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Basic HIV Primary Care Overview3rd Edition

Module Core Competency

Provide Evidence-Based HIV Primary Care to Persons with HIV Infection

Target Audience

Explore key elements of the initial evaluation of HIV and learn about oral and cutaneous manifestations; recommended immunizations; primary care of common comorbidities; mental health screening; substance use disorders; and retention in care.

Editor

David H. Spach, MD

David H. Spach, MD
Professor of Medicine
Division of Allergy & Infectious Diseases
University of Washington

Disclosures: None

1Lesson 1 Initial Evaluation

Learning Objectives
- Explain the goals and components of the initial evaluation of persons with HIV who are entering, reentering, or transferring care
- Categorize the different stages of HIV disease and the criteria used to define each stage
- Summarize the important elements of the medical history to perform at the initial evaluation
- Describe key elements for the physical examination to focus on at the initial evaluation
- List recommendations for the initial monitoring visit and baseline laboratory tests
Quick ReferenceInitial Evaluation Core Concepts

2Lesson 2 Oral Manifestations

Learning Objectives
- Discuss periodontal disease in persons with HIV
- Describe common oral manifestations in persons with HIV
- Summarize appropriate diagnostic procedures when evaluating HIV-related oral lesions
- List appropriate treatments for HIV-related oral lesions
- Recognize oral cancers that occur in persons with HIV
Quick ReferenceOral Manifestations Core Concepts
Activity 2B.Implementing Oral Health Care into HIV Primary Care Settings Curriculum
Activity 2C.Intraoral Examination
Activity 2D.How to Check Patients for Oral Cancer

3Lesson 3 Cutaneous Manifestations

Learning Objectives
- List common causes of cutaneous findings in persons with HIV
- Recognize diagnostic features of common HIV-related cutaneous manifestations in people with HIV
- Summarize appropriate treatment for common dermatological manifestations in people with HIV
- Explain treatment approaches to cutaneous Kaposi’s sarcoma
- Discuss vaccine strategies to prevent cutaneous zoster and anogenital warts
Quick ReferenceCutaneous Manifestations Core Concepts

4Lesson 4 Immunizations in Adults

Learning Objectives
- Discuss immunization recommendations for hepatitis A and hepatitis B in people with HIV
- Describe the conjugate meningococcal vaccine schedule in people with HIV
- Explain the options for pneumococcal immunization in people with HIV
- List the indications and schedule for zoster vaccine in people with HIV
- Summarize the contraindications for the use of live vaccines in people with HIV
Quick ReferenceImmunizations in Adults Core Concepts

5Lesson 5 Primary Care Management

Learning Objectives
- List cancer screening recommendations for persons with HIV
- Discuss the evaluation of common comorbidities in people with HIV
- Explain appropriate management of common comorbidities in people with HIV
- Summarize key similarities and differences in managing medical comorbidities in people with and without HIV
- Discuss tobacco use and smoking cessation strategies in people with HIV
Quick ReferencePrimary Care Management Core Concepts

6Lesson 6 Screening for Mental Health Conditions

Learning Objectives
- Explore the interrelationship among mental health conditions, HIV acquisition, and risk of HIV transmission
- Discuss the association between major depression and the increased risk for mortality in persons with HIV
- List common screening tools for mental health conditions
- Explain how to integrate screening tools for mental health conditions into primary HIV care
- Summarize the approach to screening for HIV-associated neurocognitive disorders
Quick ReferenceScreening for Mental Health Conditions Core Concepts
Activity 6B.Screening for Dementia

7Lesson 7 Substance Use Disorders

Learning Objectives
- Discuss the resources available to screen for different substance use disorders
- Explore the epidemiology of substance use disorders in the United States
- Describe the unique impact that substance use disorders have on persons with HIV
- Explain the rationale for employing behavioral, psychosocial, and pharmacotherapy interventions in treating common substance use disorders
- Define the concept of harm reduction as related to treating substance use disorders
Quick ReferenceSubstance Use Disorders Core Concepts

8Lesson 8 Retention in HIV Care

Learning Objectives
- Explain the HIV Continuum of Care
- Define methods to evaluate retention in care among persons with HIV
- Discuss the current rate of retention in care in the United States
- Identify factors associated with decreased retention in HIV medical care and strategies to promote reengagement in care
- Summarize methods to improve retention and reengagement in HIV medical care
Quick ReferenceRetention in HIV Care Core Concepts

The Check-on-Learning Questions are short and topic related. They are meant to help you stay on track throughout each lesson and check your understanding of key concepts.

Screening and Diagnosis