say? Join Dr. Maile Young Karris, Co-Director of the San Diego Center for AIDS Research Clinical Investigations Core, and an Associate Professor from the Department of Medicine at the University of California in San Diego, as we discuss strategies to mitigate the effects of comorbidities in older people living with HIV — in this issue of eHIV Review.  Hosted on Acast. See acast.com/privacy for more information.

PrEP. For most patients, that’s a simple drug regimen that can be prescribed after a negative HIV screen. Safe. Effective. Proactive protection to stop the spread of HIV infection in MSM, cisgender, and transgender individuals.Post-test for CME credits: https://elit.dkbmed.com/issues/228/test Hosted on Acast. See acast.com/privacy for more information.

How will the current research advancements in long-acting ART affect clinicians’ ability to provide better care for their patients with HIV? The recent data show that the low uptake and adherence to PrEP may be largely due to the pill burden and potential stigma of daily dosing. How might the newer longer-acting PrEP regimens challenge this reluctance?Post-test for CME credits: https://elit.dkbmed.com/issues/226/test Hosted on Acast. See acast.com/privacy for more information.

The primary health concern for all individuals living with HIV should be managing their disease, particularly maintaining adherence to their ART treatment. Yet for many, the more immediate demands of their substance use disorder — whether for stimulants and/or opioids — take precedence and can readily become the central focus of their lives. What signals can help a clinician recognize a substance use disorder? How can they differentiate a clinical SUD from intermittent (even though harmful) substance use? What evidence-based treatments should they consider?Post-test for CME credits: https://elit.dkbmed.com/issues/217/test Hosted on Acast. See acast.com/privacy for more information.

People living with HIV who’ve had criminal legal involvement face significant challenges that complicate their ability to remain in the HIV care continuum. Many, while incarcerated, have stopped treatment, and once back in the community have been reluctant to resume ART. Why? What are the key drivers behind their disengagement from care? What can clinicians do to encourage these patients to return to treatment? What strategies have been tried, and what’s been shown to work? What does the evidence say?Post-test for CME credits: https://elit.dkbmed.com/issues/213/test Hosted on Acast. See acast.com/privacy for more information.

Widespread use of highly effective ART has increased the life expectancy of people living with HIV (PLWH) to close to that of the general population. But despite highly effective viral suppression, the risks for cardiovascular diseases continue to increase in these individuals. So too do the risks of neurocognitive impairment.Post-test for CME credits: https://elit.dkbmed.com/issues/206/test Hosted on Acast. See acast.com/privacy for more information.

Current ART regimens can successfully manage HIV infection in nearly all PLWH. But what happens when a patient with HIV is coinfected with a dangerous pathogen ART alone cannot handle? Two of the most common are hepatitis B and latent tuberculosis infection.Post-test for CME credits: https://elit.dkbmed.com/issues/203/test Hosted on Acast. See acast.com/privacy for more information.

Pregnancy and menopause — for many women, these are two of the most significant healthcare events in their lives. For WLWH (women living with HIV) and their healthcare providers, managing these life-changing periods is often complicated by many questions.Post-test for CME credits: https://elit.dkbmed.com/issues/201 Hosted on Acast. See acast.com/privacy for more information.

In part 1 of this eHIV Review Special Edition (still available at eHIVreview.org), eHIV Review Program Director Justin Alves, Nurse Educator at Boston Medical Center, reviewed the recent evidence describing some of the barriers to care experienced by marginalized individuals at risk for or living with HIV. In this Part 2 issue, he again calls upon two front-line clinicians in the fight to end the HIV epidemic in the U.S. — Nicky Mehtani, MD, from UCSF Medical Center in San Francisco, and Vanessa Loukas, NP, from Boston University’s Chobanian & Avedisian School of Medicine —to share their clinical approaches.Post test for CME/CE credit: https://elit.dkbmed.com/issues/191/test Hosted on Acast. See acast.com/privacy for more information.

Marginalized individuals at risk for or living with HIV — the formerly incarcerated, immigrants, people with unstable housing, residents of rural communities, the rising number with substance use disorder — have long faced disparities in obtaining adequate health care. What do HCPs need to know to understand the unique needs of these underserved populations? How can they provide meaningful, helpful, and culturally sensitive care? What barriers continue to prevent their being brought into the HIV care continuum? Hosted on Acast. See acast.com/privacy for more information.