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Disclaimer: CME certification for these activities has expired. All information is pertinent to the timeframe in which it was released.


4th Annual Optimizing Care for Minority Patients with HIV/AIDS: A Call to Action (Monograph)


Goal
To provide physicians, nurses, pharmacists, social workers, counselors, and advocates who care for minority patients with HIV/AIDS with up-to-date information and strategies for overcoming barriers to optimal treatment and adherence in racial/ethnic minority patients.

Target Audience
This activity is designed for physicians, nurses, pharmacists, social workers, counselors, and advocates who care for minority patients with HIV/AIDS. No prerequisites required.

Learning Objectives
After completing this activity, the participant should demonstrate the ability to:

  • LIST 3 potential barriers to optimal care for racial/ethnic minority patients who disproportionately bear the burden of HIV disease.
  • DEVELOP 2 methods to reduce or overcome barriers to successful treatment in minority populations.
  • DESCRIBE strategies participants can implement to overcome voluntary and involuntary challenges that minority patients have in adhering to treatment.
  • DESIGN 2 interventions that can be incorporated into daily clinical practice to increase culturally competent care of minorities at risk for HIV/AIDS.
The Johns Hopkins University School of Medicine and the Association of Nurses in AIDS Care take responsibility for the content, quality, and scientific integrity of this CME/CNE activity.

Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Johns Hopkins University School of Medicine and the Association of Nurses in AIDS Care. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

ANAC is an approved provider of continuing nursing education by the Virginia Nurses Association Continuing Education Approval Committee, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Credit Designation Statement
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity for 1.5 contact hours has been provided by the Association of Nurses in AIDS Care (ANAC).


The estimated time to complete this educational activity: 1 hour and 30 minutes.

Release date: December 15, 2009. Expiration date: December 15, 2011.

HOW TO RECEIVE CREDIT OR CONTACT HOURS
After reading this monograph, participants may receive credit or contact hours by completing the CME/CNE test, evaluation, and receiving a score of 70% or higher.

Full Disclosure Policy Affecting CME Activities:
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a provider has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation.

The Course Directors, Planners, and Participating Faculty reported the following:

COURSE DIRECTORS

Mary Catherine Beach, MD, MPH
Associate Professor of Medicine and Health, Behavior & Society
The Johns Hopkins University
Baltimore, Maryland
Dr Beach reports having no relationships with commercial interests related to this activity.

 

Sheila Davis, DNP, ANP-BC, FAAN
MGH Institute of Health Professions School of Nursing
Massachusetts General Hospital Infectious Diseases
Boston, Massachusetts
Ms Davis reports having no relationships with commercial interests related to this activity.

 

Bisola Ojikutu, MD, MPH
Assistant Professor of Medicine
Infectious Disease Division
Massachusetts General Hospital
Harvard Medical School
Senior HIV/AIDS Advisor
John Snow, Inc
Boston, Massachusetts
Dr Ojikutu reports having no relationships with commercial interests related to this activity.

 

PARTICIPATING FACULTY

Geetanjali Chander, MD, MPH
Assistant Professor of Medicine
Department of Internal Medicine
The Johns Hopkins University
Baltimore, Maryland
Dr Chander reports having no relationships with commercial interests related to this activity.

Ira B. Wilson, MD, MSc
Professor of Community Health
Brown University
Providence, Rhode Island
Dr Wilson reports having no relationships with commercial interests related to this activity.

 

Planners
No planners have indicated that they have any financial interests or relationships with a commercial entity.

Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

Off-Label Product Discussion: No faculty member has indicated that their presentation will include information on off-label products.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.


Internet CME Policy
The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protect the privacy of its members and customers. Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals, and the public. Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet-based activity. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine’s CME activity. CME collects only the information necessary to provide you with the services that you request.

4TH ANNUAL OPTIMIZING CARE FOR MINORITY PATIENTS WITH HIV/AIDS: A CALL TO ACTION
Mary Catherine Beach, MD, MPH,* Sheila Davis, DNP, ANP-BC, FAAN, and Bisola Ojikutu, MD, MPH

Over the last 2 decades, the management of HIV infection has been transformed by the introduction of a growing number of effective antiretroviral agents and combination regimens. Many patients are now able to achieve long-term control of HIV infection without debilitating adverse side effects. As a result, the average life expectancy for those with HIV has increased from approximately 10 years in 1996 to more than 20 years today.1 Although the annual number of new HIV infections in the United States remains fairly constant at approximately 56 000 per year, the number of individuals living with HIV/AIDS has soared from approximately 400 000 in 1985 to more than 1 million today.2 Despite these improvements in long-term HIV survival, there remain significant racial and ethnic disparities in HIV/AIDS prevalence and clinical outcomes. The management of HIV infection usually requires patients to maintain high levels of adherence to complex drug regimens and to attend frequent clinic visits to assess the response to therapy. Long-term studies have clearly shown that patients who remain in treatment have better clinical outcomes, including significantly higher rates of long-term survival.3 However, as described in detail in this educational activity, minority patients with HIV face many treatment barriers, including economic and employment difficulties, uncertain insurance status, higher rates of substance use problems, and lower rates of treatment for a broad range of healthcare problems. A recent analysis of nationwide mortality found that the gap in life expectancy between black and white Americans increased markedly between 1983 and 1993, largely due to growth in the rate of HIV infection.4 Since then, improvements in HIV treatment for minority patients have begun to narrow this gap, although the HIV-related mortality rate remains much higher for blacks than whites. Greater efforts are clearly needed to overcome the significant disparities in HIV recognition, treatment, and outcomes in the United States.

This online issue of Johns Hopkins Advanced Studies in Medicine, which includes proceedings from a symposium held in Coral Gables, Florida, on September 18, 2010, will describe methods to improve HIV prevention, testing, patient-provider communication, and treatment adherence for minorities with HIV/AIDS and other medical comorbidities. In the first article, Bisola Ojikutu, MD, MPH, of Harvard Medical School, provides an overview of the racial and ethnic disparities in HIV/AIDS care in the United States, and examines some of the underlying causes of these disparities. Geetanjali Chander, MD, MPH, of The Johns Hopkins University, discusses the impact of substance use problems and mental health disorders on HIV management. Mary Catherine Beach, MD, MPH, of The Johns Hopkins University, describes recent research that has examined how patient-provider communication patterns differ by race and ethnicity, and discusses the importance of understanding patient perspectives in successful HIV care. Finally, Ira B. Wilson, MD, MSc, of Brown University, discusses how more effective communication strategies may be used to enhance adherence to treatment and other outcomes for patients with HIV. At the conclusion of this activity, clinicians should be better able to care for black, Hispanic, and other minority patients, who disproportionately bear the burden of HIV infection in the United States.

REFERENCES

1. Harrison KM, Song R, Zhang X. Life expectancy after HIV diagnosis based on national HIV surveillance data from 25 states, United States. J Acquir Immune Defic Syndr. 2010;53:124-130.

2. Centers for Disease Control and Prevention. HIV in the United States. Available at: http://www.cdc.gov/hiv/resources/factsheets/us.htm. Accessed October 20, 2010.

3. Giordano TP, Gifford AL, White AC Jr, et al. Retention in care: a challenge to survival with HIV infection. Clin Infect Dis. 2007;44:1493-1499.

4. Harper S, Lynch J, Burris S, Davey Smith G. Trends in the black-white life expectancy gap in the United States, 1983-2003. JAMA. 2007;297:1224-1232.

*Associate Professor of Medicine and Health, Behavior and Society, The Johns Hopkins University, Baltimore, Maryland.

MGH Institute of Health Professions School of Nursing, Massachusetts General Hospital Infectious Diseases, Boston, Massachusetts.

Assistant Professor of Medicine, Infectious Disease Division, Massachusetts General Hospital, Harvard Medical School, Senior HIV/AIDS Advisor, John Snow, Inc, Boston, Massachusetts. Address correspondence to: Mary Catherine Beach, MD, MPH, Associate Professor of Medicine and Health, Behavior and Society, The Johns Hopkins University, Research Johns Hopkins University 2024 East Monument Street, Room 2-511, Baltimore, MD 21287. E-mail: mcbeach@jhmi.edu.

The content in this monograph was developed with the assistance of a medical writer. The authors made substantial contributions to the intellectual content of the articles by conceiving and designing the original presentations, researching references and studies, drafting the manuscripts, reviewing and revising the manuscripts, and/or providing supervision.





Johns Hopkins Advanced Studies in Medicine (ISSN-1558-0334), is published by Galen Publishing, LLC, d/b/a ASiM, PO Box 340, Somerville, NJ 08876. (908) 253-9001. Copyright ©2012 by Galen Publishing. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. ASiM is a registered trademark of The Healthcare Media Group, LLC.