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      Friday, June 2, 2023
      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
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      CME / ABIM MOC / CE

      Options for HIV Pre-Exposure Prophylaxis: Oral and Injectable Preparations

      • Authors: Rupa R. Patel, MD, MPH
      • CME / ABIM MOC / CE Released: 2/28/2023
      • Valid for credit through: 2/28/2024
      Start Activity

      • Credits Available

        Physicians - maximum of 0.50 AMA PRA Category 1 Credit(s)™

        ABIM Diplomates - maximum of 0.50 ABIM MOC points

        Nurses - 0.50 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)

        You Are Eligible For

        • Letter of Completion
        • ABIM MOC points

      Target Audience and Goal Statement

      This activity is intended for primary care physicians, ID/HIV specialists, nurses/nurse practitioners, and obstetricians and gynecologists.

      The goal of this activity is for learners to be better able to discuss the different options for pre-exposure prophylaxis (PrEP) that are available, including oral and injectable formulations.

      Upon completion of this activity, participants will:

      • Have increased knowledge regarding the
        • Characteristics of available pre-exposure prophylaxis (PrEP) formulations
      • Have greater competence related to
        • Selection of a PrEP regimen based on individual patient characteristics
      • Demonstrate greater confidence in their ability to
        • Discuss HIV PrEP with patients

      Disclosures

      Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

      All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.

      Disclosures for additional planners can be found here.

      Faculty

      • Rupa R. Patel, MD, MPH

        Associate Research Professor (Voluntary)
        Division of Infectious Diseases
        Washington University in St. Louis
        St. Louis, Washington

        Disclosures

        Rupa R. Patel, MD, MPH, has the following relevant financial relationships:
        Research funding from: Gilead Sciences, Inc.; ViiV Healthcare
        Other: One-time advisory meeting for Gilead Sciences, Inc.; Roche; ViiV Healthcare

      Editors

      • Maria B. Uravich, BSc, ELS

        Senior Medical Education Director, Medscape, LLC 

        Disclosures

        Maria B. Uravich, BSc, ELS, has no relevant financial relationships.

      • Ashley Stumvoll, MRes

        Associate Medical Writer, Medscape, LLC 

        Disclosures

        Ashley Stumvoll, MRes, has no relevant financial relationships.

      Compliance Reviewer/Nurse Planner

      • Stephanie Corder, ND, RN, CHCP

        Associate Director, Accreditation and Compliance, Medscape, LLC

        Disclosures

        Stephanie Corder, ND, RN, CHCP, has no relevant financial relationships.

      Peer Reviewer

      This activity has been peer reviewed and the reviewer has no relevant financial relationships.

      Accreditation Statements



      In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

        For Physicians

      • Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

        Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

        Contact This Provider

        For Nurses

      • Awarded 0.50 contact hour(s) of nursing continuing professional development for RNs and APNs; 0.00 contact hours are in the area of pharmacology.

        Contact This Provider

      For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

      Instructions for Participation and Credit

      There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

      This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

      Follow these steps to earn CME/CE credit*:

      1. Read about the target audience, learning objectives, and author disclosures.
      2. Study the educational content online or print it out.
      3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

      You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

      *The credit that you receive is based on your user profile.

      < Clinical Advances in HIV PrEP
      From Medscape Education Family Medicine
      CME / ABIM MOC / CE

      Options for HIV Pre-Exposure Prophylaxis: Oral and Injectable Preparations

      Authors: Rupa R. Patel, MD, MPHFaculty and Disclosures

      CME / ABIM MOC / CE Released: 2/28/2023

      Valid for credit through: 2/28/2024

      processing....

      References

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      2. Durosinmi-Etti O, et al. Communication needs for improved uptake of PrEP and HIVST services among key populations in Nigeria: a mixed-method study. AIDS Res Ther. 2021;18:88.
      3. Marcus JL, et al. Words matter: putting an end to "unsafe" and "risky" sex. Sex Transm Dis. 2020;47:1-3.
      4. Mabire X, et al. Pleasure and PrEP: pleasure-seeking plays a role in prevention choices and could lead to PrEP initiation. Am J Mens Health. 2019;13:1557988319827396.
      5. Conniff J, et al. Preexposure prophylaxis (PrEP) for HIV prevention: the primary care perspective. J Am Board Fam Med. 2016;29:143-151.
      6. Gilmore HJ, et al. Participant experiences and facilitators and barriers to pill use among men who have sex with men in the iPrEx pre-exposure prophylaxis trial in San Francisco. AIDS Patient Care STDS. 2013;27:560-566.
      7. Lee K, et al. Factors associated with use of HIV prevention and health care among transgender women -- seven urban areas, 2019-2020. MMWR Morb Mortal Wkly Rep. 2022;71:673-679.
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      20. Khawcharoenporn T, et al. HIV risk perception and preexposure prophylaxis interest among a heterosexual population visiting a sexually transmitted infection clinic. AIDS Patient Care STDS. 2012;26:222-233.
      21. Teitelman AM, et al. Beliefs associated with intention to use PrEP among cisgender U.S. women at elevated HIV risk. Arch Sex Behav. 2020;49:2213-2221.
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      26. Calabrese SK, et al. How stigma surrounding the use of HIV preexposure prophylaxis undermines prevention and pleasure: a call to destigmatize "Truvada Whores". Am J Public Health. 2015;105:1960-1964.
      27. Storholm ED, et al. Risk perception, sexual behaviors, and PrEP adherence among substance-using men who have sex with men: a qualitative study. Prev Sci. 2017;18:737-747.
      28. CDC. Infographics. Accessed January 27, 2023. https://www.cdc.gov/hiv/library/infographics/?Sort=Title%3A%3Aasc&Topic=PrEP&Format=Infographics&Language=English%20(US)
      29. Asiago-Reddy EA, et al. Perceived access to PrEP as a critical step in engagement: a qualitative analysis and discrete choice experiment among young men who have sex with men. PLoS One. 2022;17:e0258530.
      30. Smith DK, et al. Estimated coverage to address financial barriers to HIV preexposure prophylaxis among persons with indications for its use, United States, 2015. J Acquir Immune Defic Syndr. 2017;76:465-472.
      31. Patel RR, et al. Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention. PLoS One. 2017;12: e0178737.
      32. Serota DP, et al. Lack of health insurance is associated with delays in PrEP initiation among young Black men who have sex with men in Atlanta, US: a longitudinal cohort study. J Int AIDS Soc. 2019;22:e25399.
      33. Chan PA, et al. Retention in care outcomes for HIV pre-exposure prophylaxis implementation programmes among men who have sex with men in three US cities. J Int AIDS Soc. 2016;19:20903.
      34. Chapin-Bardales J, et al. HIV pre-exposure prophylaxis persistence and adherence among men who have sex with men in 4 U.S. cities. J Acquir Immune Defic Syndr. 2023. doi:10.1097/QAI.0000000000003160 [Epub ahead of print]
      35. Krakower D, et al. HIV providers' perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav. 2014;18:1712-1721.
      36. Auerbach JD, et al. Beyond "getting drugs into bodies": social science perspectives on pre-exposure prophylaxis for HIV. J Int AIDS Soc. 2015;18(4 Suppl 3):19983.
      37. Wilson K, et al. Provider-patient communication on pre-exposure prophylaxis (Prep) for HIV prevention: an exploration of healthcare provider challenges. Health Commun. 2021;36:1677-1686.
      38. Lumsden J, et al. Improving access to pre-exposure prophylaxis for HIV prescribing in a primary care setting. BMJ Open Qual. 2022;11:e001749.
      39. Zucker J, et al. Predictors of disengagement in care for individuals receiving pre-exposure prophylaxis (PrEP). J Acquir Immune Defic Syndr. 2019;81:e104-e108.
      40. Spinelli MA, et al. Promises and challenges: cabotegravir for preexposure prophylaxis. Curr Opin HIV AIDS. 2022;17:186-191.
      41. Sullivan PS, et al. Implementation strategies to increase PrEP uptake in the south. Curr HIV/AIDS Rep. 2019;16:259-269.
      42. Department of Health and Human Services. Ready, Set, PrEP: find out if you qualify to enroll for free PrEP medications. Accessed February 13, 2023. readysetprep.hiv.gov
      43. World Health Organization. Health topics: HIV/AIDS. 2023. Accessed January 27, 2023. https://www.who.int/health-topics/hiv-aids#tab=tab_1
      44. Centers for Disease Control. HIV basics: prevention. 2022. Accessed January 27, 2023. https://www.cdc.gov/hiv/basics/prevention.html
      45. Centers for Disease Control. A guide to taking a sexual history. 2022. Accessed January 27, 2023. https://www.cdc.gov/std/treatment/SexualHistory.htm
      46. Ramchandani MS, et al. A demedicalized model to provide PrEP in a sexual health clinic. J Acquir Immune Defic Syndr. 2022;90:530-537.
      47. Saberi P, et al. "You can't have a PrEP program without a PrEP coordinator": implementation of a PrEP panel management intervention. PLoS One. 2020;15:e0240745.
      48. McNulty MC, et al. Shared decision making for HIV pre-exposure prophylaxis (PrEP) with Black transgender women. Cult Health Sex. 2022;24:1033-1046.
      49. Mansergh G, et al. Preference for using a variety of future HIV pre-exposure prophylaxis products among men who have sex with men in three US cities. J Int AIDS Soc. 2021;24:e25664.
      50. Koechlin FM, et al. Values and preferences on the use of oral pre-exposure prophylaxis (PrEP) for HIV prevention among multiple populations: a systematic review of the literature. AIDS Behav. 2017;21:1325-1335.
      51. Parsons JT, et al. Familiarity with and preferences for oral and long-acting injectable HIV pre-exposure prophylaxis (PrEP) in a national sample of gay and bisexual men in the U.S. AIDS Behav. 2016;20:1390-1399.
      52. Jolayemi O, et al. Perspectives on preparing for long-acting injectable treatment for HIV among consumer, clinical and nonclinical stakeholders: a qualitative study exploring the anticipated challenges and opportunities for implementation in Los Angeles County. PLoS One. 2022;17:e0262926.
      53. Garfinkel DB, et al. Predictors of HIV-related risk perception and PrEP acceptability among young adult female family planning patients. AIDS Care. 2017;29:751-758.
      54. Irie WC, et al. Preferences for HIV preexposure prophylaxis products among Black women in the U.S. AIDS Behav. 2022;26:2212-2223.
      55. Meyers K, et al. To switch or not to switch: Intentions to switch to injectable PrEP among gay and bisexual men with at least twelve months oral PrEP experience. PLoS One. 2018;13:e0200296.
      56. Henkhaus ME, et al. Barriers and facilitators to use of a mobile HIV care model to re-engage and retain out-of-care people living with HIV in Atlanta, Georgia. PLoS One. 2021;16:e0247328.
      57. Kates J, et al. Insurance coverage and financing landscape for HIV treatment and prevention in the USA. Lancet. 2021;397:1127-1138.
      58. Sharma M, et al. Decentralizing the delivery of HIV pre-exposure prophylaxis (PrEP) through family physicians and sexual health clinic nurses: a dissemination and implementation study protocol. BMC Health Serv Res. 2018;18:513.
      59. Schaefer R, et al. HIV PrEP and viral hepatitis: a unique opportunity for integration. Lancet HIV. 2022;9:e745.
      60. Drak D, et al. Renal function and risk factors for renal disease for patients receiving HIV pre-exposure prophylaxis at an inner metropolitan health service. PLoS One. 2019;14:e0210106.
      61. Walensky RP, et al. Comparative pricing of branded tenofovir alafenamide-emtricitabine relative to generic tenofovir disoproxil fumarate-emtricitabine for HIV preexposure prophylaxis: a cost-effectiveness analysis. Ann Intern Med. 2020;172:583-590.
      62. Sharfstein JM, et al. Long-acting cabotegravir for HIV prevention. JAMA. 2022;327:921-922.
      63. Piper KN, et al. Exploring the heterogeneity of factors that may influence implementation of PrEP in family planning clinics: a latent profile analysis. Implement Sci Commun. 2021;2:48.
      « Return to: Options for HIV Pre-Exposure Prophylaxis: Oral and Injectable Preparations
      CME / ABIM MOC / CE Information
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