Over the past academic year, the LA AETC developed and instituted an HIV Inter-Professional Education Program (HIV IPE) in conjunction with the UCLA David Geffen School of Medicine, the USC School of Pharmacy, and the Chares Drew University Mervyn Dymally School of Nursing. [Read more…] about Pacific AETC Local Partner, Los Angeles (LA) Area AETC: University of California, Los Angeles, CA Interprofessional Education (IPE) sites: UCLA David Geffen School of Medicine, the USC School of Pharmacy, and the Chares Drew University Mervyn Dymally School of Nursing, Los Angeles, CA
RI Regional Partner developed HIV, hepatitis C (HCV), and STD screening protocols at PCHC. As part of a PT project quality improvement (QI) initiative, PCHC implemented electronic health records (EHR) reminders for HIV and HCV screening among at risk populations in June 2017. Although the EHR reminders resulted in little impact on HIV screening rates, HCV screening among patients born between 1945-1965 increased 8-fold in the six months following the EHR intervention. No EHR reminder was installed for STD screening despite increases in syphilis screening and extragenital STD testing.
HIV testing: HIV testing rates in the adult medicine clinic increased from 39% in November 2016 to 50% in November 2017. At the end of June 2018, 65-70% of patients seen in the adult medicine clinic within the last year had been tested for HIV. This met the CHS PTP goal of testing at least 65% of patients. Feedback from CHS about their participation in PTP: “[PTP] held them accountable and motivated to improve testing rates.” Additional PTP successes included increasing the capacity of providers who are comfortable with prescribing PrEP. CHS is now partnering with other organizations to provide PrEP counseling and treatment.
HIV Testing: The city of Brockton ranks 2nd in MA for HIV incidence (29.8 annual HIV diagnoses per 100,000 compared to 10.7 in the state). The high rate solidified the need for additional PTP activities focused on HIV testing. BNHC and MA RP launched a promotional campaign on local buses to increase HIV testing. HIV testing at BNHC increased from 17% of the clinic population tested in 2016 to 53% tested in 2017.
A family nurse practitioner in a multispecialty clinic in the Midwest called the PEPline regarding her 28-year old female patient who had condomless vaginal intercourse the night before with a non-mutually monogamous man of unknown HIV status. The partner has repeatedly declined HIV testing, and the patient’s last negative HIV test was more than a year ago. The patient takes fluoxetine for depression, and has no other medical conditions. The caller asked whether post-exposure prophylaxis (PEP) is warranted. [Read more…] about Clinician Consultation Center Post-Exposure Prophylaxis Hotline (PEPline) and Pre-Exposure Prophylaxis Hotline (PrEPline)
A physician in the rural Southwest called about a 27-year-old HIV-positive man who has been taking emtricitabine/rilpivirine/tenofovir alafenamide for the past two years. He has had no opportunistic infections or other HIV-related complications, but has developed gastroesophageal reflux disease (GERD) and will require medication to treat it- the caller was considering lansoprazole, which is on the patient’s insurance formulary. His CD4 count is 530 cells/µL and viral load is undetectable. The caller asked for guidance on medication interactions between the patient’s ARVs and lansoprazole. [Read more…] about Clinician Consultation Center HIV Management Warmline