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Self-Study Modules and Sections
- Learn about HIV epidemiology in the United States, routine HIV screening recommendations, HIV diagnostic testing methods, acute HIV, and how to successfully link diagnosed people to care.
- Explore key primary care elements, including the initial evaluation, common oral and cutaneous manifestations, recommended immunizations, primary care comorbidities, screening for mental health conditions, substance use disorders, and retention in care.
- Learn how to select appropriate antiretroviral medication regimens, manage common adverse effects and drug interactions, switch regimens when indicated, and evaluate and manage virologic failure.
- Examine how to diagnose and treat latent tuberculosis, prevent common opportunistic infections, treat serious opportunistic infections, screen and treat sexually transmitted infections, and manage viral hepatitis coinfections.
- Explore how to identify and implement strategies to prevent HIV transmission related to perinatal transmission, treatment of HIV as prevention, occupational and nonoccupational postexposure prophylaxis, and preexposure prophylaxis.
- Learn about several additional key populations impacted by HIV, including infants and children, adolescents and young adults, women, older adults, individuals in correctional facilities, and persons who acquire HIV-2.
Core Competencies for the National HIV Curriculum
The following is an outline and list of Core Competency Modules (with sub-competency lessons and learning objective performance indicators).
Module 1. Screening and Diagnosis
Module Core Competency
Apply Evidence-Based Recommendations to Provide HIV Screening, Diagnosis, and Linkage to Care
Lessons
Learning Objective Performance Indicators
- Distinguish between HIV prevalence and incidence
- Describe the contemporary epidemiology of HIV-1 in the United States
- Identify populations with lower knowledge of HIV status
- Recognize trends and causes of HIV-related deaths in the United States
- Summarize key features of global HIV epidemiology trends
- Chronicle the history of HIV testing in the United States
- Initiate HIV screening and strategies to overcome potential barriers to routine screening
- Implement routine Centers for Disease Control and Prevention (CDC) HIV screening recommendations
- Perform repeat HIV screenings based on indications in screening recommendations
- Establish effective mechanisms for communicating HIV test results
- Collaboratively select appropriate HIV diagnostic tests for routine HIV screening
- Differentiate time to positivity among different types of HIV diagnostic tests
- Identify factors that may result in false-negative and false-positive screening results
- implement the CDC/APHL-recommended HIV testing algorithm
- Effectively interpret and deliver HIV diagnostic test results including counseling and linkage to care
- Identify early, recent, and acute HIV infection
- Summarize the immunopathogenesis and clinical manifestations of acute HIV
- Utilize appropriate testing for the diagnosis of acute HIV infection
- Recognize the public health benefits of promptly diagnosing and treating a person with acute or recent HIV infection
- Implement recommended antiretroviral treatment regimens for persons with acute or recent HIV infection
- Summarize U.S. federal benchmarks and goals for successful linkage to HIV care
- Assess metrics used to estimate and monitor linkage to HIV care
- Analyze current estimated HIV linkage to care data in the United States
- Facilitate strategies to optimize linkage to HIV care for persons newly diagnosed with HIV
- Identify barriers that impede successful linkage to HIV care
Module 2. Basic HIV Primary Care
Module Core Competency
Provide Evidence-Based HIV Primary Care to Persons with HIV Infection
Lessons
Learning Objective Performance Indicators
- Analyze initial evaluation goals for persons with HIV entering, reentering, or transferring care
- Categorize the different stages of HIV disease and the criteria used to define each stage
- Integrate key elements of a medical history and physical exam when performing an initial evaluation
- Implement baseline laboratory and screening recommendations
- Engage persons with HIV in a discussion about the importance of appropriate immunizations
- Conduct an oral examination including visual and tactile components
- Collaborate with dental professionals to initiate or continue routine and preventive dental care
- Identify clinical manifestations of HIV-related oral diseases
- Initiate treatment for HIV-related oral lesions
- Identify clinical manifestations of oral cancers in people with HIV
- Identify the common causes of cutaneous findings in persons with HIV
- Differentiate diagnostic features of common HIV-related cutaneous manifestations in people with HIV
- Provide appropriate treatment for common dermatological manifestations in people with HIV
- Coordinate diagnostic and treatment approaches to address common dermatological manifestations in people with HIV
- Collaboratively implement vaccine strategies to prevent cutaneous zoster and anogenital warts
- Coordinate with clinical team to facilitate timely administration of recommended immunizations for people with HIV
- Adhere to the conjugate meningococcal vaccine schedule in people with HIV
- Administer the appropriate pneumococcal conjugate vaccine in people with HIV
- Determine zoster vaccine indications and schedules for people with HIV
- Identify the contraindications for the use of live vaccines in people with HIV
- Collaboratively implement cancer screening recommendations for persons with HIV
- Identify indicators for common comorbidities in people with HIV
- Classify common comorbidities in people with HIV
- Engage multidisciplinary teams to appropriately manage common comorbidities in people with HIV
- Initiate and monitor appropriate statin therapy in persons with HIV
- Analyze how mental health conditions influence HIV acquisition risk and HIV transmission
- Evaluate the impact of major depression on mortality in people with HIV
- Identify common screening tools for mental health conditions
- Collaboratively integrate common mental health screening tools into primary HIV care
- Select and use appropriate screening tools for a baseline neurocognitive assessment for people with HIV
- Select and use appropriate screening resources for substance use disorders in people with HIV
- Evaluate the unique impact that substance use disorders have on persons with HIV
- Initiate recommended medication-assisted treatment for common substance use disorders
- Coordinate with behavioral, psychosocial, and pharmacotherapy providers to treat common substance use disorders
- Collaborate with local agencies, community groups, and specialty providers to implement effective harm reduction strategies
- Analyze key benchmark indicators across the HIV Care Continuum
- Review multiple data sources to select appropriate HIV retention measures
- Compare the current rate of retention in care with the National HIV/AIDS Strategy that at least 90% of persons with HIV are retained in HIV care
- Address factors associated with decreased retention in HIV medical care and strategies to promote reengagement in care
- Collaborate across health-related disciplines and institutions to improve retention and reengagement in HIV medical care
Module 3. Antiretroviral Therapy
Module Core Competency
Apply Evidence-Based Antiretroviral Therapy for Persons with HIV
Lessons
Learning Objective Performance Indicators
- Differentiate the major classes of antiretroviral medications according to their mechanism of action
- Initiate preferred antiretroviral therapy regimens for people with HIV who are treatment naïve
- Highlight specific clinical scenarios for when an alternative antiretroviral therapy regimen should be initiated
- Obtain appropriate laboratory studies at baseline and while monitoring response to antiretroviral therapy
- Collaboratively manage antiretroviral therapy as related to elite controllers, treatment interruption, and suboptimal CD4 recovery
- Differentiate common adverse effects of antiretroviral therapy by class of medication
- Identify serious adverse effects caused by antiretroviral therapy
- Select appropriate laboratory studies when initiating or changing an antiretroviral therapy regimen
- Obtain laboratory tests to monitor treatment response in persons taking antiretroviral therapy
- Collaboratively implement strategies to address antiretroviral-related adverse effects or contraindications
- Explain the difference between pharmacokinetics and pharmacodynamics
- Access reputable resources for checking drug interactions that involve antiretroviral therapy medications
- Identify commonly used antiretroviral medications that often cause significant drug interactions
- Analyze current medications to determine if adjustments are needed after initiation of an antiretroviral therapy regimen
- Collaboratively determine potential drug-antiretroviral therapy interactions when prescribing commonly used medications to treat comorbid conditions
- Provide a rationale for switching or simplifying antiretroviral therapy
- Identify the circumstances that warrant simplifying an antiretroviral therapy regimen or switching to a newer agent
- Assimilate a composite of all past drug resistance test results before switching to a new antiretroviral therapy regimen
- Analyze key findings of switch studies based on the class of antiretroviral medication
- Collaboratively implement switch to appropriate FDA-approved two-drug regimens for maintenance antiretroviral therapy
- Recognize when persons taking antiretroviral therapy are in virologic failure based on HIV RNA levels
- Identify virologic failure and collaboratively employ appropriate resistance testing
- Utilize an HIV resistance database tool to assist in the optimal selection of regimens in persons with HIV drug resistance
- Differentiate drug resistance profiles based on antiretroviral drug classes
- Identify key factors including pharmacokinetic issues when selecting a salvage antiretroviral regimen in persons with virologic failure
Module 4. Co-Occurring Conditions
Module Core Competency
Apply Evidence-Based Recommendations for the Evaluation and Management of Co-Occurring Conditions in Persons with HIV Infection
Lessons
Learning Objective Performance Indicators
- Examine the epidemiology of tuberculosis (TB) and HIV coinfection in the United States
- Implement routine screening for latent TB in people with HIV
- Describe and compare recommended screening tests for latent TB
- Select guideline‑based treatment regimens for latent TB in persons with HIV
- Identify and manage clinically significant drug interactions between latent TB regimens and antiretroviral therapies
- Initiate primary prevention of opportunistic infections (OIs) in people with HIV based on OI guidelines
- Use recommended OI prophylaxis regimens when prophylaxis is indicated
- Evaluate and manage persons with a positive screening cryptococcal antigen
- Discontinue primary prophylaxis if criteria for stopping prophylaxis is met
- Identify potential adverse effects and contraindications for medications used to prevent OIs
- Recognize and characterize the immune reconstitution inflammatory syndrome (IRIS)
- Recognize the clinical manifestations of common serious opportunistic infections (OIs)
- Initiate recommended treatment of OIs
- Collaboratively determine indicators for discontinuing OI treatment based on clinical response and guideline criteria
- Implement recommendations of when to delay initiation of antiretroviral therapy in the setting of an active OI
- Coordinate recommended screening for sexually transmitted infection (STI) in people with HIV
- Select and use appropriate laboratory diagnostic methods for STIs in persons with HIV
- Implement CDC recommended treatment for STIs in persons with HIV
- Collaboratively follow after syphilis treatment to monitor clinical and laboratory response
- Manage first-episode and recurrent genital herpes infections in persons with HIV
- Implement appropriate triple-screen testing for evaluation of hepatitis B virus (HBV) infection and immunity
- Initiate and monitor appropriate antiretroviral treatment for persons with HIV and HBV coinfection
- Identity and manage HBV-related immune reconstitution syndrome
- Implement treatment and prevention strategies in pregnant women and neonates
- Collaboratively provide longitudinal hepatocellular carcinoma surveillance when indicated in persons with chronic HBV and HIV
- Initiate HCV screening at entry to HIV care
- Apply CDC‑recommended HCV diagnostic algorithms collaboratively, including reflex RNA testing for positive antibody results
- Initiate simplified HCV treatment in people with HIV based on eligibility criteria and current guidelines
- Collaboratively provide longitudinal hepatocellular carcinoma surveillance in persons with HCV and cirrhosis when indicated
- Summarize management of pregnant women with HCV and HIV coinfection
Module 5. Prevention of HIV
Module Core Competency
Apply Evidence-Based Recommendations for the Prevention of HIV Transmission
Lessons
Learning Objective Performance Indicators
- Collaborate with a multidisciplinary team to prevent mother-to-child HIV transmission throughout pregnancy and postpartum care
- Administer preferred or alternative initial antiretroviral regimens for pregnant women with HIV
- Analyze maternal HIV RNA levels when considering using intravenous zidovudine or cesarean section for pregnant women with HIV
- Initiate recommended antiretroviral prophylaxis for infants born to pregnant women with HIV
- Provide recommended initial management of infants exposed to HIV, including HIV diagnostic testing and monitoring
- Synthesize study data supporting the concept that "undetectable equals untransmittable" in the context of preventing sexual transmission of HIV
- Implement strategies to diagnose HIV as early as possible to increase HIV status awareness, HIV RNA suppression, and decrease HIV transmission
- Counsel people with HIV on biobehavioral methods that reduce HIV transmission to others
- Initiate antiretroviral therapy for all persons diagnosed with acute HIV
- Partner with local public health systems to implement HIV status disclosure, partner notification, and referral services
- Coordinate across multiple disciplines to establish policies and procedures to address occupational exposure to HIV
- Assess specific potential occupational HIV exposure risks to determine appropriate postexposure prophylaxis (PEP) response strategies
- Immediately evaluate health care personnel exposed to HIV to determine the type and timing of exposure before initiating PEP
- Provide recommended antiretroviral therapy regimens for occupational HIV PEP
- Consult medical specialists to appropriately manage HIV PEP for specific populations identified in the HIV Occupational PEP Guidelines
- Assess indications for the use of HIV nonoccupational postexposure prophylaxis (nPEP)
- Initiate appropriate antiretroviral therapy regimens and duration of therapy for HIV nPEP
- Provide recommended monitoring and vaccinations following nonoccupational exposure to HIV
- Transition persons on HIV nPEP to HIV preexposure prophylaxis (PrEP) when indicated
- Obtain expert consultation for HIV nPEP in complex situations such as pregnancy, sexual assault, and renal or hepatic impairment
- Synthesize study data that supports the use of HIV preexposure prophylaxis (PrEP) for people at risk for HIV acquisition
- Offer HIV PrEP to individuals at risk of acquiring HIV
- Collaboratively perform baseline evaluation and counseling for HIV PrEP initiation and ongoing laboratory monitoring
- Initiate appropriate PrEP regimen formulations and dosing based on approved indications for HIV PrEP
- Collaboratively address follow-up, management of adverse effects, and discontinuation of HIV PrEP
Module 6. Key Populations
Module Core Competency
Apply Evidence-Based Care Recommendations for Key Populations of Persons Living with HIV
Lessons
Learning Objective Performance Indicators
- Describe unique age-specific considerations in diagnosing and managing pediatric HIV
- Perform appropriate diagnostic and confirmatory HIV testing for infants and children based on age and perinatal exposure to HIV
- Initiate and monitor appropriate preferred or alternative antiretroviral therapy regimens for infants and children with HIV
- Collaboratively implement strategies to optimize ART adherence in a variety of settings
- Identify and implement immunization and opportunistic infection prevention recommendations in children with HIV
- Explain epidemiologic and developmental factors that influence HIV risk and testing among adolescents and young adults
- Select, initiate and monitor appropriate antiretroviral therapy based on sexual maturity rating
- Collaboratively implement strategies to improve adherence at initial intervention, medication selection, and monitoring
- Identify and implement recommended commonly administered vaccines and screening for sexually transmitted infections
- Collaboratively develop and/or implement a transition to adult HIV care settings
- Select and initiate antiretroviral therapy for women with HIV based on reproductive potential, pregnancy plans, and medication interactions
- Recommend appropriate contraceptive options for women with HIV and consider potential interactions with antiretroviral therapy
- Counsel HIV-serodifferent couples on strategies for conception to minimize HIV transmission risks
- Diagnose and treat the most common vaginal infections in women with HIV
- Collaboratively screen for and address intimate partner violence and menopause-related symptoms and health risks in women with HIV
- Summarize the impact older adults have on HIV prevalence and HIV incidence in the United States
- Address the interplay of HIV and the aging process within the framework of accelerated and accentuated aging
- Select and initiate appropriate antiretroviral therapy for persons 50 years of age and older
- Monitor and address virologic responses, immunologic recovery, and drug interactions
- Collaboratively screen, treat, and monitor common comorbid conditions in older adults with HIV
- Identify the barriers, challenges, and opportunities to provide HIV testing, care, and monitoring of persons with HIV in the carceral population
- Implement effective HIV testing practices aligned with the carceral facility policies
- Develop strategies to initiate or continue antiretroviral therapy, support adherence, and protect confidentiality in carceral settings
- Coordinate care for common comorbidities including hepatitis C, mental health conditions, and substance use disorders
- Collaboratively plan transitions to community-based care that supports medication access, retention in HIV care, and HIV prevention
- Distinguish between HIV-2 and HIV-1 with respect to epidemiology, natural history, and pathogenesis
- Utilize the CDC and Association of Public Health Laboratories HIV diagnostic algorithm to detect HIV-2 infection
- Select and interpret diagnostic tests used for an HIV-2 diagnosis
- Differentiate antiretroviral therapy medication classes based on HIV-2 susceptibility and resistance
- Initiate appropriate antiretroviral treatment recommendations for people with HIV-2 only or with HIV-1 and HIV-2 dual infection
Curriculum Progress Tracker - 3rd Edition
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Curated Curriculum 0
Screening and Diagnosis
This module is for any health care provider who would like to establish core competence in testing for HIV, recognizing acute HIV infection, and linking persons diagnosed with HIV to medical care.
|
Curated Curriculum 1
Basic HIV Primary Care
The Basic HIV Primary Care module is intended for any clinician who may interact with persons who have HIV infection in a clinical setting, with an emphasis on the primary care management issues related HIV.
|
Curated Curriculum 2
Antiretroviral Therapy
The Antiretroviral Therapy module is geared toward clinicians who provide antiretroviral therapy to persons with HIV infection, with an emphasis on initiating antiretroviral therapy and management of virologic failure.
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Curated Curriculum 3
Co-Occurring Conditions
Examine how to diagnose and treat latent tuberculosis, prevent common opportunistic infections, treat serious opportunistic infections, screen and treat sexually transmitted infections, and manage viral hepatitis coinfections.
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Curated Curriculum 4
Prevention of HIV
The Prevention of HIV module emphasizes new prevention strategies both for persons with HIV infection and for persons not infected with HIV. This module also addresses occupational and nonoccupational HIV postexposure prophylaxis.
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Curated Curriculum 5
Key Populations
Learn about several additional key populations impacted by HIV, including infants and children, adolescents and young adults, women, older adults, individuals in correctional facilities, and persons who acquire HIV-2.
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2nd Edition. There is a newer edition of this curriculum.
Curriculum Progress Tracker - 2nd Edition
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Curated Curriculum 0
Screening and Diagnosis
This module is for any health care provider who would like to establish core competence in testing for HIV, recognizing acute HIV infection, and linking persons diagnosed with HIV to medical care.
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Curated Curriculum 1
Basic HIV Primary Care
The Basic HIV Primary Care module is intended for any clinician who may interact with persons who have HIV infection in a clinical setting, with an emphasis on the primary care management issues related HIV.
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Curated Curriculum 2
Antiretroviral Therapy
The Antiretroviral Therapy module is geared toward clinicians who provide antiretroviral therapy to persons with HIV infection, with an emphasis on initiating antiretroviral therapy and management of virologic failure.
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Curated Curriculum 3
Co-Occurring Conditions
The Co-Occurring Conditions module addresses the prevention and management of infectious and non-infectious complications in persons with HIV infection. ObjectiveApply Evidence-Based Recommendations for the Evaluation and Management of Co-Occurring Conditions in Persons with HIV Infection |
Curated Curriculum 4
Prevention of HIV
The Prevention of HIV module emphasizes new prevention strategies both for persons with HIV infection and for persons not infected with HIV. This module also addresses occupational and nonoccupational HIV postexposure prophylaxis.
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Curated Curriculum 5
Key Populations
The Key Populations module is intended for any medical provider involved in the care of key populations of persons with HIV.
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